TEST BANK for Leadership in Nursing Practice Changing the Landscape of Health Care, 3rd Edition By D

5. Change should be considered if all of the following are true except when: a. safety is enhanced. b. new evidence is available. *c. cost is not an issue. d. excellence is advanced.

6. Reasons not to change include: a. a lack of compelling evidence. b. when there is no significant risk to patients and employees. c. isolated issues that are closely linked with individual performance rather than system performance. d. indications that an intervention or change is more likely to be a fad of the moment. *e. All of these are correct.

7. Competencies that are essential for change effectiveness include: a. personal knowledge and accountability for one's own strengths and limitations specific to change and innovation, including technical capability and computer literacy. b. understanding the essence of change and innovation concepts as well as the tools of innovation. c. the ability to collaborate and fully engage team members. d. competence in embracing vulnerability and risk taking. e. personal knowledge and accountability for one's own strengths and limitations specific to change and innovation, including technical capability and computer literacy, understanding the essence of change and innovation concepts as well as the tools of innovation; and competence in embracing vulnerability; and risk taking. *f. All of these are correct.

8. You are asked to lead a committee to update the emergency room at your facility. As leader, you recommend analyzing workflows, taking photos, and interviewing current members of the staff to ensure the proper needs of the department are being met and to achieve the desired outcome. Which tool have you chosen to advance this change and innovation? *a. Deep dive b. Directed creativity c. Mind mapping d. Brainstorming

9. Rational risk taking is: a. taking risks for the right reasons. b. focused.

c. consistent. d. viewed negatively. *e. taking risks for the right reasons, focused, and consistent are correct.

Chapter 2 1. All of the following are considered elements of a profession except: a. great knowledge. b. important work. c. making a difference. *d. being governed by another profession.

2. Membership in a profession is earned by: *a. obtaining a unique body of knowledge. b. joining an organization. c. applying for a position. d. None of these is correct.

3. You were a nurse for 20 years and decided to take a break for a while to pursue other interests. You started a business which has become successful and you have no thoughts of practicing nursing again; however, you would be able to practice as long as what is kept active? *a. License b. Membership c. Continuing education d. Job vacancy

4. The concept of professionalism providing a socially sanctioned or mandated service means that: a. licensing regulations may exist. b. the mandate includes language about the service that is provided. c. competence is necessary to hold membership. d. there are penalties for nonperformance or professional wrongs. *e. All of these are correct.

5. A nurse notices that it is much more difficult to provide proper nursing care on the 3-11 shift than it is on the 7-3 shift. She documents her findings, presents them to the supervisor, and it is found that there are fewer staff members employed on the 3-11 shift than on the 7-3 shift. This documentation and systematic method of presenting the facts to achieve a desired outcome is an example of which of the following? a. Knowledge-based practice *b. Evidentiary dynamics c. Patient autonomy d. Social mandates

6. All of the following are components of evidence-based practice except: a. formulating a critical clinical question. b. searching for and gathering data regarding integrated and relevant evidence. *c. using all data available. d. using the evidence for a particular clinical scenario. e. evaluating the impact of evidence-based choice(s).

7. A professional code of ethics assures others that: *a. their best interests will not be jeopardized by members of the profession. b. the members will often act outside the parameters of the code and the law but that this will be acceptable. c. the members will not be forced to abide by the code. d. the code will never require updating.

8. The ANA Code of Ethics states that a nurse: a. is responsible and accountable for individual nursing practices. b. determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care. c. owes the same duties to self as to others. d. participates in establishing, maintaining, and improving healthcare environments and conditions of employment that are conducive to the provision of quality health care. *e. All of these are correct.

9. A nurse is responsible for the care of a patient who has a rare condition of which many, including hospital administrators, are unfamiliar. This nurse takes it upon herself to communicate the very clear needs of this patient to physicians and hospital administrators.

Which process is this nurse undertaking to communicate the needs of this patient? a. Public policy *b. Advocacy c. Accountability d. Governance

10. The definitive characteristic of the requirements of professional membership in the traditional professions is succinct, crisp, and definitive in relation to education, certification, and experience. In nursing: *a. it is diffuse, often undifferentiated, and frequently broadly described and relative. b. it is organized and definitive related to experience.

c. it is very organized and goal oriented. d. it has firmly defined roles.

Chapter 3 1. Leaders _________ a context for the performance of the people of the organization. a. coordinate b. integrate c. facilitate d. provide *e. All of these are correct.

2. Leaders should: a. be involved in the intensity of the day-to-day activities of work. b. avoid becoming overwhelmed by day-to-day pressures. c. see beyond the day's work. d. help staff find meaning and sustainability in their work. *e. avoid becoming overwhelmed by day-to-day pressures, see beyond the day's work, and help staff find meaning and sustainability in their work.

3. Change is: a. consistent. b. constant. c. a condition of living. d. a rare occurrence. *e. consistent, constant, and a condition of living.

4. A leader realizes that due to increased economic stress on the facility, he is forced to reduce his workforce by 10%. Which of the following represents the conditions under which this leader is performing? *a. Emergent conditions b. Evidence of best practices c. Digitalization d. Collaboration

5. All of the following directly and radically impact the role of the leader except: a. meaning is always informed by purpose. *b. others in the work environment usually have nothing important to contribute. c. the leader remains a servant to the system and its people. d. leaders understand the constancy of change in their own lives.

6. The role of management includes all of the following except: a. managers have subordinates. b. management is an organizational position and function. *c. managers have a horizontal relationship to those they manage. d. management style is largely transactional.

7. The leadership role includes all of the following except: *a. leaders have subordinates. b. leadership has little to do with traditional notions of management. c. leaders tend to influence others by virtue of their relationship skills. d. leadership is about the people rather than the work.

8. One of the largest mistakes a leader can make is believing everyone is equal. A leader must recognize the unique aptitude and skill set each member of the team offers and respect each person according their unique contribution. Which of the following describes the process of recognizing and honoring these individual differences? a. Equality b. Autonomy *c. Equity d. Hierarchy

9. The following statements are true about analysis except: *a. Analysis is the act of combining and integrating numerous complex elements or components of a system. b. Analysis is breaking down the components of a problem or issue into parts or elements. c. Management focuses on analysis. d. Analysis may include synthesis.

10. A cardiology practice depends on a number of different individuals with varying skill sets. It requires competent nursing staff to provide care, adequate technical staff to produce high quality electrocardiograms and echocardiograms, as well as support staff to fill prescriptions and coordinate appointments. The combination of this group of individuals is an example of which of the following? a. Analysis *b. Synthesis c. Hierarchy d. Shared governance

Chapter 4 1. Two members of a team have differing opinions on the best course of action. One member feels a staff reduction is inevitable while the other believes a staff reduction can be avoided if volumes are increased. Which of the following are these two team members experiencing? a. Collaboration *b. Conflict c. Ethical dilemma d. Crisis

2. All of the following are embedded in the fear of conflict except: a. personal security. b. identity. c. safety. d. relational integrity. *e. All of these are correct.

3. Early identification of conflict is important to help prevent escalation. Many stressors are manifested in particular modes of: a. communication. b. relationships. c. interactions. d. expression of personal emotions. *e. All of these are correct.

4. Since the events of 9/11, in the United States, there have been a multitude of religious, socio-political, and cultural differences that have evolved human behavior into dangerous forms of expression. These religious, identity, and cultural differences have raised the danger associated with conflict and are referred to as which of the following? a. Political polarization b. Economic polarization *c. Ideological polarization d. Geographical polarization

5. Which of the following statements is false? a. Challenges that differences in personalities create need to be addressed. b. Values must have a voice, and that voice must be honored, respected, and included. *c. All problems can be solved.

d. Challenges that exist in matching demand to available resources need expression if conflict about them is to be allayed.

6. A leader needs to be comfortable with conflict. Which of the following factors are important for this to occur? a. A leader must be comfortable with the self-expression of feelings, personal insights, and challenges to prevailing views and circumstances. b. A leader needs an environment that is not constraining or controlling or that creates structural barriers that make it difficult to express personal feelings. c. A good leader embraces his or her own feelings regardless of their intensity. d. A leader must assess his or her level of comfort and selfexpression in the presence of conflict. *e. All of these are correct.

7. Creating a context of trust is an essential framework for: a. a place where an employee can share all of his or her problems with you. *b. a safe place where conflict can be dealt with as easily and effectively as any other function, process, or relationship. c. a quicker discovery of mistakes, allowing for the proper punishments to be delivered more quickly. d. None of these is correct.

8. The sense of a lack of justice comes from what are considered to be: a. unfair working conditions. b. unfair procedures. c. unfair relationships. *d. All of these are correct.

9. All of the following are examples of poor cooperation when fully sharing personal views, insights, or opinions except: *a. Staff vocalizes affirmatively. b. You see people nodding their heads or sitting in silence in response to a statement or question raised. c. You notice that people stop questioning or raising issues because they fear being labeled as “not team players.” d. None of these is correct.

10. An individual who is new to a leadership position takes the appropriate time to read about the conflict management process, attend classes on conflict management, and practice conflict scenarios. Which

of the following personal barriers to engaging conflict is this individual addressing? a. Fear b. Uncertainty c. Negativity *d. No skills

Chapter 5 1. Patient workforce management includes five highly interconnected and interrelated components, which include all of the following except: a. the establishment of a patient care delivery model. b. patient needs and nurse interventions identification. c. creation of a core staffing schedule to support patient needs. *d. a consistent daily staffing process. e. an evaluation of value and outcome.

2. A patient care delivery model: a. is the method or system of organizing and delivering nursing care. b. includes work delegation and resource utilization. c. emerges from the organizational mission, vision, values, and structures. *d. All of these are correct.

3. A nurse leader decides the patient care delivery model that is most successful for her unit is to create a two-person team that is responsible for delivering patient care to groups of patients. Which model is the nurse leader implementing on her unit? a. Functional nursing b. Primary nursing c. Team nursing *d. Modular nursing

4. The historical usage approach to staffing involves: *a. looking at usage from the year before. b. the assumption that all patients are similar in needs. c. identifying nurse-to-patient ratios based on the experiences and perceptions of nurses. d. the use of a patient classification system.

5. Patient care needs categories include: a. cognitive needs. b. pain and comfort needs. c. family information and support needs. d. treatments and interventions. e. Both cognitive needs and family information and support needs. *f. All of these are correct.

6. Motion and time studies involve:

a. sampling activities at systematic or random intervals. *b. continuous timed observations of a single person during a typical time period or shift of work. c. asking the individual to log the work performed using a data collection tool with start and stop times of each activity recorded. d. using time standards developed from past experiences.

7. The expert opinion or expert panel technique to measure work: a. identifies time requirements for certain work. b. is a consensus approach. c. uses professional judgment to determine staff required. d. provides a flexible approach that focuses on a critical review of nursing practice. e. both identifies time requirements for certain work and provides a flexible approach that focuses on a critical review of nursing practice. *f. All of these are correct.

8. Validity measures: a. the extent to which data are reproducible. b. the extent to which a workforce management system measures what it is designed to measure. c. the ability to quantify and/or predict patient needs for nursing care. *d. Both the extent to which a workforce management system measures what it is designed to measure and the ability to quantify and/or predict patient needs for nursing care. e. All of these are correct.

9. A nurse leader is asked to create a schedule based on the identified historical patient needs of the unit and the projected patient volume for the unit. What type of schedule is this leader asked to create? a. Call schedule *b. Core schedule c. Shift schedule d. Flexible schedule

10. A nurse leader may be asked to send staff home early, postpone admissions, postpone nonemergent care, and reevaluate patient acuity ratings. All these tasks are used to address which of the following in regards to staffing? a. Shifts b. Nurse fatigue *c. Variances d. Historical trends

Chapter 6 1. All physicians take the Hippocratic Oath prior to beginning professional practice. The Hippocratic Oath is an act of which of the following? a. Beneficence *b. Nonmaleficence c. Justice d. Pragmatism

2. A nurse knows that she should be delivering medications at a certain time, instead, she chooses not to deliver medications and to do something else at that particular time. What process is this nurse exhibiting with this behavior? a. Pragmatism b. Beneficence *c. Rationalization d. Morality

3. You are confronted with a problem, and all of the possible solutions are equally unfavorable. This situation is called a(n): a. ethical erosion. *b. ethical dilemma. c. ethical fading. d. boundary crossing.

4. When a healthcare professional performs favors for a patient that are outside the therapeutic relationship, this is called: *a. boundary violation. b. boundary crossing. c. ethical fading. d. whistle-blowing.

5. Bioethics is: a. the sum total of individual and collective experience, knowledge, and good sense. b. guidelines for behavior that are specific to a moral framework for professional practice. c. supporting and promoting patients' healthcare rights and enhancing community health and policy initiatives that focus on the availability, safety, and quality of care. *d. a subdiscipline of applied ethics that studies questions surrounding biology, medicine, and the health profession.

6. Care at the end of life, for which there is little hope of benefit, is an example of: *a. medical futility. b. organizational integrity. c. nonmaleficence. d. rationalization.

7. _______ is an American school of philosophy that rejects the esoteric metaphysics of traditional European academic philosophy in favor of more down-to-earth, concrete questions and answers. a. Morality b. Utilitarianism *c. Pragmatism d. Bioethics

8. A co-worker witnesses a nurse being unnecessarily mistreated by a hospital administrator. Despite the perceived retribution of the hospital against the co-worker, the co-worker reports this mistreatment to the proper channels. Which of the following represents this process? a. Veracity *b. Whistle-blowing c. Advocacy d. Public policy

9. One of the most respected character traits among the human population is the ability to tell the truth and, for professionals, a duty to tell the truth. Which of the following names this character trait? a. Justice b. Morality c. Ethics *d. Veracity

10. Sources of ethical dilemmas include: a. values. b. diversity. c. political views. *d. All of these are correct.

Chapter 7 1. All of the following statements regarding the evolution of interdisciplinary teams are true except: a. Digital technology has helped to create the demand for interdisciplinary teams. b. The complexity-based biopsychosocial model lends itself to health along a continuum and therefore to a role for a wide variety of clinical members. *c. The physician is always the team leader and, therefore, guides the team. d. In this increasingly complex health environment, no one discipline has all of the information, skills, and resources necessary to address the many intersecting needs of individual patients and patient populations.

2. Over the years, it has been demonstrated that a team emphasizes a need to address and sustain a health script along the continuum of care rather than simply implementing late-stage incremental interventions in a tertiary care framework. Which model is this modern team based upon? a. Biomedical model *b. Biopsychosocial model c. Bioethical model d. Biochemical model

3. The following are purposes for creating teams except: a. providing a general framework for care delivery. b. advancing the capacity of professionals to fully engage in particular planning activities. c. guiding problem-solving in a way that addresses patient care and improves team effectiveness. *d. making staffing ratios easier to calculate.

4. Which of the following statements is true about goals? a. They give a team clear and specific directions. b. They create a point of reference for teams to evaluate their progress and determine movement toward completion. c. They are generally frowned upon by hospital administration. d. They involve both the team and individual members in defining the performance expectations of the team. *e. They give a team clear and specific directions, they create a point of reference for teams to evaluate their progress and determine movement toward completion, and they involve both the team and individual members in defining the performance expectations of the team. f. All of these are correct.

5. Once the team has been created, it is the responsibility of the leader to fully engage the team in establishing its goals. It is critical for all members of the team to be engaged in establishing the team's direction and clarifying the expectations of the actions and goals of team members. Which of the following best describes this process? *a. Participatory process b. Engagement process c. Proclamation process d. Delegation process

6. Which of following elements needs to be included in an assignment of work? a. Individuals charged with the responsibility for a particular goal need to be clear about the specifics and expectations. b. Team members working on an activity need to be clear about the time and resources needed to undertake the work. c. The work timetable is generally not as important as resource utilization. d. Measures of success must be incorporated into team member work. *e. Individuals charged with the responsibility for a particular goal need to be clear about the specifics and expectations, team members working on an activity need to be clear about the time and resources needed to undertake the work, and measures of success must be incorporated into team member work. f. All of these are correct.

7. All of the following statements are team fables except: *a. Team members are not always committed to implementing a good team process. b. All team members are created equal. c. Team members generally use good critical-thinking skills to resolve their questions and issues. d. Team members will set aside their emotional issues in the interest of effective team decision making.

8. All of the following are team progress–related response strategies that a team leader could initiate within the team process except: a. reaffirming specific goals and activities that have been identified as essential to the team's progress toward fulfillment of the purpose of the teams. b. placing the specific problem, barrier, or challenge within the context of particular stages or elements of change management. c. when the context of the issue has been delineated, helping to break the problem down into smaller issues.

*d. asking the team members to fuse objectives into new overarching goals.

9. The team you led successfully achieved its goal. All members of the team worked well together, deliberated purposefully, and acted in ways that were in the best interests of both the patient and the team. Which of the following best describes your team? *a. Collaboration b. Delegation c. Accountability d. Morality

10. Setting the table means: *a. knowing how all the decisions need to be served. b. making all of the decisions for the team. c. selecting team members based solely on how well they work together. d. limiting the diversity of the group.

Chapter 8 1. Major resources in a healthcare organization include: a. fiscal support. b. physical setting. c. supplies. d. technology. *e. All of these are correct.

2. Healthcare economics is: a. a branch of economics focused on efficiency, effectiveness, and behavior in the production and consumption of healthcare goods and services. b. the study and science of how human needs are perceived in relationship to what supplies are available. c. a topic that only managers need to be aware of. *d. both a branch of economics focused on efficiency, effectiveness, and behavior in the production and consumption of healthcare goods and services and the study and science of how human needs are perceived in relationship to what supplies are available.

3. All of the following statements are true about price except: a. It is based on available dollars and the need for a good or service. b. Prices are considered from the perspective of the actual costs of services. *c. The seller of goods does not determine the price for the goods. d. Prices are considered from the perspective of the overall expenditure of dollars.

4. The supply of healthcare goods and services includes: a. people. b. supplies. c. technology. d. time. e. funds to pay for services. *f. All of these are correct.

5. Material supply levels are impacted by: a. the types of services provided. b. available staff. c. access to supplies. d. the cost of supplies.

*e. the types of services provided, access to supplies, and the cost of supplies. f. All of these are correct.

6. As a nurse leader, you take it upon yourself to orient all newly hired nurses, communicate exactly what their duties are, and make proper introductions to other nursing staff. This process is vital to nurse retention. What is this process known as? a. Orientation b. Rounding c. Networking *d. Onboarding

7. Insured individuals include: a. those with employer-sponsored health plans. b. older citizens. c. military. d. illegal aliens. *e. those with employer-sponsored health plans, older citizens, and military

8. You are responsible for the financial expenditures of your facility.

You perform an analysis that compares the early discharge of low-birthweight infants whose care was managed by advanced practice nurses with those who were cared for by physicians. A comparison of two or more alternatives, such as the one mentioned, is an example of which type of analysis? a. Cost-minimization analysis b. Cost-effectiveness analysis c. Cost-utility analysis *d. Cost-consequences analysis

9. Which of the following is a strategy for assessing one's time management? a. Determine what your personal abilities are for managing your work across a span of time. b. Take into consideration both your own personal assessment and feedback from others on your team. c. Personal reflection specific to meeting deadlines, feeling stressed or overwhelmed, and managing interruptions are areas that should be considered. *d. All of these are correct.

10. As a nurse leader, part of your duties is to purchase new equipment. Diagnostic equipment, including technology hardware and software, are funded from which type of budget? a. Operating budget b. Equipment budget c. Resource budget *d. Capital budget

Chapter 9 1. Structure in the healthcare system that best supports healthcare leadership: a. is resource effective. b. is timely. c. is value based. d. works to advance the mission and vision of the healthcare system. *e. All of these are correct.

2. Complex adaptive systems theory: a. is grounded in research conducted in the fields of biology, mathematics, physics, and complexity science. b. as applied to human behavior, is represented in the study of a number of different approaches to understanding the relationship among behavior, organizations, and the larger systems that form the context. *c. is both grounded in research conducted in the fields of biology, mathematics, physics, and complexity science, and as applied to human behavior, is represented in the study of a number of different approaches to understanding the relationship among behavior, organizations, and the larger systems that form the context are correct. d. None of these is correct.

3. All of the following fall within the realm of complexity science except: a. behavioral economics. *b. linguistics. c. game theory. d. nonlinear dynamics.

4. Which of the following statements is true? *a. Optimization in the system is a reflection of the strong “goodness of fit” between the human organizational dynamics and the technological functional processes that comprise the overall structure of the work environment. b. Complex thinking that focuses on either social or technical processes increases the predictable forces affecting systems, organizations, and work groups. c. Health care contains little interaction between social and technical forces. d. Nursing involves complex adaptive systems whether it occurs in a large hospital or a small private practice.

5. In complex adaptive systems, power is: a. located in the formal structure. *b. closely aligned with the point-of-care decision making. c. both located in the formal structure and closely aligned with the point-of-care decision making. d. None of these is correct.

6. Individuals at the point of service need to be: a. more self-directed. b. more collaborative. c. more reliant on management. *d. both more self-directed and more collaborative.

7. Significant shifts that are taking place in the healthcare realm include which of the following? a. Tertiary care is slowly being deconstructed. b. Digital technology is making it possible to create an increasingly portable diagnostic, therapeutic, and interventional environment, making the provision of healthcare services increasingly mobile, fluid, flexible, and portable. c. Systems are competing for value and quality. d. The fundamental value of practice is no longer embedded in volume measures related to how much an individual has done but in what difference and impact an action has had. *e. All of these are correct.

8. Which of the following characteristics of real autonomy centers around the belief in the centrality of the patient when making responsible decisions both independently and interdependently that reflect advocacy for the patient? *a. Professional nurse autonomy b. Aggregate autonomy c. Structural autonomy d. Attitudinal autonomy

9. The structure of which of the following clearly reflects the principles of partnership, equity, accountability, and ownership and clearly identifies the locus of control for practice accountabilities and for organizational accountabilities? a. Autonomy *b. Shared governance c. Collaboration d. Delegation

10. Which type of approach is based on the premise that no one healthcare organization can own, control, or unilaterally mandate all of the service linkages and connections necessary to fully serve a specific population at any level of adequacy, and that partnership, relationship, interaction, and collective correlation of effort are the keys to delivery of comprehensive and integrated population service? *a. Continuum of care approach b. User-centric approach c. Physician-centric approach d. Organizational approach

Chapter 10 1. Nursing is: a. a scientific process founded on a professional body of knowledge. b. a learned profession based on an understanding of the human condition across the lifespan. c. an art dedicated to caring for others. d. a dynamic discipline that increasingly involves more sophisticated knowledge, technologies, and client care activities. *e. All of these are correct.

2. Transition to nursing practice is sometimes difficult because: a. an adequate support system for new graduates may not be in place. b. subtle hazing may occur to a new employee. c. new ideas presented by a new employee are often quickly dismissed and discouraged. d. both an adequate support system for new graduates may not be in place and subtle hazing may occur to a new employee. *e. All of these are correct.

3. Nursing opportunities may be found in all of the following settings except: a. healthcare organizations. b. community centers. c. outpatient settings. d. insurance industry. *e. All of these are correct.

4. As a nurse, you have advanced your career to a point in which you are now a specialist involved with the design and implementation of complex documentation and monitoring systems, which allows you to bridge disciplines and ensure that the intended goals of effectiveness, efficiency, and safety are met. In what area have you advanced your career? *a. Informatics b. Nursing research c. Biostatistics d. Epidemiology

5. An underlying reason for advancing to management and leadership positions is: a. the desire to advance quality practices.

b. to advance excellence. c. a dislike for the clinical role. d. introducing new ideas for a better work environment. *e. the desire to advance quality practices, to advance excellence, and introducing new ideas for a better work environment. f. All of these are correct.

6. As a nurse leader, you should be able to share your experience and wisdom with new nurses in order for them to gain knowledge and to develop their nursing skills. This sharing process is defined as which of the following? a. Onboarding b. Coaching *c. Mentoring d. Rounding

7. Applying for a new position leads to which of the following changes? a. It changes the individuals you socialize with. b. It changes your ability to manage policies and practices. c. It changes your salary and benefits. d. It changes your work location. *e. All of these are correct.

8. As a nurse leader, you notice that one of your employees has a tendency to be manipulative and hard to deal with, tends to avoid issues, and has tunnel vision. You have the responsibility of counselling this person because he or she is showing signs of lacking which of the following? a. Integrity b. Diversity *c. Collaboration d. Communication

9. The multistate licensure: a. allows a nurse to have a license in a primary state of residence and be able to practice in other states with multistate status. b. increases the cost of licensure fees when nurses practice in more than one state. c. is available in 25 states. d. is available in all states. *e. both allows a nurse to have a license in a primary state of residence and be able to practice in other states with multistate status and is available in 25 states. f. both increases the cost of licensure fees when nurses practice in more than one state and is available in all states.

10. Challenges with technology include: a. computer and technology competency. b. the identification of boundaries between an employer and personal electronic products. c. the use of social media. *d. All of these are correct.

Chapter 11 1. The study of healthcare policies includes: a. national or state legislation initiatives and processes. b. organizational policies necessary for order and progress. c. external agencies. *d. All of these are correct.

2. The Federal Register is: a. a policy that refers to rules that govern the workplace. *b. the official daily publication for rules, proposed rules, and notices of the federal government and an unbiased source of information. c. a document that regulates nursing practice. d. the overarching federal administrative agency concerned with quality health care in the United States.

3. Social policy is: *a. intended to enhance public welfare. b. laws passed by the legislature. c. authoritative rulings related to those decisions made by government. d. directed toward promoting the health of citizens.

4. The provision of tangible recognition of professional achievement in a defined functional or clinical area of nursing is: a. the State Nurse Practice Act. *b. nursing certification. c. nursing licensure. d. None of these is correct.

5. Policies that are authoritative rulings related to decisions made by government are known as: a. social policies. b. organizational policies. *c. public policies. d. institutional policies.

6. During the process of policy development, when nurses become recognized by key stakeholders as knowledgeable and necessary for effective policies, it is known as what stage of political development? a. Buy-in b. Self-interest

*c. Political sophistication d. Leadership

7. A physician is a member of a network of providers that is financially rewarded for slowing the growth of patients' healthcare spending while maintaining or improving the quality of care being delivered. This physician is a member of which of the following? *a. Accountable care organization b. Health maintenance organization c. Health economics committee d. Bioethics committee

8. Which of the following is the federal statute that was enacted in March of 2010 to ensure that all Americans have access to health care? *a. Patient Protection and Affordable Care Act b. Future of Nursing: Leading Change, Advancing Health c. Transition of Care Program d. Patient Self-Determination Act

9. As part of the PPACA, Medicare incentives are linked to effective use of electronic health records to improve quality, safety, and efficiency to reduce health disparities, engage patients and families, improve care coordination, improve public health, and to ensure adequate privacy and security protections for personal health information. This use of electronic health records is known as which of the following? a. Digitalization *b. Meaningful use c. Innovation d. Streamlining

10. Certified nurse-midwives are currently conflicted with regards to the PPACA. What did the PPACA fail to accomplish for this branch of advanced practice nurses? a. Limit the scope of practice b. Expand the scope of practice *c. Include them in the federal government's list of ACO professionals d. Offer multistate licensure

Chapter 12 1. Delegation is: a. required whenever there is a hierarchal order of individuals working together to accomplish goals. b. both a management and a legal concept. c. discussed in terms of authority, responsibility, and accountability. *d. All of these are correct.

2. As a nurse, you have obtained a license that depicts your knowledge, skills, and abilities to function in a nursing role. Which of the following does your nursing license give you to do your job? a. Autonomy *b. Authority c. Competence d. Confidence

3. All of the following statements about accountability are true except: a. Accountability is being answerable for actions or inactions of self or others. b. Accountability is the obligation to account for or explain events. c. There is individual accountability and organizational accountability for delegation. *d. Accountability describes the distribution of work that each staff member should accomplish in a given period of time.

4. As a nurse leader, you have the responsibility of distributing the work that each staff member is to accomplish in a given time period or designating another nurse to be responsible for specific patients.

Which of the following describes this distribution of work? a. Accountability *b. Assignment c. Supervision d. Responsibility

5. Decision making: a. is a complex cognitive process. b. involves choosing a particular course of action from among alternatives. c. is an essential component of the problem-solving process. *d. All of these are correct.

6. Supervision is: a. the provision of guidance or direction, evaluation, and follow-up by a delegator to accomplish a task delegated to another. b. watching over a particular activity or task being carried out by others and ensuring that it is carried out correctly. c. the transfer of responsibility for the performance of a selected nursing activity or task from a licensed nurse authorized to perform the activity or task to someone who does not have this authority. *d. both the provision of guidance or direction, evaluation, and follow-up by a delegator to accomplish a task delegated to another and watching over a particular activity or task being carried out by others and ensuring that it is carried out correctly.

7. The delegator is responsible for all of the following except: *a. accepting only those tasks or assignments for which he or she is qualified. b. assessing a situation. c. ascertaining the competence of the delegate. d. follow-up supervision. e. management of results.

8. As a nurse leader, you are responsible for the function of your entire unit. You feel the only way to do something properly is to do it yourself. By doing all the important duties yourself, which of the following challenges of delegation are you depicting? a. Delegate refusal b. Oversupervision c. Undersupervision *d. Underdelegation

9. Which of the following statements is true? *a. Physicians cannot delegate physician work to nurses. b. Physicians can delegate nursing work to physicians. c. If the activity or task is not within the nurse's scope of practice, it can be delegated by the nurse. d. Delegation is necessary even if the particular activity or task is already within the legally recognized scope of practice of the individual who is to perform the activity or task.

10. As a nurse leader, you are willing to delegate many tasks throughout the day. However, when you do so, you are constantly directing and telling the person how to do the tasks in the appropriate

manner. Which challenge to delegation are you depicting with these actions? *a. Oversupervision b. Undersupervision c. Overdelegation d. Underdelegation

Chapter 13 1. All of the following statements are true about negotiation except: *a. Effective negotiation is a skill that one is born with. b. Negotiation is learned through the process of discipline and application. c. Much of the skill and talent necessary to negotiate well can be improved through continuous and effective use and refinement of skill development and learning. d. In all negotiations, it is important to be able to develop and utilize good listening skills.

2. An essential characteristic of negotiation is: a. win-lose. *b. win-win. c. lose-lose. d. None of these is correct.

3. A core skill that must be developed and refined to ensure successful negotiation is: a. discerning, identifying, and declaring specific goals for which the risk of negotiation is worth undertaking. b. maintaining a certain level of flexibility and fluidity with regard to wants and needs. c. being well informed, clearly prepared, and understanding as much as possible about the matter under negotiation. *d. All of these are correct.

4. In the process of negotiation, it is important to uncover any aspects that are mutually agreed upon which may lay the groundwork for reaching agreements on more difficult issues later in the negotiation process. This process is known as which of the following? a. Blocking *b. Chunking c. Striking d. Bridging

5. All of the following are elements of readying for negotiation except: a. understanding the issues on the table. b. determining the personal bottom line. c. understanding the bottom line of each participant. d. practicing the approach to the interaction. *e. determining how to defeat the opponent.

6. Establishing a framework for negotiation and the terms of engagement satisfies the goal of: a. providing a structured and positive environment as the negotiation requires. b. allowing the parties to more clearly establish expectations with regard to the process. c. allowing the parties to operate within the context of fairly formal rules of dialogue. *d. All of these are correct.

7. Which of the following is a major element of the role of dialogue? a. Taking limited breaks b. Allowing the use of negative language *c. Establishing the rule of speaking without interruption d. Reminding the parties of prior failures

8. Which of the following statements about negotiation sessions is true? a. Each session stands on its own merits and reflects only the activities that have occurred within that session. b. Subsequent sessions always build on previous sessions. c. Early agreements on particular issues of conflict can provide a floor for subsequent clarity and agreement on more difficult issues (called chunking). *d. All of these are correct.

9. There are several different methods that can be used to advance a negotiation. This may take a thorough understanding of the attitudes and emotions of the parties involved. For example, you may need to keep the negotiation fact-based and free of emotional content while keeping the language clear and ensuring the intent is clear. This approach is beneficial when dealing with which of the following? a. Unclear negotiator b. Indecisive negotiator *c. Overly aggressive negotiator d. Overly emotional negotiator

10. If you are involved in a negotiation and you adopt a winner-takeall approach and present a set of absolutes that you will not deviate from, which stage of negotiation never truly unfolds? a. Implementing the agreement b. Intensive interaction *c. Bargaining d. Establishing the framework

Chapter 14 1. The obligation for social accountability represents a social contract between the society that licenses the profession and: a. those who practice a profession. *b. the persons who act in the best interest of the society. c. employees of a healthcare institution. d. None of these is correct.

2. The debate regarding nursing as a profession relates to: a. the predominant minimum level of education of the majority of the profession. b. its dependency in relationship to other disciplines. c. its lack of clarity with regard to its specific contributions to the health of society. d. an ongoing lack of a disciplined profession. e. both the predominant minimum level of education of the majority of the profession and its lack of clarity with regard to its specific contributions to the health of society. *f. All of these are correct.

3. In the early days of nursing practice, which characteristic of nursing practice set limits on nursing's role, position, authority, and power structure? a. Nurses were servants for physicians. *b. Nurses were nearly 100% female. c. Nurses lacked formal education. d. Nurses could not be licensed.

4. As a nurse, you take great pride in your work by performing all your duties properly and in a time-efficient manner. This work pride represents which of the following characteristics? a. Accountability b. Authority c. Autonomy *d. Responsibility

5. For professionals, _______ is the definitive foundation for work. *a. accountability b. responsibility c. competence d. functionalism

6. Performance evaluations review the worker regarding their capacity to function and: a. their ability to do their work. b. their ability to get the job done. c. their ability to get along with others who are doing their jobs. *d. All of these are correct.

7. As a nurse, you not only take great pride in your work on a day-today basis, you strive to grow, learn and enhance your talents, assist in helping other nurses develop their own skill sets, evaluate the effectiveness of your learning, and make a lifelong commitment to learning about your profession. In doing so, which characteristic are you embracing? a. Responsibility b. Accountability *c. Ownership d. Leadership

8. Leadership must create an organizational context that does not impede membership and ownership of work. For this to happen, which of the following circumstances and conditions needs to be present? a. Professional ownership implies that the ownership of the work belongs to the profession, not to the workplace. b. Contemporary research on the orientation of the professional/knowledge worker suggests that the traditional incentives often seen in employee-driven models do not successfully motivate the action of this worker. c. Leaders must onboard new professionals through the use of well-identified professional processes, such as granting privileges instead of hiring, and peer-based selections of incoming members instead of management of hiring practices. *d. All of these are correct.

9. Which of the following is a critical element of professional ownership? a. The individual nurse values his or her specific gifts, talents, and skills and agrees to commit to the full application of them in undertaking the work of the profession. b. The individual professional member of the staff recognizes that his or her competence depends on continuous and dynamic lifelong learning. c. Competency and skill enhancement depend on the individual's commitment to membership. *d. All of these are correct.

10. As a nurse manager, you have implemented new, effective processes that achieved positive, meaningful outcomes. As such, which of the following have you added to your facility? *a. Value b. Volume c. Credibility d. Respect

Chapter 15 1. In your role, you are expected to anticipate and predict future expectations and translate them to those around you and to assist others in accepting and engaging in change. Which of the following roles are you performing? a. Manager *b. Leader c. Administrator d. Physician

2. Now, more than ever before, patients are taking responsibility for their own healthcare decisions. Which of the following healthcare reforms does this trend represent? a. Value-driven service b. Volume-driven service *c. User-driven service d. Provider-driven service

3. Which of the following statements about conflict and conflict management is true? a. Principles of conflict management are essential for navigating the landscape of transformation and change. b. Conflict is a normative dynamic. c. A good conflict process includes identifying conflict in its earliest stages. d. Conflict resolution and mediation is a learned and developed skill that comes with practice and application. *e. All of these are correct.

4. Accountability is: *a. the cornerstone of professional expression. b. the same as responsibility. c. to be avoided by professionals. d. All of these are correct.

5. As a nurse leader, you have been given the freedom to make decisions and take action when you feel the need to do so. This freedom is an example of which of the following? *a. Autonomy b. Authority c. Accountability d. Responsibility

6. All of the following statements about accountability are true except: *a. Accountability can be delegated. b. Accountability is invested in individuals, not groups. c. Accountability is about the products of work, not the processes of work. d. Accountability implies change.

7. All of the following essentials evidence a good fit between supporting infrastructure and the capacity for sustainable professional practice except: a. Professionals organize around decisions, not positions. *b. Decisions are never driven from the point of service. c. A grid of accountability demonstrates the locus of control for all decisions in the system and clearly identifies where decisions should be made and by whom. d. Clarification and distinction of decisions that are a priori management driven and owned and those that are staff owned is an important distinction of accountability in professional organizations.

8. As a leader, it is your responsibility to ensure that the proper decision is made by the proper person, in the proper place, at the proper time, and for the proper purpose. This responsibility is the central principle for which of the following? a. Accountability *b. Shared decision making c. Critical thinking d. Boundary determination

9. Approaches to staffing decisions include: a. nurse-to-patient ratios. b. patient classification systems. c. legislative requirements. d. different skill levels. *e. All of these are correct.

10. The following statements about change are true except: a. Learning how to thrive in the presence of continual change requires both art and science in the healthcare environment. *b. All change is urgent. c. Not all change is value laden. d. Some good ideas do not need to be implemented unless there is evidence and a rationale for the change.

Final Exam 1. Typical hospital processes focus on predictability, equilibrium, and evolution while limiting flexibility, variation, and creativity in order to achieve the goals of the process. What type of change do typical hospital processes promote? a. Horizontal change b. Lateral change *c. Linear change d. Vertical change

2. _______ is a unique type of change that is novel and dramatic and fundamentally restructures the deep social and economic value of an organization. *a. Innovation b. Digitization c. Stagnation d. Modernization

3. As a nurse, your license is proof that you are capable of performing your role and you do not take your obligations lightly. Failure to adhere to the regulations of your license put you at risk for severe penalties. Performing your role as a nurse is not simple a duty. Which of the following describes your role? a. Legal mandate *b. Social mandate c. Employer mandate d. Federal mandate

4. Which of the following enumerates the conditions of membership and the statutory requisites for membership and practice of a profession? a. Educational background b. Employment history *c. Licensing regulations d. Accreditation standards

5. The ultimate goal of _______ is to observe the system acting and interacting as a whole in a way that represents the desired state. a. analysis *b. synthesis c. management d. leadership

6. The leadership characteristics of accountability, ownership, equity, and empowerment are all examples of which type of competency? a. Leadership *b. Participation c. Interpersonal d. Conceptual

7. As a nurse leader, it is easy to permit the reflective work of the profession to be sacrificed through unrelenting work expectations and by keeping team members busy without giving them an opportunity to think about what they are doing. Which of the following is this behavior encouraging? a. Collaboration b. Accreditation *c. Alienation d. Confrontation

8. For a leader to be effective in managing conflict, he or she must learn to confront conflict by overcoming which personal barrier? *a. Fear b. Uncertainty c. Negativity d. Inexperience

9. Your facility recently implemented a new workforce management system. After a year of using this system, it is realized that the system is unable to measure what it is designed to measure and does not have the ability to quantify and predict patient needs for nursing care. Which of the following is this system lacking? a. Stability b. Homogeneity *c. Validity d. Equivalence

10. Which of the following refers to the extent to which different nurses use the same workforce system to measure the same individual at the same time to derive consistent results? a. Stability b. Homogeneity c. Heterogeneity *d. Equivalence

11. As a nurse leader, you recognize that one of your patients is clearly at the end of life and no treatments are proving beneficial for

improving this patient's condition; therefore, further treatments are withheld. This process of withholding treatment is an example of which of the following? a. Ethical dilemma b. Health advocacy *c. Medical futility d. Nonmaleficence

12. Which of the following is a recently developed moral theory based on the insights of Gilligan that rejects the traditional male-centered ethics focused on rationality, individuality, and abstract principles in favor of emotion, caring relationships, and concrete situations? a. Bioethics *b. Ethics of care c. Utilitarianism d. Rationalization

13. Which of the following is essential to the decision-making process and team collaboration and vital in terms of the kinds of team members sitting around the table and their particular behaviors? a. Hierarchy b. Leadership c. Management *d. Diversity

14. All of the following are critical factors for the effectiveness of the team leader's role except: a. the use of a good process. b. adequate structuring of the team. *c. constant monitoring of team behavior. d. the progress of the team toward its goals or fulfillment of its purpose.

15. The involvement of government, the intractable uncertainty in many healthcare areas, the barriers to accessing services, and the role of third-party agents in brokering and managing funds are all unique characteristics of: a. health management. *b. healthcare economics. c. decision making. d. healthcare legislation.

16. Onboarding, employee rounding, social networking, employee recognition, and developmental stretch assignments are five practices that have been identified for increasing which of the following? *a. Nurse retention b. Nurse turnover c. Patient satisfaction d. Employee wellness

17. There are several reasons why the shared governance organizational structure operates effectively in complex adaptive systems like the healthcare environment. These reasons include which of the following? a. The sustainability of healthcare services fully depends on how the point-of-service professionals function individually and collectively. b. The emergence of knowledge organizations demonstrates that knowledge is not fixed or finite and does not operate simply as a capacity. c. In a continuum of care approach, no one healthcare organization can own, control, or unilaterally mandate all of the service linkages and connections necessary to fully serve a specific population. *d. All of these are correct.

18. For complex adaptive systems to thrive, which of the following principles must be in operation? a. The whole is never greater than the parts. b. A problem in one part of the system ultimately affects the whole system. c. All disciplines serve the user and/or serve someone who serves the user. d. In complex adaptive systems, form and function interact with each other; otherwise, they do not have a dependent relationship. e. The whole is never greater than the parts, a problem in one part of the system ultimately affects the whole system, and in complex adaptive systems, form and function interact with each other; otherwise, they do not have a dependent relationship. f. A problem in one part of the system ultimately affects the whole system, all disciplines serve the user and/or serve someone who serves the user, and in complex adaptive systems, form and function interact with each other; otherwise, they do not have a dependent relationship. *g. All of these are correct.

19. For a system to be effective, which of the following considerations must be addressed? a. Complex adaptive system providers are integrated in a collaborative and linked relationship that synthesizes well around the needs of the user.

b. The primary driving point of decision making in a complex clinical delivery system is the place where the provider and the user meet. c. Data must be available at point-of-service to support caregivers in decision making, in clinical activities, and in the evaluation of impact and value. d. Both complex adaptive system providers are integrated in a collaborative and linked relationship that synthesizes well around the needs of the user, and the primary driving point of decision making in a complex clinical delivery system is the place where the provider and the user meet. *e. All of these are correct.

20. All of the following statements are true about accountability in shared governance except: a. Accountability drives the work of professionals. b. Accountability is the foundation for all knowledge work performance. c. Every member of a complex adaptive system has both rights and obligations that generate from the full participation in the life and activities of the system. d. Every member of the system must fully contribute to the extent of his or her capacity in a way that ensures that the system thrives and fulfills its essential value. *e. All of these are correct.

21. The role of management in shared governance is: a. stewardship. b. unilateral decision making. c. servant leadership. d. ensuring a seamless interface between the system's purpose and resources. e. both stewardship and servant leadership. *f. stewardship, servant leadership, and ensuring a seamless interface between the system's purpose and resources.

22. All of the following are elements of a professional nurse portfolio except: a. continuing education records. *b. attendance records. c. committee contributions. d. contributions to the community.

23. As a professional nurse, you are required to participate in an ongoing synthesis of knowledge, skills, and abilities required to practice safely and effectively in accordance with the scope of nursing practice. Which of the following refers to this requirement?

a. Remediation *b. Continuing competence c. Certification d. Licensure

24. Strategies for enhancing personal balance include: a. minimizing negative thoughts. b. a specific time for reflection and planning for the future. c. being mindful of self within or after professional practice situations. d. stress management. *e. All of these are correct.

25. A coach is: a. a wise and trusted advisor who guides others on a particular journey. *b. one who assists others with developing viable solutions, prioritizing them, and then acting on them. c. a unit manager or leader. d. None of these is correct.

26. As a registered nurse for a number of years, you find yourself not caring as much about your patients as you once did. Which of the following are you experiencing? a. Ethical dilemma b. Boundary violation *c. Compassion fatigue d. Emotional breakdown

27. As a nurse leader, you notice there is a growing interest among your employees with regards to policy issues and the relationship to individual nurse performance and the ability to practice. Which of the following stages of political development are you recognizing among your employees? *a. Buy-in b. Self-interest c. Political sophistication d. Leadership

28. Considerations for being “media ready” include: a. practicing with internal public relations staff. b. avoiding off-the-record comments. c. defining key messages and staying on message. *d. All of these are correct.

29. Which of the following is the agency whose mission is to improve the quality, safety, efficiency, and effectiveness of health care in the United States? *a. Agency for Healthcare Research and Quality b. Commonwealth Fund c. Institute of Medicine d. Organization of Nurse Executives

30. The Institute of Medicine is: a. an organization that serves to promote health care that emphasizes access, quality, and greater efficiency, particularly for society's most vulnerable people. *b. a nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. c. the U.S. government's principal agency for protecting the health and well-being of all Americans through the provision of essential human services, especially for those who are most needy. d. None of these is correct.

31. A nurse assisting with a surgical procedure witnesses a physician explain the procedure to the patient, explain the risks involved, the expected outcomes, the potential complications, and the available alternative treatments. Which of the following has the nurse just witnessed? a. Patient history *b. Informed consent c. Implied consent d. Refusal of treatment

32. Occasionally, nurses may need to delegate some of their duties to others to ensure they are performed properly and in a timely fashion.

Who would not be appropriate personnel for a nurse to delegate to? a. Licensed practical nurse *b. Advanced practice nurse c. Medical assistant d. Licensed vocational nurse

33. A delegation can be improper if any of the five “rights” are violated. These “rights” include: a. the right task. b. the right patient.

c. the right circumstances. d. the right directions. e. the right supervision. *f. All of these are correct.

34. Underdelegation is when: *a. not enough work is delegated. b. the workload is beyond what the delegate can reasonably do in the assigned time. c. the delegator is constantly looking over the shoulders of the person asked to do the work. d. any of the five rights are violated.

35. As a nurse, occasionally you will ask someone to do something they have not achieved the proper competency for or are not licensed to perform. Which challenge of delegation have you just encountered? a. Refusal by delegate b. Overdelegation *c. Boundary clarity d. Oversupervision

36. All of the following are principles of delegation from the ANA or NCSBN websites except: a. Delegation to competent individuals. b. Care coordination and the use of assistants in providing patient care. *c. Ensuring the integrity of the physical plant. d. The essence of professional responsibility and accountability.

37. At the beginning of negotiation, one party states “there is absolutely no deal unless a certain action occurs.” Which of the following has that party just established? a. Ultimatum b. Bargaining point c. Balance of power *d. Bottom line

38. Bargaining: a. is the phase of negotiation that emphasizes the give and take related to the variety of positions at the table. b. is the work of exchange. c. initiates the serious give and take necessary to determine which legitimate positions emerge and the degree of support for any particular position or view.

*d. All of these are correct.

39. You will encounter many different personalities throughout negotiations. Becoming more visual by putting thoughts in writing, using visual presentations, placing submissions in a bullet-point format, or restating the participant's contribution as a way of clarifying will go a long way when dealing with which type of negotiator? *a. Unclear negotiator b. Indecisive negotiator c. Aggressive negotiator d. Emotional negotiator

40. Collective bargaining is protected by: a. the Department of Commerce. b. the National Labor Relations Act. c. the Taft-Hartley Act. d. Public Law 93-360. e. Both the Department of Commerce and the National Labor Relations Act. *f. The National Labor Relations Act, the Taft-Hartley Act, and Public Law 93-360. g. All of these are correct.

41. Collective bargaining agreements include all of the following except: a. salaries. b. benefits. c. working conditions. *d. healthcare costs.

42. To date, performance evaluations review the worker in the context of the capacity to function and the ability of the worker to do or perform the work. In reality, what are performance evaluations assessing? a. Accountability b. Authority c. Autonomy *d. Responsibility

43. It is not uncommon to hear nurses refer to their profession as a job with a laundry list worth of tasks, functions, actions, and effort, and it doesn't take long for that attitude to spread throughout the entire staff where everyone considers their profession a job. Which of the following represents this mindset?

*a. Employee work group syndrome b. Nurse fatigue c. Compassion fatigue d. Collaboration

44. Value is: a. doing the right work rather than doing a good job. b. work that is informed by purpose. c. the product of a measured and defined relationship between an effective process and a meaningful outcome. *d. All of these are correct.

45. Risk is: a. a sign of the continuous and dynamic reach of the human experience in new directions in new ways. b. exploring new territory in a way that advances the human experience and improves it in important ways. c. to be avoided in the healthcare arena. d. present at some level with all meaningful change. *e. a sign of the continuous and dynamic reach of the human experience in new directions in new ways, exploring new territory in a way that advances the human experience and improves it in important ways, and present at some level with all meaningful change. f. All of these are correct.

46. The central characteristics of accountability that are nonnegotiable for the profession represent which of the following principles? a. Accountability generally reflects an individual's professional commitment to performance and to action. b. Accountability demands a dynamic convergence between ownership, action, impact, and outcome. c. Individual accountability cannot be sustained if the system structure does not allow it to be legitimately expressed by those who own it. *d. All of these are correct.

47. As a nurse leader, your responsibility is to make sure the necessary power to decide and act is located in the place where the right to decide to act is located. Which of the following characteristics refers to this responsibility? a. Autonomy *b. Authority c. Accountability d. Competence

48. Nurses should know the: a. source of healthcare policies. b. content of healthcare policies. c. consequences of healthcare policies. d. role of the professional in providing feedback to policymakers when policies are no longer effective. *e. All of these are correct.

49. Just because you are a licensed, professional nurse does not mean you are going to behave and conduct yourself in a professional manner.

Which of the following are in place to ensure the unique trust society has for licensed, professional nurses? a. Laws b. Regulations *c. Codes of ethics d. Performance evaluations

50. Nursing career management includes all of the following except: a. maintaining a current license. b. maintaining continuing competence. c. participating in professional organizations. *d. exploring alternative careers.

51. Knowledge workers (professionals): a. need a very specific organizational context in order to facilitate good practice and positive outcomes. b. are intrinsically motivated. c. see their work as more than simply a job. d. both need a very specific organizational context in order to facilitate good practice and positive outcomes and are intrinsically motivated. *e. All of these are correct.

Mid Term Exam 1. The following are all considered guidelines for rational risk taking except: *a. maintaining the status quo. b. advancing the organization. c. whistle-blowing. d. developing skills. e. mandatory reporting.

2. Strategies to minimize risk in change include all of the following except: a. speaking up with evidence or a rationale for action. b. timing and tinkering. c. encouraging upward communication. d. accelerating personal competence. e. apologizing with a flair. *f. All of these are correct.

3. The change process includes all of the following except: a. assessment of the conditions. *b. taking an unnecessary risk. c. reflection with the team specific to the needed work that must occur. d. integration of information into a plan.

4. The positive outcomes of course correction include all of the following except: a. information gained from less-than-successful attempts is needed in health care. b. they provide new insight and opportunities for further dialogue. *c. the information should be filed away and not used in future decision making. d. course correction and remediation should be employed.

5. Remediation is preferred when: a. potential risks of physical, emotional, or financial harm due to the incident are low. b. the event is a singular event with no prior pattern of poor practice. c. there have been multiple events and prior counseling has occurred.

d. the individual exhibits a conscientious approach to and accountability for his or her practice and now appears to have the knowledge and skill to practice safely. *e. potential risks of physical, emotional, or financial harm due to the incident are low; the event is a singular event with no prior pattern of poor practice; and the individual exhibits a conscientious approach to and accountability for his or her practice and now appears to have the knowledge and skill to practice safely. f. potential risks of physical, emotional, or financial harm due to the incident are low; there have been multiple events and prior counseling has occurred; and the individual exhibits a conscientious approach to and accountability for his or her practice and now appears to have the knowledge and skill to practice safely.

6. Which of the following is an example of an irrational risk? *a. Poor judgment b. Whistle-blowing c. Mandatory reporting d. Developing skills

7. Which of the following practices was identified by Phillips in the late 1980s through the 1990s as a means of comparison against industry standards as an indication of performance compared with other companies? a. Course correction b. Assessment *c. Benchmarking d. Integration of ideas

8. The cornerstones of a profession's ownership and accountability are: a. practice. b. quality. c. competence. d. knowledge management. *e. All of these are correct.

9. Professional behaviors can be neither obtained nor sustained in an employee work group structure where: a. the expectations for performance are defined and controlled by the workplace and predominantly function in orientation. b. few peer-driven performance and evaluation processes operate. c. work value is based on volume, time, and motion determinants. d. work is highly subordinated to others and essentially management controlled and driven. *e. All of these are correct.

10. Active participation in the life of a profession includes: a. advancing the interests of the profession. b. participation in decisions affecting practice. c. participation in decisions related to quality of care, education, competence, and research. d. generation of knowledge. *e. All of these are correct.

11. The critical role played in the representation that people make about themselves includes: a. personal codes of dress. b. conversation. c. action. d. expression. *e. All of these are correct.

12. Public policy is defined as: a. volunteer work in nursing organizations. *b. principled action undertaken by governments. c. working on committees in the hospital. d. None of these is correct.

13. Which of the following describes a characteristic of a shared decision? a. Centralized b. Individual-based c. Exclusive *d. Point-of-service based

14. Evidence indicates that the perceptual presentation an individual makes during the first _____ of interactions with others sets the perceptual frame of reference that will linger for the longest time in the memory of others. a. 1 minute *b. 3 minutes c. 5 minutes d. 10 minutes

15. Management focuses on: a. the short-term. b. efficiency.

c. function. d. process. *e. All of these are correct.

16. Leadership focuses on: a. longer trajectories. b. relationship. c. interactions. d. confluence of forces. *e. All of these are correct.

17. Personal attribute questions pertaining to leadership that one would ask about oneself would include all of the following except: a. Do I genuinely like people? *b. Do I dislike being a team player? c. How developed are my communication skills? d. Am I able to live with a high degree of ambiguity and uncertainty?

18. Elements related to courage that are important to manifest in the personal exercise of the leadership role include: a. the courage to initiate and act. b. the courage to stand up for what is right in others. c. the courage to trust. d. exhibiting a personal connection to leadership courage. *e. All of these are correct.

19. All of the following statements are true about the relationship between leaders and stakeholders except: a. Leaders firmly stay within the context obligations of their role and support stakeholders in addressing their ownership of the content of their issue or concern. b. The leader raises the right issues, engaging appropriate stakeholders. c. The leader helps others to find the core of the issue or problem. *d. The leader strives to solve all of the problems for the stakeholders.

20. All of the following statements are expectations of a leader except: a. Leaders are transparent and become exemplars of what is valuable and right. *b. Leaders have no time for self-reflection.

c. Leaders understand the constancy of change in their own lives. d. Leaders remain servants to the system and its people.

21. Which of the following is defined as the act of combining and integrating numerous complex elements or components so as to view the system as an integrated whole? *a. Synthesis b. Analysis c. Assessment d. Teamwork

22. The personal barriers that have a dramatic impact on the individual leader's ability to understand, engage, and manage conflict include: a. willingness to confront conflict. b. uncertainty about the capacity to handle the conflict emotionally and personally. c. recognizing that most people's attitude toward conflict is a negative one. d. lack of skill. e. lack of exposure and experience. f. previous family conflicts experienced. *g. willingness to confront conflict, uncertainty about the capacity to handle the conflict emotionally and personally, recognizing that most people's attitude toward conflict is a negative one, lack of skill, and lack of exposure and experience. h. All of these are correct.

23. Steps in handling conflict include: a. identifying the problem. b. immediately reporting the problem to hospital administration. c. making sure issues are expressed. *d. both identifying the problem and making sure issues are expressed.

24. The types of conflicts are: a. relationship conflicts. b. information conflicts. c. interest conflicts. d. organizational conflicts. e. values-based conflicts. f. conflicts with administration. *g. relationship conflicts, information conflicts, interest conflicts, organizational conflicts, and values-based conflicts. h. All of these are correct.

25. Values conflicts are: a. the easiest to address in the workplace. *b. difficult to resolve because they relate to who people are. c. easy to resolve because they relate to what people believe. d. both difficult to resolve because they relate to who people are and easy to resolve because they relate to what people believe.

26. Areas to include in the mediation process as relationship issues are explored include all of the following except: a. mutual respect. b. needs versus wants. c. compassion and empathy. *d. blaming others.

27. Different cultures, ethnic groups, religion, and political ideology are common sources of which type of conflict? a. Organizational conflict *b. Values-based conflict c. Relationship conflict d. Interest conflict

28. Which type of conflict is filled with emotional content? a. Informational conflict b. Values-based conflict c. Organizational conflict *d. Relationship conflict

29. Which of the following are important considerations in constructing the basic core schedule? a. Anticipated patient needs volume b. Shift length c. Experience d. Available research evidence for staffing effectiveness *e. All of these are correct.

30. All of the following are true about nursing staff skill mix except: a. it consists of the numbers of licensed and non-licensed staff. *b. it is determined based on who is available to work. c. it is determined based on the work that needs to be done. d. it is difficult and challenging to determine due to the multifaceted nature of patients and caregivers.

31. The role of advanced practice nurse providers and clinical experts includes: a. writing orders. b. providing general patient care oversight. c. providing care. d. assisting staff in the care of more complex patients. *e. All of these are correct.

32. Variance management is: *a. analysis of the required staff needed for care and the actual staff. b. using multiple indicators to evaluate staffing effectiveness. c. assisting less-experienced staff in organizing and providing care. d. eliminating non-value-added work.

33. Which of the following are examples of interventions to address the gap between needs and actual staffing? a. Reevaluating patient acuity ratings b. Postponing admissions c. Postponing nonemergent patient care d. Floating existing staff to the unit of need *e. All of these are correct.

34. Which type of study is designed to determine the best way to complete a repetitive job? a. Time study *b. Motion study c. Work sampling d. Self-reporting

35. Which of the following is defined as the long-range plan that combines the organization's goals, legislation, regulation, and accreditation requirements, and planned patient demand? a. Staffing b. Workforce management *c. Scheduling d. Patient classification

36. Inappropriate communication with patients could involve all of the following ethical issues except: a. autonomy.

b. betrayal. *c. pragmatism. d. nonmaleficence.

37. Legislative issues could impact which of the following ethical issues? a. Boundary violations b. Betrayal c. Code of ethics d. Rationalization e. Boundary violations, betrayal, and code of ethics *f. Boundary violations, code of ethics, and rationalization

38. You have just witnessed an incident where a patient could have been harmed by the care of another nurse. The type of ethical dilemma you are facing is a: a. boundary crossing. *b. nurse-nurse ethical dilemma. c. whistle-blowing. d. nurse-patient ethical dilemma.

39. All of the following are examples situations that could lead to nurse-patient ethical dilemmas except: a. pain management. b. patient restraint. c. patient privacy. *d. All these choices could lead to nurse-patient ethical dilemmas.

40. Practice breakdown is: *a. disruption or absence of any of the aspects of good practice. b. brief excursions from an established boundary for a therapeutic purpose. c. a process that obscures the ethical dimensions of a decision. d. when a person knows what is right and doesn't want to do it.

41. Which of the following is defined as the elimination of arbitrary distinctions and the establishment of a structure of practice with proper share, balance, or equilibrium among competing claims? a. Health advocacy b. Morality *c. Justice d. Utilitarianism

42. Which of the following is the most common practice breakdown error? *a. Lack of professional responsibility b. Lack of clinical reasoning c. Lack of attentiveness d. Lack of intervention

43. Terms of engagement contain all of the following elements except: a. each member of the team will have an opportunity to speak. b. avoid the use of judgment terms, such as “I agree” or “I disagree.” *c. team members should never use “I” statements. d. the use of appreciative strategies in conversation should be encouraged and stimulated.

44. Major factors that are critical to the effectiveness of the team leader's role relate specifically to the: a. adequate structuring of the team. b. type of healthcare setting. c. use of good process. d. progress of the team toward its goals or in fulfillment of its purpose. *e. adequate structuring of the team, use of good process, and progress of the team toward its goals or in fulfillment of its purpose. f. All of these are correct.

45. The impact of technology on the team process means that: a. communications become available to team members more quickly. b. communication may be more succinct. c. body language and emotions are not available to factor in with electronic communication. *d. All of these are correct.

46. All of the following are team fables except: *a. team members usually do not use good critical thinking to resolve their questions and issues. b. each team member fully understands why they act the way they do. c. people always want to work with others. d. building trust is an important role of the team leader.

47. All of the following statements are true about the team leader and their role except:

a. It is the role of the team leader to both monitor and moderate the effect of progress and challenges to an effective team dynamic. b. The team leader must not be overwhelmed by the seesaw between small successes as they intertwine with moments of challenge. c. The team's small successes should be celebrated by members as they progress. *d. The leader should never point out signs of progress until a goal is totally achieved.

48. Which of the following is defined as knowing how all the decisions need to be served, which talent or expertise needs to be gathered, how the size of the team will affect the issues the team is addressing, and which particular gifts and skills will be available to the team members as they deliberate the questions before them? *a. Setting the table b. Identifying the problem c. Individual awareness d. Terms of engagement

49. Examples of productivity metrics include: a. registered nurse hours/day. b. admissions, discharges, and transfers/shift. c. new staff orientation hours/total worked hours. *d. All of these are correct.

50. A balance sheet is: *a. a financial statement that includes assets, liabilities, and equity. b. a financial statement that includes information about revenue sources and expenses at a specific point in time. c. a financial report that shows the cash inflow and outflow activities or financial stability of the organization.

51. Cash flow operating activities are a: a. financial statement that includes assets, liabilities, and equity. b. financial statement that includes information about revenue sources and expenses at a specific point in time. *c. financial report that shows the cash inflow and outflow activities or financial stability of the organization.

52. Criteria for assessing and monitoring meaningful measures include:

a. prioritizing consumer and purchaser needs. b. focusing measurement on areas where there is a potential for improvement in outcome quality. c. requiring that all patients fitting clinical criteria be included in analysis. d. measuring provider performance at all levels. *e. All of these are correct.

53. Dashboards are: *a. a combination of graphics and numbers to quickly display important data elements. b. a discrepancy between needs and resources. c. financial statements that include information about revenue sources. d. a way to chart medications given.

54. Which type of value analysis is a special type of costeffectiveness analysis that includes measures of both quantity and quality of life? a. Cost-benefit analysis *b. Cost-utility analysis c. Cost-consequences analysis d. Cost-minimization analysis

55. The comprehensive management of human resources includes all of the following except: a. recruitment. b. management. *c. advancement. d. retention.

56. Teamwork often must be broken down into smaller components, and leaders and small groups of team members must become more focused on particular goals and tasks associated with the team's progress. *a. True b. False