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Test Bank for Nursing Leadership and Management.

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Test Bank for Nursing Leadership and Management. A nurse working on the unit budget would recognize that the resources needed to deliver quality health care such as nurses, practitioners, medical records, buildings, and pharmaceuticals are considered which aspects of health care? a. Process b. Structure c. Organization d. Practice ANS: B, The health care structure is comprised of the resources or structures needed to produce quality health care. Some of these structures or resources are human (staff and personnel) or physical (buildings or facilities). REF: ORGANIZATION OF HEALTH CARE 6. The human resource manager understands that an example of a quality performance outcome measure involves which of the following? a. Patient satisfaction b. Return on assets (ROI) c. Staff satisfaction d. Organizational climate ANS: C, An outcome for a quality performance measure related to human resources is staff satisfaction. Patient satisfaction is a clinical care outcome, and return on assets (ROI) is a financial management outcome. The organizational climate is a human resource process, as opposed to the outcome. REF: TABLE 2-1 EXAMPLES OF PERFORMANCE MEASURES BY CATEGORY 7. A nurse is on vacation visiting a number of countries. If the nurse becomes ill, in which country will the nurse most likely be hospitalized in a government hospital, with the government paying the bills. a. Canada b. New Zealand c. Taiwan d. Germany ANS: B, If the nurse became ill in New Zealand health care would be provided in a government hospital with the government paying the bills. Canada and Taiwan rely on private-sector providers, paid for by government-run insurance. Germany, the Netherlands, Japan, and Switzerland provide universal coverage using private doctors, private hospitals, and private insurance plans. REF: HEALTH CARE PAYMENT IN OTHER COUNTRIES 8. An instructor wants to determine if a group of nursing students know the important features related to the benefits of primary care. Which of the following responses by the students would indicate that further teaching is necessary? a. Care that is continuous b. Care that began at first contact with the patient c. Care that is integral d. Care that is community orientated ANS: C, The seven important features of primary care are care that is continuous, community oriented, comprehensive (not integral), coordinated, family centered, culturally competent, and begun at the first contact with the patient. REF: NEED FOR PRIMARY HEALTH CARE 9. A group of nursing students are given a test on Starfields (1998) foundations of primary care. Which of the following responses by the students describing the foundations of primary care would indicate that further teaching is necessary? a. Comprehensiveness b. Organization c. First contact d. Coordination ANS: B, According to Starfield (1998), both clinicians and patients need to work together to appropriately utilize services based upon these four foundations of primary care: first contact (conduct the initial evaluation and the plan for the dysfunction, treatment options, and health goals), longitudinality (maintaining the clinician-patient relationship continuously over time), comprehensiveness (managing the wide range of needs for each patient), and coordination (care is organized and integrated, thus eliminating duplication of services). REF: NEED FOR PRIMARY HEALTH CARE 10. Which agency/division is not a part of the U.S. Department of Health and Human Services? a. Food and Drug Administration (FDA) b. Centers for Disease Control and Prevention (CDC) c. Institute of Medicine (IOM) d. Indian Health Service (HIS) ANS: C, Some of the major divisions and agencies that comprise the U.S. Department of Health and Human Services are Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDC), Indian Health Service (HIS), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid (CMS), Health Resources and Services Administration (HRSA), and Substance Abuse and Mental Health Services Administration (SAMHSA). The Institute of Medicine (IOM) is not under the auspices of the U.S. Department of Health and Human Services. REF: THE FEDERAL GOVERNMENT 11. Which of the following was not identified as an area of health care disparities according to the 2008 National Healthcare Disparities Report? a. Age groups b. Socioeconomic groups c. Geographic areas d. Racial and ethnic populations ANS: A, The 2008 National Healthcare Disparities Report found that health care disparities often persist across socioeconomic groups, racial and ethnic populations, and geographic areas. The report also noted that across the process of care measures tracked, patients received the recommended care less than sixty percent of the time. REF: HEALTH CARE DISPARITIES 12. Which of the following is not one of the three key pieces of legislation that established national standards that states use to regulate health insurance? a. ELISA b. COBRA a. HIPAA c. ERISA ANS: A, Three integral pieces of federal legislation that states use to regulate health insurance through the development of national standards are COBRA (Consolidated Omnibus Budget Reconciliation Act), HIPAA (Health Insurance Portability and Accountability Act), and ERISA (Employee Retirement Income Security Act). ELISA (Enzyme-Linked ImmunoSorbent Assay) is a biochemical test used to determine certain serum antibody concentrations such as HIV. REF: STATE REGULATION OF HEALTH INSURANCE 13. Thorpe, Woodruff, and Ginsburg (2005) have noted a variety of key elements that have contributed to the rising costs of health care. Which of these elements does not belong? a. Aging of the population b. Increased use of new c. Practitioner behavior d. Nursing shortage technologies ANS: D, Thorpe, Woodruff, and Ginsburgs (2005) key factors that contribute to the rising costs of health care are an aging population with the resultant growth in the demand for health care, increased use of expensive new technologies, pharmaceuticals, practitioner behavior, rising hospital care costs, cost shifting, and administrative costs. The nursing shortage is not a key factor contributing to rising costs of health care. REF: FACTORS CONTRIBUTING TO RISING HEALTH CARE COST 14. A staff nurse has volunteered to work on the hospitals Quality Insurance Committee. As part of the training, the nurse would be taught that tracking the rate of medication errors is a clinical: a. outcome. b. practice. c. structure. d. process. ANS: D, Tracking the rate of medication errors as a performance measure is considered a clinical process. An example of a clinical structure is the percentage of nurses and pharmacists who are certified or licensed, and an example of a clinical outcome is the number of deaths from medical errors. REF: TABLE 2-1 EXAMPLES OF PERFORMANCE MEASURE BY CATEGORY 15. The hospital pharmacist explains to a group of nursing students that the use of generic drugs and drug formulary are which type of performance measures? a. Clinical care measure b. Financial management c. Financial management d. Clinical care structure structure ANS: C, Using generic drugs and drug formulary as a quality performance measure is an example of a financial management process. An example of a financial management structure is the use of preadmission criteria, and a clinical care structure for performance measurement is the presence of magnet recognition. REF: EXAMPLES OF PERFORMANCE MEASURES BY CATEGORY 16. There are numerous factors that contribute to the rising number of uninsured in the United States. Which is not necessarily a contributing factor? a. People being eligible for public programs b. Higher premiums c. People between jobs or unemployed d. Employers not offering health insurance

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,Chapter 1: Nursing Leadership and Management

MULTIPLE CHOICE

1. According to Henri Fayol, the functions of planning, organizing, coordinating, and controlling
are considered which aspect of management?

a. Roles
b. Process
c. Functions
d. Taxonomy

ANS: B, The management process includes planning, organizing, coordinating, and controlling. Management roles include
information processing, interpersonal relationships, and decision making. Management functions include planning, organizing,
staffing, directing, coordinating, reporting, and budgeting. A taxonomy is a system that orders principles into a grouping or
classification.

2. Which of the following is considered a decisional managerial role?

a. Disseminator
b. Figurehead
c. Leader
d. Entrepreneur

ANS: D, The decisional managerial roles include entrepreneur, disturbance handler, allocator of resources, and negotiator. The
information processing managerial roles include monitor, disseminator, and spokesperson. The interpersonal managerial roles
include figurehead, leader, and liaison.

3. A nurse manager meets regularly with other nurse managers, participates on the
organizations committees, and attends meetings sponsored by professional organizations in order
to manage relationships. These activities are considered which function of a manager?

a. Informing
b. Problem solving
c. Monitoring
d. Networking

ANS: D, The role functions to manage relationships are networking, supporting, developing and mentoring, managing conflict
and team building, motivating and inspiring, recognizing, and rewarding. The role functions to manage the work are planning
and organizing, problem solving, clarifying roles and objectives, informing, monitoring, consulting, and delegating.

4. A nurse was recently promoted to a middle-level manager position. The nurses title would
most likely be which of the following?

a. First-line manager
b. Director
c. Vice president of patient care services
d. Chief nurse executive

ANS: B, A middle-level manager is called a director. A low managerial- level job is called the first-line manager. A nurse in an
executive level role is called a chief nurse executive or vice president of patient care services.

5. A nurse manager who uses Frederick Taylors scientific management approach, would most likely
focus on which of the following?

, a. General principles
b. Positional authority
c. Labor productivity
d. Impersonal relations

ANS: C, The area of focus for scientific management is labor productivity. In bureaucratic theory, efficiency is achieved through
impersonal relations within a formal structure and is based on positional authority. Administrative principle theory consists of
principles of management that are relevant to any organization.

6. According to Vrooms Theory of Motivation, force:

a. is the perceived possibility that the goal will be achieved.
b. describes the amount of effort one will exert to reach ones goal.
c. describes people who have free will but choose to comply with orders they are given.
d. is a naturally forming social group that can become a contributor to an organization.

ANS: B, According to Vrooms Theory of Motivation, Force describes the amount of effort one will exert to reach ones goal.
Valence speaks to the level of attractiveness or unattractiveness of the goal. Expectancy is the perceived possibility that the goal
will be achieved. Vrooms Theory of Motivation can be demonstrated in the form of an equation: Force = Valence Expectancy
(Vroom, 1964). The theory proposes that this equation can help to predict the motivation, or force, of an individual as described
by Vroom.

7. According to R. N. Lussier, motivation:

a. is unconsciously demonstrated by people.
b. occurs externally to influence behavior.
c. is determined by others choices.
d. occurs internally to influence behavior.

ANS: D, Motivation is a process that occurs internally to influence and direct our behavior in order to satisfy needs. Motivation
is not explicitly demonstrated by people, but rather it is interpreted from their behavior. Motivation is whatever influences our
choices and creates direction, intensity, and persistence in our behavior.

8. According to R. N. Lussier, there are content motivation theories and process motivation
theories. Which of the following is considered a process motivation theory?

a. Equity theory
b. Hierarchy of needs theory
c. Existence-relatedness-growth theory
d. Hygiene maintenance and motivation factors

ANS: A, The process motivation theories are equity theory and expectancy theory. The content motivation theories include
Maslows hierarchy of needs theory, Aldefers existence- relatedness-growth (ERG) theory, and Herzbergs hygiene maintenance
factors and motivation factors.

9. The theory that includes maintenance and motivation factors is:

a. Maslows hierarchy of needs.
b. Herzbergs two-factor theory.
c. McGregors theory X and theory Y.
d. Ouchis theory Z.

, ANS: B, The two-factor theory of motivation includes motivation and maintenance factors. Maslows hierarchy of needs includes
the following needs: physiological, safety, security, belonging, and self-actualization. In theory X, employees prefer security,
direction, and minimal responsibility. In theory Y, employees enjoy their work, show self-control and discipline, are able to
contribute creatively, and are motivated by ties to the group, organization, and the work itself. The focus of theory Z is collective
decision making and long-term employment that involves slower promotions and less direct supervision.

10. A nurse is appointed to a leadership position in the local hospital. The nurses position would be
considered which of the following?

a. Informal leadership
b. Formal leadership
c. Leadership
d. Management

ANS: B, Formal leadership is based on occupying a position in an organization. Informal leadership is shown by an individual
who demonstrates leadership outside the scope of a formal leadership role or as a member of a group. Leadership is a process of
influence whereby the leader influences others toward goal achievement. Management is a process to achieve organizational
goals.

11. A nursing instructor is evaluating whether the nursing students understand the three
fundamental qualities that leaders share. According to Bennis and Nanus, the fundamental
qualities of effective leaders are:

a. guided vision, passion, and integrity.
b. knowledge of self, honesty, and maturity.
c. intelligence, self-confidence, and determination.
d. honesty, self-awareness, and sociability.

ANS: ABennis and Nanus list guided vision, passion, and integrity as fundamental qualities of effective leaders. Knowledge of
self, honesty and maturity; intelligence, self-confidence and determination; self-awareness and sociability are all desirable
traits in leaders as well as in others.

12. The six traits identified by Kirkpatrick and Locke that separate leaders from non-leaders were:

a. respectability, trustworthiness, flexibility, self-confidence, intelligence, sociability.
b. self-confidence, progression of experiences, influence of others, personal life factors, honesty,
drive.
c. intelligence, self-confidence, determination, integrity, sociability, honesty.
d. drive, desire to lead, honesty, self-confidence, cognitive ability, knowledge of business.

ANS: D, Research by Kirkpatrick and Locke concluded that leaders possess six traits: drive, desire to lead, honesty, self-
confidence, cognitive ability, and knowledge of the business. Woods identified five dominant factors that influenced leadership
development: self-confidence, innate qualities, progression of experience, influence of significant others, and personal life
factors. Stogdill identified the following traits of a leader: intelligence, self- confidence, determination, integrity, and
sociability. Murphy and DeBack identified the following leader characteristics: caring, respectability, trustworthiness, and
flexibility.

13. A nurse manager who uses a leadership style that is participatory and where authority
is delegated to others is most likely using which of the following leadership styles?

a. Autocratic
b. Democratic
c. Laissez-faire

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