Chapter 6: Being an Effective Follower
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Q1) As a new nurse manager,you are aware of leadership,management,and followership principles.The concept of followership is rather new as relating to leadership.What is the role of the follower in followership?
A) Leading the group in task
B) Submission position in organization
C) Person who may influence team
D) Negative meaning for worker
Q2) As a nurse manager,you are a leader and a follower in health care and on the unit you manage.Looking at the larger picture of health care and patient environment on the unit,what is the primary role of the followers on the unit,as defined in nursing?
A) Direct care provider
B) Implements leader's policy unquestioned
C) Passive role on unit
D) Devalued staff member
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Chapter 8: Communication and Conflict
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Q1) Two nurses on a psychiatric unit come from different backgrounds and have graduated from different universities.They are given a set of new orders from the unit manager.Each nurse displays different emotions in response to the orders.Nurse A indicates that the new orders include too many changes; Nurse B disagrees and verbally indicates why.This step in the process is which of the following in Thomas' stages of conflict?
A) Frustration
B) Conceptualization
C) Action
D) Outcomes
Q2) Staff at Valley Hospital are concerned that recent staffing cuts will affect their ability to provide quality patient care,and they express their concerns to senior management.The CEO of Valley Hospital makes the following statement: "We need to contain costs because our funding has been decreased." This is a good example of which of the following conditions that propel a situation toward conflict?
A) Incompatible goals
B) Role conflicts
C) Structural conflict
D) Competition for resources
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Chapter 11: Organizational Structures
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Q1) In the Unity Healthcare organization,decisions,including those at the unit level,are made by a group of senior executives.Rules for employees are clear,and nursing care is delineated by procedures and protocols.This exemplifies:
A) transformational leadership.
B) transactional leadership.
C) bureaucratic organization.
D) Chaos theory.
Q2) Because of rapid turnover and the ongoing hiring of new graduates,the skill levels of staff in a busy CCU are varied.Senior staff are becoming burned out with the need to provide mentorship and guidance to new staff.As the manager,you propose the addition of a nurse in advanced practice to provide consultation and education for staff.What is this position considered?
A) Hierarchical position
B) Ancillary
C) Line position
D) Staff position
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Chapter 12: Care Delivery Strategies
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Q1) In an acute care unit,the nurse manager utilizes the functional nursing method as the care delivery model.The nurse manager's main responsibility is the needs of the: A) department.
B) unit.
C) staff.
D) patient.
Q2) In comparing team and functional models of care,a nurse manager favors the team model.In particular,she finds that the team model:
A) can be effective in recognizing individual strengths and backgrounds of staff.
B) promotes autonomy and independence for the RN.
C) avoids conflict because of role clarity.
D) is efficient in delivering care to a large group of patients, utilizing a staffing mix.
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Chapter 13: Staffing and Scheduling
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Q1) As the unit manager,you post the staffing plan and compliance reports.This initiative is aimed at:
A) maintaining unit morale.
B) complying with national requirements.
C) demonstrating patient outcomes.
D) inviting staff participation in decision making.
Q2) A small rural hospital has been designated as a critical access hospital.It has 40 beds and an average occupancy of 34 beds.To prepare the staffing,the chief nursing officer computes the occupancy as being:
A) 90%.
B) 85%.
C) 75%.
D) 60%.
Q3) Your healthcare organization has a decentralized system for scheduling.As part of this process,after you have developed a draft schedule,you may need to:
A) seek budgetary approval.
B) balance personal schedules against institutional needs.
C) negotiate the schedule with unit staff.
D) submit the schedule to a centralized staffing office for review.
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Chapter 14: Work Force Engagement Through Collective
Action and Governance
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Q1) Martin,the unit manager,receives complaints from community agencies that patients who have been discharged from his unit seem to lack understanding about their disorder and immediate strategies for managing elements of their care.Martin checks the patient teaching sheets and notes that the sheets are initialed by staff.He calls the agencies and indicates that teaching has been done.Potential outcomes of Martin's actions include:
A) poor morale on the unit.
B) disruption in community relationships.
C) corruption of patient-staff relationships.
D) patient outcomes for quality care are met.
Q2) In a nurse managers' meeting,strategies for ways to help retain staff are discussed.One strategy for assisting nurses in developing collective action skills is:
A) accepting the practice of "going along to get along."
B) attending as many workshops as practical.
C) spending as much time as possible in clinical settings.
D) taking the opportunity to work with a mentor.
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Chapter 15: Making Decisions and Solving Problems
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Q1) Jane,an experienced head nurse,is given the task of completing the summer vacation schedule for the pediatric unit.She is fully aware of the hospital's restrictions on time off and the number of staff on vacation at any given time,as well as its issues regarding seniority.She weighs the options of allowing staff choice,such as it takes more time but gives employees options.However,if choice is allowed,this could cause arguments.Which of the following is the best alternative?
A) Ask for requests for vacation time in advance, and post the times.
B) Post the completed vacation schedule.
C) Post a tentative schedule, and request feedback.
D) Post a blank schedule, and ask staff members to fill in their times by a given date.
Q2) Knowing when to have the entire team participate in the decision-making process or when to have only the team leader make the decisions depends on the situation and the desired outcomes.The autocratic process is used in which of the following situations?
A) The task and the outcome are relatively simple and defined.
B) It is unlikely that the group will reach a consensus.
C) A decision has to be discussed thoroughly.
D) A number of options need to be considered.
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Chapter 16: The Impact of Technology
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Q1) Despite the implementation of bar-code medication administration (BCMA)on your busy medical unit,you notice that the number of medication errors has not significantly decreased.Which of the following reasons might explain the lack of change in errors?
A) A number of new medications have been introduced into the hospital pharmacy that are not yet recognized in the CDS.
B) There have been an unusually high number of patients on the unit who have been unable to confirm their identity at the time of medication administration.
C) Lack of staff understanding and support for BCMA has led to overrides or failures to scan bar codes during busy times.
D) Clinical data that have been entered into the system to guide administration of the medications are outdated.
Q2) A necessary,basic condition for successful integration of clinical information systems is:
A) software.
B) standard medical nomenclature.
C) confirmatory evidence from nursing-led studies.
D) strong interdisciplinary cultures.
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Chapter 17: Delegating: Authority, Accountability,
Responsibility in Delegation Decisions
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Q1) Sally is an experienced nurse on the unit and is very experienced with ICP monitoring.She is assigned David,a patient who has been admitted with a severe head injury.In communicating with Sally,what does is an appropriate action by the charge nurse?
A) Provide a detailed explanation of what she needs to do with ICP monitoring.
B) Tell her when she needs to provide an update about David's status.
C) Ask her to tell you what she knows about ICP monitoring and share expectations about reporting.
D) Advise her that you are available if she needs you.
Q2) You are a member of a team assigned to care for 15 general medical/surgical clients.You have all worked well together in the past in this same type of care.If you are assigned to coordinate this team's work,your best strategy,based on the Hersey model,would be to:
A) have a list of tasks to be accomplished and tell each member of the team what he or she must do.
B) encourage people to discuss their frustrations in providing this care.
C) ignore them-they've done it before.
D) provide minimal direction and let them come to you with questions.
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Chapter 18: Leading Change
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Q1) Elizabeth is an example of a(n):
A) early adopter.
B) late majority.
C) laggard.
D) resister.
Q2) As a new manager,you are shocked to learn that your unit is still using heparin in heparin locks.You are aware of evidence related to this practice and want to change this practice as quickly as possible on your unit.You are in which stage of Lewin's stages of change?
A) Unfreezing
B) Experiencing the change
C) Moving
D) Refreezing
Q3) 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?"
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Chapter 20: Managing Costs and Budgets
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Q1) The chief nursing officer works with her nurse managers by helping them understand how to develop and implement a budget.A nurse manager can best describe a budget as a:
A) day-to-day plan for operations.
B) unit of service.
C) statement of revenues and services.
D) financial plan.
Q2) A nurse manager is planning to request three new infusion pumps at a cost of approximately $1500 each.What would BEST support the capital request?
A) Number of patient care hours anticipated for the year
B) Cost comparisons; how much and how often infusion pumps are used; condition of existing pumps
C) Outline of cost for each pump
D) Estimation of total cost; no further details
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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Chapter 21: Selecting, developing, and Evaluating Staff
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Q1) Sue,a nurse manager,discusses her concerns about the hospital's employee appraisal system with her work group,noting that it includes only one rating scale and that it means nothing unless the manager has effective relationship skills.Sue's concerns reflect which best practices associated with performance appraisal?
A) Rating scales are too generalized to be considered valid or reliable.
B) The effectiveness of appraisal is enhanced by a combination of methods and effective communication skills.
C) BARS is considered superior to simple rating scales in terms of performance appraisal.
D) Rating scales need to be designed by users to be well accepted.
Q2) During the performance appraisal session,the manager should:
A) maintain a relaxed and professional manner.
B) inquire about the employee's personal life and how it is affecting performance.
C) allow the employee to express opinions orally and in writing.
D) plan to give specific examples only for poor performance.
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Chapter 23: Managing Quality and Risk
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Q1) Patient perceptions are useful in:
A) determining disciplinary actions in QI.
B) establishing the competitive advantage of QI decisions.
C) providing one source of data for QI initiatives.
D) establishing blame for poor-quality care.
Q2) Healthcare organization X is committed to improving patient outcomes and,as part of the QI process,examines its executive structure and organizational design.This approach recognizes:
A) the importance of decentralized structure in QA.
B) that structure influences nurse burnout and participation in quality improvement initiatives.
C) the need to ensure sufficient supervisory staff to respond in a corrective manner when mistakes occur.
D) that a narrow hierarchy ensures accountability for errors and outcomes.
Q3) 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.
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Chapter 24: Translating Research Into Practice
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Q1) Once evidence related to the use of prompted voiding in patients with cognitive impairment has been appraised and integrated with practice,it is important to:
A) consider whether patients' families see this as necessary for the well-being of family members.
B) search large databases such as CINAHL to amass further evidence.
C) clarify the clinical practice question.
D) solicit input regarding integration with practice.
Q2) Marie is a long-term staff nurse on the rehab floor.Her unit manager has been eager to adopt evidence-based recommendations related to family-centered care on the unit.Marie's response has been that she rarely has time to provide care to patients,let alone families,and that there is no good reason to do anything different than what she is already doing.An approach that may gain Marie's support of the idea is to:
A) invite Marie to review the studies for herself.
B) suggest that she does not need to provide family-centered care.
C) avoid discussion of the idea with her until she initiates it.
D) secure the support of her closest colleagues on the unit.
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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 most important approach that a nurse manager can take with an emotionally troubled employee is to:
A) act as a therapist for the employee.
B) adjust the standard of care to assist the employee.
C) assist the employee in obtaining professional help.
D) adjust the employee's work schedule to decrease stress.
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Chapter 26: Role Transition
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Q1) Sarah is a nursing graduate of 5 years who is very confident in her clinical skills.She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus.She is excited about being able to use her knowledge and interest by being hired as a nurse manager.Before beginning her new position,Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage.Sarah finds a mentor,Amy,who has been in the role of unit manager for 3 years and has a similar interest in clinical excellence.During their frequent meetings,Amy provides assistance with learning aspects of the manager's role,including technical aspects,such as how to interpret budget printouts and to achieve budget outcomes.The success of Amy's coaching depends on:
A) clarity of Amy's information.
B) organizational support for the mentor relationship.
C) the congruence of Amy's beliefs with Sarah's beliefs.
D) willingness of Sarah to receive feedback.
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Chapter 27: Managing Your Career
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Q1) A new graduate is seeking a new position in nursing and wants to "sell" herself effectively.The best strategy is to:
A) create a résumé.
B) practice interviewing.
C) call the personnel offices.
D) create a curriculum vitae.
Q2) A nurse manager has been employed in the same facility for 20 years and has held the same position.This career style is known as:
A) linear.
B) spiral.
C) steady state.
D) entrepreneurial/transient.
Q3) 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.
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Chapter 29: Developing the Role of Manager
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Q1) Electronic health records (EHRs)are being instituted at Pleasant Valley Hospital.Some of the staff on Unit 4 complain to the manager that acquiring the technologic skills required is too time consuming.They question its value in patient care.The manager responds that:
A) the use of technology is inevitable in our technologically oriented society.
B) the hospital is no longer able to find the space to accommodate paper record-keeping.
C) the initiative is being driven by decision makers higher up in the hierarchy and there is no choice.
D) EHRs will increase effectiveness of care by enhancing coordination and improving patient outcomes.
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.
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Chapter 31: Thriving for the Future
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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) A business condition that may assist forecasting but add to the complexity of change is:
A) consulting with professional groups about change.
B) researching about trends on futuristic sites.
C) asking patients to examine options for change.
D) building profit projects and sustainability into planning.
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