(Test Bank) Essentials of Nursing Leadership & Management

Kelly,Tazbir, 3

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Author(s): Kelly, Tazbir

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Test Bank for Essentials of Nursing Leadership & Management 3e Patricia Kelly Janice Tazbir (All Chapters) Chapter 1: Nursing Leadership, Management, and Motivation MULTIPLE CHOICE 1. According to Lussier (1999), motivation __________. a. is unconsciously demonstrated by people b. occurs externally to influence behavior c. is determined by the choices of others 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 our needs. Motivation is not explicitly demonstrated by people, but rather interpreted from their beha vior. Motivation is whatever influences our choices and creates direction, intensity, and persistence in our behavior. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Motivation 2. Lussier (1999) noted that 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. expectancy -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 Maslow’s hierarchy of needs theory, Aldefer’s exp ectancy -relatedness -growth theory, and Herzberg’s hygiene maintenance factors and motivation factors. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Motivation 3. The theory that includes maintenance and motivation factors is: a. Maslow’s hierarchy of needs c. McGregor’s theory X and theory Y b. Herzberg’s two -factor theory d. Ouchi’s theory Z ANS: B The two -factor theory of motivation includes motivation and maintenance factors. Maslow’s 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 to the work itself. The focus of theory Z is based on colle ctive decision making and long -term employment that involves slower promotions and less direct supervision. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Motivation 4. Leadership that is based upon occupying a position in an organization is called: a. informal leadership c. leadership b. formal leadership d. management ANS: B Formal leadership is based upon occupying a particular position in an organizati on. Informal leadership is shown by an individual who demonstrates leadership behavior outside of a formal leadership role or as a member of a group. Leadership itself is a process of influence whereby the leader influences others toward goal achievement. Management is a process to achieve organizational goals. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Leadership 5. Bennis and Nanus (2003) identified fundamental qualities that effective leaders share. These three qualities are: a. vision, passion, and integrity b. knowledge of self, honesty, and maturity c. intelligence, self -confidence, and determination d. honesty, self -awareness, and sociability ANS: A Bennis and Nanus (1985) have stated that guided vision, passion, and integrity are fundamental qualities of effective leaders. Knowledge of self, honest y and maturity; self -confidence and determination; self -awareness and sociability are also desirable characteristics in leaders, but are not part of the group of qualities identified by Bennis and Nanus. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Leadership Characteristics 6. Kirkpatrick and Locke identified six traits that separate leaders from nonleaders. These traits are: a. respectability, trustworthiness, flexibility, self -confidence, intelligence, and soc iability b. self-confidence, progression of experiences, influence of others, personal life factors, honesty, and drive c. intelligence, self -confidence, determination, integrity, sociability, and honesty d. drive, desire to lead, honesty, self -confidence, cognitive ability, and knowledge of business ANS: D Research by Kirkpatrick and Locke (1991) concluded that leaders posses six traits: drive, desire to lead, honesty, self -confidence, cognitive ability, a nd knowledge of business. Wood identified five dominant factors that influenced leadership development: self -confidence, innate qualities, progression of experience, influence of significant others, and personal life factors. Stodgill identified the follow ing traits of a leader: intelligence, self -confidence, determination, integrity, sociability. Murphy and DeBack (1991) identified four characteristics of leaders: caring, respectability, trustworthiness, and flexibility. PTS: 1 OBJ: Cognitive Level: Under standing TOP: Leadership Characteristics 7. The type of leadership that is participatory and delegates authority to others is called: a. autocratic c. laissez -faire b. democratic d. employee -centered ANS: B Democra tic leadership is participatory and authority is delegated to others. Autocratic leadership involves centralized decision making, with the leader making decisions and using power to command and control others. Laissez -faire leadership is passive and permis sive, and the leader defers decision making. Employee -centered leadership focuses on the human needs of subordinates. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Democratic Leadership 8. The leadership theory that considers follower readiness as a f actor in determining leadership style is called: a. contingency c. situational b. path goal d. charismatic ANS: C Situational leadership considers the readiness of the follower as a factor in determining leadership style. Contingency theory views that pattern of leader behavior as dependent on the interaction of the personality of the leader and the needs of the situa tion. In path goal theory, the leader works to motivate followers and influence goal accomplishment. Charismatic leadership has an inspirational quality that promotes an emotional connection from followers. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Situational Theory 9. In contingency theory, the feeling and attitudes of followers regarding acceptance, trust, and credibility of the leader are called: a. task structure c. low task structure b. position power d. leader -member relations ANS: D In contingency theory, leader -member relations are feelings and attitudes of followers concerning the acceptance, trust, and credibility of the leader. Task structure of contingency theory means the degree to which work is defined, with specific procedure s, explicit directions, and goals. Low task structure involves work that is not routine, predictable, or clearly defined. Position power in contingency theory is the degree of formal authority and influence associated with the leader. PTS: 1 OBJ: Cognitiv e Level: Understanding TOP: Fiedler’s Contingency Theory | Task Structure 10. In situational theory, a telling leadership style is considered to be: a. high task, high relationship behavior c. low task, high relationship behavior b. high task, low relationship behavior d. low task, low relationship behavior ANS: B A telling leadership style is high task and low relationship behavior. A high task, high relationship style is referred to as a selling leadership style. A low task, high relationship style is called a participating leadership style. A low task and low relationship style is called a delegating leadership style. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Situational Theory 11. A leader who is committed to a vision that empowers others is called a ________ leader. a. transformational c. transactional b. charismatic d. autocratic ANS: A A transformational leader empowers others. A charismatic leader has an appeal based on personal power. A transactional leader focuses on day -to-day operations. An autocratic leader has central power and does not empower others. PTS: 1 OBJ: Cognitive Level : Understanding TOP: Transformational Leadership Theory 12. A leader who focuses on the day -to-day operations of a unit or department and short -term goals is considered to be a: a. transformational leader c. transactional leader b. charismatic leader d. autocratic leader ANS: C Transactional leaders tend to focus on day -to-day operations and are short -term goal orientated. A transformational leader inspires and motivates others to excel and participate in a vision that goes beyond self -interest. A charismatic leader displays self -confidence and strength in convictions and communicates high expectations. An autocratic leader makes decisions and uses power to command and control others. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Transformational Leadership Theory 13. Fiedler’s (1967) contingency theory of leadership is based upon three primary factors. Which of the following is not one of these factors? a. leader -member relations c. task structure b. follower -joiner relations d. position power ANS: B Fiedler’ s (1967) contingency theory of leadership views leadership effectiveness as dependent upon the interaction of the leader’s personality and the needs of the situation. These are based upon leader -member relations (not follower -joiner relations), task struct ure, and position power. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Fiedler’s Contingency Theory 14. Leaders who “commit people to action, convert followers into leaders, and convert leaders into agents of change” are called: a. transactional lead ers c. charismatic leaders b. situational leaders d. transformational leaders ANS: D The leadership description that includes committing people to action, converting followers into leaders, and converting leaders into agents of change refers to transformational leaders (Bennis & Nanus, 1985). Transactional leaders are more concerned with t he day -to-day operations. Situational leaders adapt their leadership style according to the situation at hand. Charismatic leaders display self-confidence and strength in their convictions and tend to lead by using personal power and evoking emotion in the ir followers. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Transformational Leadership Theory 15. The acronym used to identify Gulick and Urwick’ s (1937) seven principles associated with management is: a. PDQRZ c. POSCORD b. POSDCORB d. POSDCD ANS: B Gulick and Urwick’ s (1937) seven principles that define the management process are: planning (P), organizing (O), staffing (S), directing (D), coordinating (CO), reporting (R), and budgeting (B). Therefore the acronym is: POSDCORB. PTS: 1 OBJ: Cognitive Level: Remembering TOP: The Management Process 16. Mintzberg’s managerial taxonomy includes three categories of managerial roles. Which of the following is not one of those categories? a. Information -processing roles c. managing roles b. interpersonal roles d. decision -making roles ANS: C Mintzberg (1973) categorized the roles or behaviors, expectations, and recurring activities that managers do into a taxonomy or classification system. Mintzberg’s taxonomy of management roles included the following 1) information processing roles, 2) inter personal roles, and 3) decision -making roles. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Management Roles 17. Which of the following is not considered a management decision role? a. entrepreneur c. allocator of resources b. disturbance handler d. liaison ANS: D Mintzberg’s managerial taxonomy (1973) noted three distinct categories of roles that manager do, one of which is the decision -making role category. Some examples of decision roles include: entrepreneur, disturbance handler, allocator of resources, and negotiator. Liaison is considered to be part of the interpersonal managerial role set. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Management Roles 18. Which of the following is not one of the content motivation theories? a. Maslow’s hierarchy of needs theory b. Alderfer’s expectancy -relatedness growth theory c. Equity theory d. McClelland’s manifest needs theory ANS: C Motivation theories can be divided into two categories: as content motivation theories and process motivation theories (Lussier, 1999). Content motivation theories include Maslow’s hierarchy of needs theory, Alderfer’s expectancy -relatedness growth theory, and McClelland’s manifest needs theory and model of achievement, power, and affiliation. Equity theory is considered to be a process motivation theory. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Motivation 19. Which of the following motivation the ories and models contains: collective decision making, long-term employment, use of quality circles, and holistic concern and mentoring? a. Theory X c. Theory Z b. Theory Y d. McClelland’s model ANS: C Ouchi’ s (Shortell & Kaluzney, 2006) theory Z noted the following four qualities: 1) collective decision making, 2) long -term employment, 3) use of quality circles, and 4) holistic concern and mentoring. Theory X includes two primary areas: security (direction an d minimal responsibility emphasis) and coercion (threats and punishment necessary). Theory Y includes: people enjoy work and are disciplined and creative in getting work done. McClelland’s model includes three primary areas: achievement, power, and affilia tion. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Motivation 20. When leaders work to remove obstacles and barriers while employees have self -control and self-discipline and are rewarded by their involvement in their work, they are working under whi ch theory? a. Hierarchy of needs c. Theory Z b. Two-factor theory d. Theory Y ANS: D Douglas McGregor’s (1960) theory Y espoused that leaders must remove work obstac les and barriers while workers have self -discipline and self -control in their work and the reward is the opportunity to be involved in their work and be creative. Ouchi’s (1981) theory Z focuses primarily upon collective decision making, long -term employme nt, and a holistic concern. Herzberg’s (1968) two -factor theory is based on hygiene maintenance factors such as adequate salary and job security as well as motivation factors to maintain a satisfied work force. Maslow’s (1970) hierarchy of needs is based u pon a series of human needs ranging from physiological to self -actualization to describe human behavior. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Motivation 21. Benner’ s Model of Novice to Expert (1984) is based on how many levels of experience? a. five c. seven b. six d. four ANS: A Benner’ s Model of Novice to Expert (1984) acknowledges that there are certain skills, tasks, and outcomes that can be associated with differing levels of experience. Benner uses five levels of experience, which are novice, advanced beginner, competent, proficient , and expert. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Benner’s Model of Novice to Expert 22. Organizations meet self -actualization needs of employees by: a. merit pay increases c. safe working conditions b. achievement and promotion d. providing job security ANS: B Organizations meet the self -actualization needs of its employees by the development of the employee’s skills, the chance to be creative, achievement and promotions, and the ability to have complete control over their jobs. Merit pay raises are included und er esteem needs. Job security and safe working conditions would be included in safety needs. PTS: 1 OBJ: Cognitive Level: Applying TOP: Selected Motivational Theories 23. One common employee motivation problem may be seen when staff have a lack of goal s. One solution to this problem could include: a. Well -defined job descriptions c. feedback on performance b. pay for performance d. enhanced hygiene factors ANS: A One common employee motivation problem is an inadequate performance definition. This can include lack of goals, inadequate job descriptions, inadequate performance standards, and inadequate performance assessment. Potential solutions to these problems incl ude well -defined job descriptions, well-defined performance standards, and goal setting. Feedback on performance and enhanced hygiene factors are solutions for impediments to performance and pay for performance is related to inadequate performance -reward l inkages. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Common Employee Motivational problems and Potential Solutions 24. According to Benner’ s Model the competent nurse has approximately ______years of work experience? a. three –five c. four–six b. one–two d. two–three ANS: D According to Benner’ s Model of Novice to Expert the competent nurse has been on the job in the same or similar situations for two –three years. Competence begins to develop when the nurse begins to see his or her actions as part of long -range goals or plans. PTS: 1 OBJ: Cogni tive Level: Understanding TOP: Benner’s Model of Novice to Expert 25. One important component of leadership is: a. influence c. self-directed employees b. control d. being liked by everyone ANS: A Leadership involves influencing the attitudes, beliefs, behaviors, and feelings of other people (Spector, 2006). Leaders influence others, often by inspiring, enlivening, and engaging others to participate. Controlling others and being liked by everyone ar e not traits of effective leaders. The most valuable followers are skilled, self -directed employees who participate actively in setting the group’s direction and invest time and energy into the group. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Leader ship MULTIPLE RESPONSE 1. Which of the following researchers did not coin the phrase “Leaders are people who do the right thing; managers are people who do things right”? Select all that apply. a. Kotter (1990) c. McCall (1998) b. Stodgill (1948) d. Bennis and Nanus (2003) ANS: A, B, C Bennis and Nanus (2003) are responsible for the phrase: “Leaders are people who do the right thing; managers are people who do things right.” PTS: 1 OBJ: Cognitive Level: Remembering TOP: Leadersh ip 2. Which of the following are considered to be the three major classifications of leadership theories? Select all that apply. a. behavioral c. motivational b. contingency d. contemporary ANS: A, B, D The major leadership theories can be classified according to the following approaches: behavioral, contingency, and contemporary. The behavioral approach includes three leadership styles: autocratic, democratic, and laissez -faire. The contingency approach acknowledges that other factors in the environment influence outcomes as much as the leadership style. Contemporary approaches to leadership address leadership functions necessary to lead the process of change. PTS: 1 OBJ: Cognitive Level: Remembering TOP : Leadership Theories 3. Five basic emotional and social competencies have been associated with emotional intelligence. Which of the following are some of these competencies? Select all that apply. a. self-awareness c. motivation b. self-regulation d. self-actualization ANS: A, B, C The five basic competencies (Goleman, 1998) associated with emotional intelligen ce are: self-awareness, self -regulation, motivation, empathy, and social skills. Self -actualization is not one of these basic competencies for emotional intelligence. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Emotional Intelligence 4. Nursing is t ransitioning into the information age. Trends that are occurring with this transformation are termed which of the following? Select all that apply. a. mobility c. user-driven practices b. virtuality d. application of technology ANS: A, B, C In the information age, it is the development of new knowledge and innovation and its meaningful interpretation and application that becomes the source of transactions for patients and staff. Nursing’s transition to the information age is influenced by thr ee key trends. These trends are mobility, virtuality, and user -driven practices. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Knowledge Workers Chapter 2: The Health Care Environment MULTIPLE CHOICE 1. The link between adverse patient outcomes and cleanliness was discovered by: a. W. Edwards Deming c. Isabel Hampton Robb b. Florence Nightingale d. Dorothea Dix ANS: B Florence Nightingale was the first to discover the link between hand washing, cleanliness, and adverse patient outcomes. W. Edwards Deming is known for his contribution to continuous performance improvement, and Isabel Hampton Robb was the first president of the American Nurses Association (ANA) and a leading pioneer in nursing education. Dorothea Dix is best known for her patient advocacy, particularly in the areas of improved conditions for jails and mental asylums. PTS: 1 OBJ: Cognitive Level: Understan ding TOP: History of U.S. Health Care 2. Three components of health care systems are: a. strategy, outcome, and performance c. structure, process, and outcome b. process, strategy, and opportunity d. outcome, procedure, and structure ANS: C The three components of health care systems are: 1) structure (resources or “structures” required to deliver health care), 2) process (quality activities, procedures, and tasks performed to deliver quality health care), and 3) outcome (the results of good health care delivery). PTS: 1 OBJ: Cognitive Level: Understanding TOP: Organization of Health Care 3. When the United States health care system is compared to other countries such as Germany or Canada, it is noted that our health care system is: a. more organized and better equipped to handle large volumes of emergencies b. less organized, but with better access to equipment and tech nological advances c. more organized and more expensive d. less organized and more expensive ANS: D The United States is one of only a few large countries without a universal system of health care for its people. Health care in the United States is much less organized and more expensive than in other countries. This health care is considered more expensi ve, given the total health care expenditure as a percentage of the gross domestic product (GDP), than is the case in countries such as Germany, Canada, or Great Britain that have a universal health care system. PTS: 1 OBJ: Cognitive Level: Understanding TOP: U.S. Health Care Rankings 4. Seven important features have been identified as benefits of primary care. Which of the following is not one of these seven benefits? 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 oriented ANS: C Seven important benefits of primary care are that it: 1) is care that is continuous, 2) is care that is community -oriented, 3) is comprehensive (not integral), 4) is coordinated, 5) is family -centered, 6) is culturally competent, and 7) begins at the first contact with the patient. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Need for Primary Health Care 5. 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 Di sease Control and Prevention (CDC) c. Institute of Medicine (IOM) d. Indian Health Service (IHS) ANS: C Some of the major divisions/agencies that are part of the U.S. Department of Health and Human Services are: 1) the Food and Drug Administration (FDA), 2) Centers for Disease Control and Prevention (CDC), 3) Indian Health Service (IHS), 4) Agency for Health care Research and Quality (AHRQ), 5) Centers for Medicare and Medicaid (CMS), 6) Health Resources and Services Administration (HRSA), and 7) Substance Abuse and Mental Health Services Administration (SAMHSA). The Institute of Medicine (IOM) is not a part o f this U.S. government -based department. PTS: 1 OBJ: Cognitive Level: Understanding TOP: The Federal Government 6. How many Americans under the age of 65 feel they lack access to health care services due to their lack of any form of insurance? a. 23 million c. 56 million b. 47 million d. 15 million ANS: B According to the National Coalition on Health Care (2008), 47 million Americans below the age of 65 lack access to health care services due to their lack of any form of health insurance. This, in turn, also translates to potential financial ruin for these individuals should they become ill or injured. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Introduction 7. Which United States president formed the Committee on Economic Security as a means of helping the nation’s needs? a. Theodore Roosevelt c. Woo drow Wilson b. Lyndon B. Johnson d. Franklin Roosevelt ANS: D President Franklin Roosevelt formed the Committee on Economic Security as a means of meeting the needs of the nation. The “New Deal” program that was implemented at this time provided federal relief programs, social services, and aid for the elderly. Later, the 1939 Amendments to the Social Security Act went into effect, which defined the role of the government in the financing and del ivery of health care services (Maville and Huerta, 2007; Ross, 2002). PTS: 1 OBJ: Cognitive Level: Understanding TOP: Political Influences on Health Care 8. What is the leading cause for personal bankruptcy in the United States? a. credit card fraud c. credit card debt b. medical debt d. unemployment or loss of job ANS: B The number one cause of personal bankruptcy in the United States has been identified as medical debt . While credit card debt, credit card fraud, and unemployment or loss of job may also contribute to personal bankruptcy, none of them is the leading cause o f this type of bankruptcy. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Rising Health Care Costs 9. Which country has been identified as having the best health care system in the world? a. Belgium c. Germany b. France d. Japan ANS: B Nolte and McKee (2008) identified France as having the best health care system worldwide. French health care is provided through both private and government insurance, but in France everyone is insured with no additional patient charges for insurance deduc tibles (Shapiro, 2008). PTS: 1 OBJ: Cognitive Level: Understanding TOP: France 10. Improvement in perceived quality of care has been reported in magnet organizations. According to several studies, which of the following is thought to contribute signific antly to these quality outcomes and quality of care? a. nurse’s work environment c. performance improvement practices b. quality assessment practices d. shorter lengths of stay in the hospital ANS: A Research by Aiken, Havens and Sloane (2000), Friese (2005), and Lake and Friese (2006) noted that health care facilities that have obtained magnet status tend to have environments that are indicative of nurse job satisfaction, prevention of burnout, and an improvement in perceived quality of care. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Magnet Program 11. Which country spends 10% of its gross domestic product (GDP) annually on its health care system, and has the eighth largest global health care budg et? a. Japan c. Canada b. United States d. France ANS: C Canada has been noted to spend 10% of its gross domestic product (GDP) on its national health care system, and it has the eighth largest global health care budget worldwide (Organization for Economic Co-operation and Development, 2008). All Canadians have equal access to the same quantity and quality of health care under this system. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Canada 12. Which of the following is not considered to be one of the five most expensive health conditions? a. heart disease c. trauma b. cancer d. diabetes ANS: D Five health conditions have been noted to be the most expensive, requiring the utilization of expensive technologies and medications (Stanton, 2006). These five conditions are: 1) heart disease, 2) cancer, 3) trauma, 4) mental disorders, and 5) pulmonary c onditions. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Technology and Rising Hospital Costs 13. Which country is noted to have the longest life expectancy, provide comprehensive health care for its people, and have one of the most advanced health care systems in the world? a. United States c. France b. Canada d. Japan ANS: D Japan is noted to have the longest life expectancy in the world at 82.4 years (O rganization for Economic Co -operation and Development, 2008). It also provides comprehensive health care to all and is one of the most advanced health care systems in the world. Japan spends 8.2% of its gross domestic product (GDP) on health care. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Japan 14. Two of the areas of physician shortage most prevalent in the United States are: a. family practice and dermatology c. family practice and psychiatry b. family practice and orthopedics d. family practice and geriatrics ANS: D The number of physicians per person in the U.S. is less than any other wealthy c ountries such as France, Canada, or Japan. This shortage is more pronounced in family practice physicians and geriatric physicians. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Practitioner Behavior 15. Prescription medications for the elderly have c ontinued to rise. How much is the total cost for these medications to the national health care expenditures? a. 15% c. 5% b. 10% d. 20% ANS: B Prescription medications are used by 92% of seniors. These medication cost add 10% to national health care expenditures. Prescription drug use increased among the elderly after Medicare, Part D, a prescription drug benefit, was introduced in 2006. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Aging and Pharmaceutical Use 16. One factor of hospital design which could improve patient outcomes is: a. exposure to natural light c. good interior design b. carpeted hallways and rooms d. short hallways for nurses ANS: A Research is finding links between the physical environment and patient outcomes, patient safety, and patient and staff satisfaction. Studies show that elements of hospital design such as exposure to natural light, private rooms, and facilities that are staff friendly and have less noise contribute to improved patient outcomes. Although carpet, paint color, and le ss walking are commendable, they do not directly affect patient outcomes. PTS: 1 OBJ: Cognitive Level: Applying TOP: Structuring Hospitals around Nursing Care 17. One activity which could be included in the process component of health care is: a. medi cal records b. referrals to specialists c. absence of health care –acquired infections d. recruitment and retention of nurses ANS: B The process component of health care includes the quality activities, procedures, tasks, communication, and process performed within the health care structures. These include hospital admissions, surgical operations, nursing and medical care delivery, refe rrals to specialized physicians, and discharge procedures. Medical records would be included in the structure component. The absence of health care infections and recruitment and retention of nurses are both part of the outcome component of health care. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Organization of Health Care 18. Variables in health care disparity may include: a. type of illness c. mental illness b. health care access d. type of hospital ANS: B Health care disparities are persistent irregularities between the health outcomes of people in one group versus the people in another group due to variables such as gender, sexuality, age, ethnicity, socioeconomic status, lifestyle, and/or health care acces s. The type of illness one has, or the type of one hospital one uses, does not affect health care disparity. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Health Care Disparities 19. The United States spends how much of the gross domestic product (GDP) on health care? a. 16% c. 20% b. 12% d. 10% ANS: A Health care costs in the United States are increasing 2.5 percent faster than th e U.S. GDP. U.S. national health care expenditures were $1.9 trillion in 2004. A staggering 16% of the GDP was spent on health care. Health care spending continues to increase faster than the overall U.S. economy. PTS: 1 OBJ: Cognitive Level: Understandin g TOP: Rising Health Care Costs 20. Which piece of federal legislation provides tax exclusions for medical savings accounts? a. ERISA c. HIPAA b. COBRA d. AHRQ ANS: C The Health Insurance Portability and Accountability Act (HIPAA) of 1996 imposed exclusions of restriction for those with preexisting conditions, provided protection of insurance coverage as employees change employers, and provides tax exclusions to medical savings accounts. The Employee Retirement Income Security Act (ERISA) allows states to regulate health insurers. The Consolidated Omnibus Reconciliation Act (COBRA) ensured employees who were laid off could maintain their health insurance for 18 months. A HRQ is not a piece of legislation but stands for The Agency for Healthcare Research and Quality. PTS: 1 OBJ: Cognitive Level: Understanding TOP: State Regulation of Health Insurance 21. Raising the costs of the privately insured to offset the cost of Medicare and Medicaid is known as: a. cost shifting c. budgeting b. cost containment d. resource utilization ANS: A The practice of cost shifting, whereby health care providers raise prices for the privately insured to offset the lower health care payments from both Medicaid and Medicare as well as the often nonpayment of health care premiums from the uninsured, continu es to raise the cost of health care. Health care providers shift charges for health care costs to the private sector. This method does not adhere to the budget, contain costs, or utilize resources effectively. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Cost Shifting and Administrative Costs 22. There are many forces which affect overall health care utilization. Which of the following is not included in these forces? a. technological advances c. increase in chronic illness b. increased accountability d. changes in consumer preferences ANS: D There are several forces that affect overall health care utilization. These include pay for performance, increased accountability for performance, technological advances, increase in chronic illness and access to patient information. Changes in consumer pr eferences may actually decrease health service utilization. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Forces That Affect Overall Health Care Utilization 23. What is one of the two measures utilized to measure the health quality of the nation? a. immu nization rates c. infant mortality b. persons older than 65 d. cost of care ANS: C The two measures used to measure the health quality of the nation are infant mor tality rate and the life expectancy at birth. According to the Central Intelligence Agency (2010), the United States ranked 45th in all nations for infant mortality. Although immunization rates, the elderly population, and cost of care may influence a nati on’s overall health care picture, they are not used by the CIA as one of the two measurements. PTS: 1 OBJ: Cognitive Level: Understanding TOP: U.S. Health Care Rankings 24. Primary health care serves to benefit the patient in three ways. Which one of t he ways is not correct? a. reduce hospitalizations c. reduce morbidity b. improve health d. reduce costs ANS: D In 1996 the Institute of Medicine defined primary care to meet the needs of the population. Starfield (1998) took that definition and goal further. He outlined seven facets that are important to primary care. These include that the care should begin at the first contact and that it should be continuous, comprehensive, coordinated, community oriented, family centered, and culturally competent. By providing primary health care interventions, such as health promotion and timely preventative care and medication administration, we can reduce the need for hospitalizations, improve the health of patients, and avert adverse morbidity and mortality outcomes. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Need for Primary Health Care 25. The costs of health care using a downstream focus means a. health care costs more c. cost is about the same b. health care costs less d. cost is twice as much ANS: A With a downstream focus of health care most of the focus is on illness care and hospitalization, which is the most costly form of providing care. A focus on upstream efforts directed at keeping the population well through health promotion and illness strat egies would be much less costly. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Emphasis on Hospital Care MULTIPLE RESPONSE 1. The Institute of Medicine has defined six improvement aims for the health care system. Which of the following are included in these six improvement aims? Select all that apply. a. safety c. timeliness b. equity d. cost-effectiveness ANS: A, B, C The Institute of Medicine (IOM) identified six ambitious goals for our nation’s health care system. These are: 1) safety, 2) equity, 3) timeliness, 4) effectiveness ( not just cost -effectiveness ), 5) patient -centeredness, and 6) efficiency. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Collecting Data 2. Which of the following are methods for reimbursement for health care services in the United States? Select all that apply. a. universal health care c. publicly funded payers b. private insurers d. direct payment by consumers ANS: B, C, D Reimbursement for health care services in the United States is obtained through four primary methods: 1) private insurers, 2) publicly funded payers, 3) direct payment by consumers, and 4) charitable entities. The United States is the only major industrialized country that does not have a universal health care plan. PTS: 1 OBJ: Cogni tive Level: Understanding TOP: Health Care Spending 3. A number of key pieces of federal legislation developed the national standards that the individual states use to regulate health insurance. Which of the following are some of these key pieces of legislation? Select all that apply. a. the Employee Retirement Income Security Act b. the New Deal (ND) c. the Consolidated Omnibus Budget Reconciliation Act d. the Health Insurance Portability and Accountability Act ANS: A, C, D Three key pieces of federal legislation that have contributed to guidelines that states use to regulate health insurance are: 1) the Employee Retirement Income Security Act (ERISA), 2) the Consolidated Omnibus Budget Reconciliation Act (COBRA), and 3) the Health Insurance Portability and Accountability Act (HIPAA). PTS: 1 OBJ: Cognit ive Level: Understanding TOP: State Regulation of Health Insurance 4. The Institute of Medicine’s (2003) report Health Professions Education: A Bridge to Quality centered on five competencies that health care professionals’ training programs should in clude. Which of the following are some of these competencies? Select all that apply. a. ability to use health information technology b. ability to provide rapid triage of illness and devise effective treatment plans c. ability to provide patient -centered care d. ability to measure the quality of care ANS: A, C, D In 2003, the Institute of Medicine published a report entitled Health Professions Education: A Bridge to Quality. This report focused on methods to improve current methods for health professionals’ training and education. Five key competencies were identified as being essential for these types of programs. They are: 1) ability to use health information technology, 2) ability to provide patient -centered care, 3) ability to measure the quality of care, 4) ability to effectively work in interdisciplinary teams, and 5) understanding of evidence -based practices. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Improving Quality through Health Professions Education Chapter 3: Nursing Today MULTIPLE CHOICE 1. The first Nightingale School for Nurses was founded when? a. 1825 c. 1885 b. 1860 d. 1910 ANS: B The first Nightingale Training School for Nurses was opened in 1860 at St. Thomas’s Hospital in London, England. This school has also been referred to as the first Nightingale School of Nursing. PTS: 1 OBJ: Cognitive Level: Remembering TOP: Evolution of N ursing 2. Which of the following is not considered to be a nurse -sensitive patient outcome? a. deep vein thrombosis c. shock b. pneumonia d. hip fractures ANS: D Nurse -sensitive patient outcomes are those that can be impacted directly and indirectly by nursing practice. Some of these nurse -sensitive outcomes are deep vein thrombosis, pneumonia, shock, cardiac arrest, and “failure to rescue” (Needleman, Buerhaus, Ma ttke, Stewart, & Zelevinsky, 2002). PTS: 1 OBJ: Cognitive Level: Understanding TOP: Nurse -Sensitive Patient Outcomes 3. Which of the following is not considered to be an identified professional value characteristic of a professional? a. caring c. truth b. equality d. political awareness ANS: D A number of characteristics have been identified and associated with professionals. Some characteristics specifically assigned as professional values include caring, equality, truthfulness, ethics, and nonjudgmental attitude. Professional characteristics concerned with professional behaviors and attributes include: political awareness , self -discipline, time -management skills, appearance, initiative, an d effective communication. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Characteristics of a Profession 4. A number of resources are available for nurses regarding evidence -based care. Which of the following resources is not a journal source for these practices? a. Centre for Evidence -Based Nursing b. Health Affairs c. Hasting Report d. Worldviews on Evidenc e-Based Nursing ANS: A Today’s nurses have access to a large variety of resources on evidence -based practice. Some of these that are journal -based include Health Affairs, Hasting Report, Advances in Nursing Science, and Worldviews on Evidence -Based Nursing. Some resources that are not journals, but are Internet or Web-based, include Centre for Evidence -Based Nursing , Sigma Theta Tau, Research C entre for Transcultural Studies in Health, and Cochrane Collaboration. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Evidence -Based Practice 5. Which of the following does not provide health care ratings or scoring of hospital performance? a. Health G rades b. Morningstar c. Leapfrog Hospital Quality and Safety d. Department of Health and Human Services’ Hospital Compare site ANS: B Several groups and agencies report on health care and hospital quality and perfo rmance. Some of these groups include Health Grades, Leapfrog Hospital Quality and Safety, Thomson Reuters, the Department of Health and Human Services’ Hospital Compare site, and U.S. News and World Report. Morningstar is a financial investment -based publi cation. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Health Care Ratings 6. The development, provision, and evaluation of multidisciplinary health care serv ices to population groups experiencing increased health risks or disparities, and performed in conjunction with health care consumers and the community as a means of improving the health of the community is called: a. population -focused nursing practice c. population -based health care practice b. population -based nursing practice d. population -based care ANS: C Population -based health care practice is the development, provision and evaluation of multidisciplinary health care services to population groups experiencing increased health risks or disparities. It is performed in conjunction with health care consumers and the community in order to improve the health of the community and its diverse groups. Population -focused nursing practice is defined by nursing activities that concern all people and reflects responsibility to and for the people. Population -based nursing practice is defined as the practice of nursing in which the primary concern of care is to improve the health status of vulnerable or at -risk population groups within a community by employing health promotion and disease prevention across the health continuum. Population -based care requires active partnership of both providers and recipients of care. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Population -Based Health Care 7. Vulnerable populations are groups of people that are subgroups of a community with certain characteristics. Whi ch of the following is not necessarily one of the criteria for vulnerable population groups? a. powerless c. enfranchised b. marginalized d. experiencing health disparities ANS: C Vulnerable population groups are subgroups of communities whose common experiences meet certain criteria which categorize them as being vulnerable. These criteria include being powerless, marginalized, disenfranchised (not enfranchised ), and experiencing h ealth disparities. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Population -Based Health Care 8. Variables that increase or decrease the probability of illness or death and that can be modified are called: a. health determinants c. vulnerable population groups b. underserved d. health risk factors ANS: D Health risk factors are variables that increase or decrease the probability of illness or death. Health risk factors may be modifiable. Health determinants are variables that include biological, psychological, environmental, and health system factors that may cause changes in the health status of individuals, families, groups, communities, or populations. Vulnerable population groups are subgroups of a community who are powerless, marginalized, or disenfranchised and are experiencing health disparities. The underserved are those people who have not received adequate medical care services. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Population -Based Health Care 9. One goal of population -based health care is to: a. maintain access to health care servic es b. maintain quality of health care services c. reduce health care disparities d. increase health care delivery costs ANS: C The goals of population -based health care include: 1) reduction of health disparities among different population groups, 2) improvement of access to health care services, 3) improvement of quality of health care services, and 4) reduction of health care de livery costs. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Population -Based Health Care 10. At least 50% of the Joint Commission’s accreditation standards for hospitals and other health care facilities were written to align with whose conditions for participation? a. HIPAA c. Medicare b. IOM d. Leapfrog ANS: C When the Joint Commission designed their accreditation standards for hospitals, they aligned as many as 50% of these standards with criteria from Medicare’s conditions for participation for hospitals and other health care facilities. These criteria set for th by Medicare are requirements for reimbursement for these health care facilities. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Accreditation 11. Which of the following chapters from the Joint Commission’s hospital accreditation manual does not fall under the category of patient -focused functions? a. provision of care, treatment, and services b. medication management c. nursing services d. ethics, rights, and responsibilities ANS: C The Joint Commission’ s standards for hospital accreditation have identified a number of different chapters that can be categorized into two groups: patient -focused functions and organization -focused functions. The identified patient -focused functions are: 1) provision of care, treatment, and services; 2) medication management, 3) ethics, rights, and responsibilities, and 4) surveillance, prevention, and control of infections. Organization -focused functions are: 1) nursing services , 2) medical staff, 3) management of information , 4) management of human resources, 5) management of the environment of care, 6) leadership, and 7) improving organization performance. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Accreditation 12. Which nursing theorist was responsible for Human Becoming theory? a. Nightingale c. Neuman b. Parse d. Peplau ANS: B Rosemarie Rizzo Parse is the theorist responsible for Human Becoming theory. The key concepts of this theory are centered on three ideas: 1) structuring (cocreating reality through language of valuing and imaging), 2) cocreating (rhythmical patterns of relating), and 3) cotran scending (unique ways of originating the process of transforming). Florence Nightingale was responsible for Environmental theory (1859). Betty Neuman was responsible for Systems Model (1972/1995), and Hildegard Peplau was responsible for Interpersonal Proc ess theory (1952). PTS: 1 OBJ: Cognitive Level: Understanding TOP: Selected Nursing Theorists and Their Model 13. Public Law 93 -360 on Collective Bargaining identified certain characteristics that relate to professions. Which of the following is one o f these characteristics? a. varied work environments c. work has social value b. autonomous practice d. existence of a code of ethics ANS: A A number of different groups and entities have identified characteristics of what constitutes a profession. Some of these characteristics are, according to Public Law 93 -360 on Collective Bargaining: varied work environments , predominately intellectual wor k, requires discretion and judgment, and requires advanced instruction and study. Bixler and Bixler (1959) included autonomous practice, growing body of knowledge, education takes place in higher education institutions, and service above personal gain. Pav alko (1971) noted the following additions to the characteristics of a profession: work has social value, existence of a code of ethics, group identity and subculture, and autonomy. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Profession of Nursing 14. Under the National Prevention Strategy there are seven priority areas. Under the area of injury - and violence -free living what is one of the targeted areas? a. mandated car seat laws c. reporting laws for abuse b. School -based physical education d. preventing drug abuse ANS: A The Community Preventive Services has identified seven priority areas as strategy for prevention nationwide. Under the area of injury - and violence -free living one targeted area is mandated laws for car seats for children. The other priority areas are tobacco -free living, preventing drug abuse, healthy eating, active living, reproductive and sexual health, and mental and emotional well -being. PTS: 1 OBJ: Cognitive Level: Applying TOP: Popu lation -Based Health Care 15. One example of a population -based public health intervention program is the social marketing: college campus initiative. This program targeted: a. offering condoms at health centers b. increased use of helmets for campus bikers c. weight loss programs d. preventative health screening ANS: B According to Ludwig, Bucholz, and Clarke (2005), an example of a population -based public health intervention defined under social marketing is a “grateful head” theme used to increase helmet use on a college campus. This example is defined under the indivi dual/family level of practice. The other choices are not listed as examples of public health intervention programs. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Population -Based Public Health Intervention Programs 16. One characteristic of a profess ion is that it has a peer review of its practice. This is attributed to: a. Flexner c. Manthey b. Pavalko d. Public Law 93 -360 ANS: C Manthey (2002) described the characteristics of a profession as those that have a peer review of practice, there is an identification with a professional organization as a standard setter, there is autonomy of decision making, and there is an identifiable body of knowledge that can be attributed via formal education. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Characteristics of a Profession 17. The Johns Hopkins Nursing Evidence -based Practice Model is based on the initials PET. These initials stand for: a. problem, evidence, transmission b. practice question, evidence, transmission c. problem, evidence, translation d. practice question, evide nce, transition ANS: D PET in the Johns Hopkins Evidence -based Practice Model stands for the three step s in the process: practice question, evidence, and translation. The model progresses through 18 steps from the asking of the question needing an answer to the dissemination of the knowledge when the answer is identified. PTS: 1 OBJ: Cognitive Level: Apply ing TOP: Evidence -Based Practice Model 18. Outcomes provide evidence about benefits, risks, and results of treatments so individuals can: a. make informed decisions c. seek specialty care b. seek high quality care d. find the best hospital ANS: A Evidence -based practice uses evidence -based resources to guide the development of appropriate strategies to deliver quality, cost -effective care. Outcomes provide evidence so individuals can make informed decisions and choi ces to improve their quality of life. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Evidence -Based Practice 19. Members of a profession continually evaluate the quality of the service they provide to: a. adapt to trends c. protect the public b. provide group identity d. standardize education ANS: C General characteristics of a profession include (1)an occupation which involves a unique practice that carries individual responsibility and is based on theoretical knowledge, (2) The privilege to practice is granted only after the individual has completed a standardized program of highly specialized education, (3) the body of special ized knowledge is continually developed and evaluated through research, and (4) the members continually evaluate the quality of service provided in order to protect the individual members and the public. Professions may provide a group identity and help st andardize education, but these are not the reasons professions evaluate the quality of service they provide. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Profession of Nursing 20. Professional nursing behaviors and attributes include all of the following except: a. time management skills c. caring b. self-evaluation d. self-discipline ANS: C Professional nursing behaviors include appearance, time management skills, self -discipline, maintenance of licensure/certification, political awareness, and self -evaluation among other attributes. Caring is one of the professional values of nursing. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Characteristics of a Profession 21. Sentinel events have been found to be linked to: a. poor quality care c. preventable errors b. ineffective team communication d. autonomy of health professionals ANS: B Sentinel events, medical errors, and patient care quality have been linked to ineffective team communication in the hospital. Outside the hospital there is an increased concern that communication and lack of coordination of care result in preventable readmissions to the hospital. PTS: 1 OBJ: Cognitive Level: Understanding TOP: The Interdisciplinary Team 22. Asking the question, did our services meet the greatest unmet health needs of the community? when evaluating a population -based nursing program determines: a. quality c. cost b. access d. equity ANS: A Evaluating programs of population -based nursing practice involves evaluating qua lity, access, cost, and equity. When evaluating quality, some questions to ask are as follows: Did our services meet the greatest unmet health needs of the community? Did their health status improve? Were their health risks reduced? PTS: 1 OBJ: Cognitive Level: Applying TOP: Program Evaluation of Population -Based Nursing Practice 23. One external force that influences health care is financial incentives that rewa rd superior performance. An implication for management in this area would be: a. an increased diverse workforce c. increased disease prevention b. increased demand for primary care d. redesign of patient delivery ANS: D Management implications that occur from the external force of financial incentives that reward superior performance include the need for increased efficiency, productivity and quality, the redesign of patient care delivery and the development of strategic alliances that add value. An increased diverse workforce comes under the external force of an increased ethnic and cultural diversity of the population. Increased demand for primary care comes under the force of the aging population and associated increas e in chronic illness. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Forces Influencing Health Care Delivery and Their Implications for Nursing Management 24. The National Prevention Strategy includes all of the following except: a. healthy and safe commu nities c. smoking cessation programs b. elimination of health disparities d. community preventative services ANS: C The purpose of the National Prevention Strategy is to increase the number of Americans who are healthy at every stage of life. The four facets of this strategy include healthy and safe community environments, to empower people, to eliminate health disparit ies, and to provide clinical and community preventative services. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Population -Based Health Care 25. Which nursing theorist is responsible for the theory of self -care deficit? a. Rogers c. Roy b. Orem d. Orlando ANS: B Orem is responsible for the self -care deficit theory. Rogers is responsible for the science of unitary beings. Roy is responsible for the adaptation model. Orlando is responsible for the nursing process theory. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Nursing Theorists MULTIPLE RESPONSE 1. Which of the following are correct regarding criteria that constitute a profession? Select all that apply. a. the body of specialized knowledge is continually developed and evalu ated through research b. members are self -organizing and collectively assume responsibilities of establishing standards for education in practice c. the privilege to practice is granted only after the individual has completed a standardized program of specified education and has demonstrated the ability to meet the standards of practice d. professional status is achieved when an occupation involves a unique practice and its members declare it one ANS: A, B, C While there are different views and opinions regarding what constitutes an occupation and a profession, there are a number of elements that are in general agreement concerning professions. Some of these include 1) the body of specialized knowledge is continually developed and evaluated through research, 2) members are self -organizing and collectively assume responsibilities of establishing standards for education in practice, 3) the privilege to practice is granted only after the individual has completed a standardized program of specified education and has demonstrated the ability to meet the standards of practice, and 4) professional status is achieved when an occupation involves a unique pract ice that carries with it individual responsibility and is based on theoretical knowledge ( not is declared one when its members declare it to be one ). PTS: 1 OBJ: Cognitive Level: Understanding TOP: Profession of Nursing 2. According to Pavlko, which of the following are characteristics of a profession? Select all that apply. a. work has social value c. autonomy of decision making b. service to the public d. growing body of knowledge ANS: A, B, D Accor ding to Flexnor, some of the characteristics of a profession are there is a service to the public, there is autonomy, there is a commitment to the profession, work has social value, and there is the existence of a code of ethics. Autonomy of decision makin g is attributed to Manthey. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Characteristics of a Profession 3. Professional values of nursing include which of the following? Select all that apply. a. caring c. self-evaluation b. justice d. human dignity ANS: A, B, D The professional values of nursing include caring, altruism, equality, freedom, justice, truth, ethics, human dignity, and nonjudgmental. Self -evaluation is one of the professional behaviors and attributes. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Characteristics of a Professional Chapter 4: Decision Making, Critical Thinking, Technology, and Informatics MULTIPLE CHOICE 1. Which of the following is not a definition of critical thinking? a. making sense of our world by carefully examining our thinking and the thinking of others in order to clarify and improve our understanding b. the understanding of argument, recognizing fallacies, and distinguishing premises from conclusions c. thinking a bout your thinking while you’re thinking in order to make your thinking better d. purposeful, outcome -directed thinking based upon a body of non -scientific knowle dge derived from research and other courses of evidence ANS: D Ignatavicius’s (2001) definition of critical thinking is that it is a “purposeful, outcome -direct thinking based upon a body of scientific knowledge (not non-scientific ) derived from researc h and other courses of evidence.” Paul (1992) provided a rather interesting and somewhat amusing view of critical thinking as “thinking about your thinking while you’re thinking in order to make your thinking better.” Other definitions include the making s ense of our world through examination of our thinking and the thinking of others (questioning) and the understanding of argument, recognition of fallacies, and the recognition of premises from conclusions. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Critical Thinking 2. Three types of thinking comprise the decision -making process. Which of the following is not one of these types of thinking? a. reflective thinking c. intuitive thinking b. clinical thinking d. critical thinking ANS: B Delaune and Ladner (2011) define decision making as considering and choosing from a repertoire of actions to achieve the desired outcome. There are five steps in the decision -making process. These five steps are: 1) decision making, 2) critical thinking , 2) reflective thinking , 4) intuitive thinking , and 5) problem solving . While critical thinking processes are used in fight -or-flight situations as well as clinical settings in health care, there is no specific type of thinking called “fight -or-flight thinki ng” or “clinical thinking” that is part of the decision -making process. PTS: 1 OBJ: Cognitive Level: Understanding TOP: Problem Solving 3. What process is used in clinical settings to promote reflective thinking after a situation such as a cardiac arres t or a. venting c. problem solving b. debriefing d. contemplation ANS: C Reflective thinking (Pesut & Herman (1999) is the process where we watch ourselv es as we perform a task and reflection after a situation has occurred can allow the individual to reflect upon the situation. The process of debriefing is a highly effective type of reflective thinking used in clinical settings to encourage the reflective self to evaluate a situation, problem, or event. PTS: 1 OBJ: Cognitive Level: Analyzing TOP: Reflective Thinking