Nursing Practice Management Exam Preparation Guide
Course Introduction
Nursing Practice Management is a comprehensive course designed to equip nursing students with the essential leadership, management, and organizational skills necessary for effective professional practice within healthcare settings. The course focuses on principles of management, delegation, team coordination, conflict resolution, resource allocation, quality improvement, and evidence-based decision-making. Through an exploration of legal, ethical, and regulatory frameworks, students gain insights into policy development, budgeting, and strategic planning. Emphasis is placed on communication strategies, effective supervision of staff, and fostering a culture of safety and collaboration to optimize patient outcomes and support professional development in dynamic healthcare environments.
Recommended Textbook
Leadership and Nursing Care Management 6th Edition by Diane Huber
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Page 2
Chapter 1: Leadership and Management Principles
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Q1) A quality improvement team is working to enhance teamwork among the staff in a newly developed Alzheimer's program. Which of the following statements would be an expected behavior that illustrates quantum leadership?
A) "After the meeting today, each member on this team will be a role model of good communication techniques to other staff members."
B) "How would you describe an ideal collaborative practice environment?"
C) "What do you think about sharing our opinions today in a mutually respectful manner as we move around the table?"
D) "You folks are highly motivated and smart enough to develop a plan on your own. I'll support you as needed."
Answer: B
Q2) Leadership is best defined as:
A) an interpersonal process of participating by encouraging fellowship.
B) delegation of authority and responsibility and the coordination of activities.
C) inspiring people to accomplish goals through support and confidence building.
D) the integration of resources through planning, organizing, and directing.
Answer: C
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Chapter 2: Change and Innovation
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Q1) Individual members of a group will adapt to change at different rates. Which of the following groups would take the longest to accept change?
A) Early adopters
B) Late majority
C) Innovators
D) Laggards
Answer: D
Q2) A nurse manager recognizes that her staff's emotional responses to organizational change are similar to:
A) adaptation techniques.
B) integrative tactics.
C) symptoms of mental illness.
D) the grief model.
Answer: D
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Page 4
Chapter 3: Organizational Climate and Culture
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Q1) What drivers of change are impacting nursing care? (Select all that apply.)
A) Transparent communication
B) Overabundance of nursing staff
C) Evidence-based practice
D) Information technology
E) Reduced acute care needs
Answer: A, C, D
Q2) The nursing manager of a telemetry unit has developed a policy in which all nurses automatically are scheduled to have a day off from work on their birthday unless they request to work on that day. He also gives a small gift to each nurse who becomes certified in his or her specialty area. This manager's actions are positively affecting the _____ of the unit.
A) climate
B) culture
C) interactions
D) operation
Answer: B
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Page 5
Chapter 4: Managerial Decision Making
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Q1) A client becomes confused after surgery. He is in a room farthest away from the nurses' station. The client tries to get out of bed several times during the shift. The nurse informs the physician and obtains an order for soft restraints. In addition she moves the client close to the station and assigns a sitter to watch him. Which of the following did the nurse utilize? (Select all that apply.)
A) Clinical judgment
B) Clinical decision making
C) Autocratic decision
D) Financial decision
Q2) Nurses working on the intermediate care unit have had many hours of overtime in the last 6 months. Before forming a team, the nurse manager gathers data about patient condition severity, staffing ratios, educational levels of staff, and personality mixes on each shift. What level of decision making is this process?
A) Establishment of solution evaluation criteria
B) Evaluation of the alternative solutions
C) Identification of a problem, issue, or situation
D) Search for alternative solutions or actions
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Chapter 5: Managing Time and Stress
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Q1) Nurses who must manage unplanned and regular responsibilities simultaneously may experience:
A) complexity compression.
B) resilience.
C) moral distress.
D) empowerment.
Q2) Job stress can accumulate into: (Select all that apply.)
A) better time management skills.
B) feelings of elation.
C) burnout.
D) physical exhaustion.
Q3) An internal obstacle that may contribute to moral distress is:
A) lack of resources.
B) lack of confidence.
C) lack of structure.
D) lack of processes.
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Chapter 6: Legal and Ethical Issues
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Q1) A Middle Eastern man has just been diagnosed with terminal cancer. The family has asked the medical and nursing staff to keep this information from the patient because in their culture they are fearful of delivering bad news as it may cause the patient to give up hope. Which ethical principles and dilemmas might be faced by nursing staff? (Select all that apply.)
A) Justice
B) Autonomy
C) Veracity
D) Confidentiality
Q2) Which ethical principle is violated when there are insufficient community resources to meet the needs of low-income families?
A) Nonmaleficence
B) Autonomy
C) Beneficence
D) Justice
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Chapter 7: Communication Leadership
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Q1) A client's wife is concerned about her husband's declining health. He has been admitted with an acute myocardial infarction and has had two myocardial infarctions before this admission. He is not a candidate for surgery. She and her husband have discussed "no breathing machine" for long-standing care, but she is unsure of his wishes if he were to need a "breathing machine" for a short period. The nurse discusses his current condition and care with the client and his wife. She also organizes a team meeting consisting of the client's physicians, social worker, pastoral care person, and nursing staff. During this meeting, the nurse helps the wife share her concerns and the client's concerns with the rest of the team. What type of communication technique is being utilized by the nurse? (Select all that apply.)
A) Bargaining
B) Negotiation
C) Persuasion
D) Spiritual assessment
E) Collective action
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Chapter 8: Team Building and Working With Effective Groups
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Q1) What are some of the positive aspects of utilizing teams in a professional setting such as health care? (Select all that apply.)
A) Teams have the potential to perform at higher levels than individuals on their own.
B) Teams are a way to keep decision making at the management level.
C) Teams may contribute to constraints within the budget.
D) Teams can motivate individual members and provide encouragement, constructive criticism, and praise.
E) Teams can make individuals feel more connected to the larger organization.
Q2) In planning for an effective committee meeting, what are some of the roles of the leader? (Select all that apply.)
A) Allowing the group to set the agenda during the meeting
B) Speaking for every member to ensure all opinions are heard
C) Identifying the purpose of the meeting
D) Ensuring that the meeting starts and ends on time
E) Keeping the meeting directed toward accomplishing objectives
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Chapter 9: Delegation in Nursing
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Q1) The nurse has asked a nurse's aide to greet a postoperative patient who has just arrived on the unit and to determine whether he is in stable condition. This act of delegation is an example of a nurse inappropriately delegating:
A) assessment of the patient.
B) evaluation of an intervention.
C) nursing judgment.
D) teaching to a delegate.
Q2) The nurse manager determines that communication style is contributing to problems with delegation on her unit. What tool is used to teach principles of communication, leadership, situation monitoring, and mutual support?
A) American Nurses Association (ANA)
B) Agency for Healthcare Quality and Research (AHRQ)
C) Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)
D) Institute for Healthcare Improvement (IHI)
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11
Chapter 10: Power and Conflict
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Q1) Subunit power is derived from:
A) being independent within the organization.
B) providing resources on which the organization most depends.
C) supplying multiple cross-trainable functions within the organization.
D) voicing unique opinions and values within the organization.
Q2) Nurses derive much of their power from being:
A) authority figures in emergent situations.
B) central to the delivery of health care services.
C) organized through public associations.
D) the care coordinator of the health care team.
Q3) Which of the following statements describe structural determinants of power within an organization? (Select all that apply.)
A) Power is derived from independence.
B) Power is derived from providing resources.
C) Power is derived from certainty.
D) Power is derived from being irreplaceable.
E) Power is derived from the ability to affect the decision process.
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Chapter 11: Workplace Diversity
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Q1) What is the most modifiable factor in the provision of equitable health care?
A) Availability of services
B) Socioeconomic status
C) Care that is responsive to cultural needs
D) Education level
Q2) When nurses portray an attitude that their cultural group is superior to another, it is known as practicing the concept of cultural:
A) diversity.
B) egocentrism.
C) ethnocentrism.
D) prejudice.
Q3) Equity is the absence of avoidable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically. Which group formulated this definition?
A) World Health Organization
B) Affordable Care Act
C) Centers for Disease Control
D) Agency for Healthcare Research and Quality
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13
Chapter 12: Organizational Structure
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Q1) Which of the following statements are accurate when describing responsibility and accountability? (Select all that apply.)
A) The assignment of responsibility assumes accountability.
B) A manager is assigned responsibility by a subordinate.
C) Accountability is the liability for task performance.
D) The assignment of responsibility and the granting of authority create accountability.
E) Accountability flows upward or outward.
Q2) The nursing staff on a critical care unit thought that professional growth could be enhanced. Which of the following interventions would support empowerment of the nursing staff? (Select all that apply.)
A) Eliminating computers and reverting back to paperwork
B) Increasing pay wages for ancillary and professional staff
C) Providing various methods for ongoing education and continuing education units
D) Working to make equipment and medications readily available
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14
Chapter 13: Decentralization and Shared Governance
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Q1) The nurse manager should use which of the following behaviors when implementing a shared governance structure?
A) Autocratic decision making of the manager
B) Coaching the staff to be successful
C) Harboring the vision within the team
D) Reimbursing the staff for overtime
Q2) Nurses' involvement in shared governance is an important component of:
A) practice models.
B) Magnet recognition.
C) increased reimbursement.
D) physician satisfaction.
Q3) Participative leadership was first introduced in the late 1970s. It was adapted by health care organizations to form the basis of shared governance and has evolved to define the roles of nurses and resolve issues related to:
A) patient care.
B) nursing liability
C) nursing salaries.
D) nursing turnover.
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Chapter 14: Strategic Management
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Q1) The guiding framework that describes the organization's purpose and future direction is the:
A) futuristic guidelines.
B) mission and vision.
C) strategic plan.
D) core purpose.
Q2) A hospital with a large surgery department is concerned about surgeons starting their own surgical centers. In relation to the environmental assessment process, this is an example of:
A) an economic monopoly.
B) an external threat.
C) marketplace competition.
D) political strength.
Q3) Operational choices for action that are made to implement a strategy are called: A) tactics.
B) objectives.
C) core values.
D) strategic plans.
Q4) A competitive move or business approach designed to produce a successful outcome is called _______.
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Chapter 15: Professional Practice Models
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Q1) A well-known conceptual framework by Donabedian (1988) is used to promote positive outcomes in an organization. The framework is composed of concepts related to: (Select all that apply.)
A) structure.
B) outcomes.
C) processes.
D) values.
E) quality.
Q2) Mary Lou is a nurse in the critical care unit. She works 12-hour shifts. Each shift she is assigned to one or two critical care patients. She is responsible for planning and delivering the care and treatment for each one of the patients she is assigned to. This is an example of which nursing model?
A) Team nursing
B) Managed care
C) Total patient care
D) Functional nursing
Q3) A(n) _____ is the operational mechanism by which care is actually provided to patients and families.
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17
Chapter 16: Case and Population Health Management
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Q1) Which of the following scenarios would require disease management?
A) A blood pressure screening clinic is started at the senior citizen center.
B) A person with multiple chronic illnesses is admitted to the hospital.
C) A program is started to address diabetes in the Native American population.
D) An initiative is developed to promote fluoride treatments in schools.
Q2) _____ has garnered considerable attention in health care in part because of the publication Crossing the Quality Chasm, a health care quality initiative of the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division).
A) Disease management
B) Development research groups
C) Case management
D) Diagnosis-related groups
Q3) The core element common to all provider interventions in case management (CM), disease management (DM), and population health management (PHM) is:
A) disease preventative care.
B) care coordination.
C) client-centered.
D) population-focused.
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Page 18
Chapter 17: Evidence-Based Practice: Strategies for Nursing Leaders
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Q1) A clinical nurse specialist is meeting one on one with staff nurses while they are working to discuss data about the evidence-based practice. This is known as:
A) academic detailing.
B) champion coaching.
C) individual instruction.
D) professional mentoring.
Q2) A rigorous scientific process used to combine findings from research (usually randomized controlled trials) into a powerful and clinically useful report to guide practice is known as a systematic review. Standard components of a systematic review to consider are: (Select all that apply.)
A) process for initiating.
B) standard reporting format.
C) reliability and validity of data.
D) process for synthesizing the body of evidence.
E) process for finding and assessing individual studies.
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Chapter 18: Quality and Safety
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Q1) A framework for understanding health care improvement has been proposed by the IOM Committee on Quality of Health Care in America. The aims for health care quality improvement propose that health care systems ensure that care is: (Select all that apply.)
A) safe.
B) timely.
C) efficient.
D) cost-controlled.
E) patient-centered.
Q2) A nursing quality improvement supervisor is proposing to enhance the current quality improvement program. One of the most important themes that a nursing quality improvement supervisor should consider is:
A) budgetary considerations.
B) collaboration between health care teams.
C) regular staff training programs.
D) suggestions from patients.
Q3) _____ is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
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Chapter 19: Measuring and Managing Outcomes
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Q1) Donabedian's aspects of quality include: (Select all that apply.)
A) goals.
B) process.
C) policies.
D) structure.
E) outcomes.
Q2) The process of managing outcomes includes five steps. List the five steps below in the correct order.
A) Variances are investigated.
B) Data are collected about outcomes.
C) Trends are identified from data analysis.
D) Changes are implemented and reevaluated.
E) Appropriate service delivery changes are determined.
Q3) _____ involves accounting for patient factors, the intrinsic risks that a patient brings to the health care encounter in the form of clinical and/or demographic factors, before drawing conclusions about the meaning of different values for indicators.
Q4) A(n) _____ is the result or results obtained from the efforts to accomplish a goal.
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Chapter 20: Prevention of Workplace Violence
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Q1) An evaluation of a specific threat of violence and an evaluation of the person making the threat is conducted by ______.
Q2) A nurse executive is a member of a collaborative committee assigned to revise the violence prevention program. After reviewing the program, the committee has determined that the following components already were included in the existing program: a written plan available to all employees, a system for tracking work-related assaults, and specific strategies for reducing the severity of violent injuries. A primary revision recommended by the committee should be the inclusion of a:
A) detailed description of last year's injuries.
B) list of preferred work injury health care providers.
C) method for evaluating the effectiveness of the program.
D) way to determine whether an employee is at fault.
Q3) Administrative controls that may affect workplace violence include: (Select all that apply.)
A) adequate staffing levels.
B) controlled access.
C) development of systems to alert security personnel to threats of violence.
D) conflict resolution.
E) architectural modifications.
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Page 22
Chapter 21: Confronting the Nursing Shortage
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Q1) The future projected demand for nurses is related to the aging population and the increase in:
A) acute illnesses.
B) chronic illnesses.
C) medication costs.
D) primary prevention.
Q2) According to McHugh et al. (2008), a major barrier to the recruitment of IENs has been related to:
A) limited visas.
B) language barriers.
C) cultural differences.
D) the inability of IENs to pass state board exams.
Q3) The newest approach to orienting is referred to as:
A) selecting.
B) onboarding.
C) submersion.
D) precepting.
Q4) Authentic respect for others requiring time, presence, engagement, and intention to seek common ground is called _____.
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Chapter 22: Staffing and Scheduling
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Q1) Assigning individual personnel to work specific hours, days, or shifts and in a specific unit or area over a specified period of time is known as:
A) scheduling.
B) staffing effectiveness.
C) nursing direct-care hours.
D) human resources staffing strategy.
Q2) Key to effective staffing are protocols and processes for daily staffing decision support that are aligned with a budget-sensitive variable staffing plan. In a decentralized model, the responsibility of daily staffing allocation belongs to the:
A) float pool.
B) staffing office.
C) department manager.
D) chief nursing officer.
Q3) The workload standard commonly used in nursing when calculating staffing patterns is:
A) patient days.
B) patient acuity system.
C) average length of stay.
D) nursing care hours per patient day.
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Page 24
Chapter 23: Budgeting, Productivity, and Costing Out Nursing
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Q1) A(n) _____ is the difference between the budgeted and actual amounts.
A) expense
B) margin
C) revenue
D) variance
Q2) The manager of a rural, thriving, nurse-managed clinic is considering purchasing equipment to furnish two additional examination rooms. The resource he must consider is the _____ budget.
A) capital
B) expense
C) operating
D) product line
Q3) A(n) _____ is a written financial plan aimed at controlling the allocation of resources.
Q4) A(n) _____ is the difference between the budgeted and the actual amounts.
Q5) Staff nurses involvement in budgeting is essential because they:
A) have the final authority on the annual budget.
B) have the ability to contain costs at the unit level.
Page 25
C) have a unique perspective on the budgetary process.
D) are the largest user of the budgeted funds for the unit.
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Chapter 24: Performance Appraisal
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Q1) A nurse is receiving her annual performance appraisal. To evaluate the nurse's performance, the manager considers feedback about the nurse's performance from the nurse's peers, subordinates, and patients. This type of evaluation is a:
A) feedforward technique.
B) self-report rating.
C) 360-degree feedback review.
D) peer review.
Q2) A nursing manager is evaluating an employee's dependability, responsibility, and decision-making ability on a scale of 1 to 5. This is an example of what type of rating system?
A) Behaviors
B) Competencies
C) Results
D) Traits
Q3) The ability to perform a skill successfully is:
A) competency.
B) acuity.
C) aptitude.
D) motivation.
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Page 26
Chapter 25: Emergency Management and Preparedness
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Q1) The Joint Commission's (TJC's) emergency management accreditation standards call for hospitals to sustain disaster operations for at least ______ hours.
A) 24
B) 48
C) 72
D) 96
Q2) Hospital leadership should consider which of the following ethical dilemmas prior to experiencing an actual disaster? (Select all that apply.)
A) Which clinical leader will make the decision about distribution of scarce resources
B) Criteria to determine which patients receive aggressive treatment and which will receive palliative care
C) Which nursing staff will be the first to report to the hospital in the event of a disaster
D) How prophylactic pharmaceuticals will be distributed to protect staff and their families
E) Who will be primarily responsible for external communication
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Chapter 26: Data Management and Clinical Informatics
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Q1) Which of the following statements are true regarding health information technology (HIT) applications in nursing services? (Select all that apply.)
A) HIT involves nursing administration, clinical informatics, and effectiveness research.
B) Health information data allow nursing leaders to make informed decisions regarding patient care.
C) HIT is used primarily for financial decision making.
D) Clinical decision support utilizes tools for downloading, collecting, organizing, and analyzing data.
E) HIT is used by senior leaders only.
Q2) What are the primary purposes and benefits of EHRs? (Select all that apply.)
A) Single source of clinical, financial, and legal record
B) Electronic format supports the storage and exchange of continuity of care
C) Available within the health care facility to ensure confidentiality
D) Originate from a single place
E) Virtual record of retrospective, concurrent, and prospective information
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Chapter 27: Marketing
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Q1) Which of the following phrases best describes the focus of health care marketing?
A) Delivery of high-quality patient care
B) Pursuing a high level of patient satisfaction
C) Recruitment and retention of nurses
D) Creating and delivering superior customer value
Q2) A center of excellence for geriatric care is put in place in a large retirement community. This is an example of which of the following marketing concepts?
A) Segmentation
B) Targeting
C) Product differentiation
D) Positioning
Q3) Marketing mix from a seller's point of view includes:
A) client service, charges, comfort, and connecting.
B) customer solution, cost, convenience, and communication.
C) patient, physicians, perfection, and publicity.
D) product, price, place, and promotion.
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