The integration and coordination of health services to a specified population of patients or to individual patients has been described as case management. Select the best statement to describe this approach.
A
A comprehensive, integrated approach to care
D
The correct answer is that it includes the steps of care coordination, which is a comprehensive collaborative process of assessment, planning, facilitation, and communication to organize and evaluate patient care activities and advocate for services and
The accountable care organization (ACO) will need to measure progress toward optimized population health. The measures for the ACO would include:
A
benchmarks that provide frames of reference against which an organization can compare itself relative to ot
B
The correct answer is ACOs will need population health measures on clinical process and outcome indicators, patient satisfaction, functional status, quality of life, economic and utilization indicators, and changes in health disparities. The first answe
Which of the following statements correctly describes case management?
A
Primary therapists have therapeutic relationships with the clients and provide primary case management functions.
B
Physicians must document the effects of interventions on client ou
D
The correct statement is that RNs have emerged as the large majority of case managers, especially in hospitals, because of their specialized expertise for the function of determining medical necessity for health care payment and because of care coordina
The degree to which a client or population with common personal or environmental characteristics continues a negotiated treatment is a parameter. To measure this indicator in a community or interdependent organizations, such as ACOs, would be:
A
complianc
B
The correct answer is adherence, which is the degree to which a client or population with common characteristics continues a negotiated treatment within the community or interdependent formal organization that functions to meet a variety of collective n
A model of population care management would include:
A
population needs assessment, identification of health services, targeted health planning, wellness and prevention, care management, and case management.
B
population needs assessment, prioritization o
A
Population care management includes six levels of activities: population needs assessment, identification of health services, targeted health planning, wellness and prevention, care management, and case management.
Given the interdisciplinary nature of case management, who would be best in the case manager role?
A
Associate degree nurses are skilled in the coordination of client care.
B
Geriatric advanced practice nurses are skilled in the coordination of client car
D
Advanced practice nurses are best for the case manager role because they draw on a wealth of knowledge to lead and coordinate the health care team. Associate degree nurses are lacking some formal leadership knowledge, critical thinking, and clinical rea
Case managers were deployed to decrease fragmentation; reduce expense by streamlining care; and control costs by linking, advocating, coordinating, negotiating, educating, and monitoring. Today the model that guides hospitals and clinics to case manage is
D
Public health guides the health care organization to coordinate and integrate services across the continuum from hospital to community to reduce costs and eliminate redundancy of services. The continuum includes health promotion/illness prevention, publ
Although all clients need coordinated care, disease management best serves the needs of targeted, high-risk populations for:
A
coordinating the care of the individual client in relation to one or more diseases or health conditions after hospitalization.
B
C
Disease management best serves the needs of targeted, high-risk populations for a specific disease or health condition of a population group, with subsequent application to individuals over time, such as with diabetes mellitus. The first answer is about
Leaders and managers should know the many aspects of case management. Two statements are correct and two statements are incorrect. Identify the two correct statements (select all that apply).
A
Case management focuses on continuity of the plan.
B
Case man
B, C
Case management entails providing holistic care, conservation of resources, and care across episodes and settings, and there is a current trend to push for accountability and accreditation for case management organizations. The first statement is inc
Multiple unique goals are achieved with case management services that are different from the goals of managed care. Nurses as case managers contribute to which of these goals (select all that apply)?
A
Coordinating client-focused care by planning and arra
A, B, D
Case management goals focus on client advocacy, coordination of health care delivery, and facilitation of specific cost and quality outcomes by direct interventions that include 1) coordinating client-focused care by planning and arranging access
A complex combination of a hierarchical structure with project teams is the definition of which type of organization structure?
A
Decentralized
B
Matrix
C
Centralized
D
Divisionalized
B
A matrix organization is a complex combination of a hierarchical structure with project teams. Decentralized organization is when the power to make decisions is filtered down toward the individual worker. Centralized organization is when the power to ma
The analysts who design, plan, change, or train individuals to do the work of the organization are known as holding the:
A
technostructure position.
B
line position.
C
staff position.
D
support staff position
A
The technostructure position is held by the analyst who designs, plans, changes, or trains individuals to do the work of the organization. The line position is described as the direct line of hierarchical authority. The staff position is the position th
Changing the operational process of an organization is often necessary when adding or updating patient care and health information technologies. The process to engage in making this change is called:
A
scalar process.
B
job redesign.
C
workflow.
D
reengin
D
Reengineering is changing the operational processes of an organization by radical redesign of business processes. A scalar process is the creation of levels of authority in a hierarchy, where the increased layers of management help the organization cope
Identify the elements of organizational structure that address patient safety. What structural changes do you recommend for further improving safety in this organization using organizational design principles?
A
Empowering employees to report problems or
A
The correct answer is empowering employees to report problems or potential problems, encouraging innovations and improvements in processes, and rewarding continual learning and exploration. Risk managers are involved in the safety work of organizations
A health care organization plans to integrate an electronic health record (EHR) into all clinical areas. Using the five theories of organization as a social system would put forward to manage the challenge, which approach is best for nursing?
A
Scientific
C
The correct answer is open systems theory, where the leaders emphasize the dynamic interaction and interdependence of the organization, and key individuals, nursing staff, and support staff provide input based on their role, expertise, and experience. T
When nurses actively engage in making decisions regarding nursing practice, quality of patient care, education, nursing peer issues, and issues in the work environment, what model is likely being used?
A
Shared governance model
B
Administrative model
C
Co
A
In the shared governance model, nurses actively engage in making decisions regarding nursing practice, quality of patient care, education, nursing peer issues, and issues in the work environment. The administrative model is not a professional practice m
Shared governance requires slow, gradual development, role-modeling, and mentoring by nurse leaders, and continual coaching, nurturing, and education for nursing staff and management. Select the statement that is an accurate statement about shared governa
A
Shared governance models empower nurses to provide quality care. Not all clinical nurses are in favor of a shared governance system in which accountability and decision making are encouraged. The implementation of shared governance systems is not necess
Centralization and decentralization are organizational philosophies about where decision-making authority resides in the institution. What is the best description of centralization and decentralization?
A
Confident administrators will decentralize during
D
Decentralization is dispersing decision-making authority throughout the organization. Confident administrators will centralize during crisis and decentralize during stable times. An organization may use selective decentralization for decision making in
Implementation of a shared governance model is best accomplished when which of the following steps are considered within the organization?
A
Administrators must justify the initial cost in terms of personnel time, effort, and financial commitment.
B
The c
C
Education about shared governance at all levels is necessary to disseminate the accountability and support the innovation. Administrators will need to justify a startup budget and eventually operational costs in terms of personnel time, effort, and fina
Nurse leaders who encourage transformation through their commitment to the journey will find roles changing. Which of the following statements best describe the role of nurse managers (select all that apply)?
A
Staff members in decentralized organizations
A, B, C
The statement that staff members in decentralized organizations are more accountable because fewer people provide functional supervision, quality monitoring, or unit-specific responsibilities is correct because these accountabilities were previous
When clients are grouped together and cared for by one nurse, this is known as:
A
functional nursing.
B
team nursing.
C
group nursing.
D
primary nursing.
C
Group nursing is when clients are grouped together and cared for by one nurse. It is a model used in the past but is how physicians have organized their care around a group or panel of patients for whom they are responsible. Functional nursing is the as
A collaborative process of assessment to use a system of health service delivery, coordination, and monitoring to meet multiple service needs of clients is known as:
A
case management.
B
total client care.
C
private duty nursing.
D
managed care.
A
Case management is correct because the collaborative process involves assessment to use a system of health service delivery, coordination, and monitoring to meet multiple service needs of clients. Total client care is when nurses provide care to one or
Nurse managers, in collaboration with nursing leadership, design nursing systems for the provision of client care and the betterment of the organization. Nurse managers should consider which of the following important?
A
Two factors that nurse managers mu
D
The correct answer is to include staff nurses in the development and selection process of the professional model. The two factors that nurses and managers must consider when designing a care delivery system are cost and quality. Mixed model approaches o
Variables that influence nursing practice and client care delivery include:
A
client-centered versus task-focused versus provider-focused perspective.
B
skill mix for client condition severity, nurse-to-client ratio, use of temporary staff, workload, nurs
B
The best answer is measureable skill mix for client condition severity, nurse-to-client ratio, use of temporary staff, workload, nursing education and experience, and technology are influencing nursing practice within a variety of service settings and l
Nurses involved in the selection or development of a nursing care delivery system should consider which of the following important (select all that apply)?
A
Fiscal accountability, client characteristics, staffing composition, case mix severity, and clini
A, B, C, D
The selection of a nursing care delivery system requires the consideration of several specific issues related to the organization, practice, and role of the RN and interaction with the client, physician, and others.
The organization and individuals engaged in scientific investigation using methods and variables that influence the rate and extent of adoption of practices to improve clinical services is known as:
A
translation research.
B
evidence-based practice.
C
res
A
The correct answer is translation research or implementation science, where the organization and individuals invest in scientific investigation using methods and variables to determine the influence rate and extent of adoption of evidence-based practice
A strategy of demonstrating an opportunity for improvement at baseline, outlining current practice related to specific care process indicators is:
A
outreach or academic detailing.
B
change champions.
C
performance gap assessment.
D
audit and feedback.
C
Performance gap assessment is a strategy of demonstrating an opportunity for improvement at baseline, outlining current practice related to specific care process indicators. Outreach or academic detailing is a marketing strategy in which a trained indiv
A rigorous scientific process used to combine findings from research into a powerful and clinically useful report to guide practice is:
A
performance appraisal.
B
practice guideline.
C
implementation science.
D
systematic review.
D
Systematic review is a rigorous scientific process used to combine findings from research into a powerful and clinically useful report to guide practice. Performance appraisal is an evaluation process based on job descriptions, with inclusion of evidenc
What are four building blocks nurses should use to develop the organizational structures to support an evidence-based practice environment?
A
Incorporate evidence-based practice terminology into mission, vision, and strategic plan; integrate research find
C
The correct answer is to (1) incorporate evidence-based practice terminology into the mission, vision, strategic plan, and performance appraisals of staff; (2) integrate the work of evidence-based practice into the governance structure of nursing depart
Leadership is necessary across all organizational levels, and different roles can support implementing evidence-based changes. Which of the following roles are important to the success of this transformation of practice (select all that apply)?
A
Senior l
C, D
There are many roles, such as the chief nurse executive through nurse managers, advanced practice registered nurses, and staff nurses. Everyone in evidence-based practice work has a role that builds upon their knowledge and skills. Nurse executives h
Professional nurses develop performance and quality improvement programs and conduct evidence-based improvement studies and research. Which statement is true about standards?
A
Structure standards measure whether the services provided by the organization
D
Standards essentially define quality, against which performance and outcomes are measured. Structure standards measure the internal characteristics of the organization and its personnel. A standard of care is describing the scope of professional standar
Health care quality and safety principles and practices form the foundation of any accessible, reliable care services. In establishing this foundation, which of the following statements helps guide it?
A
The importance is on outcomes rather than process a
A
The importance is on outcomes rather than process and structure today. Risk management programs are designed to mitigate risks or prevent errors or events from ever happening; these steps do not ensure a high level of quality. The three areas in which q
An overarching organizational strategy to ensure accountability of all employees, to incorporate evidence-based health care quality indicators, and to improve care delivered to various populations is best known as:
A
the accreditation and certification pr
C
A performance improvement program is an overarching organizational strategy to ensure accountability of all employees to incorporate evidence-based health care quality indicators and to continuously improve care delivered to various populations. The acc
Which of the following describes ways in which nurse managers can create an environment devoted to health care safety?
A
Developing a punitive work environment to remove staff who lack behaviors for safety
B
Establishing a culture of safe, effective, pati
B
Nurse managers should establish a culture of safe, effective, patient-centered, timely, efficient, and equitable care that is consistent with the Institute of Medicine (IOM) Committee on Quality of Health Care in America. The nurse manager should develo
A number of industry-based models for quality management and measurement have been adopted by the health care industry over the past two decades. The model that provides a holistic approach to enterprise transformation and focuses on stakeholders' value p
B
The correct answer is Lean Enterprise, which is a model of quality measurement that was originally associated with Deming but reintroduced to the United States in the mid-1990s to eliminate operational waste in an organization. Six Sigma is a strategy t
Quality can be defined in which of the following ways (select all that apply)?
A
When outcomes compare favorably with standards
B
When activities and interventions are examined
C
The measurement of effectiveness, efficiency, benefits, and appropriateness
A, C
When outcomes compare favorably with standards, the minimum expectation has been achieved. The measurement of effectiveness, efficiency, benefits or harms, and the appropriateness of care services is also a way to define quality. When activities and
Which of the following describe the four tenets embraced by members of the IOM Committee on Quality of Health Care in America and how these tenets incorporate into nursing practice (select all that apply)?
A
Nurses use standardization of processes when us
A, C, D
The use of nursing diagnoses and interventions aligns with the tenet of standardization of processes as the key to managing work and people. The tenet is that processes and systems are the problems, not people. The use of assessments and data coll
Valid, reliable, and operationally defined measures that are important, feasible, and have clinical logic and measurement properties are known as:
A
end results.
B
indicators.
C
outcomes.
D
findings.
B
Indicators are valid, reliable, and operationally defined measures. End results are the end product from formal tests or outcomes research to explain what the condition or level is for a client. Outcomes are dependent on measured and quantified observed
Outcomes management is a process that can be described accurately by which of these statements?
A
Outcomes management provides relatively little data for internal use in health care organizations.
B
Effects of outcome management are used as measures of al
C
Outcomes management is an interdisciplinary process designed to provide quality care, decrease fragmentation, and constrain costs. Outcomes management collects data for internal use in health care organizations, and the information derived from measurin
The process for determining the effect of different conditions to nurses and nursing practice on the health status of patients is:
A
research using risk adjustment.
B
health services research.
C
outcomes research.
D
nursing effectiveness research.
D
Nursing effectiveness research is determining the effect of different conditions to nurses and nursing care on the health status of patients and is also known as nursing outcomes research. Research using risk adjustment uses analysis to account for rele
Managers and executives in practice will struggle to make decisions regarding staffing and practice to achieve best outcomes. Staffing levels have often but not always been associated with a number of unfavorable outcomes, including increased surgical mor
B
The correct answer is to identify data systems that are comprehensive for outcomes management in order to support the monitoring of nursing-sensitive outcomes and establish continuous monitoring of outcomes against internal and external benchmarks using
What are two health care trends that can impact the use for measuring and managing outcomes would include (select all that apply)?
A
The lack of documentation of effectiveness of client services and the variations in practice have triggered the demand for
B, D
Management decision making should be evidence-based wherever possible in order to optimize quality of care. Cost-containment strategies often involve a focus on decreasing staff coverage or reducing the proportions of registered nurses in staff mixes
The condition in which the delicate balance of nurse supply and nurse demand is not at equilibrium is described within the following statements. Identify which statement is correct regarding shortages.
A
A nursing shortage is the understaffing of nursing
C
Strategies are important to enhance the image of nursing and nurses to attract individuals into the profession of nursing. The nursing shortage is not the result of understaffing of nursing units caused by tight budgets or poor working conditions. Using
A manager's role in an organization is important and influences the retention of nurses. The following statements offer correct and incorrect ways to improve retention. Identify the correct statement.
A
A large span of control is conducive to a supportive
B
The correct answer is for nursing leaders to initiate a mentoring program in which each nurse new to an institution has a nurturing mentor. Adjusting the span of control for nurse managers will impact the supportive work environment and autonomous pract
Nurse managers play a role in staffing a nursing area, and they need to explore all opportunities to sustain staffing at appropriate levels. Nurse managers who determine the most qualified applicant for a posted job are in the process of:
A
identifying st
D
Selection is determining the most qualified applicant with skills, knowledge, and experience for a posted job. Identifying staff vacancy is determining the part- or full-time equivalent employee positions needed. Recruitment is seeking out and identifyi
A manager who experiences the failure to retain an employee who is performing satisfactorily or better is dealing with a:
A
turnover.
B
transfer.
C
termination.
D
resignation.
D
Resignation is the failure to retain an employee who is performing satisfactorily or better. Turnover is the loss of an employee because of transfer, termination, or resignation. A transfer is movement of an employee from one area in the organization to
Several ways to attract nurses include efforts within an organization in which individuals continually expand their talents and work collectively. This strategy is known as:
A
instituting a greater registered nurse (RN) staffing mix.
B
formative evaluatio
C
A learning organization is an organization in which individuals continually expand their talents and work collectively. Instituting a greater RN mix for staffing has demonstrated fewer care outcomes that are negative in research studies. Formative evalu
According to Laschinger et al., structural empowerment and creation of a culture of civility are important managerial and organizational behaviors related to staff satisfaction and intention to stay. This approach is consistent with the report In Our Hand
A, C
The correct answers are related to civility, which is the authentic respect for others requiring time, presence, engagement, and intention to seek common ground. People expect to be treated with respect and have a sense of security within the job and
Organizational and leadership factors that are important to the recruitment and retention of nurses in the workplace are described by which of the following statements (select all that apply)?
A
Nurses want to have control over their practice and collabor
A, B, D
Three of the statements are correct in describing the characteristics desired by professional nurses who are recruited within the evidence-based Magnet Recognition Program�. The nurses want to have control over their practice and collaborative rel
The turnover rate of a new graduate ranges from 22.6% to 60% in the first year while in a workforce. That produces averages in age of 45 years old, and nurses begin to phase into retirement beginning at age 55 years. In light of these facts, it became imp
B, D
The two strategies would include a residency program and preceptor to promote nurse autonomy and the nurse role on the interdisciplinary team, and social networking and support to address incivility and cynicism. The first statement would be a better
A budget is a composed document used to forecast revenues and expenditures to control costs and to allocate resources. The development of the budget and the evaluation of its effectiveness are managerial responsibilities. A form of budgeting in which base
A
A traditional budget is a form of budgeting in which baseline data for the budget are determined from previous costs plus an inflation factor. A zero-based budget is a form of budgeting in which the entire budget is developed from scratch. An operating
Expenses related to overhead, administration, or building are known as:
A
budgets.
B
indirect costs.
C
expenses.
D
revenues.
B
Indirect costs are expenses related to overhead, administration, or building. Other fixed staff members, such as unit clerks, need to be included. A budget is a financial plan that guides resource use. Expenses are the costs incurred for services provid
Accurately determining the costs of providing patient care service is an important budgetary function. Nurses will need to plan better and negotiate for budgeted dollars. Nursing has historically been seen as a cost center and not a revenue generator, so
D
Costing out nursing service to know actual costs associated with providing patient care interventions within the cost center is the most important skill for planning. The interventions relate to activity-based costing that can reflect what it costs to p
Continuous change in the health care delivery and reimbursement systems has created a challenge to controlling or avoiding costs, while continually improving the quality of care. Nurses should use the resources of the client to maximize health benefits, w
C
Fiscal responsibility is explained by examples where the nurse may use the most expensive tape (institution costs) on a client with poor skin integrity to ensure the tape sticks and offers some waterproof (to avoid adverse events such as skin tears, whi
Nurses have not yet clearly defined their contributions to health care services nor readily know the costs and outcomes associated with their care when asked. Nurse managers can find this knowledge when making use of which of the following items described
A, C, D
Managers can use technology and computerization to evaluate productivity, with increased accuracy of capturing nursing documentation in a standard method using defined concepts, which is necessary in data analysis. Managers can use techniques for
Violence in hospitals is caused by a combination of internal and external factors. A systematic review of the literature on the effects of violence toward nurses reported the predominant responses to be anger, fear, anxiety, posttraumatic stress disorder
C
Horizontal violence is common in nursing and is a form of bullying. Most researchers agree that violence against nurses is significantly under-reported. Health care workers and social workers have the highest incidence of injuries from workplace assault
Managers of health care organizations have an ethical obligation to protect the safety of workers. What information, approaches, or practices would help managers with this ultimate responsibility?
A
The National Institute for Occupational Safety and Healt
C
OSHA will identify common risk factors and include policy recommendations and practical corrective methods to help prevent and mitigate the effects of workplace violence. The first answer is information about one of the leading causes of occupational in
Manager decisions and treatment of employees associate with workplace violence. Any toleration of hostile or threatening behavior can result in escalation that results in physical harm. Which type of behavior is often tolerated and not reported?
A
Employe
D
Intimidation, pushing, and slapping behaviors are not often reported as workplace violence. Employees being fired; acts of bullying with verbal threats; presence of weapons; and the use of alcohol or drugs tend to get the attention of employees, and whe
Antagonistic behaviors including gossip, verbal and nonverbal innuendo, scapegoating, passive-aggressiveness, disrespecting privacy, and bullying have a psychological impact on working relationships. They can impair work performance and impact health care
C
The correct answer is post-incident response counseling that could involve an integrated system of services and procedures to reduce the potential impact of a violent incident on employees. Incident debriefing should be offered to all employees when suc
NIOSH recognizes that workplace violence happens in the health care industry and recommends which violence prevention strategies for employers (select all that apply)?
A
Writing violence prevention plans that do not tolerate violence, reporting violence,
B, C, D
NIOSH strategies include environmental designs, behavior modifications, and administrative controls. The overlap of agencies providing recommendations, guidelines, and/or strategies can create confusion for leaders, but often the agencies will att
People are knowledgeable about natural disasters within their local regions; however, many have not had to consider the devastation that can be caused by terrorism such as radiological exposures, nuclear blasts, conventional bombings, or agricultural cont
D
A cyber disaster is a catastrophic event affecting large numbers of people and lasting more than a few hours that impacts the ability to use information technology. A chemical disaster is an incident involving an agent such as a deadly gas, but it is no
Community stakeholders, including local government, fire and rescue workers, and hospitals, have been focused on gathering information from a variety of resources, developing collaborative response plans, and preparing for a probable disaster. As nurse ma
A
Establishing an all-hazards preparedness plan to create an AHPTF and local, state, and national response plans is the first step. When engaging acute care facilities to be prepared and have a plan in place, external and internal disasters such as fires
During the start-up, the system-wide task force will need to meet frequently and begin with which steps?
A
Equipping the hospital emergency incident command system for disasters with communication devices
B
Including the public health department, police,
B
The first steps are to include the public health department, police, and other critical community organizations in all-hazards community preparedness plan meetings and to conduct a hazard vulnerability analysis. The hazard vulnerability analysis is impo
The resources for nurse executives, nurse leaders, or other nurse representatives would include some of the following references to conduct a gap analysis to determine needs, but where should the managers begin to access knowledge about planning for disas
D
The correct answer for community response and conducting an effective gap analysis would be to use FEMA (www.emforum.org/vforum/FEMA/Gap Analysis Program Guidance 03-13-2009.pdf) to determine necessary planning tools for the response plans. AHRQ (wwwahr
Nurse leaders and their teams need to understand the guidelines and plan processes at local and regional levels. Clearly defined roles can prevent duplication of efforts and enhance coordination and orchestration of the all-hazards plan during an actual d
A, D
Having procedures to provide easy-to-follow, step-by-step action plans, fact sheets, and algorithms to identify the type of disaster, how to intervene, and which authorities to notify; and determining prophylactic pharmaceutical dissemination plans t
The process of integrating nursing and health sciences with computer and information sciences to manage and communicate data, information, knowledge, and wisdom in practice is known as:
A
clinical information system (CIS).
B
nursing informatics.
C
data re
B
Nursing informatics is the process of integrating nursing and health sciences with computer and information sciences to manage and communicate data, information, knowledge, and wisdom in practice. CIS is the capture of clinical data to support more effi
The electronic health record (EHR) implementation of computerized provider order entry (CPOE), clinical decision support (CDS), barcode scanning, and electronic medication administration records (eMAR) applications is dependent on design and use. The best
C
The EHR design and clinical documentation with evidence-based definable terms must support nursing care models and the nursing process workflow for patient-centered care. Patients who receive nursing plans will be able to search definitions of terms use
Nursing data are used to evaluate client care, provider staffing, administration of care and the organization, and knowledge-based research for evidence-based practice. The analysis of large data warehouses using epidemiological methods would best support
A
Effectiveness research is the analysis of large databases or data warehouses using epidemiological methods. A management information system dashboard is an integrated system to collect and manipulate data for the purposes of directing and controlling re
Nursing must have standardized, uniformly collected, retrievable, and comparable service-related management data elements. A Nursing Management Minimum Data Set (NMDS) provides nurses which of the following options?
A
Repository sets providing classificat
B
NMDS needs to provide the option of an integrated management information system for collecting, storing, retrieving, and processing a collective set of data to evaluate nursing interventions on client outcomes. The data set may obtain data from multiple
Health information exchange (HIE) is defined as the electronic movement of health-related information among organizations according to nationally recognized standards. Health information exchange organizations are responsible for which of the following?
A
A
The correct answer is establishing a statewide provider directory and secure provider-provider messaging, exchanging the continuity of care document, and e-prescribing for ambulatory medications. These are a few of the initial requirements for statewide
1. Which of the following statements is true about problem solving?
A.
Problem solving is a high-level skill used only by health care professionals.
B.
Critical thinking and problem solving are the foundation of effective decision making.
C.
The team prob
D. Problem solving is a rational and logical thought process.
The statement that problem solving is a high-level skill used only by health care professionals is incorrect, because the high-level skill nurses and others use is critical thinking, a cognitiv
2. Any decision in a chaotic health care delivery environment may cause an unanticipated future problem. Identify the true statement about decision making.
A.
Decision-making strategies are interchangeable and can be used effectively in any situation.
B.
B. Decision making is used to solve problems.
The statement "Decision-making strategies are interchangeable and can be used effectively in any situation" is incorrect because, for example, ethical decision making uses ethical principles and moral reasonin
3. Select the statement that describes how clinical decision making differs from managerial decision making.
A.
Professional nurses in clinical practice are making clinical decisions about client diagnoses and care plan orders, but the technical nurses ar
D. Clinical decision making focuses on diagnosing client health issues, risks, or problems and planning or coordinating nursing interventions, but managerial decision making focuses on resolution of organizational problems and the plans to achieve organiz
4. Decision-making tools and strategies support the process for decisions. Select the one statement that is true.
A.
Group decision making tends to be more ineffective for system problems.
B.
All decision tree questions have a yes or no answer.
C.
Manager
D. Critical pathways are a type of decision tree.
They are used for clinical care and other industry decisions. The first statement is incorrect because group decision making tends to be more reflective and include more information and experts to effectiv
5. A transformative leadership style influences the effectiveness of group decision making. The rational group decision-making model is based on which of the following?
A.
Power, influence, negotiation, bargaining, and interest group influence
B.
Economic
B. Economic perspective of decision making and maximum utility
The first answer is incorrect because it is the political model that is based on power, influence, negotiation, bargaining, and interest group influence. The third answer is incorrect because
6. Critical thinking is central to decision making. Which of the following is a true statement?
A.
Critical thinking and creative problem solving are the same.
B.
Two cognitive processes, intuition and analysis, are used in critical thinking for nursing j
B. Two cognitive processes, intuition and analysis, are used in critical thinking for nursing judgments.
The first statement is incorrect because critical thinking is a set of cognitive skills that include interpretation, analysis, evaluation, inference,
7. A number of decision-making strategies have been identified for clinical and managerial decision making. An effective strategy for nurse managers to select in examining possible causes related to production would be:
A.
pilot projects.
B.
cost-benefit
D. fish bone charts.
Pilot projects are limited experimental trials used to develop an optimal and alternative solution to a problem. Cost-benefit analysis is an appropriate strategy to use when deciding budgetary issues and may include listing the positi
8. Complexity and chaos theory has application to leadership and management decision making. Which of the following statements apply to this theory (select all that apply)?
A.
A web of interdependence and mutual interconnection among nurses, physicians, a
A. A web of interdependence and mutual interconnection among nurses, physicians, and support staff results in an adaptive system with open boundaries, multiple levels of organization, and rule sets that serve as the organization's operating procedures.
D.
9. What habits are characteristic of critical thinking by nurses? (select all that apply)
A.
Questioning, reflection, contextual perspective
B.
Confidence, creativity, flexibility
C.
Open-mindedness, perseverance
D.
Purposeful, systematic, within a frame
A. Questioning, reflection, contextual perspective
B. Confidence, creativity, flexibility
C. Open-mindedness, perseverance
Scheffer and Rubenfeld (2000) have stated that habits of the mind that are characteristic of critical thinking by nurses include con
10. Important decisions are made by nurses. Which of the following are examples of collaborated decisions (select all that apply)?
A.
Devise an array of plans to optimize client recovery, mobility, and self-care; maintain airway patency and hemodynamic st
B. Plan steps to achieve organizational goals, implement multisystem change processes, and improve service delivery and client outcomes
C. Address complicated and difficult client care risks and problems regarding infection, injury, and contamination
Nurs
1. Role strain means:
A.
expectations are incompatible with the professional values of the nurse.
B.
one cannot possibly complete all assigned activities in the scheduled time frame.
C.
expectations of the multiple responsibilities of the manager can prod
C. expectations of the multiple responsibilities of the manager can produce stress.
Role incongruity means the role expectations are incompatible with the professional values. Role overload is when one cannot possibly complete all assigned activities in t
2. Levels of job stress that are either too low or too high have which consequence?
A.
They manifest in emotional and physical exhaustion.
B.
They decrease individual productivity.
C.
They increase tension related to the person-in-environment demands.
D.
B. They decrease individual productivity.
The first answer is not seen with low job stress but is a consequence of when job stress is high. It is also known as burnout, and this will lower job productivity. The third answer is an aspect related to job str
3. People are often unaware of exactly how they are spending their time. The best strategy is to:
A.
take control of your calendar using a time journal to see precisely where all one's time is spent in 30-minute increments.
B.
use every minute possible in
A. take control of your calendar using a time journal to see precisely where all one's time is spent in 30-minute increments.
The best strategy is to take control of your calendar using a journal to record how time is used in increments, which makes the a
4. Healthy work environments increase patient satisfaction, support patient outcomes, and avoid errors. Healthy work environment standards to adopt would include:
A.
setting expectations and controlling behaviors within the workplace.
B.
establishing tran
C. acknowledgement, awareness, and assessment of workplace stress.
Health care organizations that want to assure quality care for patients can begin with the acknowledgement, awareness, and assessment of workplace stress. The first answer should state set
5. Which time management strategies are the best strategies to re-energize people to handle the activities of the workplace and decrease the stress response?
A.
Dividing up a project into manageable parts and setting deadlines for each part
B.
Having time
B. Having time to think
A key survival technique in health care services where timeliness is of the essence for many is having time to think. There is a need to create time, plan for it, and commit to it. An appointment for thinking time is self-energizin
1. What is a wrongful act committed against another person or organization or their property that causes harm and can be remedied by a civil lawsuit?
A.
Malpractice
B.
Legal liability
C.
Tort
D.
Negligence
C. Tort
Malpractice is the failure of a professional person to act as other prudent professionals with the same knowledge and education would act under similar circumstances. Legal liability is legal responsibility for harm caused to others. Nurses, nurse
2. Duty of care owed by the nursing professional to the client is the minimum requirements that define an acceptable level of care. The minimum requirements are best located in:
A.
the Social Policy Statement and Washington Manual.
B.
published standards
D. state nurse practice acts, standards published by nursing professional organizations and specialty practice groups, and/or a facility's policy and procedure manuals.
In malpractice cases, the standard of care owed to the injured client is commonly intr
3. Ethical dilemmas encountered as a result of the clash between clinical and organizational ethics differ from those encountered in clinical practice. Budget cuts, the inability to replace equipment that is failing, and lost time to complete services wou
A. developing an organizational culture of respecting each other's ethical standards and not asking nurses to compromise their ethics.
Is the best strategy listed. The steps to develop such a culture would be educational opportunities; processes that incl
4. Nurses and nurse managers are guided by both legal and ethical considerations in making decisions. Which of the following is the correct statement regarding this fact?
A.
Administrative rules include those regulations promulgated and adopted by federal
A. Administrative rules include those regulations promulgated and adopted by federal or state agencies to implement statutory law adopted by Congress or state legislatures.
The Centers for Medicare & Medicaid Services would be an example of a federal agen
5. __________ is being loyal and faithful to commitments and accountable for responsibilities.
A.
Autonomy
B.
Veracity
C.
Fidelity
D.
Values
C. Fidelity
Autonomy is a client's right to self-determination and freedom of decision making. Veracity is a norm of telling the truth and not intentionally deceiving. Values are strongly held beliefs that are freely chosen.
6. A nurse manager and a nurse are liable for which of the following (select all that apply)?
A.
Delegating to unlicensed assistive personal
B.
Supervising completion of appropriate tasks and functions
C.
Decisions and actions
D.
Skills of licensed and un
A. Delegating to unlicensed assistive personal
B. Supervising completion of appropriate tasks and functions
C. Decisions and actions
D. Skills of licensed and unlicensed personal
Nurses and nurse managers are accountable for their own acts and decisions,
1. Effective communication can best be described by which one of the following statements?
A.
The major part of any communication is the words that we say to others.
B.
Conversation that is clear, direct, straightforward, and offers frequent message trans
B. Conversation that is clear, direct, straightforward, and offers frequent message transmission is most effective.
The major part of any communication is not just the words we say to others; the tone, voice, and expressions add content to the message. To
2. The roles of sender and receiver must be assumed in interpersonal communication. This is reflected within which description of communication?
A.
Communicating with diagnosing and adapting is one of the basic competencies of influencing, effectiveness i
C. Interpersonal communication is a two-way level of communication involving face-to-face interactions between people who are consistently aware of each other.
Is the best definition of interpersonal communication. The roles of sender and receiver evolve
3. When the leader engages in dialogue with the nurse to share ideas and help in making decisions, what style of Situational Leadership� communication is being used?
A.
Selling
B.
Delegating
C.
Telling
D.
Participating
D. Participating
The leader engages in dialogue with the nurse to share ideas and help in making decisions; this includes supervision with coaching and mentoring. Selling is when the leader motivates the nurse by explaining the rationale for the task and
4. Nurses may communicate using humanizing and dehumanizing attitudes which impact the outcome of communication: Select the most humanizing option below.
A.
In a small group session, there were varying opinions, with two individuals quite vocal about thei
D. The manager engaged nurses to share their concerns and ideas openly and their fears about the developing project.
The fourth situation provides a humanizing attitude as conceptualized within the Humanizing Nursing Communication Theory. The first statem
5. Select the best statement for why communication processes are important to organizations.
A.
Horizontally decentralized organizations are more efficient than centralized organizations.
B.
Positive communication techniques include agreeing uncritically
D. Human interaction issues are the general area in which leaders and managers spend most of their time.
The first statement is not correct because the horizontally decentralized organization takes much more effort in communication and is not necessarily
6. Leaders who give and take exchanges aimed at resolving issues are doing which of the following?
A.
Bargaining
B.
Effective communication
C.
Persuasion
D.
Negotiation
D. Negotiation
Bargaining is the exchange of a series of offers and counteroffers about what each party will do, give, and/or receive, until an agreement is reached to the satisfaction of all. Effective communication is a skilled process necessary in nego
7. Research has shown which two of these statements are correct (select all that apply)?
A.
Nurses need to be responsible for beliefs, values, meanings, goals, and relationships.
B.
Experienced leaders feel comfortable with the star pattern communication
A. Nurses need to be responsible for beliefs, values, meanings, goals, and relationships.
C. In crisis situations, members work in a team that capitalizes on the skills and strengths of each team member.
The second answer should state that experienced lea
1. Effective delegation skills are important for leaders and managers whose function is to get work done through the efforts of others. The individual who accepts this work is called:
A.
delegate.
B.
adaptor.
C.
supervisor.
D.
delegator.
A. delegate.
Delegates accept the service, work, activities, or projects that need to get done. In nursing, a team of delegates from an organization may gather together to do service projects locally in communities or in third world countries. An adaptor
2. The determinant for the decision to delegate is the legal scope of delegation rules described within:
A.
an institutional policy.
B.
a nurse practice act.
C.
the American Nurses Association (ANA) Code of Ethics.
D.
The Joint Commission (TJC) Patient Ca
B. a nurse practice act.
The state's nurse practice act contains language that allows registered nurses to delegate. Institutional policies do not set rules but rather provide further interpretation of the procedural steps to guide nurses in the intervent
3. The decision to delegate is not an easy one. There were five factors identified by the critical care nurses specialty organization that should be considered to make the best decisions. Which of the following identifies all five factors?
A.
Care is comp
A. Care is complex and requires adaptation in approach, with some risk that the activity may cause potential harm, and the level of patient interaction and the patient's response to the activity are unpredictable.
The first answer is the best because it c
4. Chief nursing officers (CNOs) are accountable for establishing systems to assess, monitor, verify, and communicate ongoing competence requirements related to delegation, for both RNs and delegates. Which statements are correct (select all that apply)?
A. A key element in delegation is to assess the competency level of the staff.
C. A state's nurse practice act consists of rules that govern how RNs delegate to competent staff.
B when an RN delegates a task, he or she is responsible for supervision and i
5. Criteria can be used to assess co-workers' competency for delegation. Which of the following methods can be used to assess the competency of nursing assistive personnel (select all that apply)?
A.
Micro-managing and being able to step in and take over
C. Supervising with periodic review and performance feedback
D. Orienting to the job description and evaluating tasks within a designated time frame
Micro-managing and being able to step in and take over tasks are incorrect because these will result in mi
1. The type of power exhibited when providing the opportunity for others to take responsibility and accountability for their work is:
A.
referent power.
B.
empowerment.
C.
expert power.
D.
legitimate power.
B. empowerment.
Referent power is a power based on charisma and interpersonal appeal, which is used to inspire others. Expert power is power within individuals who possess special skills, talents, and knowledge. Legitimate power is the authority to act ba
2. Personal conflict can arise when trying to ingratiate another person because there is the use of:
A.
influencing an individual or group to gain a scarce resource.
B.
providing a pay raise, promotion, or advancement.
C.
threats, discipline, or negative
D. lavishing praise on another to make him or her feel important to gain favor.
Thus initiating personal conflicts with others. The first answer is incorrect because power is used to influence an individual or group to gain a scarce resource, so others ar
3. Conflict is a natural and inevitable outcome in any group or organization. Select the correct statement from the following statements.
A.
A defensive framework for conflict resolution includes winning some resources and losing others.
B.
To build effec
A. A defensive framework for conflict resolution includes winning some resources and losing others.
To build effective interdisciplinary teams, conflict must be present, and managers have a role with conflict resolution to achieve a win-win solution rathe
4. Which is a perceived antagonistic process at the individual-organization level of interaction that affects productivity, morale, and teamwork in organizations?
A.
Interpersonal conflict
B.
Organizational conflict
C.
Job conflict
D.
Social conflict
C. Job conflict
Interpersonal conflict is a dynamic between interdependent parties who experience reactions to perceived disagreements and interference with attaining their goals. Organizational conflict is defined as the struggle for scarce organizationa
5. Resolving conflict requires interventions. One intervention is to initiate a timely private discussion to respect individual differences and be empathetic to both sides, yet have an assertive dialogue about facts and feelings to frame the main issue on
A. Creative problem solving
Produces feelings of gain and no feelings of loss for all conflict participants. This technique is the most effective but often not the first approach. The second answer involves smoothing or finessing the issue through an orga
6. Marshall discussed several approaches to prevent and manage conflict. One such approach was to adopt the AVID approach. What are nurses engaged in with this approach?
A.
Avoid conflict; verify the information associated with the conflict; investigate w
C. Assume the positive about others; validate the situation; ignore it and let it go; do something
The correct answer is A: assume the positive about others and their behavior; V: validate the situation; I: ignore it and let it go; D: do something, such a
1. A business approach that ensures a competitive advantage over similar enterprises involves conducting an environmental scan, knowing the competition, establishing goals, setting targets, developing an action plan, implementing the plan, and evaluating
D. Strategic management involves strategic planning and implementation.
The best strategic planning is not from the top down but involves an opportunity for nurses to be recognized for their ideas and contributions. The strategic planning process is an op
2. What is the administrative, systematic, environment-related, future-oriented, and sensitive to the correct positioning of the organization known as?
A.
Strategic management
B.
Tactics
C.
Strategy
D.
Operational effectiveness
A. Strategic management
Tactics are operational choices for action that are made to implement strategy. Strategy is a competitive move or business approach designed to produce a successful outcome. Operational effectiveness is performing similar activitie
3. Implementation of a strategic plan can be accomplished when a priority order for achieving the strategic objectives or outcomes exists, responsibility for achieving these objectives has been determined, and some available financial support is provided
C. integrating the strategy into daily activities and keeping the strategy a major agenda item for their nursing department or service.
Nurses should integrate the strategy locally into daily activities and keep the strategy a major agenda item for their
4. Similarities between the nursing process and the strategic planning process allow nurses to shortcut the learning curve and begin to move forward with the implementation phase. Strategic management involves:
A.
assessing the nursing mission, diagnosing
C. developing a strategic mission or vision, setting objectives, developing strategies to achieve the objectives, implementing the strategies, and evaluating the results.
The first answer is not the best answer because it uses the nursing process terms to
5. New policies, programs, projects, and services are developed to meet the needs of patients. Which statements are a description of when nurses take steps to use these items (select all that apply)?
A.
Strategic management is the processing of an organiz
A. Strategic management is the processing of an organization's vision or mission.
C. Strategic management is nurses making decisions about the delivery of care.
Strategic planning is a process of developing an action plan for actualizing the mission, but
1. Staffing management is one of the most critical, highly complex, and time-consuming activities for nurse leaders at every level of the health care organization today. Which of the following statements is correct?
A.
Staffing is the implementation of a
C. The staffing management plan is a structured approach to the process of identifying and allocating unit-based personnel resources in the most effective and efficient way.
The major goal of staffing management is to provide the right number of nursing s
2. Which of the following are efforts to measure nursing workload?
A.
The number of client days and the intensity and hours of nursing care required per client day.
B.
Acuity is the severity of a client illness and is an automated patient assessment. Info
A. The number of client days and the intensity and hours of nursing care required per client day.
The number of client days and the intensity and hours of nursing care required per client day is correct, because the volume of nurses with a certain skill l
3. Demand management focuses on:
A.
automating staffing plans in order to staff according to average forecasted care levels.
B.
creating predictable and cost-effective staffing according to real-time patient information based on individual patients moving
D. measuring, predicting, and understanding demand for services, and deploying resources and management to meet consumers' wants and needs.
Demand management is measuring, predicting, and understanding demand for services, and deploying resources and mana
4. Scheduling by predictive modeling forecasts unplanned patient and staff events, such as admissions by day of week and unplanned sick calls. Principles supporting such a scheduling process for demand management would include:
A.
scheduling and daily sta
C. embedding a decision support system that receives continuously measured progress on patient outcomes in real time, throughout a patient's stay, with which actual progress may be compared on individual patient changes in the outcomes-driven acuity syste
5. Healthier work environments are associated with better staffing, lower burnout, lower turnover, and improved nurse-physician collaboration. Nurse managers likely should support which of the following statements (select all that apply)?
A.
Unlicensed as
B. An astute nurse manager can match the skill sets and experience with the patient care needs to deliver the best possible care for clients.
D. Health care agencies that obtain Magnet status often have improved nurse satisfaction, decreased nurse burnout
1. A part of performance appraisal whereby the employee performs a self-assessment of his or her performance compared with pre-established criteria is known as:
A.
formal performance appraisal.
B.
self-evaluation.
C.
peer review.
D.
informal performance a
B. self-evaluation.
Self-evaluation is a part of performance appraisal whereby the employee performs a self-assessment of his or her performance compared with pre-established criteria. Formal performance appraisal is a summative performance appraisal with
2. When managers address problem performance, such as substandard work like missed deadlines, absence or tardiness, and more, the manager should engage in:
A.
coaching.
B.
counseling.
C.
mentoring.
D.
performance management.
B. counseling.
Counseling is taking action to address problem performers whose work or behaviors are consistently substandard. Coaching is used to improve employee performance and ability to do a job. Mentoring is for an employee who shows promise. It is
3. The evaluation process used to quantify a performance may be influenced by perceptions, biases, and values of the employee and manager. Standards are criteria with a designation of levels. The manager can avoid differences by utilizing alternative appr
D. 360-degree evaluation to obtain reflections from related stakeholders
The manager should evaluate the advance practice nurse using the 360-degree evaluation to obtain feedback from stakeholders including staff nurses, pharmacists, and physicians whom t
4. High performance can be rewarded with incentive payments for achieving high quality on national quality indicators specific to hospitals and ambulatory care environments. Pay, promotions, and other rewards can be tied to performance and its evaluation.
A. Transformational leaders will emphasize organizational learning and see knowledge, skill, and professional development and the individual's accomplishments toward goals rewarded.
Transformational leaders emphasize organizational learning to prevent err
5. Managers will need to manage a performance achieving or surpassing organizational and social objectives and responsibilities. The opportunity is to mere the performance appraisal process with the quality improvement process, which makes both a continuo
A. Performance appraisals and quality improvement share many of the same process steps, including data collection, standards comparison, needs assessment, and mutual goal setting.
C. Both processes are concerned with outcomes management and monitoring act
1. A blend of marketing strategies and models used to achieve established goals is known as:
A.
exchange.
B.
marketing mix.
C.
marketing orientation.
D.
market share.
B. marketing mix.
Marketing mix is a blend of marketing strategies used to achieve established goals. The mix offers options for a broad number of stakeholders. Exchange is the act of obtaining a valued product from someone by giving something in return.
2. Desires that are satisfied by specific products or services that are influenced by external cues are:
A.
wants.
B.
market.
C.
needs.
D.
products.
A. wants.
Wants are desires satisfied by specific products or services that are influenced by external cues. Market is actual or potential buyers and users of goods, services, and ideas. Needs are a basic biological, psychological, and social needs. Produ
3. Marketing is a social and managerial process where individuals or groups obtain what they need and want by a process of exchange with others. For most nurses, the primary markets are clients, the employing organization, and physicians. Identify the cor
B. Gathering and analyzing information will lay the foundation for proactive capitalization on change opportunities.
Gathering and analyzing information will lay the foundation for proactive capitalization on change opportunities. Marketing is used in cha
4. Customer relationships concentrate energy on the identification of the needs and wants of customers and on the delivery of services that create satisfaction. A daily example of this is when
A.
health records generated by health care professionals' prac
D. nurses provide care by using the nursing process to diagnose and intervene on needs for health promotion or problems and risks.
Nurses provide care through customer orientation every day by using the nursing process to identify problems, risks, and nee
5. An increasing number of nurses are being recognized for their knowledge, expertise, and contributions to the health care system. As nurses assume expanded roles, such as advanced practice and case management, the image of nurses is being elevated from
C. Customer's view of the costs, the convenience, communication and their needs and wants regarding their psychosocial and emotional concerns with health.
First, the customers who see the four C's which are costs, convenience, communication and customer n