Introduction to Nursing Administration Exam Bank
Course Introduction
Introduction to Nursing Administration provides an overview of the fundamental principles and practices involved in managing nursing services within healthcare organizations. The course covers topics such as leadership roles, decision-making, strategic planning, organizational structure, human resource management, budgeting, and quality improvement in nursing settings. Students will explore the responsibilities of nurse administrators in fostering effective communication, ensuring ethical and legal compliance, and promoting patient-centered care. Through case studies and practical applications, students will develop skills essential for effective leadership and management in diverse healthcare environments.
Recommended Textbook
Leading and Managing in Nursing 7th Edition by Yoder Wise
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Page 2
Chapter 1: Leading, Managing, and Following
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Q1) After assessing an older adult patient in long-term care who has been slowly deteriorating for weeks,the nurse manager calls the family and asks them to come in,as the patient is dying.What is the most likely basis for the nurse manager's request?
A) An established clinical pathway
B) Confirmatory scientific evidence
C) Unit protocol
D) Experience
Answer: D
Q2) According to the complexity theory,what would be the focus of measurement?
A) Cost per hospital day
B) Bed utilization
C) Infection rates
D) Staff morale and budgets
Answer: D
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Chapter 2: Clinical Safety: The Core of Leading, managing, and Following
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Q1) A client requires an appendectomy.The surgeon explains the procedure and asks the client to sign the consent.The patient speaks very little English and looks worried.What is the appropriate action by the nurse?
A) Suggest that an interpreter explain the procedure to the client and answer any questions.
B) Ask the client if he has any questions.
C) Draw a picture to show the incision.
D) Not intervene.
Answer: A
Q2) How would a nurse manager and the staff prepare for redesignation as a Magnet Hospital?
A) Commit staff resources over a 6-month period to updating procedure manuals.
B) Educate staff through meetings and training sessions regarding appropriate answers to questions.
C) Prepare a manual that outlines orientation procedures and ensure that all safety issues are addressed.
D) Ensure that there are empirical data to support review of patient outcomes, actions taken, and results of actions.
Answer: D
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Chapter 3: Legal and Ethical Issues
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Q1) One means of ensuring that the nurses floated to other patient care areas in healthcare organizations are qualified to work in the areas they are floated is:
A) employing additional staff to assist with orientation processes.
B) cross-educating staff members to other areas of the institution.
C) transferring patients to units where the staffing pattern is optimal.
D) orienting staff members to all patient care areas as part of their general orientation to the institution.
Answer: B
Q2) To reduce the incidence of falls in a skilled nursing unit,the nurse manager contacts the risk manager.Risk management is a process that attempts to identify potential hazards and:
A) compensate for previous injuries.
B) eliminate these risks before anyone else is harmed.
C) supersede the need for staff members to file incident reports.
D) discipline staff members who have been involved in previous incident reports.
Answer: B
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5
Chapter 4: Cultural Diversity and Inclusion in Health Care
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Q1) Individuals living with asthma,who also live in poverty,are much less likely to seek early care and are more likely to go to emergency rooms for assistance.This example reflects:
A) stereotyping.
B) cultural diversity.
C) ethnocentricity.
D) transcultural care.
Q2) When interviewing a candidate for a nursing position who has an Aboriginal background,you recognize that the candidate's lack of eye contact reflects the candidate's cultural sensitivity.You are exhibiting:
A) acculturation.
B) cultural sensitivity.
C) ethnocentrism.
D) transculturalism.
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Chapter 5: Gaining Personal Insight: The Beginning of Being a Leader
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Q1) Excellent leaders need to have or develop the skills of empathy and expressiveness when dealing with others in the workplace.This is also known as understanding and managing own feelings and emotions as well as discerning the emotions of others.What is this an example of required by good leaders?
A) Social awareness
B) Self-awareness
C) Emotional intelligence
D) Intellectual ability
Q2) A staff nurse is the person on the unit everyone seeks for input and asks questions.What type of leadership position is the staff nurse displaying?
A) Position leadership
B) Informal leadership
C) Personal leadership
D) Formal leadership
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Chapter 6: Being an Effective Follower
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Q1) The definition of leader refers to a person who has ability to guide people.In nursing,the leader does more.What is NOT a role of a leader in nursing?
A) Active listening
B) Open communication
C) Accountability in decisions
D) Tight control of decisions
Q2) In nursing theory,one theorist developed the idea of new nurses progressing to experienced nurses and playing an important role in patient care in all stages.The new nurses follow their role and progress through stages to advanced nurse.Who was this theorist?
A) Dorothea Orem
B) Patricia Benner
C) Ida Jean Orlando
D) Robert E, Kelley
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Chapter 7: Managing Self: Stress and Time
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Q1) Sources of occupational stress in nursing include all except which of the following?
A) Authoritarian leadership
B) Concern about moral wrongdoing by colleagues
C) Multiple changes in a short time
D) Rotating shifts
Q2) The education consultant at St.Joseph Hospital is giving a workshop on cognitive reframing.The consultant explains that cognitive reframing reduces stress by:
A) aiding individuals in identifying positive stressors.
B) helping people realize that negative thinking causes emotional distress.
C) eliminating negative stressors.
D) replacing positive self-statements with negative irrational beliefs.
Q3) As a nurse manager,the one activity you should not overlook is:
A) posting the yearly rotation schedule.
B) reviewing vacation requests.
C) scheduling staffing for holidays 6 months in advance.
D) anticipating staff sick days.
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Chapter 8: Communication and Conflict
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Q1) Mrs.Hill,aged 68,was hospitalized after a stroke.The speech therapist recommended that oral feeding be stopped because of her dysplasia.During visiting hours,Mr.Hill fed his wife some noodles.The nurse noticed this and stopped Mr.Hill from feeding his wife,telling him it was the doctor's decision.An hour later,the nurse returned and found Mr.Hill feeding his wife again.The nurse tried to stop him again.Mr.Hill refused and claimed that the clinical staff was trying to starve his wife; he also threatened to get violent with the nurse.The nurse decided to walk away and documented the event in Mrs.Hill's chart.The outcome as depicted by Thomas' conflict stages can be considered to be:
A) compromising.
B) confronting.
C) constructive.
D) destructive.
Q2) After using a mediator to resolve a conflict between the nurse manager and two staff nurses,the chief nursing officer decides to:
A) observe to make sure the conflict has been resolved.
B) fire both staff nurses.
C) reassign both staff nurses.
D) reassign the nurse manager.
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Page 10
Chapter 9: Power,Politics,and Influence
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Q1) During a unit meeting,you notice that Vivian listens attentively when Mary is speaking and offers support and advice when Mary presents ideas to the group.You are surprised because Vivian has often confided that she does not like Mary.Vivian's behavior is best described as:
A) insincere.
B) networking.
C) politically sophisticated.
D) collegial.
Q2) Lucy,head nurse on the surgical unit,works with her staff to find ways in which they can work together with other disciplines to provide more effective care for patients on the unit.Lucy likely knows her power is:
A) limited, thereby necessitating involvement of others in implementing ideas.
B) restricted, which necessitates finding alternative means to achieve strong patient outcomes.
C) directed primarily toward those who are subordinate to her.
D) of unlimited capacity when shared with others.
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Chapter 10: Healthcare Organizations
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Q1) The Wellington Mental Health Institute is fully accredited by the AOA and not directly by the CMS.This means that the Wellington facility:
A) cannot accept mental health patients who are Medicare beneficiaries.
B) can care for only Medicaid and not Medicare beneficiaries.
C) has not met the standards set by the CMS as determined by an external review panel.
D) has been reviewed and accredited by the AOA, which is a deeming authority for CMS.
Q2) As a nurse manager in a hospital,you would expect what to be the major contributor to funding and revenues in your organization?
A) The federal government
B) Medicare
C) Medicaid
D) Blue Cross/Blue Shield
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Chapter 11: Organizational Structures
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Q1) In what situations would you expect low morale and frustration?
A) Statement of philosophy indicates "We value our staff." When staff members leave, careful evaluation is done to determine whether staff should be replaced by full- or part-time employees.
B) Practices include annual staff recognition celebrations. During times of change, staff members are actively included in issue identification and solution finding.
C) Recruitment ads promise opportunities for advancement for everyone. Promotions are given only to individuals with long-standing service and entrenched relationships.
D) The vision indicates that there is strong commitment to lead in research. The organization has tried to implement a strong campaign to attract leading nurse researchers but has experienced difficulty in doing so.
Q2) "At Thoroughcare,we provide health care for women and children in transition" is an example of a:
A) vision statement.
B) mission statement.
C) goal statement.
D) statement of philosophy.
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Chapter 12: Care Delivery Strategies
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Q1) The nurse manager is comparing functional nursing and primary nursing for potential adoption.The nurse manager determines that patient and nurse satisfaction in primary nursing are:
A) similar to those in functional nursing.
B) not of significance in either model.
C) low by comparison with functional nursing.
D) high when compared with functional nursing.
Q2) When hiring a case manager for a rehabilitation setting,you would most likely consider a:
A) registered nurse with a master's degree.
B) physiotherapist with a background in stroke rehabilitation.
C) social worker with a background in counseling.
D) health professional with advanced background who is client and outcome focused.
Q3) Case managed care may enhance profit in a for-profit health organization by:
A) minimizing costs in high resource consumption areas.
B) combining licensed and non-licensed care providers in delivering patient care.
C) increasing reimbursement from third-party payers.
D) reducing the amount of technology used to support clinical decision making.
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Chapter 13: Staffing and Scheduling
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Q1) To maintain patient safety,studies suggest that scheduling should avoid:
A) rotating shifts.
B) weekends.
C) 8-hour shifts.
D) mandatory overtime.
Q2) Scheduling is a function of implementing the staffing plan by assigning unit personnel to work specific hours and specific days of the week.To retain nursing staff,the nurse manager must incorporate into the schedule plan:
A) all weekends off.
B) all holidays off.
C) a variety of scheduling options.
D) rotating shifts.
Q3) A factor evaluation system:
A) utilizes financial data to determine number of staff-to-patient ratios.
B) utilizes DRGs to determine acuity on a unit.
C) combines interventions and time required for interventions to determine levels of care required.
D) combines financial resources and nursing interventions to determine patient contact hours.
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Page 15
Chapter 14: Work Force Engagement Through Collective
Action and Governance
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Q1) Senior executives at Hospital A determine that the hospital will engage in a strategic planning process after changes in healthcare funding and concerns expressed in the community about care that is being delivered at the hospital.The senior executives decide on a participatory process in which staff are widely consulted regarding input about the organization and the external environment and are actively invited to be part of decisions related to the mission statement,goals,and objectives.For true shared governance to be seen as part of this approach:
A) it must be evident in the outcomes of the process that staff and senior executives have partnered on the decisions.
B) stakeholders must be assured of the value of their input even though final decisions rest with senior executives.
C) publications must clearly outline how staff input was solicited and obtained.
D) staff must be reassured that significant concerns will be kept in mind even if they have not been addressed in planning documents.
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Chapter 15: Making Decisions and Solving Problems
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Q1) To solve a problem,the nurse manager understands that the most important problem-solving step is:
A) the implementation phase.
B) identification of numerous solutions.
C) accurate identification of the problem.
D) evaluation of the effectiveness of problem resolution.
Q2) In a busy rehabilitation unit,the team manager decided that the best way to reward the staff was to give them a monetary bonus rather than time off.The staff was very concerned about the decision and went to the administration with a number of complaints.Critical thinking is a process that entails a number of steps.What steps did the manager omit? She should have:
A) identified what assumptions were underpinning the issues.
B) considered why it was important to make this change or the context for the change.
C) considered how this change might affect staff relationships.
D) attained a majority consensus of all staff.
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17
Chapter 16: The Impact of Technology
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Q1) A 39-year-old patient awaits a kidney transplant.Because he must immediately arrange to get to the hospital when a donor kidney is available,it is important that he can be reached anywhere and at any time.To ensure that he receives the message,what type of technology is most effective?
A) Internet
B) Telecommunications
C) WL pager
D) CDS
Q2) The nursing manager of a surgical unit has been asked by administration to evaluate client outcomes post cardiac catheterization.Using data about client outcomes post cardiac catheterization for the past 6 months in order to modify practice is an example of:
A) information.
B) cost-effective care.
C) meeting standards.
D) evidence-based practice.
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Chapter 17: Delegating: Authority, Accountability,
Responsibility in Delegation Decisions
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Q1) Which of the following would be most in line with Hersey model and concepts?
A) The team of caregivers on day shift are familiar with their roles and with the patients. The nurse manager decides to work on the unit budget in her office.
B) After a year of working on the unit, Shari, an LPN, is still hesitant about many policies and procedures. The charge nurse decides to challenge Shari with more difficult patients.
C) The nursing supervisor asks one of her charge nurses to lead a technology integration project. The supervisor continuously demands involvement in decisions that the charge nurse is making in the project.
D) Team members complain that Alysha, an RN, is unmotivated, and that she refuses assignments that are complex or difficult. The charge nurse suggests that Alysha is relatively new and that she needs time to adjust.
Q2) With delegation,responsibility and accountability remain with the:
A) physician.
B) professional who delegates.
C) individual who receives the delegation.
D) individual who previously performed the task.
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Page 19
Chapter 18: Leading Change
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Q1) Which of the following are examples of application of the Leadership Rounding Tool?
A) "What is working well for you during bedside reporting?"
B) "What has not worked for you today?"
C) "Is there someone on your team who deserves special recognition for her efforts in the implementation?"
D) "Did you have a good vacation?"
Q2) Elizabeth is an example of a(n):
A) early adopter.
B) late majority.
C) laggard.
D) resister.
Q3) When goals/outcomes are somewhat unclear in early preparation for a complex change,the manager and the change management team develop several acceptable goals/outcomes.This change in management approach is termed:
A) unfreezing.
B) nonlinear.
C) cybernetic.
D) linear.
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Chapter 19: Building Effective Teams
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Q1) A nurse manager is experiencing conflicts between herself and staff members.She had tried to develop a team by using a shared leadership model to empower the staff.Staff members are functioning:
A) as a team.
B) independently.
C) interdependently.
D) as a group.
Q2) As a nurse manager,you notice that one of your new nurses has provided exceptional care for a patient with especially complex needs.What would be the MOST effective way of recognizing the nurse's performance?
A) At the next performance review, note specifically what the nurse did to make the patient comfortable.
B) To avoid embarrassing the nurse in front of others, find a way to compliment the nurse in private.
C) When the nurse comes out of the room, tell the nurse specifically what you appreciated about the care that was provided.
D) Encourage the patient to note the care on the patient feedback form so that the institution can recognize the nurse's efforts.
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Chapter 20: Managing Costs and Budgets
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Q1) A staff nurse regularly works two 12-hour shifts each week and one 8-hour shift every other week.How many FTEs is this position?
A) 0.6
B) 0.7
C) 0.8
D) 1
Q2) After a major flu vaccination campaign,an agency bills a private insurance company for allowable costs for administration of each vaccination according to the schedule established by the insurance company for reimbursement.This is an example of which major payment method?
A) Cost-based reimbursement
B) Charges
C) Contractual allowance
D) Prospective reimbursement
Q3) Which of the following factors is not implicated in rising healthcare costs?
A) Rising expectations of consumers for cure and care
B) Marketing of drugs to consumers
C) Large administrative staffs to process medical billings
D) Rising Medicare costs
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Page 22
Chapter 21: Selecting, developing, and Evaluating Staff
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Q1) Joanne,a new nurse manager,writes certain assumptions regarding the organization's objectives into her budget.Her supervisor tells her that the objectives implied in her assumptions are not entirely consistent with the organization,and that she needs to clarify these objectives with her supervisor.Joanne apologizes and says she had more latitude with the budget where she previously worked.This is an example of:
A) role complexity.
B) role ambiguity.
C) role conflict.
D) time-dependent roles.
Q2) John notes that the next section is specific to the organizational philosophy and has a 4-point ordinal scale that describes performance from "always meets expectations" to "does not meet expectations." This type of evaluation is most commonly known as:
A) a behavior-anchored rating scale.
B) management by objectives/learning goals.
C) the forced distribution scale.
D) a graphic rating scale.
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Chapter 22: Person-Centered Care
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Q1) A 27-year-old woman is admitted to your ICU in a coma,following an accident.The family of the patient,who is a Native American,places a medicine pouch in the bed with the young woman.As the nurse in this situation,it is important to:
A) explain to the family that the medicine pouch may contain herbs that may bother other patients.
B) ask the family about the significance of the medicine pouch for them.
C) remove the pouch when the family is not present.
D) put the medicine pouch on the shelf beside the bed.
Q2) The chief nursing officer decides to establish a client advocacy position in an oncology unit.Advocacy is best represented by:
A) establishing private and professional networking systems.
B) asking social services to handle clients' concerns.
C) identifying community support groups.
D) empowering others by promoting self-determination.
Q3) An example of a factor that would impede a patient's learning is:
A) poverty.
B) limited health insurance.
C) being an older adult.
D) heavy sedation.
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Page 24
Chapter 23: Managing Quality and Risk
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Q1) The nurse manager is concerned about the negative ratings her unit has received on patient satisfaction surveys.The first step in addressing this issue from the point of view of quality improvement is to:
A) assemble a team.
B) establish a benchmark.
C) identify a clinical activity for review.
D) establish outcomes.
Q2) A method commonly used in quality assurance to monitor adherence to established standards is:
A) a Pareto chart.
B) brainstorming.
C) patient interviews.
D) chart audit.
Q3) A new graduate is asked to serve on the hospital's quality improvement (QI)committee.The nurse understands that the first step in quality improvement is to:
A) collect data to determine whether standards are being met.
B) implement a plan to correct the problem.
C) identify the standard.
D) determine whether the findings warrant correction.
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Page 25
Chapter 24: Translating Research Into Practice
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Q1) After searching the literature,Tara,the unit manager develops a table that outlines the findings of studies on management of incontinence.She then examines the studies in terms of risk and whether the findings fit within her practice context and for her population of moderately to severely cognitively impaired patients.This is which phase of a research utilization model?
A) Preparatory
B) Validation
C) Evaluation
D) Application
Q2) A strategic goal for nursing in the facility developed by the chief nursing officer is to implement an evidence-based practice program.What is an appropriate strategy that can be used by a nurse manager who is beginning to implement an evidence-based practice program on the unit?
A) Conducting a review of adverse events and incident reports
B) Soliciting input from staff members
C) Reviewing specialty organization guidelines
D) Identifying patients with extended lengths of stay
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Chapter 25: Managing Personal and Personnel Problems
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Q1) Ellen is a novice nurse on your unit.Even though she has come to you highly recommended,as her supervisor,you have noticed some knowledge and skill deficiencies.These deficiencies have been noticed by her peers as well,who cover for her because she is new and they like her.Which of the following is likely to be the greatest asset to Ellen in improving her performance?
A) Ignore Ellen's errors until she has more experience.
B) Instruct staff to avoid working with Ellen until she learns to how do things herself.
C) Ask Ellen to complete a self-assessment, using a standard skills checklist.
D) Encourage staff to report every behavior of Ellen's that is different from theirs.
Q2) The chief nursing officer reviews the policy about "progressive discipline process." The progressive discipline process includes which of the following? The manager:
A) acts as a counselor and friend to the employee.
B) should reprimand and suspend the employee as a last resort.
C) should rehire the employee after a reasonable length of time.
D) should terminate the employee if the problem persists.
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Chapter 26: Role Transition
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Q1) As a new manager,you reflect on what professional development would be most valuable to assist you in taking on this role.Which of the following would you most likely identify?
A) Opportunities to hone clinical skills that are used most often on the unit that you will manage
B) A workshop on conflict management and communication skills
C) Attendance at a conference on global healthcare economics
D) Attendance at a workshop on survey tool development and statistical measurement
Q2) In assisting new graduates to make the role transition to graduate nurse,Ted,the unit manager initiates which of the following?
A) Self-check list to assess competencies that have been strengthened
B) Discussions that focus on what the new graduates have yet to learn
C) Fixed target dates for acquisition of competency and transition to RN role
D) Frequent formal meetings to provide feedback on performance and areas to be strengthened
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Chapter 27: Managing Your Career
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Q1) The primary difference between a résumé and a CV is that a résumé:
A) reflects your skills, knowledge, and background in relation to a specific position.
B) offers a detailed listing of positions held and where positions were held.
C) includes a long and detailed explanation of academic and work experience.
D) provides contact information and focuses on your background, in general.
Q2) In preparing for a fair interview process as a hiring manager,you should:
A) put water out for the candidates.
B) ensure that you know the names of all candidates.
C) dress comfortably and professionally.
D) prepare a schedule of questions to be asked of all candidates.
Q3) A unit manager recently graduated as a clinical nurse specialist with a focus in gerontology.She applied to take a certification exam.Certification is designed to recognize:
A) basic knowledge in a specified area.
B) advanced practice in functional roles.
C) special knowledge beyond basic licensure.
D) continued competence as a registered nurse.
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Chapter 28: Developing the Role of Leader
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Q1) Recruiting among the emerging work force (18 to 35 year olds)is a challenge for healthcare agencies.Marketing brochures should address the leadership and vision of the healthcare agency.Which of the following workplace environments will attract applicants in the emerging work force?
A) A highly professional environment
B) A nurturing and receptive environment
C) An environment highlighted by lots of meetings, so staff members can have lots of input
D) A totally online environment, so staff members will not have to interface with uncaring colleagues
Q2) While explaining the importance of developing leadership skills among nurses to a group of first-year nursing students,Natalie,a nursing unit manager,emphasizes that:
A) most nurses are not expected to assume leadership roles.
B) the role of nurse leadership is only at the bedside, ensuring that patient care is performed according to established standards.
C) only individuals in formal leadership roles are expected to be leaders.
D) the public depends on nurses to assume leadership in moving consumer advocacy concerns forward.
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Chapter 29: Developing the Role of Manager
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Q1) A nurse manager in a hospital is deeply concerned that senior administration makes decisions about budgetary directions that affect staffing and other resources without sharing the rationale for changes or demonstrating concern as to how these changes may affect patients or staff.She says she does not feel respected and is emotionally tired as a result.This situation represents:
A) bureaucratic organization.
B) realities of current health care.
C) negative organizational culture.
D) lack of engagement by administration.
Q2) The successful integration of informatics into healthcare settings is key to:
A) quality decision making related to management of resources and patient care.
B) accessing current information about business practices.
C) meeting the modern-day expectations of staff regarding technology use.
D) speeding up calculations and decisions in budget development.
Q3) Budgeting and protection of revenues is a function of:
A) leadership.
B) management.
C) team leadership.
D) followers.
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Chapter 30: The Strategic Planning Process
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25 Verified Questions
25 Flashcards
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Sample Questions
Q1) Planning is a process designed to achieve goals in dynamic,competitive environments.As a new manager,what is the first step you will undertake to develop a strategic plan of action for a congestive heart failure program?
A) Search the environment to determine changes that may affect the organization.
B) Appraise the organization's strengths and weaknesses.
C) Identify the major opportunities for and threats to the organization.
D) Identify and evaluate the various strategies available to the organization.
Q2) To conduct assessment of the internal environment,the strategic planning team for Pacific Hospital:
A) invites community members and staff of the hospital to an evening focus group session.
B) discusses what it sees as the primary threats and opportunities in demographic shifts affecting the hospital.
C) invites all levels of staff to focus groups on the effectiveness of the hospital environment, including information systems and staffing.
D) asks the board to provide a summary of major opportunities for the future.
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Chapter 31: Thriving for the Future
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Sample Questions
Q1) Your organization is in the middle of re-designing patient care units,with decisions based on best practices and various other sources of evidence.In the middle of the transition,there is a temporary halt called to the transition because of a re-design of the health care system and greater emphasis on primary care.As a manager in this situation,your staff experience a gap between what they expected (the original re-design of the units)and what is actually happening (a need to integrate primary care in some way).According to Selye,the nurses on your nursing team are likely experiencing what?
A) Eustress
B) Distress
C) Stress
D) Compression
Q2) Which of the following will require greater attention in the future?
A) Chronic disorders
B) Obstetrical outcomes
C) Prevention of hospital-based errors
D) Team conflict resolution strategies
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