Professional Issues in Nursing
Mock Exam
Course Introduction
Professional Issues in Nursing explores the contemporary challenges and responsibilities faced by nurses within the healthcare system. This course examines topics such as ethical and legal considerations, professional standards, advocacy, cultural competence, interprofessional collaboration, and workforce issues including leadership, workplace violence, burnout, and career development. Students will engage in critical reflection on the impact of policy, social justice, and evidence-based practice on the nursing profession, equipping them with the knowledge and skills to navigate and influence the evolving landscape of healthcare while upholding the values and integrity of nursing practice.
Recommended Textbook
Leadership and Nursing Care Management 6th Edition by Diane Huber
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Page 2
Chapter 1: Leadership and Management Principles
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Q1) _____ are vital to good leaders because they are able to take the vision of the leader and achieve the determined goals.
A) Managers
B) Motivators
C) Visionaries
D) Followers
Answer: D
Q2) Interpersonal communication and the ability to apply _____ are two critical skills every nurse needs to enhance professional practice.
A) vision
B) supervision
C) delegation
D) problem solving
Answer: D
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Chapter 2: Change and Innovation
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Q1) The development of new practices in response to new evidence is called:
A) altered direction.
B) organizational flux.
C) planned change.
D) status revision.
Answer: C
Q2) A hospital system is implementing an electronic health record. The facility conducts education and training for nursing staff, medical staff, and ancillary staff over a period of 6 months. This is an example of:
A) emergent change.
B) planned change.
C) transformation.
D) innovation.
Answer: B
Q3) Almost all changes encounter:
A) attitudes.
B) resistance.
C) knowledge.
D) communication.
Answer: B
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Chapter 3: Organizational Climate and Culture
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Q1) What is the purpose of a mission statement?
A) To provide a method of achieving success and a competitive advantage
B) To aid recruitment
C) To guide members on problem solving and relationship management
D) To offer a snapshot of strategic priorities
Answer: D
Q2) Culture change within nursing homes was initiated by the:
A) Nursing Home Reform Act.
B) National Citizens' Coalition for Nursing Home Reform.
C) Pioneer Network.
D) Eden Alternative.
Answer: A
Q3) Culture is best defined as (the):
A) deviation from the majority.
B) differences in likes and dislikes.
C) shared beliefs and values.
D) similar views and opinions.
Answer: C
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Chapter 4: Managerial Decision Making
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Sample Questions
Q1) A staff RN is leading a quality improvement team on the care of the total hip replacement patient. The issue is an increased length of stay from 1 year ago. The nurse asks team members to reframe the problem statement from their perspective. Twenty different problem statements were developed. The team is focusing on four of the problem statements. This is an example of which of the following techniques?
A) Decision making
B) Evaluating the consequences
C) Inclusive judgment
D) Problem processing
Q2) The nurse in a medical-surgical unit is working short-staffed due to a sick call. Which of these is an example of prioritization?
A) Charting by exception
B) Omitting personal hygiene in favor of timely medication administration
C) Timely medication administration without scanning the patient armband
D) Deploying a rapid response team when a patient condition changes
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Chapter 5: Managing Time and Stress
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Q1) A nurse manager has several complaints from her staff that she is inaccessible during the day. What is the best strategy the nurse manager takes to improve her staff satisfaction?
A) Notify staff when she will be out of the office.
B) Block time for daily rounds with staff.
C) Set realistic follow-up deadlines for staff issues, questions, and concerns.
D) Ask the staff to communicate with her through their supervisors.
Q2) Jay, a nurse in the intensive care unit, has been caring for a patient with end-stage renal disease, congestive heart failure, and a stroke. The client has had four cardiac arrests in 4 days. Despite the grave prognosis, the client's family continues to want resuscitation at all cost. Jay knows that further medical care is futile. Jay is at risk for:
A) confrontational conflict.
B) resilience.
C) burnout.
D) moral distress.
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Chapter 6: Legal and Ethical Issues
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Q1) On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. Because of the nurse's actions, the admitting hospital may be found to be:
A) a judicial risk.
B) an ostensible authority.
C) indemnified.
D) vicariously liable.
Q2) A new RN is observed breaking sterile technique by the perioperative nurse. This is an example of a violation of which ethical principle?
A) Autonomy
B) Justice
C) Nonmaleficence
D) Confidentiality
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Chapter 7: Communication Leadership
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Sample Questions
Q1) An example of an external variable that may affect communication is:
A) circumstance.
B) personality.
C) thoughts.
D) feelings.
Q2) E-mail is a great tool for communication. When should e-mail not be used? (Select all that apply.)
A) When you are mad.
B) When scheduling a meeting
C) When you are canceling or apologizing
D) If there is any chance your words could be misunderstood
E) When rebuking or criticizing
Q3) The number one cause of preventable medical errors is:
A) hostile work environments.
B) poor communication.
C) ineffective leadership.
D) staff competency.
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Chapter 8: Team Building and Working With Effective Groups
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Q1) A small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable and whose membership should be consistent is known as a: A) committee.
B) group.
C) team.
D) unit.
Q2) A type of group that is stable, meets periodically, has an identified purpose, and is part of the organizational structure is called a: A) club.
B) committee.
C) group.
D) meeting.
Q3) Group as well as individual accountability exists within a: A) work group.
B) true team.
C) pseudoteam. D) committee.
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Chapter 9: Delegation in Nursing
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Q1) When the licensed nurse makes a determination to delegate a task, which of the following occurs in the process? (Select all that apply.)
A) The nurse assesses the situation and need for delegation.
B) A plan for specific task delegation is established.
C) The needs of the nurse are considered.
D) The nurse determines the available resources and patient safety.
E) Accountability is transferred to the manager.
Q2) The nurse has asked a nurse's aide to greet a postoperative patient who has just arrived on the unit and to determine whether he is in stable condition. This act of delegation is an example of a nurse inappropriately delegating:
A) assessment of the patient.
B) evaluation of an intervention.
C) nursing judgment.
D) teaching to a delegate.
Q3) Delegating requires clear and skillful _____ to avoid liability.
A) negotiation
B) communication
C) corrective action
D) planning
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Page 11
Chapter 10: Power and Conflict
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Q1) A staff nurse frequently is providing positive comments to get the manager in a good mood before asking about additional vacation time. This influence tactic is known as:
A) consultation.
B) ingratiation.
C) inspiration appeals.
D) rational persuasion.
Q2) What are the two major content dimensions of power? (Select all that apply.)
A) Influence
B) Integrity
C) Authority
D) Dominance
E) Control
Q3) _____ is a personal quality that is admired in the person with referent power.
A) Problem solving
B) Authority
C) Knowledge
D) Coercive power
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Chapter 11: Workplace Diversity
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Q1) Cultural diversity refers to the:
A) variety of cultural or ethnic groups within a society.
B) belief that one's own culture is similar to another's culture.
C) realization that all people in a particular culture have the same beliefs.
D) view that individuals living in a country should speak the native language.
Q2) Equity is the absence of avoidable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically. Which group formulated this definition?
A) World Health Organization
B) Affordable Care Act
C) Centers for Disease Control
D) Agency for Healthcare Research and Quality
Q3) When communicating health information with diverse populations, miscommunication and misunderstanding can lead to: (Select all that apply.)
A) cultural competence.
B) malpractice claims.
C) informed consent.
D) errors.
E) increased cost.
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Page 13
Chapter 12: Organizational Structure
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Sample Questions
Q1) Which of the following factors influences the structure of an organization?
A) Age of the building
B) Brand of computer system
C) Number of employees
D) Square footage of the facility
Q2) Which of the following statements describe the benefits of specialization in the health care setting? (Select all that apply.)
A) Improved work performance
B) Increase in expertise
C) Improved efficiency and outcomes
D) Increased workload
E) Increased error reporting
Q3) A staff nurse has been working in the neonatal critical care unit for 10 years. She believes that a professional nurse is a lifelong learner. Many staff members come to her for clinical problem solving and advice. This nurse has:
A) decisional authority.
B) formal power.
C) informal power.
D) quantum authority.
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Page 14
Chapter 13: Decentralization and Shared Governance
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Q1) Which of the following statements best describes an organizational chart?
A) All job positions are displayed clearly in a two-dimensional drawing.
B) All outside organizations with relationships to the hospital are depicted.
C) Informal and formal structures within the organization are outlined.
D) It shows organizational positions and relationships in a visual representation.
Q2) In Magnet organizations, shared governance needs to be manifested through what mechanisms for nurses' decision making?
A) Unit practice councils
B) Democratic leaders
C) Authoritarian leaders
D) System-wide practice councils
Q3) In organizations that practice shared governance, the responsibility for unit outcomes rests with the:
A) nursing team.
B) nurse manager.
C) individual nurse.
D) chief nursing officer (CNO).
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Page 15
Chapter 14: Strategic Management
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Sample Questions
Q1) Operational choices for action that are made to implement a strategy are called:
A) tactics.
B) objectives.
C) core values.
D) strategic plans.
Q2) A competitive move or business approach designed to produce a successful outcome is called _______.
Q3) An action plan:
A) breaks a strategic plan into manageable parts.
B) details a futuristic view of the institution.
C) outlines the steps in performing a procedure.
D) provides a strategic plan for actualizing the mission.
Q4) Characteristics of strategic management include: (Select all that apply.)
A) alignment with the external environment.
B) helps identify best practices on the nursing unit.
C) future orientation.
D) engagement of the entire workforce in organizational leadership.
E) use of change management strategies to achieve performance goals.
F) facilitation of decision making with well-communicated decisions.
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Chapter 15: Professional Practice Models
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Q1) The conceptual framework and philosophy under which the method of delivery of nursing care is a component is known as:
A) core values.
B) mission statement.
C) care delivery model.
D) professional practice model (PPM).
Q2) The responsibility for making decisions about and designing strategies to create a climate and environmental context around the provision of nursing and health care services lies with:
A) staff nurses.
B) care councils.
C) the nurse manager.
D) executive leadership.
Q3) Disadvantages of private duty nursing include: (Select all that apply.)
A) private duty nurses have a great degree of autonomy.
B) private duty being a costly model.
C) job security being tenuous and irregular.
D) the nurse's focus being entirely on one client's needs.
E) nurses maintaining close relationships with colleagues.
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Page 17
Chapter 16: Case and Population Health Management
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Q1) Which of the following statements is true about the New England Medical Center (NEMC) case management model?
A) It has a client-centered approach instituted during episodes of acute illness.
B) It is known as a beyond-the-walls, medical-social, across-the-continuum of care model.
C) It emphasizes the case manager's traditional linkage function.
D) CM functions are undertaken as a part or an extension of therapeutic intervention.
Q2) Case management and disease management are similar because both are interventions designed to coordinate care for better outcomes and lowered costs. Which statements are true regarding the differences between the two terms? (Select all that apply.)
A) Disease management is client focused.
B) Case management focuses on coordinating care of individuals and families.
C) Disease management is more population-based than client-centered.
D) Disease management is more episodic in its approach.
E) Case management is more population-focused.
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18
Chapter 17: Evidence-Based Practice: Strategies for Nursing Leaders
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Sample Questions
Q1) Opinion leaders are:
A) formal leaders who lead evidence-based practice development teams.
B) formal leaders who write new evidence-based practice guidelines.
C) informal leaders who influence peers by evaluating innovations for use in certain settings and promoting clinicians use of evidence in clinical decision making.
D) informal leaders who gather data about nursing practice changes.
Q2) Evidence-based practice includes:
A) collaborative practice dynamics between health care professionals.
B) documentation of patient care as evidence of nursing practice.
C) integration of research with clinical expertise and patient values.
D) mutual goal setting and application in the clinical setting.
Q3) The role of the project director is to:
A) take meeting minutes.
B) maintain the action plan.
C) set the expectations for the unit.
D) report project progress to the governing body.
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19
Chapter 18: Quality and Safety
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Sample Questions
Q1) The purpose of a root cause analysis (RCA) is to:
A) discipline the staff involved in the patient safety event.
B) disclose the medical error to the patient/patient s family.
C) identify the person(s) responsible for committing the error.
D) identify the systems issues that led to a sentinel event.
Q2) Responding to a code called in the psychiatric unit where she works, a staff nurse finds that a patient has committed suicide. The staff nurse correctly identifies this as a:
A) benchmark incident.
B) quality improvement issue.
C) performance breach.
D) sentinel event.
Q3) Attributes of a total quality organization according to BNQA include: (Select all that apply.)
A) accreditation by TJC.
B) a commitment to obtaining Magnet designation.
C) strategic planning.
D) focus on patients, other customers, and markets.
E) organizational performance results.
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Chapter 19: Measuring and Managing Outcomes
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Sample Questions
Q1) Key examples of patient-focused outcome indicators are: (Select all that apply.)
A) patient satisfaction.
B) birth rates.
C) health status.
D) quality of life.
E) ability to function.
Q2) The process of managing outcomes includes five steps. List the five steps below in the correct order.
A) Variances are investigated.
B) Data are collected about outcomes.
C) Trends are identified from data analysis.
D) Changes are implemented and reevaluated.
E) Appropriate service delivery changes are determined.
Q3) Outcomes measurement is complex because:
A) budgets are unable to allocate sufficient funds.
B) health care is multidimensional.
C) patients may not cooperate.
D) treatments are not always necessary.
Q4) A(n) _____ is the result or results obtained from the efforts to accomplish a goal.
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Chapter 20: Prevention of Workplace Violence
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Sample Questions
Q1) Employee assistance programs can be especially useful when mitigating which source of violence?
A) Patients
B) Current or former workers
C) Criminals with no connection to the employer
D) Someone who has a personal relationship with an employee
Q2) Staff nurses may be able to avoid bullying behavior through:
A) increasing time spent with patients at the bedside.
B) ignoring the assaults.
C) filing a grievance.
D) cognitive rehearsal training.
Q3) The chief operations officer of a local hospital has issued a memorandum indicating that the modular waiting room furnishings will be replaced with stationary units. This is an example of which type of strategy for preventing workplace violence?
A) Administrative controls
B) Behavior modification
C) Environmental design
D) Fixture adaptation
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Chapter 21: Confronting the Nursing Shortage
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Sample Questions
Q1) The average age of the registered nurse (RN) population is _____ years.
A) 26
B) 36
C) 45
D) 56
Q2) The process of identifying applicants for potential employment is called:
A) selection.
B) retention.
C) recruitment.
D) human resources.
Q3) The total number of nurses who left a unit in 1 year divided by the total number of nurses employed on that unit is the _____ rate.
A) actualized
B) employable
C) turnover
D) vacancy
Q4) _____ is the process in which the application is reviewed before determining whether the nurse meets the preestablished criteria for the position.
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Page 23
Chapter 22: Staffing and Scheduling
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Sample Questions
Q1) The new nursing care model, developed by the American Association of Critical-Care Nurses (2016), focuses on the needs of the patient and the competencies of the nurse. It is known as the:
A) Synergy Model for Patient Care.
B) Case Management Model.
C) Primary Nursing Model.
D) Clinical Nurse Leader Model.
Q2) The proportion of direct-care RNs to total direct-care nursing staff, expressed as a percentage of RNs to total nursing staff, is called _____.
Q3) The hospital units most likely to employ a decentralized staffing model include: (Select all that apply.)
A) the telemetry unit.
B) labor and delivery.
C) the medical-surgical unit.
D) the emergency department.
E) the neonatal critical care unit.
Q4) The amount of work performed by a unit is referred to as its _____.
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Chapter 23: Budgeting, Productivity, and Costing Out Nursing
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Q1) The key advantage of activity-based costing is:
A) workload is determined based on the required hours of nursing care.
B) it reflects what it costs to provide services and identifies why costs were incurred.
C) data can be used in constructing a personnel budget because it is linked to the volume indicator of patient days.
D) the judgment of an expert nurse clinician must override an empirical system and be based on patient's needs in real time.
Q2) A(n) _____ is the difference between the budgeted and the actual amounts.
Q3) Using resources to maximize health benefits while simultaneously using resources to maximize cost-effectiveness is:
A) costing out nursing services.
B) fiscal responsibility.
C) priority nursing management.
D) capital constraint.
Q4) A measure of the severity of illness of an individual patient or the aggregate patient population on a unit is called _____.
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Chapter 24: Performance Appraisal
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Sample Questions
Q1) A newer focus of performance appraisal that has the ability to engage high-performing nurses and motivate people toward even higher levels of performance is:
A) coaching.
B) remedial learning.
C) feedback.
D) peer review.
Q2) An experienced critical care nurse left a CCU staff nurse position to finish a master's degree. Periodically, he would return to work as a per diem nurse in the CCU. The staff was impressed with the nurse's performance; however, one staff member complained that he was unfamiliar with the new telemetry monitors when he first returned to work several months ago. This comment showed up in his evaluation, resulting in a poorer overall evaluation from the nurse manager compared with previous evaluations. This is an example of:
A) contrast bias.
B) a horn effect.
C) recent behavior bias.
D) similar-to-me effect.
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26
Chapter 25: Emergency Management and Preparedness
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Q1) Which of the following questions should be considered in the hospital gap analysis survey of clinical operations readiness in the event of a disaster? (Select all that apply.)
A) Does the facility have procedures in place to maximize staff safety in a disaster?
B) Does the facility have procedures in place for use of PPE?
C) Can the facility track patients until discharge or death while maintaining confidentiality?
D) Does the facility have a lockdown plan in case of emergency?
E) Does the facility have a mechanism of tracking costs associated with the event?
Q2) What is the role of the project facilitator in the emergency management committee?
A) Creating key components of disaster protocols
B) Keeping the plan current and in the forefront of strategic planning
C) Establishing guidelines for policy and procedures
D) Improving care by developing patient care plans.
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Chapter 26: Data Management and Clinical Informatics
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Q1) Which of the following statements are true regarding health information technology (HIT) applications in nursing services? (Select all that apply.)
A) HIT involves nursing administration, clinical informatics, and effectiveness research.
B) Health information data allow nursing leaders to make informed decisions regarding patient care.
C) HIT is used primarily for financial decision making.
D) Clinical decision support utilizes tools for downloading, collecting, organizing, and analyzing data.
E) HIT is used by senior leaders only.
Q2) Effectiveness research:
A) is the study of relationships among health care problems.
B) provides solutions to serious global health care issues.
C) reflects sound, reliable, and valid data that can be examined closely.
D) supplies data that are critical and worthy of gathering.
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Chapter 27: Marketing
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Q1) Marketing mix from a seller's point of view includes:
A) client service, charges, comfort, and connecting.
B) customer solution, cost, convenience, and communication.
C) patient, physicians, perfection, and publicity.
D) product, price, place, and promotion.
Q2) Hospitals in recent years have become more motivated to focus their marketing strategies on patient care excellence. What are some of the drivers of this focus? (Select all that apply.)
A) Heightened patient scrutiny
B) Heightened media scrutiny
C) Organizational transparency about error reporting
D) Frequent media accounts of medical errors
E) Increased litigation
Q3) Which model of patient care is based on a strong philosophy of patient-centeredness?
A) TJC
B) Thomson Reuters
C) Beacon
D) Planetree
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