Nursing Management and Leadership, Exams of Nursing

Download Nursing Management and Leadership and more Exams Nursing in PDF only on Docsity! RN 400A FINAL EXAM NEWEST ACTUAL EXAM 2024-2025 QUESTIONS AND DETAILED CORRECT ANSWERS (VERIFIED ANSWERS)| A+ GRADE An experienced RN has seen a significant increase in the need for delegation skills over the past several years. This change is most likely attributable to: A) increased numbers of uninsured clients. B) increased lengths of stay. C) increases in the use of NAP. D) decreases in nurse-client ratios Correct Answer C) increases in the use of NAP. A subordinate is reluctant to accept a task that the nurse- manager wants to delegate. The manager suspects that the subordinate's reluctance is due to a lack of self- confidence. What is the manager's best initial action? A) Teach the subordinate about the value of self- confidence. B) Try to empower the subordinate. C) Offer a reward to the subordinate in order to motivate. D) Restate the importance of the task to the subordinate Correct Answer B) Try to empower the subordinate. The nurse-manager has asked an NAP for an update on delegated tasks, and the NAP has said, "I'm swamped right now." What is the manager's best response? A) "Don't be afraid to let me know if you feel the project is overwhelming you." B) "Time management is key to keeping on schedule with your tasks." C) "I can give you a few solutions to help manage this heavy workload." D) "Do you want more time to complete your work?" Correct Answer C) "I can give you a few solutions to help manage this heavy workload." A nurse has successfully completed a difficult and complex task that the manager delegated. What is the manager's best action? A) Document the fact that the nurse completed the task. B) Assign a slightly more difficult task the next time. C) Acknowledge the nurse's significant accomplishment. D) Ask the nurse to act as a role model for other staff members Correct Answer C) Acknowledge the nurse's significant accomplishment. A nurse-manager has delegated some administrative tasks to an experienced RN. How does this act of delegation differ from the usual practice of assigning work to subordinates? Select all that apply. A) The nurse's task will be beyond his or her scope of practice. B) The manager transfers the authority for the task to the nurse. C) The nurse is practicing on the manager's license. D) The manager is released of the need to oversee the nurse. The nurse-manager is preparing for negotiations. When negotiating, what is the manager's most appropriate action? A) Be willing to win at any cost. B) Communicate only when asked direct questions. C) Compromise only as a last resort. D) Begin with a high but realistic expectations Correct Answer D) Begin with a high but realistic expectations A charge nurse has assisted two employees 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 C) A majority rule approach D) A good lesson in compromising Correct Answer B) Facilitating collaboration Which is a true statement about destructive negotiation tactics? A) Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic. B) Most managers successfully resist the helplessness tactic because of their nursing preparation. C) Negotiation tactics can sometimes be manipulative; thus, managers must be cognizant of the other party's motives. D) Nurses are known to be particularly vulnerable to the tactic of flattery Correct Answer C) Negotiation tactics can sometimes be manipulative; thus, managers must be cognizant of the other party's motives. What statement about conflict most closely reflects the interactionist theories of organizational conflict? A) "The most important response to conflict is to deal with it immediately." B) "Conflict can actually be a good thing and can help us to grow." C) "The presence of conflict in our workplace shows that there is bad management." D) "The best organizations are places where there is no conflict." Correct Answer B) "Conflict can actually be a good thing and can help us to grow." A nurse-manager has accepted a new position on a hospital unit. An experienced nurse on the unit tells the manager, "We all work really well with each other. There's never any conflict." How should the manager interpret this statement? A) The unit may be lacking in growth and new ideas. B) There is a need for the manager to introduce conflict. C) The manager needs to ensure that this characteristic continues. D) There is likely conflict that the nurse is not recognizing or acknowledging. Correct Answer A) The unit may be lacking in growth and new ideas. Which nurse is experiencing intrapersonal conflict? A) A manager who has received a negative performance appraisal and who wishes to dispute the findings B) A manager who has to confront a nurse who made a medication error but did not follow up with documentation C) A manager who is in conflict with a long-standing employee who often ignores the manager's directives D) A manager who perceives a dilemma between loyalty to staff and loyalty to the organization in a particular situation Correct Answer D) A manager who perceives a dilemma between loyalty to staff and loyalty to the organization in a particular situation Which of the following workplace situations would be categorized as latent conflict? A) A nurse expresses frustration to a colleague who did not perform some tasks that were clearly delegated. B) A nurse expresses anger to the manager, accusing the manager of preferential treatment toward other nurses. C) The most experienced nurses on a unit are allowed to self-schedule, but less experienced nurse are not. D) Two nurses were in conflict about inequities in their work assignment but were able to resolve the conflict Correct Answer C) The most experienced nurses on a unit are allowed to self-schedule, but less experienced nurse are not. A nurse-manager was involved in conflict where the other individual adopted a competing approach. This approach is evident in what circumstances? A) When fair play is important to all involved parties B) When one party wins at the expense of the others C) When managers need to control a volatile situation The nurse-manager is negotiating for the funds necessary to purchase several new isolettes for the facility's newborn nursery. The chief financial officer (CFO) states, "I've always been curious about that piece of equipment; how does it actually work?" What negotiation action has the CFO engaged in? A) Collaborating B) Smoothing C) A diversionary tactic D) Appropriate fact finding Correct Answer C) A diversionary tactic Several RNs on the unit want to address the possibility of initiating flextime on the unit because they state that the current scheduling system is unfair. What is the manager's best initial response? A) Assuring the RNs that every effort is being made to streamline the current scheduling system B) Asking the RNs to circulate a partition to be signed by employees who support the change 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 Correct Answer C) Arranging for the RNs to air their views at the next staff meeting The nurse-manager has learned that two employees are in conflict. The manager's fact gathering reveals that the conflict exists because each employee misunderstands the job description and role of the other employee. What conflict management strategy should the manager implement first? A) Responsibility charting B) Confrontation C) Behavior change D) Third party consultation Correct Answer A) Responsibility charting An employee has come to the manager with a long list of complaints about a coworker, all of which are attributable to personality factors rather than unsafe practice. What is the manager's best initial action? A) Encourage the employee to speak directly with the coworker. B) Ask the employee to e-mail or text message the complaints to the coworker. C) Arrange for third-party mediation. D) Acknowledge and document the employee's complaints Correct Answer A) Encourage the employee to speak directly with the coworker. The manager has learned that some of the more experienced nurses on the unit have been playing pranks on a newly hired nurse and delegating their most challenging tasks to the nurse. What is the manager's best response after confirming that these events took place? A) Offer support and encouragement to the newly hired nurse. B) Confront the more experienced nurses directly about their behavior. C) Implement a structure change so the experienced nurses no longer work at the same time as the new nurse. D) Arrange for third-party consultation involving the more experienced nurses, the manager and the new nurse Correct Answer B) Confront the more experienced nurses directly about their behavior. Which of the following behaviors should the nurse- manager identify as workplace violence, incivility, or bullying? Select all that apply. A) A group of nurses consistently refuse to help a nurse when that nurse has a heavy workload, despite having time to do so. B) Staff members assign an unwanted nickname to a colleague. C) A nurse's specific vacation request is denied by the manager for 2 years in a row. D) A nurse asks a colleague to assess a known verbally abusive client without warning to see how the colleague will respond. E) A nurse tells a nursing student to rush to room 311, knowing that the unit has no room 311 Correct Answer A) A group of nurses consistently refuse to help a nurse when that nurse has a heavy workload, despite having time to do so. B) Staff members assign an unwanted nickname to a colleague. D) A nurse asks a colleague to assess a known verbally abusive client without warning to see how the colleague will respond. A) Ask that the aggressive individual recognize the rights of all the other members. B) State, "I need to have time to think over all that we have discussed." C) Halt any discussion until new representatives can be appointed. D) Share with the members that aggressiveness negatively impacts the negotiations Correct Answer B) State, "I need to have time to think over all that we have discussed." 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 self-reflection Correct Answer B) Calmness and self-assuredness By contract, employees are to receive overtime pay when their workday exceeds 8 hours. A staff member attended a mandatory, hospital-sponsored CPR certification class after working an 8-hour shift. What type of paycheck adjustment can the employee expect? A) Overtime for the time spent in the class B) Regular pay for the class because there was no charge for the class C) No pay for the class because it was identified as mandatory D) Equal compensated time back during the next pay period Correct Answer A) Overtime for the time spent in the class An affirmative action plan has been established in the jurisdiction where a nurse works. The nurse should understand what characteristic of this program? A) The terms of the plan are laid out in United States Equal Employment Opportunity legislation. B) It aims to prevent workplace discrimination on the basis of age or sexual orientation. C) It actively seeks members of underemployed groups to fill job vacancies. D) Few affirmative action programs still exist because they encourage reverse discrimination Correct Answer C) It actively seeks members of underemployed groups to fill job vacancies. What is an inappropriate reason for delegation? A) To empower subordinates by "stretching" them in their work assignment B) To free the manager to address more complex unit needs C) The manager does not find the task intellectually challenging. D) Someone else is better qualified to do the task. Correct Answer C) The manager does not find the task intellectually challenging. A performance appraisal states that the manager often under delegates. What is potential cause of this delegation error? A) A high degree of trust in subordinates B) A democratic leadership style C) A need for perfectionism D) Sufficient time to accomplish unit goals alone Correct Answer C) A need for perfectionism A manager needs to delegate some tasks. What consideration should the manager prioritize when identifying the appropriate person to whom to delegate a specific task? A) Whose turn it is to delegate a task B) The qualifications of the person regarding the task C) The fiscal cost of delegating the task D) Whether the person has experience with similar tasks Correct Answer B) The qualifications of the person regarding the task A nurse-manager delegates many tasks in the course of a day. Which practice should the manager reconsider or discontinue? A) The manager grants temporary authority to support completion of a delegated task. B) The manager confirms that the person to whom a task is delegated is adequately qualified. C) The manager provides employees with exact instructions for each step of completing the task. D) The manager asks for regular updates from the employee when tasks take a long time. Correct Answer C) B) Client safety C) Effective delegation D) Micromanagement Correct Answer D) Micromanagement A member of the team has been delegated some tasks and reports, "I've been given too much to do and I'm not going to be able to complete the work on time." What is the RN's best initial action? A) Assign the work to another team member. B) Take on the responsibility of the tasks. C) Have the team member perform only the most necessary tasks. D) Examine the workload and assist the individual in reprioritizing. Correct Answer D) Examine the workload and assist the individual in reprioritizing. Which assessment should the RN prioritize when assigning tasks to nursing assistive personnel (NAP)? A) Determining the NAP's skills and knowledge level B) Assessing which tasks the NAP is motivated to perform C) Evaluating the NAP's ability to follow instructions D) Asking colleagues to appraise the NAP's strengths and weaknesses Correct Answer A) Determining the NAP's skills and knowledge level Which task would the director of a home health agency not delegate another staff RN? A) Assigning home health aides to specific client care B) Serving on a diabetic study committee of community resources C) Meeting with the agency's administration regarding budget cuts D) Reviewing the care assignment for the following shift Correct Answer C) Meeting with the agency's administration regarding budget cuts What must managers delegate to another RN in order to assure completion of a task? A) Time and space B) Leadership and creativity C) Authority and responsibility D) Personnel and knowledge Correct Answer C) Authority and responsibility A nurse-manager is new to the unit and is worried about being perceived as incompetent or underqualified by subordinates. The manager should recognize that this creates a risk for what problem? A) Underdelegating B) Overdelegating C) Improper delegating D) Inappropriate delegating Correct Answer A) Underdelegating The nurse-manager is overseeing a culturally diverse group of staff. The manager should consider what variables when planning delegation? Select all that apply. A) Communication style B) Concepts of time C) Intelligence D) Biological variations E) Social organization Correct Answer A) Communication style D) Biological variations E) Social organization An RN is leading a care team on a busy hospital unit. What tasks is the RN justified in delegating to NAP? Select all that apply. A) Feeding a client who has unilateral weakness B) Repositioning an immobile client every 2 hours C) Assessing a client's surgical wound D) Weighing a client who has chronic heart failure E) Transporting a client to a diagnostic test Correct Answer A) Feeding a client who has unilateral weakness B) Repositioning an immobile client every 2 hours D) Weighing a client who has chronic heart failure A senior manager is ensuring that organizational policies for compensation align with the Equal Pay Act of 1963. What domains of work should the manager examine? Select all that apply. A) The potential for promotion or advancement in the job B) The working conditions associated with the job C) The amount of responsibility that the job carries D) The effort that is required to perform the job E) The level of job satisfaction associated with the job F) The skill that is needed to perform the job Correct Answer B) The working conditions associated with the job C) The amount of responsibility that the job carries D) The effort that is required to perform the job F) The skill that is needed to perform the job D) Kennedy Executive Order 10988 Correct Answer D) Kennedy Executive Order 10988 During orientation to a new job, a nurse is reviewing the relevance of labor standards to the new position. What aspects of the job will these standards affect? Select all that apply. A) The number of hours that the nurse will work B) The nurse's right to a safe workplace C) The way the nurse's salary is determined and paid D) The nurse's continuing education requirements E) The nurse's accountability to his or her supervisor Correct Answer A) The number of hours that the nurse will work B) The nurse's right to a safe workplace C) The way the nurse's salary is determined and paid Which members of a private health-care organization have their right to join a union protected by the National Labor Relations Act (NLRA)? Select all that apply. A) A registered nurse with 6 months of experience in the organization B) A licensed practical nurse C) A first-level manager D) A registered nurse with 2 years' experience in the organization E) A mid-level manager Correct Answer A) A registered nurse with 6 months of experience in the organization B) A licensed practical nurse D) A registered nurse with 2 years' experience in the organization Why does membership in the American Nurses Association (ANA) pose a conflict in loyalty for some nurses in management positions? A) It fails to support male nurses sufficiently. B) Minorities are not represented on its board of directors. C) Membership is based on years of nursing experience. D) It acts as a professional association and a collective bargaining agent. Correct Answer D) It acts as a professional association and a collective bargaining agent. A situation has occurred in a health-care organization where it is important to determine whether a particular nurse is categorized as a "staff nurse" or as a supervisor. What criterion should be used to make this differentiation? A) The nurse's position in the hierarchy of the unit based on years of experienced B) The nurse position on the organization's salary scale C) The nurse's level of influence on his or her peers and colleagues D) The percentage of time that the nurse spends as charge nurse versus giving direct client care Correct Answer D) The percentage of time that the nurse spends as charge nurse versus giving direct client care Which organizational characteristic is most likely to make the employees view a union as an appealing option? A) This organizational mission is perceived as being too broad or ambitious to be achieved. B) The organization is perceived as being insensitive to employees' needs and well-being. C) The employees earn less than the average salary of comparable employees in the region. D) The organizational mission is insensitive to the population it serves. Correct Answer B) The organization is perceived as being insensitive to employees' needs and well-being. A unionization drive is taking place in a health-care organization. The National Labors Relations Board (NLRB) requires that what criterion must be met before an election for unionization can be held? A) Employees must demonstrate substandard wages or working conditions. B) At least 30% of the employees must sign an interest card. C) Management of the organization must give their written approval. D) A court order must be obtained by the organizers of the union drive. Correct Answer B) At least 30% of the employees must sign an interest card. The manager of a hospital unit has heard rumors about a unionization drive for several weeks and has just learned that the employees on the unit are planning to launch a formal drive. What is the manager's best action? A) Arrange meetings the organizers to independently address the factors that have prompted the drive. B) Collaborate with upper management and the personnel department to best address the workers' concerns. C) Apply disciplinary action to the employees who are leading the unionization drive. C) Deciding whether participating in a strike is appropriate D) Adhering to the Occupational Safety and Health Act (OSHA) Correct Answer C) Deciding whether participating in a strike is appropriate A nurse-manager works in a nonunionized medical unit that employs numerous RNs. The manager can best prevent conditions that would promote a union drive by: A) rotating the nurses' work assignments frequently. B) offering to assist with bedside care during busy times. C) demonstrating genuine concern for the well-being of the nurses. D) ensuring that the terms of the current contract are adhered to Correct Answer C) demonstrating genuine concern for the well-being of the nurses. What statement by a nurse most directly reflects a common complaint about the roles of the American Nurses Association (ANA)? A) "It doesn't seem fair that every nurse contributes to the ANA but nurses in only a few states benefit from it." B) "It's incompatible for the ANA to represent staff nurses and nursing managers at the same time." C) "It doesn't seem right that the ANA simultaneously tries to advance the nursing profession while it bargains for nurses' contracts." D) "It could be unethical for the ANA to promote nurses' rights in a profession that was founded on helping others." Correct Answer C) "It doesn't seem right that the ANA simultaneously tries to advance the nursing profession while it bargains for nurses' contracts." Working conditions have deteriorated in recent months at a hospital, and there is a strong impetus for unionization. As a result, a majority of the nurses have signed interest cards. What will happen next in the steps to starting a union? A) A vote on the matter will be held among eligible staff members. B) A union will be established at the hospital. C) Management will have the opportunity to respond to the issue. D) A final decision will be made by the state board of nursing. Correct Answer A) A vote on the matter will be held among eligible staff members. The managers of a clinic have been accused of creating an unpleasant work schedule and increased workload for a nurse who helped lead an unsuccessful union drive. How should the managers' actions be best interpreted? A) Creating schedules and work assignment are valid management roles. B) These actions are violations of labor relations law. C) Management is within its rights but in violation of ethics standards. D) These actions are criminal offenses. Correct Answer B) These actions are violations of labor relations law. A nurse has over four decades of work experience and is weighing the benefits of retiring versus continuing to work. How will the Age Discrimination in Employment Act affect this nurse? A) The nurse may continue to work but must forfeit job security. B) The nurse will be required to retire once he or she turns 70 years. C) The nurse will be required to retire once he or she turns 65 years. D) The nurse may retire, or continue to work, as long as he or she is capable of performing the job Correct Answer D) The nurse may retire, or continue to work, as long as he or she is capable of performing the job High-achieving nursing students were found to have studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided data about the students' preparation? A) Structure B) Process C) Outcome D) Concurrent Correct Answer B) Process A nurse-manager is overseeing an organization that uses the Nursing Minimum Data Set (NMDS). What will the use of the NMDS achieve? A) Comparing the quality of nursing care and medical care with reference to standardized data B) Identifying minimal levels of quality necessary for nurses to maintain licensure C) Standardizing the collection of nursing data for use by multiple users A) The Joint Commission has not updated the HEDIS since 2009. B) Managed care organizations are not required to collect HEDIS data. C) Performance indicators are exclusively process focused rather than outcome focused. D) HEDIS performance measures focus on medical interventions and do not address nursing actions Correct Answer B) Managed care organizations are not required to collect HEDIS data. As part of the quality control, managers have set standards for performance and assessed whether these standards are being met. It has been determined that several standards are not being met. What is the priority response to this finding? A) Release the findings to the public to ensure transparency. B) Compare the organization's results to benchmarks. C) Determine whether similar organizations in the region are experiencing similar results. D) Perform interventions that will correct the deficiencies Correct Answer D) Perform interventions that will correct the deficiencies What is the best course of action to stimulate broad participation of employees in quality control efforts? A) Encourage regular meetings between middle management and upper management. B) Educate staff about the relationship between the organization's accreditation and their own licensure. C) Engage closely with the frontline staff who provide client care. D) Educate staff about the correct way to document and report sentinel events Correct Answer C) Engage closely with the frontline staff who provide client care. A nurse-manager is participating in a hospital's quality control efforts and is collating data sources. What data source should the manager identify as a qualitative source? A) The hospital's rate of nosocomial infections B) The hospital's readmission rate C) Results of interviews with discharged clients D) The previous year's budget for continuing education initiatives Correct Answer C) Results of interviews with discharged clients A client was treated in the hospital for a stroke and was the client's family members assert that the client was discharged too early and did not receive sufficient rehabilitation. The client's early discharge may have been attributable to: A) the effect of diagnosis-related groups. B) a sentinel event. C) the application of total quality management. D) deliberate malpractice Correct Answer A) the effect of diagnosis-related groups. A nurse-manager has referred staff members to a clinical practice guideline (CPG) that addresses the prevention of pressure ulcers. What is a characteristic of this CPG? A) The CPG will lay out the criteria that the health-care organization must meet in order to be reimbursed for treating a client's pressure ulcer. B) It will describe interventions for nurses to follow in an effort to provide evidence-based care. C) It will describe the treatment for pressure ulcers that is provided at the best performing organizations. D) The CPG will summarize the etiology and diagnosis of pressure ulcers. Correct Answer B) It will describe interventions for nurses to follow in an effort to provide evidence-based care. A nurse-manager is opposing the expansion of the prospective payment system (PPS). What argument against the PPS should the manager cite? A) Diagnosis-related groups have caused an increase in health-care costs. B) The PPS has unnecessarily increased the length of hospital stays. C) The PPS is linked to increased prices for pharmaceuticals. D) The PPS has been linked to a decline in the quality of care Correct Answer D) The PPS has been linked to a decline in the quality of care A health-care organization has experienced a rise in medical errors and has committed to implementing Leapfrog initiatives. What aspects of health care should the organization address? Select all that apply. A) Expanding the use of computerized physician-provider order entry B) establish firm and meaningful punishments for staff who commit an error. C) assign "safety officers" whose exclusive role is to monitor for, identify, and follow up errors. D) foster a climate where analysis of errors is not solely focused on blame. Correct Answer D) foster a climate where analysis of errors is not solely focused on blame. During a quality improvement initiative, the leadership of a health-care organization has worked with senior managers to implement the principles of Lean Manufacturing. This initiative will focus on what factor? A) Identifying sentinel events B) Identifying and preventing waste C) Engaging all staff members D) Performing root cause analysis of errors Correct Answer B) Identifying and preventing waste Which action is associated with the nursing leadership role in quality improvement? A) Inspiring staff to establish and maintain high standards regarding patient care B) Being aware of the changes in quality control regulations C) Reviewing research results upon which to base changes D) Identifying outcomes that support quality nursing care Correct Answer A) Inspiring staff to establish and maintain high standards regarding patient care As part of a quality improvement initiative, administrators are conducting outcomes analysis and have included nursing-sensitive outcome measures. These outcome measures will: A) highlight the aspects of nursing that are contentious or controversial. B) cause the quality improvement process to prioritize nurses over other providers. C) separate out the unique contributions that nurses make to client outcomes. D) require other members of the health-care team to rate nurses' contributions. Correct Answer C) separate out the unique contributions that nurses make to client outcomes. A hospital system is trying to address some of the deficits in care that were described in To Err Is Human. When addressing the errors that this report identified, the hospital's leaders should focus on what factor? A) Systemic flaws in health-care delivery B) Malice on the part of some health-care providers C) Lack of education for health-care workers D) Increased use of nursing assistive personnel Correct Answer A) Systemic flaws in health-care delivery A hospital is using the guidelines of the Leapfrog Group to inform safety improvements in the organization. What action will best incorporate these guidelines? A) Replacing practical nurses with registered nurses whenever possible B) Eliminating the use of high-risk medications and increasing the role of pharmacists C) Purchasing a computerized physician-provider order entry system D) Converting shared rooms to single-occupant rooms Correct Answer C) Purchasing a computerized physician- provider order entry system A nurse-manager and several colleagues are reviewing the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These results will allow the team to make what assessment? A) The root causes of adverse incidents B) Clients' perspectives on the care they received C) Consumers' health outcomes at 3 and 6 months after discharge D) Clients' health status at admission versus at discharge Correct Answer B) Clients' perspectives on the care they received What piece of data should the nurse-manager include in an outcome audit? A) Nursing handoffs occur at the client's bedside and include family input. B) Client-nurse ratios are capped at 3:1 in the day and 4:1 at night. C) Technology is acquired so documentation can be completed at the bedside. D) At discharge, a client was able to ambulate 40 feet unassisted Correct Answer D) At discharge, a client was able to ambulate 40 feet unassisted.