NSG 441 Exam 3 | Questions and Answers (Complete Solutions)

NSG 441 Exam 3 | Questions and Answers (Complete Solutions) Which concept describes activities and strategies undertaken to address the challenges faced by nurses in their practice settings? A. engagement B. empowerment C. workplace advocacy D. shared governance Rationale: workplace advocacy includes an array of activities and strategies undertaken to address the challenges faced by nurses in their practice settings. Engagement is defined as an employer's commitment to the organization's mission, vision, and values. Empowerment is defined as sharing power and control through participation in decision making. Shared governance refers to organizational strategy supporting ownership, autonomy, and input for nurses. The 2010 Institute of Medicine (IOM, now known as the National Academy of Medicine) report The Future of Nursing: Leading Change, Advancing Health advocated for having at least which percentage of the registered nurse population prepare at the baccalaureate level? A. 65% B. 70% C. 80% D. 100% Rationale: Because evidence supports lower morbidity and mortality rates with a better-educated nursing workforce. The healthcare industry has borrowed and applied models of continuous quality improvement from which industry? A. aerospace B. finance C. business D. real estate Which action would the nurse manager take to initiate the process of progressive discipline? A. verbal reprimand B. written reprimand C. counsel the employee D. referral to human resources Upon completion of the interview, what should the nurse manager do? Select all that apply. A. Send a formal note to the applicant B. Send an e-mail asking follow-up questions C. Indicate when applicants will hear about their interview D. Thank the applicant for his or her time and interest in the position. E. Inform the applicant who will contact them about the result of the interview. Which reason would the manager recognize contributes to nursing turnover? A. poor job fit B. level of education C. acuity of the patients D. length of nursing experience The nurse manager is developing the budgets for the unit. Which budget requires justification by the nurse manager because of competition for the resources within the organization? A. cash B. capital C. operating D. variance analysis Rationale: capital budgets reflect expenditures for major capital items, such as equipment. Organizations set aside a fixed amount for capital expenditures each year. Complete, well-documented justifications are needed, as competition for limited resources is stiff. Which application of information technology focuses on secure medication storage? A. "smart" infusion pumps B. automated dispensing unit/cabinet C. pharmacy automation and robotics D. bar coding and radiofrequency identification scanning. Which concept guides the knowledge content of work required for nursing practice? A. nursing process B. critical thinking C. specified procedures D. evidence-based practice Which education recommendation was made by the Institute of Medicine (IOM, now known as the National Academy of Medicine) in the 2010 report The Future of Nursing: Leading Change, Advancing Health? A. doubling the number of nurses with doctorate by 2020. B. requiring a baccalaureate degree for all registered nurses by 2020. C. increasing the percentage of nurses enrolled in advanced practice programs by 30% in 2030. D. changing the entry-level requirement for initial preparation of nurse's to a master's degree by 2050. Which action would the nurse manager take when terminating an employee who has refused to seek treatment for substance abuse? A. notify law enforcement B. notify the risk management department C. report the incident to the board of nursing D. Encourage the employee to attend rehabilitation. Which information would the nurse manager communicate to an employee who is going to be suspended? A. The employee's benefits will be held B. The employee will be suspended without pay C. The manager will determine the length of the suspension D. The manager will make decisions about continued employment during the suspension period. According to Rogers' Diffusion of Innovation theory, which term describes individuals who thrive on change? A. Rejectors B. Innovators C. Laggards D. Early adopters The nurse is caring for a patient who maintains several different cultures. Which key principle is the patient's background demonstrating? A. Ethnicity B. Multiculturalism C. Transculturalism D. Cross-Culturalism Which term describes a method in which a third-party payer decides in advance what will be paid for a service or episode of care? A. managed cost B. contractual allowance C. cost-based reimbursement D. prospective payment system Which statement reflects why a progressive discipline framework is used? A. to terminate an employee B. to correct behavioral problems C. to evaluate an employee's competency D. to create an employee educational improvement plan. The nurse leader suddenly implements several new changes to the medication administration policy. Which type of change is the nurse leader demonstrating with this sudden change? A. positive B. planned C. personal D. unplanned Which term describes the rates of healthcare services used? A. costs B. price C. utilization D. providers Which staffing process provides a regular schedule for the nurse and increase job satisfaction A. 8-hour shifts, 5 days a week B. 12-hour night shifts, 3 days on and 4 days off C. rotating night shifts with day shifts D. weekend option shifts Which element acknowledges nursing excellence and emphasizes empirical quality results? A. Six Sigma processes B. Outcomes management C. Staff certification of practice D. Magnet Recognition Program Which statement describes ethnicity? A. an individual believes that one's own ways of acting, believing, or behaving are the best, most superior, or preferred. B. groups of people are "classified" according to common racial, tribal, national, religious, linguistic, or cultural backgrounds C. an individual or group tends to impose their values, beliefs, and practices on another culture for various reasons D. an individual has the sense of being between two or more cultures, existing at the edge of each but not centrally belonging to either. Which is the nurse manager performing when completing individual evaluations of work performance? A. supervisor feedback B. performance appraisal C. evaluation information D. employee competency testing Which theory views change as being highly influenced by all individuals and systems in an organization? A. chaos theory B. complexity theory C. innovation-decision process D. Six phases of planned change Which action by the nurse manager will be most effective for decreasing workplace violence with a nurse who has intentionally sabotaged a colleague? A. enforcing a zero-tolerance policy B. transferring the nurse to a different department C. placing the nurse on a period of administrative leave D. referring the nurse to the employee assistance program Which does the Joint Commission (TJC) recommend that organizational leadership do to safely implement health information technology? A. Delay time between training and implementation. B. Mandate reporting of errors but not near misses C. Decrease environmental distraction to reduce errors D. Monitor for problems monthly during implementation. Which factor is used to determine the amount of nursing care required for a group of patients? A. available staff B. patient acuity C. nursing care hours D. number of licensed staff What are the three principles nurse managers need to accept to foster respect of different lifestyles among the nursing staff? Select all that apply. A. acculturation B. ethnocentrism C. multiculturalism D. transculturalism E. cross-culturalism F. cultural sensitivity Which staffing model provides the nurse with the greatest autonomy? A. self-scheduling B. centralized scheduling C. patient acuity systems D. decentralized scheduling Which characteristics describe a healthy work environment? Select all that apply. A. true collaboration B. appropriate staffing C. skilled communication D. unquestioned following E. effective decision making Which budget will healthcare organizations use to pay the monthly bills? A. cash B. profit C. capital D. operating Rationale: The cash budget is the operating plan for monthly cash receipts and disbursements. The capital expenditure budget is used for the purchase of major capital items such as equipment. Profits are not considered a budget, The operating budget covers day-to-day activities of an organization and is not used to pay its bills. Which applicant would be the best fit for a nursing position on the pediatric unit? A. a graduate nurse with a strong desire to work in pediatrics B. the nurse with 2 years of experience working in surgical recovery C. a nurse who is employed at the facility in the pediatric outpatient clinic D. The nurse with 1 year of experience in the pediatric emergency department at another facility Which process must the nurse manager take to discipline a nursing staff employee who is a member of the union? A. follow due process B. provide verbal notification C. offer the nurse legal counsel D. follow the whistleblower's process Which evidence-based nursing response was created to address nursing outcomes, including patient safety? A. Magnet Recognition Program B. American Nurses Association (ANA) C. American Nurses Credentialing Center (ANCC) D. National Council of the State Boards of Nursing (NCSBN) Rationale: MRP was created as a result of IOM's raised awareness of patient safety and quality of care issues, and the focus of the program is on outcomes, including data and efforts related to patient safety. Which variable plays a powerful yet underestimated role in how nurses communicate and interact with one another or mediate conflict among themselves? A. Cultural diversity B. Years of experience C. Educational background D. Leadership experience Which organization recommended moving the chief nursing officer into the boardroom as a key spokesperson on patient safety and quality issues? A. Institute of Medicine B. The Joint Commission C. National Quality Forum D. Agency for Healthcare Research and Quality Which term describes interactive computer programs designed to assist health professional with decision-making tasks by mimicking the inductive or deductive reasoning of a human expert? A. pharmacy automation and robotics B. Computerized provider order entry (CPOE) C. Clinical decision support systems (CDSSs) D. radio frequency identification (RFID) scanning At which point will efforts to retain new nursing personnel begin? A. during their interview B. on the first day of their hire C. at the end of their probationary period D. after their general orientation is completed Which group decision-making approach has the goal of creating a virtually error-free healthcare delivery environment? A. Six Sigma B. TeamSTEPPS C. Root cause analysis D. Computerized decision-making Rationale: Although all decision-making processes in health care attempt to address error, the goal of Six Sigma is explicitly stated as creation of a virtually error-free healthcare delivery environment. Which data can benchmarks help identify? A. patient outcomes B. performance gaps C. research design flaws D. underperforming staff Which resource compromises nurse-sensitive indicators collected at the nursing unit level and provides the ability for participants to benchmark performance with national averages? A. National Quality Forum (NQF) B. Core Measures for Nursing Care Performance Project C. National Database of Nursing Quality Indicators (NDNQI) D. International Organization for Standardization (ISO) 9000 The registered nurse transfers to the emergency department after working for 5 years on the medical/surgical unit. Which does the nurse expect to experience as a result of the change? A. raise in pay B. less confidence C. bullying from staff D. higher expectations Which infraction should the nurse manager focus on when counseling a nurse who yelled at a nursing assistant? A. delegation B. overt bullying C. professionalism D. communication Which concept would the nurse be able to identify when reviewing the healthcare organizations' mission and values statement? A. procedural justice B. distributive justice C. interactional justice D. organizational justice Which statement accurately defines roles within an organization? A. "Roles dictate how communication is carried out" B. "You can assume roles are performed inherently, without special training" C. "Roles within an organization affect an individual's interactions with others" D. "Additional training is required before taking on a new role within an organization" Which intervention would the nurse manager implement to improve workplace engagement of nursing staff? A. establishing trust B. offering education C. offering employee assistance D. improving occupational safety Which are goals of a performance appraisal? Select all that apply. A. reinforce negative behavior B. disciplining less-than-optimal behavior C. addressing strengths D. improving performance E. improving communication F. reinforcing positive behavior A nurse has relocated and is considering a variety of positions in a new clinical area. Which facility characteristic is likely to provide support as the nurse orients to a new clinical area? A. a well-informed clinical ladder B. a large group of novice nurses C. a preceptor program D. high-paying hourly rate Which strategy employed by the nurse leader will enable nurses to experience greater competence, meaningfulness, and self-determination? A. retention B. empowerment C. orientation D. preceptorship Which concept does the manager include when preparing to adopt the American Association of Critical Care Nurses (AACN) standards for maintaining a healthy work environment? Select all that apply. A. true collaboration B. authentic leadership C. nursing-led research D. meaningful recognition E. optimal patient outcomes Which resource does the manager review to discuss the responsibility and accountability of the nursing staff to advocate for patients and families? A. The State Board of Nursing B. Institute for Healthcare Improvement C. American Nurses Association Code of Ethics D. National Council of State Boards of Nursing Which is included in a position description statement? A. written guidelines detailing roles and responsibilities B. benefits the nurse will receive after the probationary period ends C. scope of nursing practice and how to report violations of care standards D. an explanation of the chain of command and expectations of use in practice Which is a key behavior of nurse managers conducting performance appraisals? A. providing written future plans for training needs and goals B. not permitting the nurse to voice opinions during the appraisal C. focusing only on weaknesses and negative behaviors, with suggestions for improvement D. reinforcing the significance of the performance appraisal on continued employment of the nurse The nurse is reviewing health disparity statistics for cardiovascular disease. Which population would benefit MOST from interventions to reduce the incidence of heart disease? A. Hispanics B. U.S. Caucasians C. Native Americans D. African Americans Which information must be documented in a written reminder of the attendance policy? A. statement of the problem B. an explanation for the employee's absence C. consequences for not following the reminder D. the employee's written decision to adhere to the reminder Rationale: the statement of the problem should be documented in the written reminder. From which level of government does the majority of healthcare funding originate? A. city B. state C. county D. federal Which strategy reflects an objective way to evaluate an employee's skills? A. unit skills checklist B. employee self-assessment C. shadowing a mentor on the unit D. providing unit-specific education In addition to the nurse executive, which nursing staff member is responsible for staffing variances and must align staffing decisions with financial objectives? A. team leader B. charge nurse C. nurse manager D. assistant nurse manager Which action should be taken with an employee who appears to lack clinical competency? A. terminate the employee B. offer additional training