Nursing Policy and Practice Review Questions
Course Introduction
Nursing Policy and Practice examines the relationship between health policy, healthcare systems, and nursing practice at local, national, and global levels. The course explores how policies are developed, implemented, and evaluated, and emphasizes the nurse's role as an advocate, leader, and change agent in shaping and influencing policy decisions. Students will analyze the impact of legislation, regulatory frameworks, and professional standards on nursing practice, patient outcomes, and healthcare delivery. Through case studies and critical discussions, the course prepares students to actively participate in policy development, understand ethical and legal considerations, and contribute to improvements in health care delivery and patient safety.
Recommended Textbook
Leading and Managing in Canadian Nursing 1st Canadian Edition by Patricia S. Yoder - Copy
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30 Chapters
745 Verified Questions
745 Flashcards
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Chapter 1: Leading, Managing, and Following
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) According to complexity science,which of the following should be the focus of measurement?
A) Cost per hospital day
B) Bed utilization
C) Infection rates
D) Staff morale and budgets
Answer: D
Q2) Shortly after being informed of fetal death,a labouring woman asks why she is not able to hear her baby's heartbeat on the monitor anymore.Although the monitor volume had been turned off so that the patient would be able to sleep between contractions,the nurse responded that there was no heartbeat to hear because the baby had died in utero; then the nurse asked whether the patient would like to talk about how she was feeling.This response demonstrates
A) lack of empathy.
B) ethical leadership.
C) complexity science.
D) a coercive relationship.
Answer: B
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Chapter 2: Patient Focus
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22 Verified Questions
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Sample Questions
Q1) As the nurse was about to administer an oral mediation,the patient states,"That pill is the wrong colour." The nurse goes back to the medication administration area to check the medication and realizes that it is indeed the wrong pill.Does this situation require the completion of an adverse event report?
A) No; there was no actual error.
B) No; it was the patient who stopped an error from occurring.
C) Yes; an error almost occurred, and close calls are to be reported.
D) It is up to the nurse to decide whether to complete an adverse event report.
Answer: C
Q2) During review of back injuries,it is determined that mechanical lifts and transfer belts are not being properly used.In addressing this concern,the unit manager
A) meets individually with nurses who are observed to be using the lifts incorrectly to review the correct procedure.
B) consults with the staff about the review to determine how best to proceed.
C) blames the system for inadequate funding for resources.
D) reviews the system of reporting adverse events to ensure that appropriate reporting is occurring.
Answer: B
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Chapter 3: Developing the Role of Leader
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Sample Questions
Q1) Siwan,a new graduate on the dialysis unit,appears to take the nurse manager's remarks about possible position terminations very seriously and works even harder,often volunteering for extra assignments.She also is often in the unit manager's office,advising of successes with her patients and of the extra effort that she is committing.This behaviour suggests that Siwan
A) is fearful of losing her job.
B) lacks understanding of Kari's leadership style.
C) is not intimidated by Kari's leadership style.
D) knows how to "play the game."
Answer: D
Q2) After a newly hired director of nursing has reviewed the unit's strategic plans,she develops a timeline for achieving those plans.The new leader is A) not expecting that novice leaders would have a vision.
B) inviting a seasoned leader to come and share a vision with the group.
C) getting to know staff members so they can work together for a few months.
D) translating a global document into achievable goals for implementation.
Answer: D
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Page 5
Chapter 4: Developing the Role of Manager
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Sample Questions
Q1) The nurse manager plays a unique role in institutional management in that the nurse manager
A) encourages shared decision-making.
B) models professional nursing behaviour.
C) interprets health care trends and their effect on revenues.
D) coordinates care and allocates resources.
Q2) In developing an orientation program,the hospital educator breaks essential organizational information down into chunks,which she develops as online modules.This is an application of which of Peter F.Drucker's functions of management?
A) Establishment of goals and objectives
B) Motivation and communication
C) Analysis and interpretation of performance
D) Organization of activities into manageable tasks
Q3) Which represents one of the Canadian Nurses Association's top six competencies of a good nurse manager?
A) Political activism
B) Conflict resolution skills
C) Budgetary responsibility
D) Current clinical practice knowledge
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Page 6
Chapter 5: Legal Issues
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Sample Questions
Q1) Which of the following is a publicly funded national health care program in Canada?
A) Blue Cross
B) Hospital Insurance Program
C) Medicare
D) Social assistance
Q2) One of your staff nurses asks for your advice because a patient refuses to sign a consent form for surgery.The patient says that he will not sign because he does not understand the nature of the surgery.You advise that
A) consent must not be coerced.
B) the patient has a right to choose not to consent.
C) the patient must sign the consent because the doctor wants him to sign.
D) witnessing the signing of a consent from is related only to the voluntary nature of the signature.
Q3) Which province in Canada does not have a set of common laws?
A) British Columbia
B) Ontario
C) Quebec
D) Newfoundland
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Chapter 6: Ethical Issues
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Sample Questions
Q1) A patient's husband asks to speak with the nursing manager.He is visibly upset and tells the nursing manager that while at the corner store,he overheard two nurses discussing his wife's health issues and is certain that others around him heard the discussion as well.This is an example of
A) ethical distress.
B) an ethical violation.
C) moral inappropriateness.
D) an ethical dilemma.
Q2) What is reflected when a nurse feels a lack of clarity or is unable to know even what the moral problem is,while at the same time feeling uneasy or uncomfortable about the situation?
A) Moral distress
B) Moral uncertainty
C) Ethical dilemma
D) Ethical distress
Q3) Which of the following is a key area of ethical nursing practice?
A) Nursing process
B) Therapeutic relationship
C) Decision-making model
D) Embodied knowledge
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Chapter 7: Making Decisions and Solving Problems
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Sample Questions
Q1) During a fire drill,several psychiatric patients become agitated.The nurse manager quickly assigns a staff member to each patient.This decision style is most appropriate for
A) routine problems.
B) crisis situations.
C) managers who prefer an authoritarian style.
D) followers who cannot agree on a solution.
Q2) The maintenance department wishes to have the nursing lounge renovated so that the lounge will be more "user-friendly." The department asks the nursing staff to make a wish list of everything that they would like to see in the new lounge.This process is an example of which part of the decision-making process?
A) Assessment/data collection
B) Planning
C) Data interpretation
D) Generating hypotheses
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Chapter 8: Health Care Organizations
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Sample Questions
Q1) An academic teaching hospital that provides care for patients who require inpatient and ambulatory care for addictions,through a spectrum of wellness and illness services and providers,would be considered
A) a health care network.
B) a tertiary care institution.
C) rehabilitative.
D) long-term care.
Q2) A nurse manager at a home health care service has resigned to take a position at a local ambulatory care centre.To initiate current changes,the nurse manager has to be knowledgeable about the differences between a home health care institution and an ambulatory care centre,which is a primary care institution.Primary care institutions are facilities that provide
A) rehabilitative or long-term care.
B) disease-restorative care.
C) first access to care.
D) only outpatient services.
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Chapter 9: Understanding and Designing Organizational Structures
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Sample Questions
Q1) "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.
Q2) Collaborative partnerships between hospitals and schools of nursing are examples of hybrid organizational structures.A hybrid organizational structure
A) has many divisions of labour.
B) best fits long-term care units.
C) has a mixture of the characteristics of various organizational types.
D) places the authority for decision-making closest to the places where workers perform.
Q3) A hospital and a nursing education program form a partnership to recruit more nurses to the region.This organizational structure is
A) being responsive to changes in the environment.
B) being bureaucratic.
C) creating permanent professional boundaries.
D) delineating structures for all decision-making.
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Chapter 10: Cultural Diversity in Health Care
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26 Verified Questions
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Sample Questions
Q1) A new graduate registered nurse joins your unit.After a few weeks,she complains about some of her peers on the unit and compares their practices negatively to what she learned in her nursing program.She also is vocal about how she has learned so much here that she did not in her program.She is best described as
A) having cultural sensitivity.
B) experiencing cultural diversity.
C) experiencing cultural marginality.
D) experiencing acculturation.
Q2) When interviewing a candidate for a nursing position who has an Aboriginal background,a non-Aboriginal nurse recognize that the candidate's lack of eye contact reflects the candidate's
A) lack of confidence.
B) professional behaviour.
C) cultural sensitivity.
D) ethnicity.
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12
Chapter 11: Power,Politics,and Influence
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Sample Questions
Q1) Your colleague Vanessa,a recent graduate,announces one day that she intends to leave nursing in 3 to 4 months to pursue a position in marketing.While at your agency,she plans to give patients excellent care and to learn as much as she can,because "Who knows? Nursing is a great job with a great pay and I may return someday." Vanessa's statements most accurately exemplify which orientation to the concept of nursing?
A) Nursing as a profession
B) Nursing as an occupation
C) Nursing as a flexible discipline
D) Nursing as a career with off and on ramps
Q2) Politics is usually
A) confined to legislatures.
B) seen in dysfunctional workplaces.
C) found in all social organizations.
D) a representation of self-interest.
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Chapter 12: Caring,Communicating and Managing With Technology
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Sample Questions
Q1) As a nurse manager,you want to institute point-of-care devices on your unit.The rationale that you provide to support the point-of-care devices includes which of the following?
A) Reduction in incidents of medication error
B) Immediate documentation of care
C) Improving discharge planning
D) Increasing confusion with nursing workflow
Q2) A nurse manager was orienting new staff members with regard to computerized charting.To understand computerized charting,staff members must understand informatics.Which of the following are the core concepts in informatics?
A) Hardware, software, competency, and printers
B) Data, information, knowledge, and wisdom
C) Decision making, data gathering, data analysis, and reporting
D) Wireless technology, voice recognition, and handheld devices
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14
Chapter 13: Managing Costs and Budgets
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Sample Questions
Q1) The increased use of medical services in Canada is stimulated by which of the following?
A) Consumers' attitudes
B) Population demographics
C) Managed care
D) Pharmaceutical usage
E) Attitudes of health care staff
Q2) Which of the following is an example of an initiative that may reduce total health care costs?
A) Offering nurse practitioner-led clinics that educate parents about nonpharmacologic strategies for managing ear infections
B) Educating older adults about the comparative costs of medications that are prescribed to them
C) Lowering copayments for prescription drugs for older adults
D) Advocating for more readily available magnetic resonance imaging (MRI) services to ensure early diagnosis
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15
Chapter 14: Care Delivery Strategies
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Sample Questions
Q1) When interviewing an applicant for a position,the nurse manager describes the unit's care delivery system as one in which each nursing assistant is cross-trained to perform specific tasks and in which the RNs handle all intravenous medications,admissions,and discharge teaching.The nurse applicant knows this nursing care delivery strategy to be A) the case method.
B) functional nursing.
C) primary nursing.
D) nurse case management.
Q2) You are the nurse manager of a nursing service organization that provides around-the-clock care to patients in their homes.To achieve an optimal outcome for a patient who is recovering from a hip replacement,the nursing staff will probably follow the nursing care guidelines presented in which of the following?
A) Nursing care plan
B) Physician's orders
C) Critical pathway
D) Clinical practice guidelines
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16
Chapter 15: Staffing and Scheduling
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Sample Questions
Q1) Your health care 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.
Q2) In the past year,you have noticed an increase in patient falls on your unit.In reading studies related to staffing and patient outcomes,you realize that you will need to plan for A) higher patient care hours.
B) safer facilities.
C) institution of a patient classification system.
D) an increased number of RN positions.
Q3) To project staffing needs and to avoid understaffing,it is important that nurse managers consider which of the following?
A) Maximum productive hours
B) Average nonproductive hours
C) Minimum benefit hours
D) Maximum vacation time
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Chapter 16: Selecting, developing, and Evaluating Staff
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Sample Questions
Q1) On your unit,despite efforts to build a strong sense of team,conflict between some of the staff is ongoing.Nonetheless,you want to proceed with developing a systematic and effective performance appraisal system.Which of the following approaches would be most appropriate for you to implement?
A) Peer review
B) A combination of tools
C) Anecdotal notes
D) Rating scale
Q2) The nurse manager schedules evaluations of staff members by using a newly developed performance appraisal tool.The development of a performance appraisal tool should include
A) the organizational mission and philosophy and the position requirements.
B) a generalized overview of the duties of a position.
C) a skills checklist and accreditation requirements.
D) an ordinal scale that ranks all employees.
Q3) Anecdotal notes
A) should be completed only when there are performance concerns.
B) can be used to support and justify fairness in termination discussions.
C) are unnecessary if the evaluation instrument is thorough.
D) need to be completed at the end of a performance period.
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Chapter 17: Strategic Planning and Goal Setting
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Sample Questions
Q1) In establishing the strategic plan for effective use of evidence to guide nursing practice at Pacific Hospital,the nursing unit managers take the next step,which is the implementation.Implementation would probably involve
A) revisiting the mission statement and objectives.
B) reevaluating external and internal factors affecting evidence-informed practice.
C) preparing a budget to support implementation.
D) developing unit-based objectives related to the plan.
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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19
Chapter 18: Leading Change
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Sample Questions
Q1) You follow up with Elizabeth and discover that she is quite angry about the information sessions because she believes that you are implying that what she has been doing all these years means that she is incompetent and does not care about her patients.Your response to her should indicate that
A) Elizabeth will never adopt the change.
B) Elizabeth is insecure in her practice.
C) Elizabeth requires more information about the practice.
D) change involves emotions rather than intellect.
Q2) The nurse manager frequently interacts with staff and other hospice facility employees.Communication was purposeful because the manager assessed current issues,such as specific satisfactions and dissatisfactions with the newly implemented computerized documentation system.Informally,the manager gathered available staff members to address similar learning needs.Many times,staff members were found coaching other staff about improving use of the new system.According to Senge (1990),the activities demonstrated in this example are
A) dialogue and team learning.
B) resilience and personal mastery.
C) shared vision and systems thinking.
D) mental models and teachable moments.
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Page 20
Chapter 19: Building Teams Through Communication and Partnerships
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Sample Questions
Q1) The Situation-Background-Assessment-Recommendation (SBAR)system of communications is one of the most widely used communication systems in health care because
A) it deals with all aspects of communications in patient care except communication with the physician.
B) the nurse is on the same communication level as administration.
C) it focuses on how information is provided and gleaned in an honourable way.
D) it honours an unstructured transfer of information.
Q2) A mediator suggested that the nurse manager and staff members decide on a method to resolve conflicts.Why is it important to have agreements about how team members will work together?
A) If there are no agreements, each member will make up his or her own procedures without consensus.
B) People are naturally difficult and will not work well together without such agreements.
C) People will naturally ask for agreements about how to be together.
D) A way to eliminate nonproductive team members must be available.
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Chapter 20: Collective Nursing Advocacy
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Sample Questions
Q1) 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 is practical.
C) spending as much time as possible in clinical settings.
D) taking the opportunity to work with a mentor.
Q2) The staff members in a local emergency department are experiencing stress and burnout as the result of excessive overtime.The staff decides to unionize to negotiate for better working conditions.Approximately what percentage of nurses in Canada are members of a union?
A) 60%
B) 70%
C) 80%
D) 90%
Q3) Health care inequities frequently arise from
A) failure of organizational structures to adhere to shared governance.
B) social determinants of health.
C) lack of commitment to health.
D) inability to pay for health services.
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Page 22
Chapter 21: Managing Quality and Risk
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Sample Questions
Q1) The outcome statement "Patients will experience a 10% reduction in urinary tract infections as a result of enhanced staff training related to catheterization and prompted voiding" is
A) physician sensitive and nonmeasurable.
B) measurable and nursing sensitive.
C) precise, measurable, and physician sensitive.
D) patient care centred and nonmeasurable.
Q2) An example of an effective patient outcome statement is
A) "Eighty percent of all patients admitted to the emergency department will be seen by a nurse practitioner within 3 hours of presentation in the emergency department."
B) "Patients with cardiac diagnoses will be referred to cardiac rehabilitation programs."
C) "The hospital will reduce costs by 3% through the annual budget process."
D) "Quality is a desired element in patient transactions."
Q3) Patient perceptions are useful in
A) determining disciplinary actions in QI.
B) establishing the competitive advantage of QI decisions.
C) establishing priorities among possible changes to care identified in QI.
D) establishing blame for poor-quality care.
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23
Chapter 22: Translating Research Into Practice
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Sample Questions
Q1) Before implementation of the new policy and procedure on central-line catheter care,the nurse manager uses an appraisal system to evaluate the evidence.What is important in using an appraisal system to evaluate the evidence gathered in preparation for development of a new protocol?
A) Limiting the search to randomized clinical trials
B) Matching the appraisal tool to the type of evidence
C) Eliminating qualitative research studies
D) Using only preprocessed evidence
Q2) Which of the following would be considered research?
A) Evaluation of the effectiveness of implementation of evidence-based guidelines for prompted voiding
B) Comparison of patient outcomes after implementation of practice guidelines against baseline (preimplementation) outcome data
C) Audit of adverse events after implementation of evidence-based guidelines for pressure ulcers
D) Interviews with terminally ill cancer patients regarding their experience of being terminally ill
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Chapter 23: Understanding and Resolving Conflict
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Sample Questions
Q1) Kala,a unit manager,in discussing a role the hospital's chief executive officer would like her to perform,makes the following statement: "I will sit on the hospital task force on improving morale if you send me to the hospital's leadership training classes next week,so I can further develop my skills and thus be more effective." Which of the following conflict management styles is Kala using?
A) Collaborating
B) Avoiding
C) Negotiating
D) Accommodating
Q2) Tina is a nurse manager in a surgical unit.She is concerned about an ongoing conflict between Lucy,a staff nurse,and one of the maintenance personnel.She explains to Lucy that unsatisfactory resolution of the conflict is typically destructive and will result in
A) decreased frustration between the maintenance worker and her.
B) a good relationship with the maintenance department.
C) eventual resolution of the problem without further intervention.
D) decreased productivity on her part.
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Chapter 24: Managing Personalpersonnel Problems
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Sample Questions
Q1) Nurses generally experience difficulty in identifying behaviours and actions that could signal chemical dependency in a co-worker.Which of the following is not a behavioural change that occurs with chemical dependency?
A) Personality and behavioural changes
B) Job performance changes
C) Changes in educational involvement and pursuit
D) Absenteeism
Q2) In keeping with guidelines of the organization,the nurse manager documents staff problems.Documentation of disciplinary problems should
A) include a plan to correct them and to prevent future occurrences.
B) state a detailed history of past problems that are related to the current one.
C) be written at the convenience of the manager.
D) accumulate until the evaluation period begins.
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26
Chapter 25: Workplace Violence and Incivility
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Sample Questions
Q1) Reza,RN,works as a staff nurse in the mental health department; Sharon works as a data entry clerk in the admissions department; Sarah is an emergency room physician; and Donna is a housekeeper in the geriatrics department.Which of the four is most likely to be a perpetrator of violence?
A) Reza
B) Sarah
C) Sharon
D) Donna
Q2) Sabotage is an example of which type of violence?
A) Threatening behaviour
B) Written threat
C) Harassment
D) Verbal abuse
Q3) Canadian knowledge of the scale of workplace violence in health care remains incomplete because
A) collected data are inflated.
B) no consistent system of data collection for workplace violence exists.
C) data is collected only in relation to physical injuries.
D) the classification of workplace violence is unclear.
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Page 27
Chapter 26: Practising and Leading in Interdisciplinary Settings
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Sample Questions
Q1) Sammi,a registered nurse,is part of an interdisciplinary team that provides care to patients with acute cardiac interferences.The team has not been functioning optimally.and Sammi is aware that this may cause a(n)
A) increase in the cohesiveness of the team.
B) escalation of turf protection.
C) increase in the quality of patient care.
D) decrease in workplace stress.
Q2) The rational for the shift to interdisciplinary teams for health care delivery in Canada is related to
A) the aging of the population.
B) increased utilization of unregulated care providers.
C) nurse shortages.
D) an increase in acute illness and comorbidity.
E) increasing specialization of health care providers.
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28
Chapter 27: Role Transition
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Sample Questions
Q1) The head nurse and the administrator of a cardiac telemetry unit disagree on how much time the head nurse should allot to various aspects of the role.Staff members on the unit complain that the head nurse is unavailable for clinical concerns because of being off the unit while attending meetings.To facilitate the process of role transition,the head nurse should
A) rely on his or her internal resources.
B) attend a workshop on how to deal with difficult people.
C) develop a relationship with a mentor who has overcome similar difficulties.
D) schedule a series of meetings with staff and the administrator to clarify expectations.
Q2) In assisting new graduates to make the role transition to graduate nurse,Teo,the unit manager,initiates which of the following?
A) Self-checklist 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 28: Self-Management: Stress and Time
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Sample Questions
Q1) Jeffrey,an RN in his 30s,has lost a parent,just purchased a new home,and is laid off with 6 months' severance pay.A the same time,Miles,an RN in his 50s,is financially secure and is asked to take early retirement with a buyout.How will the two men react to the emotional and physical influences and the sequence of stress?
A) The younger man will feel more stress.
B) The two men may or may not feel the same amount of stress.
C) The older man will feel more stress.
D) Neither man will experience any stress.
Q2) "Stress-buffering" behaviours can be elicited to reduce stress.All of the following behavioural coping responses can be used by nurse managers to reduce and manage stress except
A) distancing oneself from work.
B) using cognitive reframing to change irrational thoughts.
C) journalling and keeping an informal diary of daily events and activities.
D) exercising regularly.
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Chapter 29: Managing Your Career
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Sample Questions
Q1) A cover letter and a résumé together should be no longer than ________ page(s). A) two
B) one
C) four
D) three
Q2) During performance appraisal interviews,Joanna's nurse manager notices Joanna's excitement when she talks about how she has helped patients on a rehabilitation unit understand the complexities of their regimens.When Joanna's nurse manager asks her about her career path plans,Joanna says that she wants to become a nurse administrator.The best response to Joanna would be
A) "Nursing administration is rewarding. What experiences would help you along this path?"
B) "You do not appear excited about nursing administration. Unless you are excited by that career path, I wouldn't advise going in that direction."
C) "You seem to find teaching others very rewarding. Have you considered that as a possible career path?"
D) "You are too inexperienced to consider administration. Work for a few years, and then consider administration."
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Chapter 30: Thriving for the Future
Available Study Resources on Quizplus for this Chatper
24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/44775
Sample Questions
Q1) The phenomenon experienced by the staff in question 18 is termed A) eustress.
B) care process.
C) stereotypical thinking.
D) complexity compression.
Q2) Health care demographics,changing funding levels,and alternative approaches to care all interact with and influence one another.Nursing at individual,unit,and systems levels influences health care and society,and vice versa.The implication of this is that
A) funding levels will reduce the number of nursing positions.
B) the ethical influence of nursing on political decisions increases public trust in nursing.
C) negative publicity by politicians will negatively affect public perceptions of nursing.
D) the public has little effect on the organization of health care.
Q3) Which of the following hampers the ability of nurses to be leaders?
A) A focus on the patient and not on the system
B) Lack of interest in leadership
C) Disillusionment with change
D) Funding disparities
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