(Test Bank) Effective Leadership And Management In Nursing

Sullivan, 9

Nursing

Test Bank

9th Edition

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Test Bank for Effective Leadership And Management In Nursing, The downloadable file consists of 468 pages, and the total size of the file is 2.57 MB. Purchase now only for highly discounted price.

Author(s): Sullivan

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TEST BANK FOR EFFECTIVE LEADERSHIP AND MANAGEMENT IN NURSING, 9TH EDITION, ELEANOR J. SULLIVAN Effective Leadership & Management in Nursing, 9e (Sullivan) Chapter 1 Introducing Nursing Management 1) A nurse manager is participating in the healthcare organization's strategic planning committee. Which factor is the primary driving force and controlling factor in new initiatives this committee might recommend? 1. Cost of care 2. Access to care 3. Availability of care 4. Quality of care Answer: 1 Explanation: 1. While all of the options given are driving forces in today's healthcare environment, the cost of providing care is still the primary issue. Cost of care controls access, availability, and quality. 2. Access to care is controlled by the ability to pay. 3. Care will not be available if it cannot be funded. 4. Healthcare providers do not like to correlate quality with cost, but the economic reality is that quality care must also be funded care. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Evaluation/Leadership Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology.2) A nurse has been invited to discuss healthcare costs at a senior citizens' club. What information should the nurse plan to include in this discussion? 1. While healthcare costs continue to rise, the percentage of the United States (U.S.) economy spent on healthcare has slowly declined to less than 12%. 2. Regulations brought about by the Patient Protection and Affordable Care Act (PPACA) should bring financial relief to healthcare consumers. 3. The United States spends more money on healthcare than any other country. 4. Healthcare spending in the United States is slowly declining due to passage of bills such as the Patient Protection and Affordable Care Act (PPACA). Answer: 2 Explanation: 1. In 2009, healthcare costs consumed more than 17% of the country's gross domestic product. 2. Implementation of PPACA and its regulations have not been formulated. 3. The United States spends more than $2.5 trillion on healthcare annually, more than any other country. 4. While this act has been passed, it is not operationalized. Healthcare spending continues to rise. Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Planning/Education Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology. 3) A 70-year-old client develops a catheter-induced urinary tract infection. Which statement by the nurse would indicate to the nurse manager a need for additional understanding of this situation? 1. "I wonder if there was a break of sterility when this catheter was inserted." 2. "Thankfully we can treat this with an antibiotic." 3. "This could potentially cost the hospital a lot of money." 4. "I will talk to my unlicensed assistants about proper urinary catheter care." Answer: 2 Explanation: 1. Wondering about a break in sterility indicates that the nurse is concerned about the process that might have contributed to this infection. 2. The nurse who focuses on taking care of the results of a potential medical mistake is not accepting the seriousness of the situation. 3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred by medical mistakes. This urinary tract infection could cost the hospital the cost of treatment, including increased length of stay. 4. The nurse has identified that improper care may result in poor outcomes for the client. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Evaluation/Education Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology. 4) Which healthcare situations reflect the philosophy of quality management as designed by Deming? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. A nurse asks visitors to leave because it is after visiting hours. 2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed from nothing by mouth (NPO) status. 3. A nurse tells the manager that a housekeeper's work is not up to standards. 4. A nurse volunteers to take a Spanish language class to be able to communicate with clients. 5. A nurse who has not made a medication error in two years asks for a salary increase. Answer: 2, 3, 4 Explanation: 1. The philosophy of quality management is focus on the needs of the client. If there is no reason for the visitors to leave other than it is after visiting hours, this is not focused on client need. 2. Even though 2:00 p.m. is after "lunchtime," this nurse is focused on the client's needs. This is an example of quality management. 3. Quality management empowers the employee to evaluate quality. 4. This nurse has seen a need and is working to improve the quality of service. This is quality management. 5. Salary increases can be tied to quality improvement initiatives, but just asking for an increase is not quality management. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology.5) A client who was discharged yesterday is very upset about the quality of care received during hospitalization for gastric surgery. What options for reporting concerns does this client have? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. There is no mechanism for complaint because the client is no longer hospitalized. 2. The client can indicate dissatisfaction on the survey often sent to clients after discharge. 3. The client can call the hospital administration. 4. The client can make a formal complaint through the American Nursing Association (ANA). 5. The client can make a public report through the Agency for Healthcare Research and Quality (AHRQ). Answer: 2, 3, 5 Explanation: 1. The client can still voice concerns even after discharge. 2. These client satisfaction surveys are a good mechanism for discussing care issues. 3. Telephone calls are a means of discussing client care issues. 4. ANA is not a forum for complaints about care in a specific hospitalization. 5. The AHRQ has a mechanism for reporting care issues. Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology. 6) A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client should choose which hospital for care during this procedure? 1. The hospital closest to the client's home 2. The hospital that has done the greatest number of these surgeries in the last two years 3. The hospital chosen by the client's primary healthcare provider 4. The hospital with the highest performance ratings for this procedure Answer: 4 Explanation: 1. This may or may not be the best choice of hospital for this procedure. 2. Just because a hospital is high volume does not mean it is high quality. 3. This may or may not be the best hospital for this procedure. 4. The Leapfrog Group focuses on quality indicators including the use of higher-performing hospitals for high-risk procedures. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Coordination of Care Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology.7) The quality management director of a large healthcare conglomerate wishes to initiate benchmarking strategies to assess care. Which directive should this manager publish? 1. We will compare outcome indicators with other healthcare conglomerates of similar size and organization. 2. Outcome data of hospitals within the organization will be compared to assess quality. 3. Each client care unit in the organization will establish specific unit goals for quality. 4. Each unit in the organization will create a quality monitor to assess how well unit policies are followed. Answer: 1 Explanation: 1. Benchmarking uses an organization's outcome data and compares it with that of a similar organization to address strengths and challenges. 2. Because the hospitals with the organization are likely managed in a similar manner, this is not an example of benchmarking. 3. While establishing goals is a part of quality management, it is not benchmarking. 4. Setting up a quality monitor is a quality initiative, but it is not benchmarking. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology. 8) The nurse manager has decided to use evidence-based practice (EBP) to solve an issue and has called staff nurses together for input. Which question, as posed by the manager, reflects the first step of the EBP process? 1. "What outcomes are we expecting from this work?" 2. "Is anyone prepared to evaluate the statistics we will find?" 3. "What is the exact clinical issue with which we are dealing?" 4. "Where can we look for information?" Answer: 3 Explanation: 1. Assessing outcomes is the last step of the EBP process. 2. Evaluation of the evidence is step 3. 3. Identifying the clinical question is the first step in the EBP process. 4. Acquiring the evidence to answer the question is step 2. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Planning/Leadership Learning Outcome: 1-2: Describe how nursing management is influenced by changes in society.9) The nurse manager asks a staff nurse why a procedure is done in a certain manner. The nurse replies, "I don't know why I started doing it this way. I've never read any research on it, but this technique always works for me." The manager would place this technique into which category of evidence? 1. Case study 2. Anecdotal 3. Nonexperimental design research 4. Statistical Answer: 2 Explanation: 1. A case study is an in-depth analysis used to translate evidence into other clinical situations. 2. Anecdotal evidence is derived from experience. 3. Nonexperimental design research includes gathering factors related to a clinical condition. 4. Statistical evidence is built from a scientific approach. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Quality of Practice Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the future.10) A nurse manager is directing a team of staff nurses working to solve a clinical problem using evidence-based practice (EBP). Which of the following statements would direct these nurses to the forms of strongest clinical evidence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "We may find studies that use only one group of participants." 2. "Look for articles that report on how to use evidence in other clinical situations." 3. "The studies we want are built around the scientific approach to solving problems." 4. "Our focus should be on studies that use both experimental and control groups to determine intervention effectiveness." 5. "Many articles will have information reported by someone who is an expert in the field." Answer: 3, 4 Explanation: 1. Studies using only one group of participants are done in a quasi-experimental design. This is not one of the two strongest forms of evidence. 2. An in-depth analysis used to translate information to other clinical situations is a case study approach. This is not one of the two strongest forms of evidence. 3. Using the scientific approach results in statistical evidence, which is one of the two strongest forms. 4. Studies that use both experimental and control groups are randomized control trials. This is one of the two strongest forms of evidence. 5. Evidence reported by an expert in the field is testimonial evidence. It is not one of the two strongest forms of evidence. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Planning/Leadership Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the future. 11) A healthcare system is considering applying to the Magnet Recognition Program. The leaders of this health system should prepare to address ________ qualities or "Forces of Magnetism." Answer: 14 Explanation: There are 14 qualities or "Forces of Magnetism" that must be demonstrated to achieve Magnet status. Cognitive Level: Understanding Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Planning/Quality of Practice Learning Outcome: 1-2: Describe how nursing management is influenced by changes in society.12) Which organization would the hospital management team contact to pursue certification as a Magnet hospital? 1. Magnet Recognition Program 2. American National Magnet Commission 3. The Joint Commission 4. American Medical Association (AMA) Answer: 1 Explanation: 1. The Magnet Recognition Program, developed by the American Nurses Credentialing Center, designates healthcare organizations that provide nursing excellence. 2. The American National Magnet Commission is fictitious. 3. The Joint Commission accredits healthcare organizations, but does not award Magnet status. 4. The AMA does not award Magnet status. Magnet status is focused on nursing excellence. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Leadership Learning Outcome: 1-2: Describe how nursing management is influenced by changes in society. 13) A graduating nurse is deciding which nursing specialty would be a good place to begin a nursing career and ensure long-term stability. Which specialty is most likely to have the greatest growth in need? 1. Pediatric nursing 2. Psychiatric nursing 3. Geriatric nursing 4. Maternity nursing Answer: 3 Explanation: 1. Pediatric nursing is not likely to see as much growth as another specialty. 2. Psychiatric nursing is not likely to see as much growth as another specialty. 3. As baby boomers age, geriatric nursing will be needed more than any other specialty. Not only are the baby boomers a large segment of the population, but better health practices are resulting in people living longer. 4. Maternity nursing is not likely to see as much growth as another specialty. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Planning/Professional Practice Evaluation Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the future.14) The nurse manager overhears staff discussing the shortage of nurses. Which statement by a staff member would the manager evaluate as misinformation? 1. "There are more nurses retiring than are entering the profession." 2. "The demand for nurses is declining because of fewer hospital admissions." 3. "There are insufficient numbers of nursing faculty to teach interested students." 4. "Women still outnumber men in nursing." Answer: 2 Explanation: 1. The average age of the registered nurse (RN) is 46 years, and while the number of RNs under age 30 is increasing, more RNs are retiring than are entering the profession. 2. The demand for nurses is increasing because of sicker clients both in the hospital and in outpatient settings. Job numbers for nurses are expected to continue to grow. 3. Nursing faculty members are also aging and moving into retirement. 4. Women continue to outnumber men in the nursing profession. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Evaluation/Communication Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the future. 15) A healthcare organization has just achieved Magnet status. During the award ceremony, the organization's chief executive officer should give primary praise for this achievement to which employees? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Medical staff 2. Nurse executive 3. Staff nurses 4. Managers in support services such as laboratory and radiology 5. Administrative professionals overseeing services such as accounting, billing, and medical records Answer: 2, 3 Explanation: 1. Magnet status is focused on nursing excellence. Medical staff would be involved in the achievement, but not as primary players. 2. While much of the work will have been delegated to others, the nurse executive is a primary force in achieving Magnet status. 3. Magnet status focuses on nursing excellence. Staff nurses are the primary drivers of this excellence. 4. While these employees would be involved in this effort, Magnet status is focused on nursing excellence. 5. While these professionals would contribute to the achievement, Magnet status is focused on nursing excellence. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Professional Practice Evaluation Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the future. 16) The nurse manager's expected outcome is to increase evidence-based practice on the nursing unit. To meet this outcome, the manager encourages nurses to base their practice on which technique? 1. Intuition 2. Personal clinical experience 3. Knowledge from nursing school 4. Current research Answer: 4 Explanation: 1. Intuition is not based in research and is not evidence based. 2. Clinical experience is useful when integrated with evidence-based practice but is not considered evidence based when used alone. 3. Knowledge from nursing school is very useful in client care but can become outdated if the nurse does not continually update that knowledge. 4. Current research is a good source of evidence-based practice strategies. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Evidence-Based Practice Learning Outcome: 1-2: Describe how nursing management is influenced by changes in society. 17) Which strategy is most likely to increase participation in the use of evidence-based practice in nursing? 1. Ensure adequate training and encourage its use by the nursing staff. 2. Elicit employee opinions of its use at least four times per year. 3. Give those nurses willing to use it extra recognition. 4. Ensure adequate training, recognition, and easy access to the internet. Answer: 4 Explanation: 1. Ensuring adequate training by itself is not enough. 2. Asking for opinions will do little to encourage the use of evidence-based practice. 3. Recognition for those willing to use evidence-based practice is an insufficient motivator. 4. There must be training, easy access, and recognition for using evidence-based practice in nursing. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Planning/Evidence-Based Practice Learning Outcome: 1-3: Identify the changes and challenges that nurses face now and in the future.18) The organization that awards Magnet status would look for environments where which practices are the norm? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Nurses are involved in decision making. 2. Rewards are focused on ideas that save money. 3. Once a decision is made, it stands. 4. Nurses may be asked to work overtime. 5. Nurses are involved in educating the community about health. Answer: 1, 5 Explanation: 1. Magnet status designates organizations that foster independence, autonomy, and creativity among the nursing staff. Nurses are involved in decision making in these institutions. 2. Money-saving ideas are not always good for staff or for clients. 3. Magnet-status organizations are flexible and encourage autonomy and independence. 4. Overtime is sometimes necessary, even in well-run facilities. 5. In Magnet organizations, staff members are encouraged to be involved in educational activities in the organization and the community. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Assessment/Quality of Practice Learning Outcome: 1-2: Describe how nursing management is influenced by changes in society. 19) The nurse is trying to understand why it has taken so long for electronic health records (EHRs) to be used in healthcare. Which statement is a reason for this delay? 1. Medical records professionals do not like these records. 2. The use of these records is more expensive than the use of paper records. 3. There have been concerns about privacy and confidentiality. 4. The transition to EHRs is time consuming and tedious. Answer: 3 Explanation: 1. The preference of medical records professionals is not the reason these records have had a slow adoption. 2. The cost of the records is not a primary reason they have had slow adoption. 3. The most overwhelming issue in using these records has been the profession's and public's concerns regarding privacy and confidentiality. 4. The transition time to EHRs is not the primary reason they have seen a slow adoption. Cognitive Level: Applying Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Assessment/Communication Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology.20) Hospital administration is considering the purchase of a robotic pharmacy system. What would be the advantage of this system to the nurses who work in the hospital? 1. The nurse will be able to leave out some of the six rights of medication administration because the robot checks the medications. 2. The nurse should get medications more quickly because the robot can work more consistently without breaks. 3. The nurse can delegate medication administration to the nursing assistant because the medications have already been checked. 4. The nurse can expect that medication administration will be easier and carry less potential for error. Answer: 2 Explanation: 1. The nurse must still complete the six rights of medication administration to ensure client safety. 2. Robots should be able to get medications to the floor more quickly. 3. The administration of medication cannot be delegated to the nursing assistant. 4. There is no assurance that medication administration will be easier. Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Implementation/Resource Utilization Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology.21) A nurse executive is considering initiating a blog to enhance communication among staff nurses, managers, and supervisors throughout the organization's different campuses. What serious considerations should the nurse make prior to starting a blog? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Open access to the blog may damage recruiting efforts. 2. Blogs are difficult to use and expensive to maintain. 3. Users of the blog must be very careful not to divulge any information that would violate client confidentiality. 4. The organization's reputation may be altered by a blog. 5. Most nurses would likely not use the blog. Answer: 1, 3, 4 Explanation: 1. Disgruntled employees may use the blog to air grievances. If the blog is open access, these grievances could quickly become community news. 2. Blogs are inexpensive and easy to use. 3. As blogs become more and more common, bloggers become more casual in their use. Violations of client confidentiality would not only be possible but could even be said to be likely. 4. The organization's reputation could be either enhanced or damaged by bloggers' comments. 5. Social media sites such as blogs have exploded in use. It is very likely that nurses would use a blog. Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Management of Care Nursing/Int Conc: Nursing Process: Planning/Communication Learning Outcome: 1-1: Explain changes to healthcare over the past decade, including those resulting from implementation of the Affordable Care Act; demands to reduce errors and improve patient safety; and evolving medical and communication technology.