HESI 101 Leadership Exam A with Answers

HESI 101 Leadership Exam A with Answers 1 1. A group of staff nurses is ANS: B . dissatisfied with the new ideas The nurse manager should serve as a presented by the newly hired nurse change agent, assisting others in manager. The staff wants to keep understanding the importance, their old procedures, and they resist necessity, impact, and process of the changes. Conflict arises from: change. a. Group decision-making options. b. Perceptions of incompatibility. c. Increases in group cohesiveness. d. Debates, negotiations, and compromises. 2 1. In designing a new healthcare ANS: A, B, C . facility, it is particularly important Although the potential for violence to pay close attention to safety and aggression exists in all healthcare elements related to violence and settings, emergency, psychiatric, and aggression in which of the following geriatric settings are at particular risk settings? (Select all that apply.) for violence. a. Emergency b. Psychiatry c. Gerontology d. Maternal-child 3 1. Nurses entering into the ANS: A, B, C, D, E . workforce today are faced with By nature, conflict is potentially which of the following relationships present in all interpersonal situations. that could create organizational The nurse manager should create an conflict? (Select all that apply.) environment that recognizes and a. Nurse-physician relationship values differences in staff, physicians, b. Nurse-nurse relationship patients, and communities. c. Nurse-patient relationship d. Nurse-chief nursing officer relationship e. Nurse-auxiliary personnel relationships 4 1. The chief nursing officer decides ANS: D . to establish a client advocacy Advocacy involves empowering and position in an oncology unit. promoting self-determination in Advocacy is best represented by: a. Establishing private and professional networking systems. b. Asking social services to handle clients' concerns. c. Identifying community support groups. d. Empowering others by promoting self-determination. 5 1. Which of the following activities . would represent a customer-friendly approach in a healthcare setting? (Select all that apply.) a. Sending a patient with a migraine headache to wait in the emergency room sitting area so that a patient with chest pain can be seen b. Repeating patient history information to the admitting clerk, the admitting nurse, and the ultrasound technician c. Ensuring that birthing preferences are on file and available when a laboring mother comes in d. Providing support to families when a family member is brought into trauma 6 1. Your healthcare organization . places a high value on workplace safety and integrates this into all aspects of administrative and patient care processes. As a unit manager, you thoroughly endorse this direction, and during the selection and hiring of new staff, you consistently: a. Refuse to hire applicants who are pushy during interviews. b. Thoroughly follow up with all others. ANS: B, C, D Service is a measure of what matters to the patient; quality is a measure of how well a standard is met. Although the patient with chest pain is seen first, and this decision would be consistent with usual practices associated with triaging, customer- friendly approaches would lead to approaches that enable handling of patients with urgent rather than emergency health concerns. ANS: B Sporadic work histories and a "pushy" attitude may or may not be associated with aggression and violence. Checking references thoroughly helps to effectively check out impressions gained during the interview and may yield useful information about issues related to violence and aggression in previous employment. references before offering a position. c. Ask applicants during the interview if drug or alcohol abuse is a problem. d. Refuse to interview applicants with sporadic work histories. 7 2. As part of performance appraisal, . the nurse manager designs strategies to acknowledge staff members. What practices by the nurse manager best acknowledge staff accountability and contribution? a. Providing new and varied learning experiences for staff members b. Fostering group cohesiveness through standardization of unit activities c. Allowing professionals greater influence over their practices d. Giving recognition for success and support for failure to staff members 8 2. Two staff nurses are arguing about . working on holidays. In trying to resolve this conflict, the nurse manager understands that interpersonal conflict arises when: a. Risk taking seems to be unavoidable. b. People see events differently. c. Personal and professional priorities do not match. d. The ways in which people should act do not match the ways in which they do act. 9 2. You need to terminate Gregory, . who has had a long-standing history of conflict with you and the staff, and who recently was charged with theft ANS: C Allowing greater control over practices implies trust and acknowledges expertise and performance. ANS: B By definition, conflict involves a difference in perception between two or more individuals. ANS: A Termination requires careful planning as to timing, privacy, safety, and how to preserve the employee's of patient belongings. You consult Human Resources, and together, you develop a plan, which includes: a. A private meeting with Gregory, a Human Resources representative, and you to deliver the news and deliver the termination notice and all other documents that are related. b. Planning an opportunity for Gregory to return and be recognized at a staff farewell. c. Calling Gregory at home to tell him that he is fired, and that his paperwork will be sent to him at a future date. d. Calling him into a meeting in your office on the ward, where assistance is available, should he become upset or agitated. dignity and avoid humiliation. Choosing a private location where colleagues are not present, and organizing all documentation that is required to be given to Gregory, achieves these goals and prevents his having to come to the organization at a future date 10 3. In which of the following . situations would you, as the head nurse, be concerned about potential safety issues? a. Jordan comes to your office to complain about inadequate staffing on the unit. He says that he is concerned because he attributes a recent incident to the staffing levels. b. Henry, a long-standing RN on the unit, has begun to miss work regularly. He calls in but is vague about his reasons for the absences. c. Carla, RN, has just ended a relationship with Jake, RN, and he will not leave her alone. You are meeting with Jake today because colleagues on nights have reported that Jake seems to have been intoxicated last night and the ANS: C Jake seems at most risk for violence because of his alcohol use and the end of what may be an obsessive relationship with Carla. In the other situations, Jordan is expressing a legitimate concern and is behaving assertively; Henry may have health concerns or other issues that are private and interfering with his work life; and Sarah's change in behavior is likely related to a higher level of comfort with work and colleagues. previous night. d. Sarah is very quiet and says almost nothing in team meetings. Lately, she has been much more animated since becoming friendly with a couple of other RNs on the unit. 11. 3. The nurse manager is aware that conflict is occurring on her unit; however, she is focused on preparing for a state health department visit, so she ignores the problem. A factor that can increase stress and escalate conflict is: a. The use of avoidance. b. An enhanced nursing workforce. c. Accepting that some conflict is normal. d. Managing the effects of fatigue and error. ANS: A Purposeful avoiding is an appropriate strategy when the conflict is interpersonal and the individuals involved in the conflict have the necessary skills and insight to be able to own the problem and solve it themselves. When these conditions are not present and avoidance is not purposeful, then avoidance can increase stress and escalate conflict. 12 3. The nurse manager understands . that the three Ps associated with client education include philosophy, priority, and performance. Effective client education programs start with a shared philosophy that such programs are worth the investment. Evidence of a philosophic commitment to client teaching is best represented by: a. Investing time and energy in teaching clients. b. Developing teaching skills among the nursing staff. c. Assuming that clients lack the knowledge they need. d. Having a teaching checklist on clients' charts. ANS: A Investment of time and energy in teaching translates vision into action and communicates commitment to service. 13 4. Delaney, one of your staff nurses, . confides that Marjorie, another nurse, has been actively telling others that you are incompetent and do not know what you are doing in relation to patient care, and that you lie to the staff about attempts to get more staffing. Through telephone calls and conversations during breaks, she is recruiting other staff to her position. Delaney confides that most of the staff find you fair, honest, and knowledgeable. Marjorie's behavior can best be characterized as: a. Political action. b. Bullying. c. Building alliances. d. Disgruntlement. 14 4. The nurse manager decides to use . a mediator to help resolve the staff's conflict. A basic strategy for truly addressing this conflict is to: a. Identify the conflicting facts. b. Be determined to resolve the conflict. c. Schedule a meeting time for resolution. d. Have a clear understanding of the differences between the parties in conflict. 15 4. The nurse manager on a pediatric . intensive care unit wants to evaluate patient satisfaction. The nurse manager understands that ultimately, positive relationships with consumers of care are evaluated by the: a. Cultural sensitivity of staff. ANS: B Workplace bullying involves aggressive and destructive behaviors such as running a smear campaign and failing to support another nurse. ANS: D The manager must determine if a conflict is constructive or destructive. In this situation, the manager has determined that the conflict is destructive and does not want the conflict to escalate, so has engaged a mediator. ANS: D Health literacy involves merging preferences and needs with the capacity to understand and process basic health information and obtain services. b. Cost-effectiveness of care delivery. c. Economic value of service. d. Outcomes for clients and their perceptions of care. 16 5. During coffee and other breaks, ANS: C . Rosalie, the new RN, is shut out of Horizontal or lateral violence and conversations with the other staff. bullying are terms used to describe When she approaches other staff on destructive behaviors towards co- the unit to ask questions, they turn workers, such as the "silent and walk off in the other direction. treatment" and shutting others out of The behavior of the staff is socializing. characteristic of: a. Dislike. b. Lack of trust in Rosalie's abilities. c. Horizontal violence. d. Cultural incompetence. 17 5. Sarah, a staff nurse on your unit, ANS: A . witnesses another nurse striking a Intrapersonal conflict occurs within a patient. Sarah wants to remain person when confronted with the friends with her colleague and need to think or act in a way that worries that confrontation with her seems at odds with one's sense of colleague or reporting her colleague self. Questions often arise that create will destroy their relationship. a conflict over priorities, ethical Sarah is experiencing which type of standards, and values. Some issues conflict? present a conflict over comfortably a. Intrapersonal maintaining the status quo and taking b. Interpersonal risks to confront people when c. Organizational needed, which can lead to d. Professional interpersonal conflict. 18 5. The nurse manager has to ANS: B . develop a patient satisfaction Because satisfaction is a measure of survey. What is one of the critical service and service is a measure of elements in selecting a patient perception of what matters to the satisfaction instrument? patient, to measure satisfaction, a. Being able to use the same surveys must include items that instrument for all clinical units reflect the perspective of the patient. b. Including items that are important from the patient's perspective c. Being able to administer the instrument before a patient's discharge from the hospital d. Being sure that the reading level is no higher than third grade 19 6. In writing the patient satisfaction . survey, the nurse manager is aware of the education levels of the families. What is the most critical element in the concept of health literacy? a. Providing instructional materials at appropriate reading levels b. Facilitating access to translators for persons with language barriers c. Obtaining, processing, and understanding basic health information so appropriate decisions can be made d. Knowing that most people have limited health literacy skills 20 6. The chief nursing officer plans a . series of staff development workshops for the nurse managers to help them deal with conflicts. The first workshop introduces the four stages of conflict, which are: a. Frustration, competition, negotiation, and action. b. Frustration, conceptualization, action, and outcomes. c. Frustration, cooperation, collaboration, and action outcomes. d. Frustration, conceptualization, negotiation, and action outcomes. ANS: A Unless health materials are written at a level that makes the material accessible to patients, then patients are unable to make sense of what has been written. ANS: B Thomas (1992) determined that conflict proceeds through these four stages in this particular order. 21 6. While working with an aggressive ANS: C