Test Bank For Leadership And Management Nurses Core Competencies 3rd Edition By Finkelman

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Leadership and Management Nurses Core Competencies 3rd Edition Finkelman Test Bank

Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care 3rd Edition Test Bank

Chapter 1

Question #1

Type: MCSA

The nurse manager has asked that all staff nurses develop effective leadership competencies. How should the staff nurses interpret this request?

  1. This is an unrealistic expectation, because only managers are leaders.
  2. This is possible if the nurses learn about and use relevant leadership and management theories and styles.
  3. In order to become leaders, the staff nurses will have to emphasize control, competition, and getting the job done.
  4. Unless the staff nurses possess the traits of a natural born leader, this is an unrealistic expectation.

Correct Answer: 2

Rationale 1: A nurse does not need to have a formal management position with a management title to be a leader; if nurses demonstrate leadership competencies, they are considered nurse leaders.

Rationale 2: In today’s healthcare environment, nurses must have knowledge of relevant leadership and management theories and styles. This knowledge helps nurses emerge as leaders. Nurses are also leaders of their own nursing practices.

Rationale 3: Control, competition, and getting the job done are past theories and styles that are not as useful in today’s environment.

Rationale 4: Leadership is a skill that can be learned.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 8 Analyze the need for more nursing leaders.

Page Number: p. 7

 

 

Question #2

Type: MCSA

Peter Drucker’s view of management stimulated the shift toward the realization of the importance of participatory organizations. Which option provides a scenario that is an example of a participatory organization?

  1. The control of the organization is centralized, and decisions are made by upper-level management.
  2. Staff nurses are expected to provide support and nurturing for management’s decisions.
  3. The organization’s approach to leadership is autocratic and bureaucratic.
  4. Staff nurses provide input into planning and changes for their own unit.

Correct Answer: 4

Rationale 1: In participatory organizations, the control of the organization is decentralized and many decisions are made by those “on the front lines” of the organization.

Rationale 2: The theory is that the staff should be nurtured to promote greater leadership competency.

Rationale 3: According to Drucker, when staff participate in the core functions of management, the organization is more effective.

Rationale 4: According to Drucker, when staff participate in the core functions of management such as planning and changes for their own units, the organization is more effective.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: pp. 7-8

 

 

Question #3

Type: MCSA

Which behavior demonstrates the nurse’s competency as an emotionally intelligent leader?

  1. The nurse is proficient in technical skills.
  2. The nurse relies on policies, not options.
  3. The nurse supports team members.
  4. Productivity is not a major concern.

Correct Answer: 3

Rationale 1: While technical skill is important for all nurses, it is not a hallmark of a competent leader.

Rationale 2: Chaos theory states that solutions are not always clear and policies might not always be applied easily; other options might need to be considered.

Rationale 3: In Emotional Intelligent theory, team members support each other and feel supported by the team leader.

Rationale 4: This statement reflects the country club leadership style.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: p. 11

 

 

Question #4

Type: MCSA

The nurse executive of a healthcare organization wishes to prepare and develop nurse managers for several new units that the organization will open next year. What should be the primary goal for this work?

  1. Focus on rewarding current staff for doing a good job with their assigned tasks by selecting them for promotion.
  2. Prepare these managers so that they will focus on maintaining standards of care.
  3. Prepare these managers to oversee the entire healthcare organization.
  4. Prepare these managers to interact with hospital administration.

Correct Answer: 2

Rationale 1: This is an illustration of the “Peter Principle,” which is promoting people to management positions just because they are doing a good job in their current position. Management level employees should be selected based upon the potential ability to manage and their desire to do so.

Rationale 2: Nurse managers are directly responsible for maintaining standards of care, and managing fiscal resources and development of staff.

Rationale 3: This is not the responsibility of most nurse managers. In this question, it is clear that managers of nursing units are being prepared and developed.

Rationale 4: Interacting with hospital administration is a rare requirement for a unit nurse manager and, if it is required, it is not as important as maintaining standards of care.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 05. Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Page Number: p. 18

 

 

Question #5

Type: MCSA

Describe the primary focus of a manager in a knowledge work environment.

  1. Developing the most effective teams.
  2. Taking risks.
  3. Routine work.
  4. Understanding the history of the organization.

Correct Answer: 1

Rationale 1: The most important focus of this manager is on developing and supporting effective teams, utilizing the knowledge of many.

Rationale 2: Risk taking is a part of knowledge work, but is not the most important of this manager’s tasks.

Rationale 3: Knowledge work is a combination of routine and non-routine work, so the manager will have focus on the routine. This is not the manager’s most important focus.

Rationale 4: Understanding the history of the organization is important as it will help the manager work within the organization, but it is not the most important focus.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Page Number: pp. 11-12

 

 

Question #6

Type: MCSA

The nursing staff communicates that the new manager has a focus on the “bottom line,” and little concern for the quality of care. What is likely true of this nurse manager?

  1. The manager is looking at the total care picture.
  2. The manager is communicating the importance of a caring environment.
  3. The manager understands the organization’s values and how they mesh with the manager’s values.
  4. The manager is unwilling to listen to staff concerns unless they have an impact on costs.

Correct Answer: 4

Rationale 1: This action would enable the manager to make a decision and not just evaluate the financial status of the environment.

Rationale 2: If the manager is indeed focusing only on the “bottom line,” the manager is not promoting a caring environment on the unit.

Rationale 3: The organization may set great value on the “bottom line,” but also must be concerned about quality of care. Problems with quality of care can impact the “bottom line.” If the manager believes the financial status of the organization is the only organization value, a misunderstanding has probably occurred.

Rationale 4: This manager has primary focus on the financial issues associated with provision of care. This will make the manager ineffective in the role.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 05. Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Page Number: p. 15

 

 

Question #7

Type: MCSA

A very young nurse has been promoted to nurse manager of an inpatient surgical unit. The nurse is concerned that older nurses may not respect the manager’s authority because of the age difference. How can this nurse manager best exercise authority?

  1. Use critical thinking to solve problems on the unit.
  2. Give assignments clearly, taking staff expertise into consideration.
  3. Understand complex healthcare environments.
  4. Maintain an autocratic approach to influence results.

Correct Answer: 2

Rationale 1: Critical thinking is important for every RN, not just a manager and will not distinguish the manager’s authority.

Rationale 2: Giving clear assignments is a characteristic of authority. The young nurse who takes staff expertise into consideration when making assignments is likely to be more successful in leading the group.

Rationale 3: Nurse managers do work in complex healthcare environments, but must create an appropriate organizational environment as a way of exercising authority.

Rationale 4: In autocratic leadership, one person has all of the power. This is not a good approach for a younger leader to adopt when working with a group of older, more experienced nurses.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 05. Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Page Number: pp. 10, 19

 

 

Question #8

Type: MCSA

What statement, made in the morning shift report, would help an effective manager develop trust on the nursing unit?

  1. “I know I told you that you could have the weekend off, but I really need you to work.”
  2. “The others work many extra shifts, why can’t you?”
  3. “I’m sorry, but I do not have a nurse to spare today to help on your unit. I cannot make a change now, but we should talk further about schedules and needs.”
  4. “I can’t believe you need help with such a simple task. Didn’t you learn that in school?”

Correct Answer: 3

Rationale 1: To develop trust, managers who make promises to staff must keep the promise.

Rationale 2: This statement implies that the staff nurse is not a team player. It also sets up one nurse against the remainder of the staff. Effective managers must be fair and supportive with all staff.

Rationale 3: This manager is standing up for staff by not allowing another unit to take a nurse today.

Rationale 4: This statement is belittling to the staff nurse. This attitude does not demonstrate trust that staff performances will be effective.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Page Number: p. 19

 

 

Question #9

Type: MCSA

The nurse has just been promoted to unit manager. Which advice, offered by a senior unit manager, will help this nurse become inspirational and motivational in this new role?

  1. “If you make a mistake with your staff, admit it, apologize, and correct the error if possible.”
  2. “Don’t be too soft on the staff. If they make a mistake, be certain to reprimand them immediately.”
  3. “Give your best nurses extra attention and rewards for their help.”
  4. “Never get into a disagreement with a staff member.”

Correct Answer: 1

Rationale 1: Managers need to be honest and forthcoming with staff, which includes taking responsibility for one’s own actions and errors. This also provides a positive role model for the staff.

Rationale 2: When errors occur, the manager should use the opportunity for improvement, not punishment.

Rationale 3: When staff feel some staff are given extra credit, they will feel uncomfortable with the manager and resentment will build.

Rationale 4: Staff need to feel that they can share their feedback, positive or negative, and not feel threatened when they disagree with the manager.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Page Number: pp. 19-20

 

 

Question #10

Type: MCMA

A key skill in today’s healthcare environment is the ability to collaborate with others. A nurse identifies need to improve in this area. Which skills or traits would be essential for an effective nurse manager to develop to improve collaboration with others?

Standard Text: Select all that apply.

  1. Flexibility
  2. The ability to share information and ideas
  3. A service orientation
  4. A desire to work hard
  5. The ability to listen to others

Correct Answer: 1,2,5

Rationale 1: In order to collaborate effectively, the nurse must be flexible, must be willing to listen to others and include them in his or her work, and work together toward the best solution to any problems that might arise.

Rationale 2: In order to collaborate effectively, the nurse must be flexible, must be willing to listen to others and include them in his or her work, and must work together toward the best solution to any problems that might arise.

Rationale 3: While a service orientation is common among nurses, it is not an essential trait for collaboration.

Rationale 4: This is not an essential skill for ability to collaborate.

Rationale 5: In order to collaborate effectively, the nurse must be flexible, must be willing to listen to others and include them in his or her work, and must work together toward the best solution to any problems that might arise.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 02. Interpret the implications of change in the healthcare delivery system on nurse leadership.

Page Number: pp. 12-13

 

 

Question #11

Type: MCMA

The new chief operating officer (COO) of the healthcare facility states, “I believe that Fiedler had it right in his Contingency theory.” The nurse executive understands that this COO will work to create which type of environment in the facility?

Standard Text: Select all that apply.

  1. Positive relationships between leaders and employees
  2. A low amount of structure in task assignments
  3. A decentralization of power from the leadership to the employees
  4. A static approach to leadership matters
  5. Leadership must change as the situation changes

Correct Answer: 1,5

Rationale 1: Fiedler believed that the best type of situation occurs when there are positive leader-member relations.

Rationale 2: Fiedler believed that high task structure resulted in the best situations.

Rationale 3: Fielder believed that high position power resulted in the best situations.

Rationale 4: This is not a static approach to leadership, but rather a situational approach.

Rationale 5: In this theory, as the groups and situations change, leadership also changes.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: p. 10

 

 

Question #12

Type: MCMA

The nurse wishes to improve personal Emotional Intelligence (EI) in hopes of a promotion to nurse manager. Which skills are important for this nurse to improve?

Standard Text: Select all that apply.

  1. Self-confidence
  2. Knowledge base of nursing
  3. Proficiency in technical skills
  4. Empathy
  5. Ability to initiate change

Correct Answer: 1,4,5

Rationale 1: EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.

Rationale 2: While this is an important aspect of professional nursing, it is not a competency of EI.

Rationale 3: While this is an important aspect of professional nursing, it is not a competency of EI.

Rationale 4: EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.

Rationale 5: EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: p. 11

 

 

Question #13

Type: MCMA

The nurse executive wishes to be a transformational leader. What should this nurse focus on to become effective in this role?

Standard Text: Select all that apply.

  1. Improving interpersonal skills
  2. Advancing personal formal education
  3. Identifying mentors
  4. Becoming an expert clinician
  5. Creating a vision for the future of nursing in the facility

Correct Answer: 1,5

Rationale 1: Transformational leadership requires interpersonal skills and having a vision for the future.

Rationale 2: While formal education might increase the nurse’s knowledge base for decision making, it is not a requirement for transformational leadership.

Rationale 3: Having a mentor is not a requirement of transformational leadership.

Rationale 4: This does not guarantee that the nurse will be a transformational leader.

Rationale 5: Transformational leadership requires interpersonal skills and having a vision for the future.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Explain the importance of transformational leadership today and the relationship to the recommendations of the Institute of Medicine.

Page Number: pp. 13-14

 

 

Question #14

Type: MCMA

Compare and contrast manager roles and leadership roles by choosing the options that are more aligned with the manager role.

Standard Text: Select all that apply.

  1. Focus is change
  2. Have the ability to influence others
  3. Control the environment
  4. Focus is on people
  5. Focus on efficiency

Correct Answer: 3,5

Rationale 1: The manager accepts the status quo, while the leader challenges it.

Rationale 2: The manager controls people, while the leader influences others.

Rationale 3: The manager controls the environment, patient care, and the staff that deliver that care.

Rationale 4: The leader focuses on people while the manager focuses on systems and structure.

Rationale 5: Managers focus on efficiency, while leaders focus on effectiveness.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 05. Compare and contrast characteristics, roles, and responsibilities of leaders and managers.

Page Number: p. 17

 

 

Question #15

Type: MCMA

Which scenarios are examples of issues facing nursing in an age of healthcare change?

Standard Text: Select all that apply.

  1. Six of the 18 nurses working on a unit speak English as their second language.
  2. The hospital has decreased medication errors dramatically in each of the last two quarters.
  3. The unit manager has been asked to use a creative strategy for scheduling with fewer staff.
  4. There was a report on the nightly news about recruitment and retention of nurses.
  5. An Emergency Room nurse was injured by a patient seeking drugs.

Correct Answer: 1,3,4,5

Rationale 1: An issue is the need for nurses to work as a team, despite differences in age, language, and culture.

Rationale 2: There is a need to develop a culture of safety, which this hospital is doing already.

Rationale 3: An issue is the need to be creative in doing more with less.

Rationale 4: An issue is the increasing press coverage of recruitment and retention of nurses.

Rationale 5: An issue is the increase in workplace violence.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 02. Interpret the implications of change in the healthcare delivery system on nursing leadership.

Page Number: pp. 3, 15-16

 

 

Question #16

Type: MCMA

Typically, the nurse manager of a unit uses a participatory style of leadership. Today, a patient suffered a cardiac arrest. The manager took over the patient’s care, issuing orders, and expecting staff to obey them immediately. Which type of leadership did this manager exhibit today?

Standard Text: Select all that apply.

  1. Bureaucratic
  2. Autocratic
  3. Permissive
  4. Directive
  5. Authoritarian

Correct Answer: 2,4,5

Rationale 1: This style is focused on organizational rules and policies.

Rationale 2: Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.

Rationale 3: This is a “hands-off” approach.

Rationale 4: Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.

Rationale 5: Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: p. 9

 

 

Question #17

Type: MCSA

There have been several patient complaints that the staff members of the unit are disorganized and that “no one seems to know what to do or when to do it.” The staff members concur that they don’t have a real sense of direction and guidance from their leader. Which type of leadership is this unit experiencing?

  1. Autocratic
  2. Bureaucratic
  3. Laissez-faire
  4. Authoritarian

Correct Answer: 3

Rationale 1: Autocratic and authoritarian leaders make decisions for the group and assume people are incapable of making independent decisions. While this is not always a good leadership style, it is unlikely the complaints in this scenario would occur.

Rationale 2: Bureaucratic leaders depend upon policy and rules. This is not always a good style of leadership, but it is unlikely the complaints in this scenario would occur.

Rationale 3: This style of leadership can be so detached that there is no direction or real leadership. This will often be reflected in the work of the staff and the perceptions of the patients.

Rationale 4: Autocratic and authoritarian leaders make decisions for the group and assume people are incapable of making independent decisions. While this is not always a good leadership style, it is likely the complaints in this scenario would occur.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: p. 9

 

 

Question #18

Type: MCMA

Compare and contrast transformational leaders and bureaucratic leaders by choosing the options that are examples of transformational leadership.

Standard Text: Select all that apply.

  1. The leader focuses on organizational functions and the structure to get work done.
  2. The most common type of leader in today’s healthcare arena.
  3. This leader follows the leadership style that is recommended by the Institute of Medicine.
  4. The leader allows the staff to take risks to improve care within the organization.
  5. The leader seeks to guide staff in their understanding of their importance to the work of the facility.

Correct Answer: 2, 3,4,5

Rationale 1: This is a characteristic of a bureaucratic organization and leadership—stick to the structure and identified functions.

Rationale 2: This is the transformational leader.

Rationale 3: The IOM recommended transformational leadership in its report Leadership by Example (2003).

Rationale 4: This is a quality of transformational leadership.

Rationale 5: This is a quality of transformational leadership.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Explain the importance of transformational leadership today and the relationship to the recommendations of the Institute of Medicine.

Page Number: pp. 8, 9, 13

 

 

Question #19

Type: MCSA

Select the reason the transformational leadership sometimes fails in an organization.

  1. The need to change is addressed urgently.
  2. The coalition guiding the facility is too diverse.
  3. Influence, power, and empowerment are all used.
  4. Poor recognition of organizational culture and does not value staff.

Correct Answer: 4

Rationale 1: Failure often results from a lack of urgency.

Rationale 2: Failure often results from a lack of a guiding diverse coalition.

Rationale 3: Failure often results from not applying influence, power, or empowerment.

Rationale 4: This is a reason for failure of transformational leadership.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 04. Explain the importance of transformational leadership today and the relationship to the recommendations of the Institute of Medicine.

Page Number: p. 14

 

 

Question #20

Type: MCSA

The rural hospital has experienced a very small patient census over the last two months. Salary costs for this period have been over budget, and the nurse manager announces that all nurses will be required to rotate taking unpaid furlough days until the census improves. Which type of leadership does this manager exemplify?

  1. Impoverished leadership
  2. Country club leadership
  3. Authority-obedience leadership
  4. Team leadership

Correct Answer: 3

Rationale 1: This style of leadership has limited interest in production or people.

Rationale 2: This type of leader has an interest in people, but productivity is not a major focus.

Rationale 3: This type of leadership focuses on efficiency and getting the job done and is not as concerned with staff members as people, but in this case this most likely is the only approach that the nurse manager can take.

Rationale 4: This type of leader is very concerned about productivity and about staff, morale, and satisfaction.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: p. 10

 

 

Question #21

Type: MCSA

Choose the option that best describes knowledge management theory.

  1. Leaders are intelligent.
  2. Focus is on routine work.
  3. The knowledge worker is critical as an organization asset.
  4. Evidence-based practice is the core.

Correct Answer: 3

Rationale 1: Knowledge is more important than intelligence.

Rationale 2: Focus is on routine and non-routine work.

Rationale 3: Knowledge management sees the knowledge worker such as nurses as critical assets to success.

Rationale 4: Evidence-based practice is important, but so are other concerns such as quality.

Global Rationale: NA

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Analyze the key modern leadership theories compared to older theories and implications for nursing leadership and management.

Page Number: p. 10

 

 

Question #22

Type: MCMA

The staff nurse is considered to be a leader by nursing peers on the unit. What characteristics does this nurse likely possess?

Standard Text: Select all that apply.

  1. Awareness of happenings throughout the hospital
  2. Ability to encourage newly hired nurses
  3. Skepticism about using technology for standard nursing tasks
  4. Adaptability
  5. Collaboration skills

Correct Answer: 1,2,4,5

Rationale 1: The staff nurse can also be a leader. The same aspects of leadership and characteristics of a person holding a leadership position are important for leaders at the staff nurse level.

Rationale 2: The staff nurse can also be a leader. The same aspects of leadership and characteristics of a person holding a leadership position are important for leaders at the staff nurse level.

Rationale 3: An important aspect of being a leader is being able to see the benefits of technology.

Rationale 4: The staff nurse can also be a leader. The same aspects of leadership and characteristics of a person holding a leadership position are important for leaders at the staff nurse level.

Rationale 5: The staff nurse can also be a leader. The same aspects of leadership and characteristics of a person holding a leadership position are important for leaders at the staff nurse level.

Global Rationale: NA

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO

Page Number: p. 20

 

 

Question #23

Type: MCMA

The AONE identifies important principles for nurse managers and executives. Which statements represent these principles?

 

Standard Text: Select all that apply.

  1. Relationships are important.
  2. The core of nursing is caring.
  3. Knowledge is synthesized.
  4. Care is patient- and family-centered.
  5. Nurse managers are the same as nurse leaders.

Correct Answer: 1, 3, 4

Rationale 1: This is an AONE principle.

Rationale 2: The core of nursing is caring and knowledge.

Rationale 3: This is an AONE principle.

Rationale 4: This is an AONE principle

Rationale 5: This is not an AONE principle—not all managers are leaders.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO

Page Number: p. 16

 

 

Question 24

Type: MCMA

Which strategy supports the American Association of Colleges of Nursing description of a professional practice environment?

Standard Text: Select all that apply.

  1. Provide an effective staff education program.
  2. Promote leadership advancement.
  3. Attract nurses to leadership positions by increasing salaries.
  4. Engage nurses in decision-making.
  5. Nursing philosophy focus is on collaboration.

Correct Answer: 1, 2, 4

Rationale 1: This is part of the AACN perspective of professional practice environment.

Rationale 2: This is part of the AACN perspective of professional practice environment

Rationale 3: Leadership opportunity is greater than salaries.

Rationale 4: This is part of the AACN perspective of professional practice environment

Rationale 5: The AACN believes collaboration should be part of the philosophy, but should also include quality and safety, and collaboration should be interprofessional.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Compare and contrast the leadership and management competencies described by AONE, ANA, and AACN.

Page Number: p. 21

 

 

Question #25

Type: MCSA

Keeping Patients Safe and The Future of Nursing reports both address important nursing issues related to leadership and management. What aspect of healthcare delivery do they both emphasize in relationship to nurses?

  1. Nursing image is an important aspect of the profession and its success.
  2. Nurses should be leaders in quality improvement, but are not fully prepared for this leadership.
  3. Nursing leadership is focused on formal management positions in healthcare organizations.
  4. Nursing scope of practice is important and needs to be broadened.

Correct Answer: 2

Rationale 1: Nursing image is not a strong focus in both reports.

Rationale 2: Both reports recognize need for nurses to be leaders in quality improvement, but there is need for more preparation in quality improvement and leadership.

Rationale 3: Nurses are leaders in many positions, not only in management, and this is not addressed in both reports.

Rationale 4: The Future of Nursing report comments on scope of practice, but not Keeping Patients Safe.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Compare and contrast the leadership and management competencies described by AONE, ANA, and AACN.

Page Number: p. 4

 

 

Question #26

Type: MCSA

 

Porter-O’Grady, a nursing leader, comments on a critical concern for nursing, as noted in this chapter. What is this concern?

  1. Need to increase the number of advanced practice registered nurses
  2. Need for more nursing publications
  3. Need to engage and embrace change
  4. Need for more nursing research

Correct Answer:

Rationale 1: This is important, but not what Porter-O’Grady comments on.

Rationale 2: This is important, but not what Porter-O’Grady comments on.

Rationale 3: This is what Porter-O’Grady thinks the nursing profession must do to succeed in the changing healthcare environment.

Rationale 4: This is important, but not what Porter-O’Grady comments on.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, assessment

Learning Outcome: LO 07. Discuss the implications of the image of nurses in the nursing profession.

Page Number: p. 6

 

 

Question #27

Type: MCSA

 

Which modern leadership theory focuses on changes within the organization and external to the organization?

  1. Contingency
  2. Connective
  3. Leadership 2.0
  4. Deming’s theory

Correct Answer: 1

Rationale 1: This describes contingency theory.

Rationale 2: This theory focuses on caring and collaboration.

Rationale 3: This theory focuses on the integration of multiple theories.

Rationale 4: This theory focuses on teams/groups.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, assessment

Learning Outcome: LO 07. Discuss the implications of the image of nurses in the nursing profession.

Page Number: p. 9

 

 

Question #28

Type: MCSA

 

A nurse manager is preparing performance appraisal evaluations. Which management function is the manager demonstrating?

  1. Planning
  2. Organizing
  3. Leading
  4. Controlling

Correct Answer: 4

Rationale 1: This is not planning. If the manager took the information from performance appraisals and made a staff education plan, it would be planning.

Rationale 2: This is not organizing, but if the manager was deciding how she would do her performance appraisals and in what order, this would be organizing.

Rationale 3: The focus in not on the function of leading—though some aspects of leading are found in all of the other three management functions.

Rationale 4: This function is controlling as the manager is ensuring quality and meeting standards.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, implementation

Learning Outcome: LO 08. Analyze the need for nursing leaders.

Page Number: p. 17

 

 

Question #29

Type: MCSA

 

Which of The Future of Nursing report recommendations will have an impact on nursing leadership?

  1. Associate degree nursing programs should increase by 20%.
  2. Nurses who provide direct care are critical and provide leadership.
  3. The rate of completion of the doctoral degree is at a high level.
  4. There should be an increase of 80% in BSN graduates.

Correct Answer:

Rationale 1: This is not a recommendation.

Rationale 2: This is not a recommendation.

Rationale 3: This is not a recommendation.

Rationale 4: This is a recommendation and is designed to increase nursing leadership by recognizing the need for the BSN as the entry-level degree for nursing.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, implementation

Learning Outcome: LO 08. Analyze the need for nursing leaders.

Page Number: p. 5

 

 

Question #29

Type: MCSA

 

 

The Future of Nursing report recommends which of the following that will have an impact on nurse leaders and quality care?

  1. Associate degree programs in nursing should be increased by 20%.
  2. The number of BSN graduates is at an appropriate number.
  3. The doctorate degree is at the best level it has been.
  4. An increase of 80% in BSN graduates is the goal.

Correct Answer: 4

Rationale 1: This is not included in the recommendations. The focus is on BSN graduates, not associate degree graduates.

Rationale 2: This is not included in the recommendations. We need more BSN graduates.

Rationale 3: This is not included in the recommendations. Doctoral degrees need to increase with the goal to double the number by 2010.

Rationale 4: This is included in the recommendations. The goal is to increase BSN graduates 80% by 2020.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, assessment

Learning Outcome: LO 01. Examine The Future of Nursing report and its relevance to nursing leadership.

Page Number:  5

 

Question #30

Type: MCMA

 

The Future of Nursing report not only identifies recommendations for the nursing profession, but also priorities for nursing research. Which of the following are included in the priorities?

Standard Text: Select all that apply.

 

  1. Teamwork
  2. Communication
  3. Quality care
  4. Nursing leadership
  5. Technology

Correct Answer: 1, 4, 5

Rationale 1: Teamwork is include in the nursing practice research priority and is critical to effective practice.

Rationale 2: Communication is not mentioned in the research priorities. It is important, but not specifically mentioned in the priorities.

Rationale 3: Nursing leadership is one of the three major priority areas.

Rationale 4: Technology is part of the practice research priority.

Global Rationale:

 

Cognitive Level: Understanding

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, assessment

Learning Outcome: LO 01. Examine The Future of Nursing report and its relevance to nursing leadership.

Page Number: pp. 5-6

Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care 3rd Edition Test Bank

Chapter 3

Question 1

Type: MCSA

The manager of a maternal-child health unit announces that the unit will be redesigned to help meet the Institute of Medicine healthcare competencies. What scenario is one that the staff of this unit might expect?

  1. Nursery, labor and delivery, and postpartum nurses will be cross-trained to work in each of these areas.
  2. The nurses will be expected to participate in telehealth throughout a three state region.
  3. There will be a reduction in staff numbers.
  4. The unit will be closed for remodeling.

Correct Answer: 1

Rationale 1: Cross-training is an example of redesign or re-engineering of healthcare.

Rationale 2: This would require re-regulating professional practice.

Rationale 3: This is an example of rightsizing.

Rationale 4: This is not what is meant by redesign in this case.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 02. Discuss critical nursing issues related to reengineering, redesigning, re-regulating, rightsizing, and restructuring.

Page: pp. 67-68

 

Question 2

Type: MCMA

In which situation would it be necessary to re-regulate practice?

Standard Text: Select all that apply.

  1. Nurses are asked to cross-train to another specialty.
  2. An insurance company opens a nationwide nurse call line.
  3. The hospital hires unlicensed assistive personnel.
  4. A nursing school revises its curriculum.
  5. The healthcare organization goes national and hopes to encourage mobility among its administrative nurses.

Correct Answer: 2,5

Rationale 1: This is a redesign practice used by many organizations to compensate for the nursing shortage.

Rationale 2: The use of telemedicine requires re-regulating professional practice because nurses can use this technology to provide care in situations in which the patient is in a different state from the one where the nurse is licensed and located.

Rationale 3: This is a redesign practice used by many organizations to compensate for the nursing shortage.

Rationale 4: This is an example of restructuring in which nursing education attempts to prepare nurses for the “real world.”

Rationale 5: This mobility would result in the nurses working in different states from where they live and are licensed.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 02. Discuss critical nursing issues related to reengineering, redesigning, re-regulating, rightsizing, and restructuring.

Page: p. 68

 

Question 3

Type: MCSA

Management has called a meeting to discuss the increase in negative patient satisfaction surveys. Which stage of Lewin’s model of change does this represent?

  1. Moving
  2. Refreezing
  3. Unfreezing
  4. Working

Correct Answer: 3

Rationale 1: The moving stage is the planning phase of the model and focuses on the development of goals and outcomes.

Rationale 2: The refreezing stage is the implementing step in the model where change becomes a part of the work environment and its processes.

Rationale 3: The unfreezing stage is the first step in Lewin’s model of change and includes recognition of a problem.

Rationale 4: Working is not a stage of Lewin’s model.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 05. Compare and contrast two key change theories.

Page: p. 71

 

Question 4

Type: MCSA

The hospital would like to decrease the amount of medication errors made secondary to transcription errors. In order to accomplish this, it is hoped that all physicians will be trained in the use of computerized physician orders by the end of the fiscal year. This is an example of which stage of Lewin’s model of change?

  1. Refreezing
  2. Unfreezing
  3. Moving
  4. Working

Correct Answer: 3

Rationale 1: The refreezing stage is the implementing step in the model where change becomes a part of the work environment and its processes.

Rationale 2: The unfreezing stage is the first step in Lewin’s model of change and includes recognition of a problem.

Rationale 3: This is an example of the moving stage, because the hospital has developed a goal and outcomes to help resolve the problem.

Rationale 4: Working is not one of the stages of the model.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 05. Compare and contrast two key change theories.

Page: p. 71

 

Question 5

Type: MCMA

Which activities represent the eight-step process for organizational change?

Standard Text: Select all that apply.

  1. Management has created a sense of urgency for the change by publishing outcome data on the organization’s intranet.
  2. Management has worked to develop and communicate a vision that can be shared by all employees.
  3. Management has empowered employees to make changes.
  4. Management is engaged in “deep change.”
  5. Management has orchestrated and celebrated some short-term successes along the path to change.

Correct Answer: 1,2,3,5

Rationale 1: The eight steps are create a sense of urgency; create a guiding coalition and mobilize commitment; form strategic vision and initiatives; enlist volunteer army; enable action by removing barriers; generate short-term wins; sustain acceleration; and institute change.

Rationale 2: The eight steps are create a sense of urgency; create a guiding coalition and mobilize commitment; form strategic vision and initiatives; enlist volunteer army; enable action by removing barriers; generate short-term wins; sustain acceleration; and institute change.

Rationale 3: The eight steps are create a sense of urgency; create a guiding coalition and mobilize commitment; form strategic vision and initiatives; enlist volunteer army; enable action by removing barriers; generate short-term wins; sustain acceleration; and institute change.

Rationale 4: This is not part of the eight steps. This is a coping strategy for what Quinn describes as “slow death.”

Rationale 5: The eight steps are create a sense of urgency; create a guiding coalition and mobilize commitment; form strategic vision and initiatives; enlist volunteer army; enable action by removing barriers; generate short-term wins; sustain acceleration; and institute change.

Global Rationale: NA

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Apply eight key steps in the change process.

Page: P. 72

 

Question 6

Type: MCSA

The nurse manager is coping with a staff member who is very resistant to change. Which strategy would be beneficial for this nurse manager?

  1. Maintain open communication with this staff member to establish trust.
  2. Help the staff member focus on parts of the change rather than on the whole change at one time.
  3. Take over all of the processes of the change.
  4. Ignore any hidden agendas brought by this staff member.

Correct Answer: 1

Rationale 1: Having an open and trusting relationship with staff will help to reduce resistance to change.

Rationale 2: Focusing on parts and being unable to see the whole picture can result in territoriality.

Rationale 3: Staff will not be innovative if managers over-direct, over-observe, or over-report.

Rationale 4: Staff with hidden agendas or motives are barriers to change and should not be ignored.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 07. Analyze the issue of resistance to change and strategies for overcoming this resistance.

Page: 75-77

 

Question 7

Type: MCMA

The nurse manager is aware of a significant change that will occur sometime in the next six months. How can this manager begin to prepare the staff for this change?

Standard Text: Select all that apply.

  1. Keep the staff apprised of as much information about the change as is possible.
  2. Attempt to keep the unit staffing as stable as possible during the time of change.
  3. Insist that all discussions about the change be conducted in a respectful manner.
  4. Let the initial information about the change come “through the grapevine.”
  5. Avoid surprises by telling the staff about how the change will increase workload very early in the process.

Correct Answer: 1,2,3

Rationale 1: Fear of the unknown is a primary reason people resist change.

Rationale 2: Stability will help the staff cope with the idea of a change.

Rationale 3: All discussions should be respectful and professional.

Rationale 4: Being upfront with information will prevent staff from believing the manager is trying to hide the change.

Rationale 5: Focusing on what the staff will lose (having to work harder) will likely increase resistance.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 07. Analyze the issue of resistance to change and strategies for overcoming this.

Page:  pp. 75-77

 

Question 8

Type: MCSA

Which option best describes a change agent that demonstrates a transformational style of leadership during the change process?

  1. The change agent describes the vision for the change, sets high expectations, and is a role model for the staff.
  2. The change agent expresses personal views about the change and empathizes with the staff.
  3. The change agent expects staff to follow the change agent’s directions required to meet the goal.
  4. The change agent provides the staff members with the resources needed to do their job.

Correct Answer: 1

Rationale 1: The charismatic change agent is an envisioning leader.

Rationale 2: These actions describe an enabling change agent.

Rationale 3: These actions describe a missionary change agent.

Rationale 4: This is an instrumental or transactional change agent.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 08. Develop strategies to improve responses to change.

Pages: p. 74

 

Question 9

Type: MCMA

 

During the change process to implement an electronic medical record, a nurse manager says, “We are experiencing a ‘slow death’.” What evidence would the manager have to support this conclusion?

  1. Work processes seem scattered
  2. Staff burnout with complaints increasing
  3. Use of a detailed project plan
  4. Staff refusing to assume more assignments

Correct Answer: 3

Rationale 1: Inability to do work effectively is a sign of ‘slow death.’

Rationale 2: Staff burnout is a sign of ‘slow death.’

Rationale 3: Using a detailed plan is a positive step and should not lead to ‘slow death’ during change.

Rationale 4: Staff who are less enthusiastic is a sign of ‘slow death.’

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 05. Compare and contrast two key change theories.

Page: pp. 71-72

 

Question 10

Type: MCSA

A nurse manager is collecting staff views about a current unit problem to make a decision about actions to take. Which style of decision-making is this manager employ?

  1. Unilateral
  2. Individual
  3. Authoritarian
  4. Consensus

Correct Answer: 4

Rationale 1: This style depends on a small amount of data, but arrives at one decision.

Rationale 2: This style focuses on individuals.

Rationale 3: This style tells the staff what will be done with the manager making the decision.

Rationale 4: This style engages the staff to arrive at a consensus.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 09. Apply the decision-making process.

Page: p. 79

 

Question 11

Type: MCSA

A patient’s finger stick blood sugar registers 70. The nurse must follow the policy and procedure for caring for a patient with hypoglycemia. This is an example of what type of decision-making process?

  1. Programmed decision-making
  2. Crisis decision making
  3. Time-limited decision making
  4. Non-routine decision-making

Correct Answer: 1

Rationale 1: Programmed decision making is more repetitive and routine and typically related to a policy or procedure.

Rationale 2: The situation is not a crisis.

Rationale 3: This is not a time-limited situation.

Rationale 4: Non-routine decision-making is not routine, can be crisis-oriented, and can require more time and consultation with others.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 09. Apply the decision-making process.

Page:  p. 81

 

Question 12

Type: MCSA

A problem has been identified in the healthcare facility. What should the nurse who has been assigned the task of change agent do next?

  1. Develop an alternative plan.
  2. Gather data.
  3. Collaborate with others.
  4. Empower staff.

Correct Answer: 2

Rationale 1: Developing alternative plans is done after a diagnosis is made.

Rationale 2: After the first step of the change process of acknowledging problem, then it is necessary to gather the data necessary to be able to define the problem and develop a plan of action.

Rationale 3: Collaborating and empowering staff takes place throughout the change process after data is collected in the assessment phase.

Rationale 4: Collaborating and empowering staff takes place throughout the change process after data is collected in the assessment phase.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Apply eight key steps in the change process.

Page:  p. 81

 

Question 13

Type: MCSA

The nurse is working in a facility that is considering a major change by incorporating interprofessional teams in all departments and units. Which type of planning is required?

  1. Policy planning
  2. Strategic planning
  3. Project planning
  4. Strategic planning and project planning

Correct Answer: 4

Rationale 1: Policy planning is required, but strategic planning is also required.

Rationale 2: Strategic planning is required, but policy planning is also required.

Rationale 3: This proposed change requires planning at levels above project planning.

Rationale 4: Both strategic planning and project planning are required, because the move toward an interprofessional approach rather than a single discipline-run unit requires a change to the organization’s components (departments) and operational matters within the organization.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 10. Compare and contrast successful strategic and operational planning.

Page: pp. 91-92

 

Question 14

Type: MCSA

The nurse has been assigned to be a change agent for the facility’s change to a computerized charting system. What type of planning will this require?

  1. Strategic
  2. Policy
  3. Project
  4. Both strategic and project

Correct Answer: 3

Rationale 1: Strategic planning will not be necessary because changes will not be made to the organizations’ departments or services provided.

Rationale 2: This change probably will not change the value system, nor will laws and regulations be changing. Therefore, policy planning will not be necessary.

Rationale 3: Since this change involves a specific time-limited initiative for the nursing department, this requires project planning.

Rationale 4: Strategic planning will not be necessary because changes will not be made to the organizations’ departments or services provided. Project planning will be required.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 10. Compare and contrast successful strategic and operational planning.

Page: p. 92

 

Question 15

Type: MCSA

What is the first step in coping with changes that occur in the healthcare environment?

  1. Understanding personal response to change.
  2. Identifying the change agent.
  3. Investigate the facility’s history of change.
  4. Identify the purpose of the change.

Correct Answer: 1

Rationale 1: Some people have an immediate negative response to change. Other people are invigorated by change, whether the change is positive or negative. The nurse must understand personal response to the idea of change so that response to a particular change can be unbiased.

Rationale 2: While this is important information, the nurse must first identify personal response to the concept of change.

Rationale 3: While this is important information, the nurse must first identify personal response to the concept of change.

Rationale 4: While this is important information, the nurse must first identify personal response to the concept of change.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 06. Apply eight key steps in the change process.

Page: p. 91

 

Question 16

Type: MCMA

The nurse manager is developing a staff education session on change in healthcare. Which concepts should be included in this information?

Standard Text: Select all that apply.

  1. Oftentimes, before one change in healthcare is completed, another is taking place.
  2. Most changes are focused on the organization’s structure.
  3. Change has been the normal state for healthcare providers for some time.
  4. Change disturbs the organization’s equilibrium.
  5. Sometimes multiple changes occur together in healthcare.

Correct Answer: 1,3,4,5

Rationale 1: This is certainly a pertinent topic in today’s healthcare environment.

Rationale 2: Important examples of change are related to the organization’s structure, but change is also affecting roles and responsibilities, communication methods and systems, policies and standards, culture, leadership and management approaches, and competencies and attitudes.

Rationale 3: This is certainly a pertinent topic in today’s healthcare environment.

Rationale 4: The equilibrium does become disturbed, so staff must learn to tolerate this equilibrium in order to be effective.

Rationale 5: This is certainly a pertinent topic in today’s healthcare environment.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Explain why the concept of change is important in the healthcare environment and to nursing leadership and management.

Page:  pp. 70-71

 

Question 17

Type: MCMA

What are the common external factors that drive change in a healthcare organization?

Standard Text: Select all that apply.

  1. Changes in reimbursement by third party payers
  2. Changes in the demographics of employees in the facility
  3. Changes in local, state, or national laws
  4. Changes in professional standards of care
  5. Changes in the organization’s salary structure

Correct Answer: 1,4

Rationale 1: This is a common external factor causing change to be necessary.

Rationale 2: This is an internal change.

Rationale 3: Any changes in these laws acts as an external force necessitating change in the organization.

Rationale 4: Changes in these standards will require change in the way the organization provides care.

Rationale 5: This is an internal change.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 04. Assess the external trends and factors that impact nursing practice and healthcare organizations.

Page: p. 70

 

Question 18

Type: MCSA

The staff of a healthcare organization is burned out and apathetic, and the organization is stagnant. The newly employed leader is working to empower staff, improve the organization’s vision, and alter the culture of accepting the status quo. According to Quinn, what is this leader trying to create?

  1. Unfreezing
  2. A “slow death”
  3. A force-field analysis
  4. A “deep change”

Correct Answer: 4

Rationale 1: This is part of Lewin’s theory of change and is not applicable to this scenario.

Rationale 2: This is what the organization is experiencing. The leader is trying to turn this situation around.

Rationale 3: This is a strategy of Lewin’s theory of change.

Rationale 4: Quinn says that in order to avoid a “slow death” leaders must create a “deep change.”

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 05. Compare and contrast two key change theories.

Page:  p. 71

 

Question 19

Type: MCMA

The nurse manager has repeatedly tried to convince a staff nurse that changing to a new scheduling format is necessary. The staff nurse continues to be negative and argumentative about the need to change. How should the nurse manager interpret this response?

Standard Text: Select all that apply.

  1. Some staff will never be ready to change.
  2. The change cannot go forward until this nurse is convinced.
  3. The nurse is being negative for the sake of negativity.
  4. The nurse will have to be terminated in order for the change to occur.
  5. The nurse may be concerned about loss of routine in personal scheduling.

Correct Answer: 1,5

Rationale 1: Some people are very threatened by the idea of change. This fear may make them respond negatively.

Rationale 2: The change may go forward with or without this staff nurse’s approval.

Rationale 3: Generally, this is not the case if the nurse manager is genuinely trying to establish rapport with the staff nurse and explain why the change in necessary.

Rationale 4: The change can go forward without terminating the nurse. If the nurse is indeed fearful of change, the nurse will probably not resign, as that is also a change.

Rationale 5: Resisters to change are often fearful of losing something they value. Scheduling changes are a particular issue when nurses have established their personal schedules based upon a routine work schedule.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 07. Analyze the issue of resistance to change and strategies for overcoming this resistance.

Page: p. 75

 

Question 20

Type: MCSA

A new management company has acquired a hospital. Since the acquisition, the hospital’s name has changed, a new vision statement has been distributed, the department structure has changed, and the staff’s cafeteria discount has be eliminated. Management has plans for many additional changes. What should happen at this point?

  1. Management should refrain from making any additional changes for a few months.
  2. Management should continue to make changes, but at a rate no faster than 1 change a month.
  3. Management should abandon plans for any additional changes.
  4. Management should institute the remaining changes as quickly as possible.

Correct Answer: 1

Rationale 1: This staff has experienced significant changes and may need a break from change for a few months.

Rationale 2: This option would have the effect of keeping the staff out of equilibrium.

Rationale 3: It is not necessary to abandon plans for the changes, but staff needs to be free of changes for a period of time.

Rationale 4: This quick strike method may result in irretrievable disequilibrium in the staff, which could adversely impact patient care and safety.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 08. Develop strategies to improve responses to change.

Page:  pp. 75-77

 

Question 21

Type: MCSA

The nurse manager has convened a staff meeting to discuss a change in the clinical ladder advancement system used by the organization. A staff nurse says, “Not again! It’s just not fair.” How should the manager respond?

  1. “What do you mean, not again?”
  2. “Please don’t be negative.”
  3. “This is going to happen. We can’t do anything about it.”
  4. Ignore the comment and continue the meeting.

Correct Answer: 1

Rationale 1: The nurse manager should determine what is meant by the comment before addressing the concern.

Rationale 2: This statement devalues the comment and the nurse who made it.

Rationale 3: This statement makes it appear that the manager does not support the change.

Rationale 4: Ignoring this comment will not help the meeting proceed.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 08. Develop strategies to improve responses to change.

Page: pp. 76-77

 

Question 22

Type: MCSA

The team is using a PDSA cycle to test a proposed change to conduct an in depth analysis of data with comparison to the predictions. In which step of the cycle is this team working?

  1. P
  2. D
  3. S
  4. A

Correct Answer: 3

Rationale 1: In the Planning stage, the objective of the test is stated; predictions are made about what will happen and why; and a plan to test the change is developed.

Rationale 2: In the Do stage, a small test is done with identification of problems encountered and first analysis of data.

Rationale 3: In the Study stage, a more in depth analysis of test data is done with comparison to predictions.

Rationale 4: In the last step Act, the change is revised based on what has been learned from the test.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 09. Apply the decision-making process.

Page: p. 86

 

Question 23

Type: MCMA

Critical thinking is key to successful planning. Which statements are evidence that the nurse manager is a critical thinker?

Standard Text: Select all that apply.

  1. I need to research the topic before I comment.”
  2. Let’s be fair in our consideration of this change.”
  3. Let’s go ahead and make the change, I have a feeling it is correct.”
  4. I’m trying to understand your point of view.”
  5. I have to take back something I said in the last meeting; it was wrong.”

Correct Answer: 1,2,4,5

Rationale 1: This is an example of intellectual humility or admitting what is not known. This is a trait of a critical thinker.

Rationale 2: This is an example of intellectual courage or awareness of the need to confront ideas fairly. This is a trait of a critical thinker.

Rationale 3: This statement reflects a jump to action and is not reflective of critical thinking.

Rationale 4: This is an example of intellectual empathy or the person making a conscious effort to understand others. This is a trait of a critical thinker.

Rationale 5: This is an example of intellectual integrity or admitting when one is wrong. This is a trait of a critical thinker.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 10. Compare and contrast successful strategic and operational planning.

Page:  pp. 91-92

 

Question 24

Type: MCMA

The staff nurse is invited to join the organization’s Strategic Planning committee. Which topics can the nurse expect to address as part of this committee?

Standard Text: Select all that apply.

  1. Planning for the next 3-5 years
  2. Changes in the core values of the organization
  3. Changes in regulations governing the organization
  4. Changes in the departmental structure of the organization
  5. Suggestions about how to change the staff-mix ratios in a department

Correct Answer: 1,2,4

Rationale 1: Strategic planning is concerned with long-term issues and goals.

Rationale 2: Long-term issues and core values are considered during strategic planning.

Rationale 3: This is an example of policy planning.

Rationale 4: Strategic planning is concerned with long-term issues and goals.

Rationale 5: This is an example of project planning.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 10. Compare and contrast successful strategic and operational planning.

Page: p. 91

 

Question 25

Type: MCMA

Which statements are true about the evaluation step of the decision making process?

Standard Text: Select all that apply.

  1. Only the change agent is responsible for the evaluation phase.
  2. Management is usually not involved in the evaluation phase.
  3. Evaluation needs to be incorporated in all the steps of the change process.
  4. All members of the team are required to evaluate the process at the end of the project.
  5. Neglecting this step has long-term consequences.

Correct Answer: 3,5

Rationale 1: All members of the team are involved.

Rationale 2: All members of the team are involved, including management.

Rationale 3: Evaluation does not happen just at the end of the project, but needs to be incorporated all the way through the project.

Rationale 4: While all members of the team are involved in evaluation, this evaluation should take place throughout the project, not just at the end.

Rationale 5: If the team does not evaluate the results of decisions, valuable information can be lost or mistakes can be made in the next change.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 09. Apply the decision-making process.

Page:  p. 73

 

 

Question 26

Type: MCSA

What is the goal of the Center to Champion Nursing in America?

  1. Advertise nursing
  2. Mobilize stakeholders
  3. Describe nursing education changes
  4. Recognize importance of APRNs

Correct Answer: 2

Rationale 1: This is important, but not the goal.

Rationale 2: This is the goal for the initiative, which is associated with The Future of Nursing report. There is need to develop a collaborative effort and this requires participation from stakeholders.

Rationale 3: This is important, but not the goal.

Rationale 4: This is important, but not the goal.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe effective environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process: Assessment

Learning Outcome: LO .01 Examine the implications of The Future of Nursing: Leading Change, Advancing Health.

Page: p. 66

 

Question 27

Type: MCMA

You are using SWOT for a review of your unit. Which of the following would be part of this process?

Standard Text:  Select all that apply.

  1. Identify strengths
  2. Identify opportunities
  3. Identify stakeholders
  4. Identify weaknesses
  5. Identify outcomes

Correct Answer: 1, 2, 4,

Rationale 1: SWOT=strengths, weaknesses, opportunities, threats

Rationale 2: SWOT=strengths, weaknesses, opportunities, threats

Rationale 3: SWOT=strengths, weaknesses, opportunities, threats

Rationale 4: SWOT=strengths, weaknesses, opportunities, threats

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe effective environment

Client Need Sub:

 

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, assessment

Learning Outcome: LO .10 Compare and contrast successful strategic and operational planning.

Page: p. 92

 

Question 28

Type: MCMA

What are the first three steps used in proactive leadership?

Standard Text:  Select all that apply.

  1. Listen and learn, adjusting the nature of the solution and the speed of the process as needed.
  2. Implement the proposed change by integrating it into organizational culture, structure, and 
strategy.
  3. Engage in debate or dialogue about the need for change and the nature of the proposed solution.
  4. Form a coalition to manage the change process.
  5. Communicate consensus or decision to all stakeholders.

Correct Answer: 3, 4, 5

Rationale 1: This step occurs during and after implementation.

Rationale 2: This is the fourth step.

Rationale 3: This is one of the first three steps—the second step.

Rationale 4: This is one of the first three steps—the first step.

Rationale 5:  This is one of the first three steps—the third step.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing process, implementation

Learning Outcome: LO .10 Compare and contrast successful strategic and operational planning.

Page: p. 92

 

Question 29

Type: MCSA

What is a method used to describe performance over time and identify trends?

  1. Graph
  2. Cost-benefit analysis
  3. WOTS-up
  4. Solution Analysis Field

Correct Answer: 1

Rationale 1: This is definition of a graph.

Rationale 2: This method focuses on comparing costs and benefits to arrive at best option.

Rationale 3: This method focuses on analysis of weaknesses, strengths, and so on.

Rationale 4: This method compares alternative solutions.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, evaluation

Learning Outcome: LO .09 Apply the decision-making process.

Page: 89

 

Question 30

Type: MCSA

Which of the following data collection methods is not one of the three common data collection methods mentioned in the textbook?

  1. Observation
  2. Survey
  3. Record review
  4. Interview

Correct Answer: 3

Rationale 1: Observation is a common data collection method.

Rationale 2: Survey is a common data collection method.

Rationale 3: Record review may be used, but is not one of the three common methods discussed in the textbook.

Rationale 4: Interview is a common data collection method.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe effective environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing process, evaluation

Learning Outcome: LO .09 Apply the decision-making process.

Page: p. 86

 

Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care 3rd Edition Test Bank

Chapter 11

Question 1

Type: MCSA

A committee of hospice nurses at a managed care organization is trying to determine what consumers want and need most. What is the best source of relevant information?

  1. The hospice’s human resources officer
  2. Families of current and recent hospice patients
  3. Hospice nurses from a wide sample of hospices
  4. The managed care organization representatives who interact directly with patients

Correct Answer: 2

Rationale 1: The human resources officer is involved in obtaining persons to provide care, but is not as central a consumer as are families and patients.

Rationale 2: Since hospice care is directed toward patients and their families, and family most often survive the patient, they together constitute the best source of consumer data.

Rationale 3: Nurses plan and provide care, but are not as central a consumer as are families and patients.

Rationale 4: Representatives of managed care are involved in obtaining and planning care, but are not as central a consumer as are families and patients.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 01. Examine the history of healthcare consumerism and its impact on healthcare.

Page: p. 288

 

Question 2

Type: MCMA

A nurse administrator is planning for the expected increase in healthcare needed for the baby boomer generation. Which attributes of this generation should be considered in this planning?

Standard Text: Select all that apply.

  1. This generation is directly assertive.
  2. This generation has grown accustomed to managed care and is comfortable with it.
  3. This generation is respectful toward health professionals and very grateful for care.
  4. This generation defers to their primary care provider and directs healthcare concerns through that person.
  5. This generation can be politically demanding as healthcare consumers.

Correct Answer: 1,5

Rationale 1: This generation has experience and a history of being outspoken.

Rationale 2: Managed care has been met with consumer complaints and opposition from this generation.

Rationale 3: Previous generations were more passive and respectful of healthcare professionals.

Rationale 4: Previous generations were more passive and submissive toward healthcare professionals.

Rationale 5: This generation has been very politically active on numerous issues, including healthcare.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 01. Examine the history of healthcare consumerism and its impact on healthcare.

Page:  289

 

Question 3

Type: MCSA

For the nurse interested in impacting public policy regarding healthcare consumerism, which involvement and activity is recommended?

  1. Joining nursing associations.
  2. Participating in Internet chat and blog sites.
  3. Reading health-related stories and articles in popular magazines and newspapers.
  4. Encouraging individual patients to formulate and submit their healthcare needs directly to their insurance companies.

Correct Answer: 1

Rationale 1: Large professional organizations, such as nursing associations have programs, data, consultants, and lobbyists that can impact public policy most effectively and powerfully.

Rationale 2: The general Internet tends to be unreliable as a source of information and the multitude of websites is scattered and chaotic in its effect on the public and upon political figures.

Rationale 3: Popular magazines and newspapers would not support this nurse’s need to become politically active as much as joining a professional organization.

Rationale 4: Nurses can best advocate for their patients in public and political arenas by direct and concerted involvement and action.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 02. Assess the relationship between public policy and the healthcare consumer.

Page:  pp. 289-290

 

Question 4

Type: MCSA

A public health team is conducting strategic planning for the next five years of service to the community. The group is reviewing the Healthy People initiative. What help will this be to strategic planning?

  1. This initiative specifies the role of nurse practitioners over the coming decade.
  2. This initiative lists consumer responsibilities for prevention of cardiac and other diseases.
  3. This initiative recommends deinstitutionalization of healthcare in favor of alternative medicine.
  4. This initiative outlines goals for preventative health measures, including objectives for age groups and populations.

Correct Answer: 4

Rationale 1: This is not a part of the Healthy People initiative.

Rationale 2: This is not a part of the Healthy People initiative.

Rationale 3: This is not a part of the Healthy People initiative.

Rationale 4: The Healthy People initiatives list specific objectives for health and longevity by age and population.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 03. Compare and contrast the consumer implications of Healthy People and the Institute of Medicine reports (Quality Chasm series).

Page: pp. 291-292

 

Question 5

Type: MCSA

A patient asks the nurse about the use of information from websites for verifying diagnostic and treatment decisions made by a primary health provider. Which response, made by the nurse, would be most helpful to this patient?

  1. “A computer search of the diagnosis should help you verify the accuracy of the diagnosis and treatment.”
  2. “You can only count on accurate and useful information if it comes from university or hospital websites.”
  3. “That is a dangerous practice, because it undermines your relationship with your primary health provider.”
  4. “You can gain general information that way, but be sure to discuss specific websites and information with your primary health provider.”

Correct Answer: 4

Rationale 1: Websites can be very misleading if taken at face value.

Rationale 2: While this information may be more accurate, misunderstanding or misapplying the information can still occur.

Rationale 3: Healthcare providers generally appreciate a patient who is involved in his or her own care and who is trying to learn more about his or her illness and health.

Rationale 4: The Internet offers an extensive array of professional information and amateur opinion that can serve as a starting point for discussion of diagnosis and treatment with one’s primary health provider.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 04. Assess how technology plays a role in consumer healthcare information.

Page:  p. 292

 

Question 6

Type: MCSA

Consumers are entitled to expect what competencies from nurses in health education roles?

  1. Creative knowledge of learning principles, health reimbursement basics, technology, and patient’s clinical needs
  2. Ability to question diagnoses made by patients’ physicians
  3. Skill in prescribing medications for common, routine disorders and evaluating their effects
  4. Awareness that nurses are limited to reinforcing and clarifying physician’s instructions

Correct Answer: 1

Rationale 1: A nurse health educator should be able to use a variety of teaching strategies to meet the needs of a range of patients, including their needs for assistance with negotiating the healthcare and insurance systems, increasing technology, and complicated health and illness facts.

Rationale 2: The nurse health educator is not qualified to question medical diagnoses.

Rationale 3: The nurse health educator is not qualified to prescribe medications.

Rationale 4: The nurse health educator can educate patients about health risks, preventive measures, and treatment compliance, whether or not this has been addressed by the patient’s physician.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 04. Assess how technology plays a role in consumer healthcare information.

Page: p. 292

 

Question 7

Type: MCSA

A nurse is being hired to assist patients to navigate the complexities of the healthcare system. What is the most pertinent experience and skill background for this nurse?

  1. Interprofessional health team collaboration and communication with insurance and managed care representatives
  2. A wide range of medical surgical skills, including familiarity with a wide assortment of chronic disorders
  3. Management and supervision within private and public hospitals and community health agencies
  4. Primary health and preventive health teaching for patients across the entire life span

Correct Answer: 1

Rationale 1: Skills required to assist patients to understand and effectively use the healthcare and payment systems include excellent personal, team, and technological communication abilities. The abilities to interact with and explain the services of various health professions and case management services are necessary.

Rationale 2: This traditional skill and experience would be helpful, but is not essential to this role.

Rationale 3: This traditional skill and experience would be helpful, but is not essential to this role.

Rationale 4: This traditional skill and experience would be helpful, but is not essential to this role.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 07. Apply patient advocacy in the role of the nurse manager.

Page:  p. 295

 

Question 8

Type: MCSA

The healthcare consumer has become increasingly concerned about retaining health expenditures. What is the nurse’s best advice to this patient?

  1. Carry at least two forms of health insurance coverage.
  2. Practice self-care, illness prevention, and collaboration with health providers.
  3. Seek private, second opinions on all treatment advice by health providers associated with managed care plans.
  4. Simplify medical treatment by complying with physician’s advice rather than questioning such advice.

Correct Answer: 2

Rationale 1: Additional health insurance will not necessarily result in reduced spending.

Rationale 2: Maintenance of one’s personal health and involvement with health providers help reduce health expenditures.

Rationale 3: In order not to incur additional expense, second opinions, when needed, must be obtained within the insurance system.

Rationale 4: Active participation, rather than passive compliance, with health providers is recommended as a means of containing costs.

Global Rationale: NA

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 07. Apply patient advocacy in the role of the nurse manager.

Page: pp. 292, 295

Question 9

Type: MCSA

A consumer complains about the lack of change in an aspect of the health plan that the consumer noted as negative in an earlier patient satisfaction survey. What is the nurse’s best response to this complaint?

  1. “That is unusual, since patient satisfaction surveys give the best evaluative information.”
  2. “They do those surveys, but the responses are so contradictory that the health plan administrators pretty much ignore the feedback.”
  3. “That is highly unethical of the plan’s administrators. The next step would be a complaint to the Surgeon General’s office.”
  4. “Patient satisfaction results are part of the evaluation process, but other factors such as professional standards also are considered.”

Correct Answer: 4

Rationale 1: Patient satisfaction surveys alone do not provide adequate data.

Rationale 2: The consumer should not be discouraged regarding his or her role in offering feedback.

Rationale 3: Rather than encouraging high-level complaints, the nurse should direct the patient to the plan’s representatives.

Rationale 4: It is important to acknowledge the consumer’s role in evaluation, but also to educate about the multifaceted aspects of this process.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 06. Critique how consumers are involved in evaluating the quality of care.

Page: pp. 288, 294-295

 

Question 10

Type: MCMA

Select the groups that are classified as macroconsumers of healthcare.

Standard Text: Select all that apply.

  1. Employers
  2. Employee’s family
  3. Employee
  4. Government
  5. Individual purchasers of healthcare services

Correct Answer: 1,4

Rationale 1: A macroconsumer is a large purchaser of healthcare services such as employers and the government.

Rationale 2: Microconsumers are the users of healthcare services, such as employees, employee families, and individual purchasers of healthcare services.

Rationale 3: Microconsumers are the users of healthcare services, such as employees, employee families, and individual purchasers of healthcare services.

Rationale 4: A macroconsumer is a large purchaser of healthcare services such as employers and the government.

Rationale 5: Microconsumers are the users of healthcare services, such as employees, employee families, and individual purchasers of healthcare services.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 01. Examine the history of healthcare consumerism and its impact on healthcare.

Page: p. 288

 

Question 11

Type: MCSA

Which consumer group makes the majority of decisions about healthcare services that directly affect care?

  1. Microconsumers
  2. Macroconsumers
  3. Both microconsumers and macroconsumers
  4. Neither microconsumers nor macroconsumers

Correct Answer: 1

Rationale 1: All consumers, whether micro or macro, make decisions about the purchase of healthcare coverage, but the microconsumer is involved in more decisions about healthcare services that directly affect them.

Rationale 2: Macroconsumers make more decisions about the healthcare of others.

Rationale 3: Microconsumers make more healthcare decisions that directly affect them.

Rationale 4: Microconsumers make more healthcare decisions that directly affect them.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 01. Examine the history of healthcare consumerism and its impact on healthcare.

Page: p. 288

 

Question 12

Type: MCSA

Managed care has lost much of its influence in healthcare. Why is managed care still of concern?

  1. It developed systems that provided high quality care.
  2. Many managed care strategies were adopted by third- party payers.
  3. It instituted strategies that resulted in increased patient satisfaction.
  4. Managed care strategies greatly reduced the cost of healthcare across the United States.

Correct Answer: 2

Rationale 1: Not all of the systems developed increased the quality of care provided.

Rationale 2: Many of today’s third-party payers are continuing to use strategies initiated by managed care.

Rationale 3: In many cases, patient satisfaction levels went down.

Rationale 4: There was no great reduction in the cost of healthcare.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 01. Examine the history of healthcare consumerism and its impact on healthcare.

Page: p. 288

 

Question 13

Type: MCMA

A woman has become very interested in healthcare policy after her father died of complications of diabetes. Which actions would help this woman become involved in the development of healthcare public policy regarding this disorder?

Standard Text: Select all that apply.

  1. Joining the American Diabetes Association.
  2. Talking to her father’s physician.
  3. Writing a letter to the editor of her local newspaper.
  4. Contacting her representative to the state legislature.
  5. Contacting her United States Senator.

Correct Answer: 1,4,5

Rationale 1: In order to be of maximal influence, this woman should think nationally, not locally.

Rationale 2: While her father’s physician may be supportive of this woman’s concerns, the physician alone cannot change policy.

Rationale 3: Letters to the editor may get local coverage of the situation, but will be unlikely to result in national policy change.

Rationale 4: In order to be of maximal influence, this woman should think nationally, not locally.

Rationale 5: In order to be of maximal influence, this woman should think nationally, not locally.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 02. Assess the relationship between public policy and the healthcare consumer.

Page: p. 290

 

Question 14

Type: MCSA

Which organizations must comply with the Patient Self-Determination Act of 1990?

  1. All hospitals
  2. Long-term care facilities that accept Medicare
  3. A home health agency that is private pay only
  4. Any healthcare organization in the United States

Correct Answer: 2

Rationale 1: It is not a requirement that all hospitals comply with this act.

Rationale 2: Technically, only facilities that accept funds from the government, such as Medicare or Medicaid, must comply with this act.

Rationale 3: If the agency is private pay and does not accept government funds, compliance is not required.

Rationale 4: It is not a requirement that all healthcare organizations comply with this act.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 02. Assess the relationship between public policy and the healthcare consumer.

Page: p. 290

 

Question 15

Type: MCMA

What are the goals of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) program?

Standard Text: Select all that apply.

  1. To decrease the costs of healthcare
  2. To assess patient-centeredness
  3. To compare and contrast provider performance
  4. To improve quality of care
  5. To act as a patient advocate in litigation

Correct Answer: 2,3,4

Rationale 1: This is not a goal of the CAHPS.

Rationale 2: The three goals of the CAHPS are to assess patient-centeredness, to compare and contrast provider performance, and to improve quality of care.

Rationale 3: The three goals of the CAHPS are to assess patient-centeredness, to compare and contrast provider performance, and to improve quality of care.

Rationale 4: The three goals of the CAHPS are to assess patient-centeredness, to compare and contrast provider performance, and to improve quality of care.

Rationale 5: This is not a goal of the CAHPS.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 02. Assess the relationship between public policy and the healthcare consumer.

Page: p. 291

 

Question 16

Type: MCSA

Which statement, made by a nursing student, reflects accurate knowledge of the NAM?

  1. It is a governmental organization focused on healthcare.
  2. It is the agency that developed the Healthy People initiatives.
  3. It is an agency developed to protect the interests of medical doctors and other healthcare professionals.
  4. It is a non-governmental agency that serves in an advisory capacity for the government.

Correct Answer: 4

Rationale 1: The NAM is a non-governmental agency.

Rationale 2: Healthy People is a project of the U. S. Department of Health and Human Services.

Rationale 3: The NAM is patient-centered.

Rationale 4: This statement is the best description of the NAM.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 03. Compare and contrast the consumer implications of Healthy People and the Institute of Medicine reports (Quality Chasm series).

Page: p. 291

 

Question 17

Type: MCMA

Which options reflect the foundational goals of the Healthy People initiative?

Standard Text: Select all that apply.

  1. Self-management of health
  2. Consumer education
  3. Increasing Medicare reimbursement
  4. Advocacy
  5. Decreasing cost of prescription medications

Correct Answer: 1,2,4

Rationale 1: Interwoven into the goals and objectives of the Healthy People initiative is the need for consumer education, advocacy, and self-management of illness via health promotion and disease and illness prevention.

Rationale 2: Interwoven into the goals and objectives of the Healthy People initiative is the need for consumer education, advocacy, and self-management of illness via health promotion and disease and illness prevention.

Rationale 3: This is not a primary goal of the Healthy People initiative.

Rationale 4: Interwoven into the goals and objectives of the Healthy People initiative is the need for consumer education, advocacy, and self-management of illness via health promotion and disease and illness prevention.

Rationale 5: This is not a primary goal of the Healthy People initiative.

Global Rationale: NA

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 03. Compare and contrast the consumer implications of Healthy People and the Institute of Medicine reports (Quality Chasm series).

Page: p. 291

 

Question 18

Type: MCSA

The nursing student is preparing a presentation on the NAM. How should this student characterize the IOM’s view of the patient?

  1. As a member of the interprofessional team
  2. As a passive recipient of care
  3. As a liability to healthcare finance
  4. As a component to be managed

Correct Answer: 1

Rationale 1: The basic, foundational construct of the NAM is that the patient is the reason healthcare is provided and should be viewed as an active member of the interprofessional team.

Rationale 2: The NAM views the patient as an active part of care delivery.

Rationale 3: The NAM does not view the patient as a liability, but rather as the reason care is delivered.

Rationale 4: The NAM does not seek to manage patients, but rather seeks to help patients participate in the management of their own care.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 03. Compare and contrast the consumer implications of Healthy People and the Institute of Medicine reports (Quality Chasm series).

Page: p. 292

 

Question 19

Type: MCSA

The patient states, “I don’t want to take this new medication. I looked it up on the Internet and there are so many side effects.” How can the nurse best assist this patient?

  1. Advise the patient not to read about medications on the Internet because the information is too complex to understand without help.
  2. Access the site and help the patient understand the information presented about the medication.
  3. Give the patient a copy of the information about the medication provided in a nursing handbook of medications.
  4. Empower the patient to talk with the physician about the decision.

Correct Answer: 2

Rationale 1: This strategy demeans the patient and the patient’s attempts at self-care.

Rationale 2: This patient has taken the initiative to read about the medication, but may not understand the information or the implications of the information. The nurse should take this as an opportunity to educate the patient about the medication and about the way medications are written about in the literature. Accessing the site would also allow the nurse to determine if the site was reputable and, if not, help the patient to find reputable sites.

Rationale 3: This would be appropriate if no Internet access was available, but it would be best to view the information that the patient has daily access to and is using.

Rationale 4: The nurse can help the patient with this decision and can educate the patient in this scenario.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 04. Assess how technology plays a role in consumer healthcare information.

Page: pp. 292-293

 

Question 20

Type: MCMA

The nurse has been asked to develop content for the Patient Education section of the hospital’s website. What skills are essential for this nurse?

Standard Text: Select all that apply.

  1. Understanding the principles of adult learning
  2. How to use technology to support learning
  3. Basic entry-level computer programming skills
  4. Clinical knowledge of the topics being developed
  5. Software development skills

Correct Answer: 1,2,4

Rationale 1: The nurse is developing educational materials and must have knowledge of the subject matter and how to best deliver it to the intended audience.

Rationale 2: The nurse is developing educational materials and must have knowledge of the subject matter and how to best deliver it to the intended audience.

Rationale 3: Computer skills will probably be necessary for this assignment, but the nurse will not need programming skills.

Rationale 4: The nurse is developing educational materials and must have knowledge of the subject matter and how to best deliver it to the intended audience.

Rationale 5: Computer skills will probably be necessary for this assignment, but the nurse will not need software development skills.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 05. Examine the relationship between patient education and healthcare consumerism.

Page:  p. 295

 

Question 21

Type: MCMA

The nursing staff has been asked to contribute to the design of a new customer/patient satisfaction survey that will be adopted for use in the hospital as a whole. What should the nurses consider when working on this document?

Standard Text: Select all that apply.

  1. Customer/patient satisfaction reflects attitudes.
  2. Customer/patient expectations play a major role in patient satisfaction.
  3. Once customer/patient satisfaction is measured, developing strategies to increase it will be a straightforward process.
  4. It is difficult to identify who the customers of a healthcare organization really are.
  5. Customer/patient satisfaction is difficult to measure.

Correct Answer: 1,2,4,5

Rationale 1: This is a reason that satisfaction is difficult to measure.

Rationale 2: Expectations are a major component of satisfaction in all areas, not just in healthcare.

Rationale 3: This is a very difficult process because the actions that produce satisfaction vary from customer-to-customer and from patient-to-patient. The goal of patient-centered care is to keep the patient well enough to be out of the hospital, so repeat surveys from the same patient may be rare.

Rationale 4: Nurses may have difficulty viewing patients as customers and may have difficulty identifying non-patient customers.

Rationale 5: This is a true statement.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 06. Critique how consumers are involved in evaluating the quality of care.

Page: p. 294

 

Question 22

Type: MCMA

The nurses on a unit are working to increase the return of patient satisfaction surveys. Which patients can the nurses expect will be more likely to return these surveys?

Standard Text: Select all that apply.

  1. Patients who are alert.
  2. Patients who are younger rather than older.
  3. Patients who are dissatisfied with care.
  4. Patients who speak English.
  5. Patients who are economically disadvantaged.

Correct Answer: 1,2,4

Rationale 1: The patients who complete surveys are patients who are able to do this—alert, typically English-speaking, and often younger.

Rationale 2: The patients who complete surveys are patients who are able to do this—alert, typically English-speaking, and often younger.

Rationale 3: This is not supported by the study cited in the text.

Rationale 4: The patients who complete surveys are patients who are able to do this—alert, typically English-speaking, and often younger.

Rationale 5: This is not supported by the study cited in the text.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 06. Critique how consumers are involved in evaluating the quality of care.

Page: p. 294

 

Question 23

Type: MCSA

The nurses who work in the Emergency Department (ED) of a hospital believe that they provide high quality care. Which option best supports that opinion?

  1. Nurses working in other areas of the hospital rate the ED nurses’ care as high quality.
  2. The physicians who work in the ED state that they are satisfied with the level of nursing care provided.
  3. Patients cared for in the ED report that the nurses provided high quality care.
  4. The hospital administrator rates the ED nurses as providing the best care in the facility.

Correct Answer: 3

Rationale 1: This is important, but not as important as patient satisfaction. Other nurses would have an idea of what quality nursing care is and would be able to access the care provided.

Rationale 2: This is important, but not as important as patient satisfaction. Physicians may not have sufficient knowledge of the role of the nurse to make a strong determination about quality nursing care.

Rationale 3: The patient’s perception of the care provided is the most important aspect of whether it is considered high quality care.

Rationale 4: This is important, but not as important as patient satisfaction. If the remaining care in the hospital is sub-standard, this is not a good rating scale.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: LO 06. Critique how consumers are involved in evaluating the quality of care.

Page: pp. 293-294

 

Question 24

Type: MCSA

The patient diagnosed with cancer has elected to abandon curative treatment in favor of palliative care. The nurse strongly believes the patient can have a long survival time if curative care continues. What nursing advocacy action is appropriate?

  1. Support the patient’s choice.
  2. Ask to have a different nurse assigned to this patient’s care.
  3. Provide education to the patient.
  4. Defer to the patient’s physician’s position on the case.

Correct Answer: 3

Rationale 1: The nurse must first be certain that the patient has sufficient education to make an informed choice on this matter and then would support that choice.

Rationale 2: This does not fulfill the nurse’s responsibility to be an advocate for this patient.

Rationale 3: The most important aspect of this situation is to ascertain that the patient has enough correct information to make an informed decision on care. Once this is assured, the nurse should support the decision made.

Rationale 4: The nurse has an important role in this situation and should not simply defer to the physician.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 07. Apply patient advocacy in the role of the nurse manager.

Page: p. 295

 

Question 25

Type: MCMA

The nurse is dedicated to the concept of empowering patients and their families by giving advice, emotional support, and providing resources. In which levels of the advocacy continuum is this nurse focused?

Standard Text: Select all that apply.

  1. The individual level
  2. The interpersonal level
  3. The community level
  4. The policy level

Correct Answer: 1,2

Rationale 1: The individual level focuses on informing patients and targeting interventions to the individual. Included are self-management and education.

Rationale 2: The interpersonal level focuses on support and empowering patients. Included are giving advice, emotional support, and provision of resources.

Rationale 3: The community level focuses on transforming culture.

Rationale 4: The policy level focuses on translating consumer voice into policy and laws.

Global Rationale: NA

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 07. Apply patient advocacy in the role of the nurse manager.

Page: p. 295

 

Question 26

Type: MCSA

Which of the following had a major impact on increasing healthcare consumerism?

  1. Affordable Care Act of 2010
  2. Use of Medicare
  3. Development of managed care
  4. Nursing advocacy

Correct Answer: 3

Rationale 1: This legislation came long after healthcare consumerism gained strength.

Rationale 2: Medicare was not a major driver of healthcare consumerism.

Rationale 3: Managed care had a great impact on healthcare consumerism as consumers became upset with the changes made such as reduced choice of providers.

Rationale 4: Nursing advocacy grew with healthcare consumerism, but it was not a major impact on it.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 01. Examine the history of healthcare consumerism and its impact on healthcare.

Page: p. 289

 

Question 27

Type: MCSA

What is an important factor in determining if the PSDA must be followed?

  1. The HCO receives Medicare payments for services.
  2. The patient is a U.S. citizen and lives in the state.
  3. The patient asks that the PSDA be followed.
  4. The HCO gets payment from multiple third-party payers.

Correct Answer: 1

Rationale 1: Any HCO that receives federal funding, such as Medicare payment, must follow this law.

Rationale 2: The meeting of the law’s requirements is not related to citizenship or residency.

Rationale 3: The meeting of the law’s requirements is not related to patient preferences.

Rationale 4: The meeting of the law’s requirements is not related to multiple third-party payers.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 02. Assess the relationship between public policy and the healthcare consumer.

Page: p. 290

 

Question 28

Type: MCSA

Which of the following factors is identified as a factor that increases patient satisfaction?

  1. Location of the HCO
  2. Shared governance in the HCO
  3. Type of third-party payer
  4. Following the PSDA

Correct Answer: 2

Rationale 1: Location may be important to a patient, but was not identified as a major factor in the book.

Rationale 2: HCOs that use shared governance receive higher patient satisfaction.

Rationale 3: Type of third-party payer is not major factor related to patient satisfaction.

Rationale 4: The PDSA law is important, but not directly related to patient satisfaction.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 06. Critique how consumers are involved in evaluating the quality of care.

Page: p. 293

 

Question 29

Type: MCMA

Which of the following examples would not demonstrate patient advocacy by a nurse?

Standard Text: Select all that apply

  1. Provide the patient with information about the patient’s problem.
  2. Tell the patient what you (the nurse) would do.
  3. Plan with the patient’s physician who will talk with the patient.
  4. Expect a patient to accept treatment for cancer.

Correct Answer: 2, 4

Rationale 1: It is helpful to provide the patient with factual information to assist the patient in decision-making.

Rationale 2: Your personal decisions are not relevant to the patient’s decision-making process.

Rationale 3: A team approach is best.

Rationale 4: Nurses should not expect patients to make a decision. Patients make the decisions, and nurses need to support the patient’s decision.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 07. Apply patient advocacy to the role of the nurse manager.

Page: p. 295

 

Question 30

Type: MCSA

In a study published in 2015 by Austin, et al., what was the conclusion about the use of report cards to rate hospitals?

  1. Rankings are not always accurate or ensure quality.
  2. There is limited variation in data and rankings.
  3. Rankings provide critical data to consumers to ensure they make best choices.
  4. Focusing on one survey result is best.

Correct Answer: 1

Rationale 1: The study indicated that the various rankings do not consistently agree and vary in their criteria used for the rankings thus impacting comparison.

Rationale 2: The study indicated that there is variation in results

Rationale 3: The study indicated that rankings are not useful enough to ensure patients make the best choices.

Rationale 4: The study indicates that just looking at one survey will not provide an honest view.

Global Rationale: NA

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

QSEN Competencies: Patient-centered care; Teamwork and collaboration; quality improvement, safety

AACN Essential Competencies: II. Basic organizational and systems leadership for quality care and patient safety; VI. Interprofessional communication and collaboration for improving patient health outcomes; V. Healthcare policy, finance, and regulatory environments

NLN Competencies: Personal and professional development; relationship centered care; teamwork

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 06. Critique how consumers are involved in evaluating the quality of care.

Page: p. 294.

 

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