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Clinical Nurse Leader (22 Sets )Exam Questions with Verified Answers,100% CORRECT
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Clinical Nurse Leader Exam 44 Questions with Verified Answers,100% CORRECT
Clinical Nurse Leader Exam 44 Questions with Verified Answers Clinician - CORRECT ANSWER designer/coordinator/integrator/evaluator of care to individual... [Show More] s, families, groups, communities, and populations; able to understand the rationale for care and competently deliver this care to an increasingly complex and diverse population in multiple environments outcome manager - CORRECT ANSWER an individual who synthesizes data, information, and knowledge to evaluate and achieve optimal client outcomes client advocate - CORRECT ANSWER an employee who is adept at ensuring that clients, families, and communities are well informed and included in care planning and is an informed leader for improving care educator - CORRECT ANSWER uses appropriate teaching principles and strategies and current information, materials, and technologies to teach clients, groups, and other health care professionals under their supervision information manager - CORRECT ANSWER an individual who is able to use information systems and technology that put knowledge at the point of care to improve health care outcomes system analyst - CORRECT ANSWER participates in system review to improve quality of client care and delivery risk anticipator - CORRECT ANSWER an individual who critically evaluates and anticipates risks to client safety with the aim of preventing medical error team manager - CORRECT ANSWER able to properly delegate and manage the team resources (human and fiscal) and serve as a leader and partner in the interdisciplinary team member of a profession - CORRECT ANSWER accountable for the ongoing acquisition of knowledge and skills to effect change in their practice and outcomes and in the profession lifelong learner - CORRECT ANSWER The CNL recognizes the need for and actively pursues new knowledge and skills as one's role and the need of the health care system evolves altruism - CORRECT ANSWER concern for the welfare and well being of others. in professional practice, altruism is reflected by the CNL's concern for the welfare of clients, other nurses, and other health care providers. accountability - CORRECT ANSWER the right, power, and competence to act. includes the autonomy, authority, and control of one's actions and decisions human dignity - CORRECT ANSWER respect for the inherent worth and uniqueness of individuals and populations. in professional practice, human dignity is reflected when the CNL values and respects all clients and colleagues integrity - CORRECT ANSWER acting in accordance with an appropriate code of ethics and accepted standards of practice. Integrity is reflected in professional practice when the CNL is honest and provides care based on an ethical framework that is accepted within the profession social justice - CORRECT ANSWER for the CNL, the value of social justice is particularly significant because it directly addresses disparities in health and health care. social justice is upholding moral, legal, and humanistic principles macrosystem - CORRECT ANSWER an entire organization - hospital, with all of the departments interacting to provide optimal patient care microsystem - CORRECT ANSWER group of professionals who work together on a regular basis to provide care to populations of patients on a specific unit. essential building blocks of the health care system. located on unit at the hospital, or a clinic, rehab unit, SNF, or anywhere else there are patients mesosystem - CORRECT ANSWER mid level organizational structure. a nursing division - all nurses in a hospital belong the the mesosystem, all PT belong to a different mesosystem lateral integration of care - CORRECT ANSWER there is a need for one clinician to manage care plans designed by various providers. The CNL works with all of the providers to create one, integrated plan of care; the center of the care is the patient, not the title of the provider top-down leadership - CORRECT ANSWER organizational objectives, goals, and needs and resulting interventions, protocols, procedures, and workflow elements being crafted at the highest leadership level and transmitted down to the frontlines of staff without seeking their input in their design. often devoid of important details known to frontline staff but invisible to top leadership bottom-up leadership - CORRECT ANSWER relies on the wisdom of those involved with the work, because they are most familiar of the work and its inefficiencies. lends itself to seeking frontline staff's meaningful input in the design of interventions, protocols, procedures, and workflow elements system level issues - CORRECT ANSWER problems that occur due to the factors beyond one microsystem; an amalgam of factors throughout the macrosystem. ex: patient flow outcomes - CORRECT ANSWER aka Nursing-Sensitive Indicators (NSIs): Clinical Quality Outcomes are patient conditions that are direct result of quality in structure, processes, and outcomes of nursing care. ex: if nurses don't perform sterile technique when inserting urinary cathetor, a UTI is likely workflow - CORRECT ANSWER set of processes needed to be accomplished, set of people or other resources available to perform those processes, and the interactions among them acuity - CORRECT ANSWER Level of intensity of care required by patients Case Mix - CORRECT ANSWER The mix (variety) of patients for whom care is delivered organized by specific characteristics (e.g., gender, DRG, payer) cost center - CORRECT ANSWER a microsystem responsible for providing services and monitoring the costs associated with such service provision Diagnosis-related groups (DRGs) - CORRECT ANSWER group used by Medicare and other payers to determine reimbursement to organizations and providers Direct costs - CORRECT ANSWER costs that are directly related to the provision of service; the cost can be specifically identified for an individual patient or activity (nurse caring for the patient, supplies used for the needed dressing, food provided, linen provided throughout the day) Expenses - CORRECT ANSWER Dollars owed as a result of both services delivered and organizational costs incurred in the delivery First-party payers - CORRECT ANSWER Individuals responsible for payment of services rendered Gross domestic product - CORRECT ANSWER Market value of all goods and services produced (created) within a country in a specific period ICD-10- CM - CORRECT ANSWER International Classification of Diseases, 10th Revision, Clinical Manifestations; used for documentation FTE - CORRECT ANSWER full time equivalent based on a 40-hour week for 2,080 hours per year; expressed as a 1.0 or fraction thereof; a 0.5 FTE is one-half of 2,080 hours or coverage for 20 hours per week; an FTE is not an individual but a position with hours associated with it. HCPPD - CORRECT ANSWER Hours of care per patient day; a numerical expression of care a type of patient receives in a 24-hour period productivity - CORRECT ANSWER the work product of a unit or individual based on the amount of work required and the hours available to deliver that care staffing matrix - CORRECT ANSWER the number of staff assigned to work on a given shift on a given day Staffing mix - CORRECT ANSWER the mixture of licensed and unlicensed staff as well as the type of license; a staffing mix may be 70% licensed and 30% unlicensed, with 80% of the licensed staff being RNs and the remaining 20% possessing an LPN license medical home - CORRECT ANSWER The medical home is best described as a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. It has become a widely accepted model for how primary care should be organized and delivered throughout the health care system, and is a philosophy of health care delivery that encourages providers and care teams to meet patients where they are, from the most simple to the most complex conditions. prospective payments - CORRECT ANSWER since 1994, prospective payments is a system wherein reimbursement to hospitals or other organizations is based on DRG or ambulatory patient classification (APC) second party payers - CORRECT ANSWER Reimbursement method in which the agency providing the services also pays for the service. third party payer - CORRECT ANSWER private or government insurance entities who pay for all or some of the services provided medicare - CORRECT ANSWER a governmental program related to social security for the elderly medicaid - CORRECT ANSWER A program sponsored by state and federal government for low-income and disabled individuals; services and payment are provided. 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Clinical Nurse Leader Exam 56 Questions with Verified Answers,100% CORRECT
Clinical Nurse Leader Exam 56 Questions with Verified Answers clinician - CORRECT ANSWER designer/coordinator/integrator/evaluator of care to individual... [Show More] s, families, groups, communities, and populations; able to understand the rationale for care and competently deliver this care to an increasingly complex and diverse population in multiple environments outcome manager - CORRECT ANSWER an individual who synthesizes data, information, and knowledge to evaluate and achieve optimal client outcomes client advocate - CORRECT ANSWER an employee who is adept at ensuring that clients, families, and communities are well informed and included in care planning and is an informed leader for improving care educator - CORRECT ANSWER uses appropriate teaching principles and strategies and current information, materials, and technologies to teach clients, groups, and other health care professionals under their supervision information manager - CORRECT ANSWER an individual who is able to use information systems and technology that put knowledge at the point of care to improve health care outcomes system analyst - CORRECT ANSWER participates in system review to improve quality of client care and delivery risk anticipator - CORRECT ANSWER an individual who critically evaluates and anticipates risks to client safety with the aim of preventing medical error team manager - CORRECT ANSWER able to properly delegate and manage the team resources (human and fiscal) and serve as a leader and partner in the interdisciplinary team member of a profession - CORRECT ANSWER accountable for the ongoing acquisition of knowledge and skills to effect change in their practice and outcomes and in the profession lifelong learner - CORRECT ANSWER The CNL recognizes the need for and actively pursues new knowledge and skills as one's role and the need of the health care system evolves altruism - CORRECT ANSWER concern for the welfare and well being of others. in professional practice, altruism is reflected by the CNL's concern for the welfare of clients, other nurses, and other health care providers. accountability - CORRECT ANSWER the right, power, and competence to act. includes the autonomy, authority, and control of one's actions and decisions human dignity - CORRECT ANSWER respect for the inherent worth and uniqueness of individuals and populations. in professional practice, human dignity is reflected when the CNL values and respects all clients and colleagues integrity - CORRECT ANSWER acting in accordance with an appropriate code of ethics and accepted standards of practice. Integrity is reflected in professional practice when the CNL is honest and provides care based on an ethical framework that is accepted within the profession social justice - CORRECT ANSWER for the CNL, the value of social justice is particularly significant because it directly addresses disparities in health and health care. social justice is upholding moral, legal, and humanistic principles macrosystem - CORRECT ANSWER an entire organization - hospital, with all of the departments interacting to provide optimal patient care microsystem - CORRECT ANSWER group of professionals who work together on a regular basis to provide care to populations of patients on a specific unit. essential building blocks of the health care system. located on unit at the hospital, or a clinic, rehab unit, SNF, or anywhere else there are patients mesosystem - CORRECT ANSWER mid level organizational structure. a nursing division - all nurses in a hospital belong the the mesosystem, all PT belong to a different mesosystem lateral integration of care - CORRECT ANSWER there is a need for one clinician to manage care plans designed by various providers. The CNL works with all of the providers to create one, integrated plan of care; the center of the care is the patient, not the title of the provider top-down leadership - CORRECT ANSWER organizational objectives, goals, and needs and resulting interventions, protocols, procedures, and workflow elements being crafted at the highest leadership level and transmitted down to the frontlines of staff without seeking their input in their design. often devoid of important details known to frontline staff but invisible to top leadership bottom-up leadership - CORRECT ANSWER relies on the wisdom of those involved with the work, because they are most familiar of the work and its inefficiencies. lends itself to seeking frontline staff's meaningful input in the design of interventions, protocols, procedures, and workflow elements system level issues - CORRECT ANSWER problems that occur due to the factors beyond one microsystem; an amalgam of factors throughout the macrosystem. ex: patient flow outcomes - CORRECT ANSWER aka Nursing-Sensitive Indicators (NSIs): Clinical Quality Outcomes are patient conditions that are direct result of quality in structure, processes, and outcomes of nursing care. ex: if nurses don't perform sterile technique when inserting urinary cathetor, a UTI is likely workflow - CORRECT ANSWER set of processes needed to be accomplished, set of people or other resources available to perform those processes, and the interactions among them acuity - CORRECT ANSWER Level of intensity of care required by patients Case Mix - CORRECT ANSWER The mix (variety) of patients for whom care is delivered organized by specific characteristics (e.g., gender, DRG, payer) cost center - CORRECT ANSWER a microsystem responsible for providing services and monitoring the costs associated with such service provision Diagnosis-related groups (DRGs) - CORRECT ANSWER group used by Medicare and other payers to determine reimbursement to organizations and providers Direct costs - CORRECT ANSWER costs that are directly related to the provision of service; the cost can be specifically identified for an individual patient or activity (nurse caring for the patient, supplies used for the needed dressing, food provided, linen provided throughout the day) Expenses - CORRECT ANSWER Dollars owed as a result of both services delivered and organizational costs incurred in the delivery First-party payers - CORRECT ANSWER Individuals responsible for payment of services rendered Gross domestic product - CORRECT ANSWER Market value of all goods and services produced (created) within a country in a specific period ICD-10- CM - CORRECT ANSWER International Classification of Diseases, 10th Revision, Clinical Manifestations; used for documentation FTE - CORRECT ANSWER full time equivalent based on a 40-hour week for 2,080 hours per year; expressed as a 1.0 or fraction thereof; a 0.5 FTE is one-half of 2,080 hours or coverage for 20 hours per week; an FTE is not an individual but a position with hours associated with it. HCPPD - CORRECT ANSWER Hours of care per patient day; a numerical expression of care a type of patient receives in a 24-hour period productivity - CORRECT ANSWER the work product of a unit or individual based on the amount of work required and the hours available to deliver that care staffing matrix - CORRECT ANSWER the number of staff assigned to work on a given shift on a given day Staffing mix - CORRECT ANSWER the mixture of licensed and unlicensed staff as well as the type of license; a staffing mix may be 70% licensed and 30% unlicensed, with 80% of the licensed staff being RNs and the remaining 20% possessing an LPN license medical home - CORRECT ANSWER The medical home is best described as a model or philosophy of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. It has become a widely accepted model for how primary care should be organized and delivered throughout the health care system, and is a philosophy of health care delivery that encourages providers and care teams to meet patients where they are, from the most simple to the most complex conditions. prospective payments - CORRECT ANSWER since 1994, prospective payments is a system wherein reimbursement to hospitals or other organizations is based on DRG or ambulatory patient classification (APC) second party payers - CORRECT ANSWER Reimbursement method in which the agency providing the services also pays for the service. third party payer - CORRECT ANSWER private or government insurance entities who pay for all or some of the services provided medicare - CORRECT ANSWER a governmental program related to social security for the elderly medicaid - CORRECT ANSWER A program sponsored by state and federal government for low-income and disabled individuals; services and payment are provided. Types of bargaining - CORRECT ANSWER Distributive=one side wins, the other loses, Zero-sum or win-lose bargaining; and Integrative is win-win where both sides attempt to arrive at a mutually acceptable solution; Productivity, depends on productivity, skills and knowledge; composite=union negotiates for both salary and standards, and may want input into work norms and environmental hazards. nursing fixed or variable? - CORRECT ANSWER nursing costs may be fixed if FTE hours remain the same, but variable if they vary according to census. Altruism - CORRECT ANSWER concern or advocating for the welfare of clients and staff and demonstrating understanding for others beliefs and values Integrity - CORRECT ANSWER carrying out practice in an ethical manner and according to standards of practice Social Justice - CORRECT ANSWER ensuring patients are treated in accordance with the laws and regarding access to care in a fair manner and without discrimination Human dignity - CORRECT ANSWER is showing respect for the individual and populations, respecting privacy and confidentiality and providing cultural competence care. Divergent thinking - CORRECT ANSWER Alows a number of diverse ideas generated, often through a brainstorming process in which various possible ideas are proposed and discussed convergent thinking - CORRECT ANSWER a type of critical thinking in which one evaluates existing possible solutions to a problem to choose the best one; rule oriented focuses on probabilities, to reach one best solution functional organizational form - CORRECT ANSWER divides departments by discipline (nurses, PTs lab personnel) with each department developing it's own hierarchical structure, policies and procedures. Parallel Organizational Structure - CORRECT ANSWER some services are shared across functional departments such as HR and RRTs program organizational structure - CORRECT ANSWER disciplines are integrated and departments formed with an integrated focus, such as women health or rehabilitation, Matrix Organization - CORRECT ANSWER An organization composed of dual reporting relationships in which some managers report to two superiors—a functional and program forms overlap [Show Less]
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Clinic Nurse Leader 245 Questions with Verified Answers,100% CORRECT
Clinic Nurse Leader 245 Questions with Verified Answers Gap Analysis - CORRECT ANSWER Compares ACTUAL performance with POTENTIAL/desired performance ... [Show More] Evaluates the strengths and weaknesses of the team in relation to required outcomes A good tool for analysis to gain better understanding of the team's functioning 3 phases of knowledge transfer when using EBP - CORRECT ANSWER 1. Knowledge creation and distillation (research and recommendations for clinical practice) 2. Diffusion and Dissemination (distribute info to users, partner with organizations like professional nursing orgs) 3. Implementation and Institutionalization (end user adoption - health care systems adopt practices) Examples of restraining forces in Lewin's Change theory - CORRECT ANSWER work against the driving forces to inhibit change example: want to quit smoking but live with people who smoke so hard to quit in that living situation Examples of driving forces for Lewin's change theory - CORRECT ANSWER factors that support change or push patient towards necessary changes such as the drive to quit smoking to breathe easier Peplau's Theory of Interpersonal Relations - CORRECT ANSWER focuses on relationship between patient and nurse 4 phases: 1. Orientation - seeks help through appts, treatment, etc. for RN to determine patients need for assistance 2. Identification - help identify who can help, set goals of care 3. Exploitation - receives care from rN 4. Resolution - care is completed Total patient care. - CORRECT ANSWER One nurse is responsible for planning, organizing and delivery of care to a particular client or group of clients during the assigned shift Primary nursing - CORRECT ANSWER a method of care in which the same RN assigned to same patient over time; assumes 24 hour responsibility for planning, directing, and evaluating client care from the time of admission through discharge team nursing - CORRECT ANSWER a nursing care pattern; a team of nursing staff is led by an RN who decides the amount and kind of care each person needs - each member responsible for certain cares such as ADLs or meds Each team member is able to contribute their own special expertise or skills caring for the client Continuity of care may suffer if daily assignment of team varies and client is exposed to many different caregivers. relative risk - CORRECT ANSWER used when the study involves comparing the likelihood, or chance, of an event occurring between two groups ratio of the absolute risk of a disease among the exposed group to the absolute risk of the disease among the unexposed group in an epidemiologic study confidence interval - CORRECT ANSWER the range of values within which a population parameter is estimated to lie based on a random sample of the population. The most common interval is the 95% confidence interval. It represents the range that one can be 95% confident that the population parameter lies. confounding - CORRECT ANSWER distortion in the degree of association because researcher failed to control, or eliminate the confounding variable, damaging the internal validity of an experiment. occurs when two variables are associated in such a way that their effects on a response variable cannot be distinguished from each other internal validity - CORRECT ANSWER extent to which a piece of evidence supports a claim about cause and effect & degree to which the results of a study are not due to bias or confounding External validity - CORRECT ANSWER the degree to which the results of the original study are applicable to a population other than the one initially targeted = generalizability An oral glucose tolerance test (OGTT) measures - CORRECT ANSWER your blood sugar after you have gone at least eight hours without eating and two hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes or prediabetes. Oral Glucose Tolerance Test (OGTT) result of 150 means what? A. Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g OGTT within 1 week. B. The results are within normal limits and do not meet the threshold for the diagnosis of gestational diabetes. C. A fasting blood sugar should be checked as soon as possible. D. Based on this abnormal value, the 3-hour OGTT is not required. - CORRECT ANSWER A. Based on a value greater than 140 mg/dL, the patient should have 3-hour 100-g OGTT within 1 week. Rationale: If your blood glucose is higher than 140 mg/dL, the next step is the oral 3-hour glucose tolerance test. This test will determine if you have gestational diabetes. After performing the literature review and developing a PICOT question, what should you do next before implementation? A. Form a team of stakeholders B. Develop a comparison group C. Talk to the manager D. Start the implementation process - CORRECT ANSWER A. Form a team of stakeholders Rationale: After performing the literature review and developing a PICOT question, you should create a team of stakeholders to ensure the intervention has the appropriate resources to make the study successful. Pt has a blood sugar of 58 with headache and blurry vision. Which of the following interventions is appropriate for the nurse to tell the CNL? A. The patient is experiencing hyperglycemia and should be given a protein snack. B. The patient is experiencing hyperglycemia and should be given insulin and 1 cup of milk. C. The patient is experiencing hypoglycemia and should be given insulin and 1 cup of orange juice. D. The patient is experiencing hypoglycemia and should be given 1 cup of skim milk. - CORRECT ANSWER D. The patient is experiencing hypoglycemia and should be given 1 cup of skim milk. Rationale: The patient's fasting blood sugar is below 60 mm/dL and is symptomatic. She must be treated for hypoglycemia by drinking 1 cup of skim milk, or 1⁄2 cup of juice, or 1⁄2 cup of soft drink. As a trial CNL, whose buy-in will be the most important in fully implementing the CNL role in the hospital? A. The chief nursing officer (CNO) B. The unit manager C. The members of the interdisciplinary team D. The staff affected by your outcomes - CORRECT ANSWER The chief nursing officer (CNO) CNO will have the most influence in your hospital Orem's self care deficit theory - CORRECT ANSWER The nurse's actions are directed toward assisting the patient to assume responsibility for self-care & based on the premise that all individuals are capable of self-care 1st step: identifying and prioritizing the client's unmet self-care needs (deficits). 2nd step: selecting methods of assisting the client to compensate for or overcome his self-care deficits. Leininger's Culture Care Theory - CORRECT ANSWER Theory of cultural care diversity and universality - Integrates patients' cultural traditions, values and beliefs into care plans Care fits with or have beneficial meaning and health outcomes for people of different or similar culture backgrounds. similar to transcultural nursing (CPOE) Computerized physician order entry - CORRECT ANSWER Feature of the EHR that assures standardized, legible communication of the medical plan of care to other members of the healthcare team Helps prevent errors (HIE) health information exchange - CORRECT ANSWER Allows for multiple health care organizations serving a client to share health information across electronic networks , allows for timely access to client information for providers Although have to be careful with protected health information/HIPAA perceived conflict (felt conflict) - CORRECT ANSWER perceive that their situation is characterized by incompatibility and interdependence mistrust, hostility, and fear; misunderstanding each other or jumping to conclusions based on limited information Negotiating Conflict Style - CORRECT ANSWER Resolve the conflict through assertive give and take concessions to deal or bargain with another - seeks agreement but not necessarily consensus; solution is rather permanent; revenue budget - CORRECT ANSWER A budget that lists forecasted and actual revenues of the organization A projection of expected income for a budget period based on volume and mix of patients, rates, and discounts. Zero-based budgeting (ZBB) - CORRECT ANSWER a method of budgeting in which managers thoroughly reevaluate organizational activities to determine their true level of importance ( all expenses must be justified for each new period) 5 rights of delegation - CORRECT ANSWER 1. Right task 2. Right circumstance 3. Right person 4. Right direction/communication 5. Right supervision accomodating conflict style - CORRECT ANSWER cooperating in that one side gives in to the other side compromising conflict style - CORRECT ANSWER each side gives something up and gains something; group members concede some goals in order to achieve other more important goals collaborating conflict style - CORRECT ANSWER seeks joint resolution w/ best solution for all - develop optimal outcomes but does take a lot of time - requires commitment Confronting - CORRECT ANSWER immediate and obvious movement to stop conflict at the very start Does not allow conflict to take root; very powerful. Conflict Management Strategies - CORRECT ANSWER Avoidance Accommodation Competing Compromise Collaboration Negotiating Confronting Organizational conflict - CORRECT ANSWER One person or a group vs an organization Example: competition for resources; Quality of patient care (nurse patient ratio) competing with COST interpersonal conflict - CORRECT ANSWER conflict that occurs between two or more individuals or team to team intrapersonal conflict - CORRECT ANSWER conflict that occurs within an individual ex. should I call in sick and attend my daughter's birthday party- I asked for the day off and didn't get it Overt behavior in conflict - CORRECT ANSWER Behavior that is directly observed - aggression, competition, debate, or problem solving. covert behavior during a conflict - CORRECT ANSWER a response that is internal or hidden from view - scapegoating, avoiding or apathy antecedent conflict conditions - CORRECT ANSWER increase in conflict, incompatible goals, role conflict, structural conflict, competition for resources, differences in values and beliefs. phenomenlogical research - CORRECT ANSWER inductive descriptive approach used to describe an experience as it is lived by an individual grounded theory research - CORRECT ANSWER discover the problems that exist in a social scene and the process that persons involved use to handle them - how people define reality and how their beliefs are related to actions Change agent strategies - CORRECT ANSWER Power-coercive: applies power from authority, economic sanctions, or political clout (e.g. don't text and drive or you'll get a ticket) Empirical-rational: assumes ppl are rational and will follow self-interest (e.g. don't text and drive or you will get hurt) Normative-reeducative: assumes ppl act in accordance with social norms and values (e.g. don't text and drive - "everyone's doing it') Justice - CORRECT ANSWER fairness Values - CORRECT ANSWER the ideas, beliefs, and attitudes about what is important that help guide the way you live Distributive Justice - CORRECT ANSWER perceived fairness of the amount and allocation of rewards/goods among individuals in a society Bureaucratic leadership/Hierarchical leadership - CORRECT ANSWER Hierarchy of authority - strictly follows set of rules/policies, assumes individuals are motivated by external factors Trusts neither followers or self to make decisions so relies on organizational policies and rules Clinical Decision Support (CDS) - CORRECT ANSWER A set of patient-centered tools embedded within EHR software that can be used to improve patient safety, ensure that care conforms to published protocol for specific conditions, and reduce duplicate or unnecessary care and its associated costs Such as pop up reminders or alerts for interacting drugs address deficits in documentation; consider potential outcomes to their decision making, or as reminders to order screening tests Allocation focus of a policy means - CORRECT ANSWER providing resources (income, services, goods) to ensure policy implementation Regulatory intent of policies focuses on - CORRECT ANSWER prescribing and controlling behavior of particular population autocratic leadership - CORRECT ANSWER leadership style that involves making managerial decisions without consulting others - leader makes all decisions and directs followers behavior authoritative control over group, assumes individuals are motivated by external forces, democratic leadership - CORRECT ANSWER A form of leadership in which the leader solicits input from subordinates - consider employees opinions, suggestions, and concerns, - involves the whole group in decision making laissez-faire leadership - CORRECT ANSWER allows the group to function more or less on its own, leaders are hand off Group members make own decisions - Lack of responsibility in leading Question: A staff nurse is curious about whether emptying the nasogastric (NG) suction canister is a task that can be delegated to a CNA. You, the CNL, guide her to what resource? A. The unit charge nurse B. Hospital policy/procedure manual C. The State Board of Nursing Scope of Practice D. The Joint Commission website - CORRECT ANSWER The State Board of Nursing Scope of Practice Rationale: The most reliable source for what tasks may be delegated is the individual state's scope of practice. What p-value indicates a significant statistical finding in research? - CORRECT ANSWER Less than 0.05 Transtheoretical Model of Change - CORRECT ANSWER Prochaska and Diclemente's model to conceptualize the process of intentional behavior change Patients may spiral in and out of stages, forward and back Question: During the policy formulation phase, all of the following are correct except: A. Possible solutions are offered. B. Political circumstances are considered. C. A problem is identified. D. Policy decisions are adjusted to accommodate changing circumstances or needs. - CORRECT ANSWER D. Policy decisions are adjusted to accommodate changing circumstances or needs. Rationale: Policy formulation is the development of effective and acceptable courses of action in order to address what has been placed on the policy agenda. This should include the following characteristics: (a) The problem is identified, (b) possible solutions are offered, (c) political circumstances are considered, and (d) policy makers, stakeholders, and legislative staff are involved. servant leadership - CORRECT ANSWER focuses on increased service to others rather than to oneself Leading originates from a desire to serve, leader emerges when others' needs take priority focus on whether the least advantaged in society benefit from the leader's service Question: You are a CNL on an oncology unit. Recently, there has been an increase in the number of catheter- associated urinary tract infections (CAUTIs) on your unit. After shadowing nurses and aides you observed a variety of practices, techniques, and expectations surrounding daily catheter care. Your hospital does not have a current policy or procedure regarding catheter care. As the CNL, what should you do next? A. Review current evidence for catheter care practice and disseminate evidence to the staff B. Form an interdisciplinary team meeting to evaluate current hospital catheter care policies C. Create a rubric for educating patients and staff on catheter care D. Discuss with the unit manager the clinical issue and create a set of evidence-based unit expectations and practices for the oncology unit. Evaluate the need to address this issue with a hospital-wide policy or procedure - CORRECT ANSWER Discuss with the unit manager the clinical issue and create a set of evidence-based unit expectations and practices for the oncology unit. Evaluate the need to address this issue with a hospital-wide policy or procedure Rationale: The CNL should act to solve the clinical issue in the short term, and evaluate the need for a larger policy to address gaps in practice hospital-wide. Hawthorne effect - CORRECT ANSWER A change in a subject's behavior caused simply by the awareness of being studied - people act as expected when being watched, the act of research effects the outcome. Neoclassical Theory - CORRECT ANSWER A modification of classical theory with human component believe in cooperation and participation, tapping into motivation of the individual Classical Organizational Theory - CORRECT ANSWER An early approach to the study of management that focused on the most efficient way of structuring organizations - efficiency through design What are different organizational theories? - CORRECT ANSWER 1. classical 2. neoclassical 3. systems theory 4. contingency theory 5. chaos theory Contigency Theory - CORRECT ANSWER Dependent on environment; performance can be enhanced by matching an organizational structure to its environment Optimal form of the organization is CONTIGENT upon the challenges and circumstances of the environment no one best way of leading, and that a leadership style that is effective in some situations may not be successful in others. Question: What organizational theory is used with rapid, unpredictable, and constant change? A. Systems theory B. Chaos theory C. Change theory D. Traditional theory - CORRECT ANSWER Chaos theory quasi-experiment - CORRECT ANSWER an experiment that estimates the causal impact of an intervention on target population WITHOUT random assignment Can be used to include pre and post measures/surveys Run chart - CORRECT ANSWER tool for tracking results over a period of time - Line graph of data plotted over time Shows trends/patterns Question: A CNL in the emergency department (ED) is auditing stroke patients' charts and the administration of tissue plasminogen activator (tPA) and notices that only 83% of patients who are eligible to receive tPA are receiving it. The CNL knows that the 83% administration rate is below the national benchmark. The CNL identifies that there is a time lag in MRI. The CNL creates a stroke team to develop a guideline implementation action plan to improve the process of timing of the MRI. What is the best tool utilized by the CNL in implementing change? A. Research study B. Meta-analysis C. Plan-Do-Study-Act (PDSA) D. Standardize-Do-Study-Act - CORRECT ANSWER Plan-Do-Study-Act (PDSA) Rationale: PDSA is a model for quickly and easily testing ideas that could lead to improvement, based on existing ideas, research, feedback, theory, reviews, audits, or evidence of what has worked elsewhere. Mesosystem - CORRECT ANSWER Multiple similar microsystems in a division of the hospital ethnographic research - CORRECT ANSWER the study of human behavior in its natural environment & promotes culturally sensitive care - obtain perspectives beyond own culture What are some examples of how you increase EBP into unit practice? - CORRECT ANSWER -Ensure policies/procedures are based on recent literature -Journal Clubs -Nursing grand Rounds Group think - CORRECT ANSWER the mode of thinking that occurs when the desire for harmony in a decision-making group overrides a realistic appraisal of alternatives Conflict resolution phenomenon when group members try to decrease conflict by reaching consensus too early without all ideas/consequences discussed Interferes with critical thinking Pareto Chart - CORRECT ANSWER a bar chart on which factors are plotted to help identify top rates and guide a focus of primary issues - bar height reflects frequency or impact of causes (descending bars) help identify the causes that are likely to have the greatest impact on the problem if addressed - guide the process of selecting key, high impact improvements Some causes have a much greater effect on problem we want to address than others: "80% of the effects come from 20% of the causes" Question: A professor is discussing the difference between quantitative and qualitative research. As a CNL student, you are aware that quantitative research is related to numeric data with statistical analysis, while qualitative research focuses on non-numeric forms of research. Which of the following is an example of a quantitative study? A. Personal interviews B. Randomized controlled trial (RCT) C. Ethnography D. Phenomenology - CORRECT ANSWER RCT Rationale: RCT is a quantitative research process that is a true experiment; it is the strongest design to support cause-and-effect relationships, in which subjects are randomly selected. Histogram Chart - CORRECT ANSWER graphical representation of data Lewin's Change Model - CORRECT ANSWER 1. Unfreezing 2. Changing 3. Refreezing Question: Quality improvement (QI), as a function of the CNL role, is related to which core role competency of the CNL? A. Client advocacy B. Clinician C. Risk anticipator D. Team manager - CORRECT ANSWER Risk anticipator Rationale: QI is a direct function of risk anticipation Flowchart - CORRECT ANSWER A diagram that shows step-by-step progression through a procedure or system Maps out and helps visualize problem Fishbone chart - CORRECT ANSWER used to aid in brainstorming and isolating the potential causes of a problem - Help identify root causes Cause and effect diagram Bounded Rationality Model - CORRECT ANSWER According to this decision making model, individuals knowingly limit their options to a manageable set and choose the first acceptable alternative without conducting an exhaustive search for alternatives emphasizes limitations of rationality of the decision maker Question: A group composed of unit-based council members was put on a task force to improve the discharge planning process because patients felt unprepared and rushed at discharge. A decision was made to create a discharge planning nurse position to educate patients the night before the discharge. Even though the new nurses did not like this solution, they deferred to the senior nurses of this group who were adamant about implementing this position. Which barrier to effective teamwork does this exemplify? A. Physical threats B. Groupthink C. Team dysfunction - CORRECT ANSWER B. Groupthink Rationale: Groupthink is a phenomenon that occurs when group members try to minimize conflict and reach consensus too early without fully vetting all ideas and consequences. Delphi Technique - CORRECT ANSWER A decision-making technique in which group members do not meet face-to-face but respond to questions posed by the group leader systematically - ex. Survey monkey Transtheoretical Model of Change parts - CORRECT ANSWER -Precontemplation -Contemplation -Preparation -Action -Maintenance Pender's Health Promotion Model - CORRECT ANSWER health promotion activities to increase levels of well in that each person has unique personal characteristics/experiences that affect their choices of actions they have 1. individual experiences/characteristics that effect choice of action, 2. behavior specific thoughts, and 3. different believed outcomes/perceived benefits of anticipated outcomes Chaos Theory/Model - CORRECT ANSWER Rapid changes, frequent The world is not orderly must adapt and change, be flexible Bioethical Decision Model - CORRECT ANSWER 10 step process in order to help with decisions in ethical dilemma Includes reviewing the situation, gathering information, identifying ethical issues, look at moral positions, identifying actions with outcomes, then deciding on action, and evaluating results Question: The CNL of the heart failure unit encourages the staff to earn advanced degrees, obtain certifications, and present and publish EBP projects. The CNL exhibits which type of leadership style? A. Relational leadership B. Transactional leadership C. Situational leadership D. Transformational leadership - CORRECT ANSWER Transformational Leadership Rationale: A transformational leader motivates others to higher performance. Relational (Connective) Leadership - CORRECT ANSWER A leadership style that values collaboration and teamwork; interpersonal skills are used to promote collegiality in achieving organizational goals Create positive relationships within the organization Situational Leadership Theory - CORRECT ANSWER a leadership contingency theory that focuses on followers' readiness; adjust style to fit developmental level of followers trying to influence Fidelity - CORRECT ANSWER principle of keeping one's promise or word veracity - CORRECT ANSWER obligation to tell the truth According to the Diffusion of Innovation theory what 2 groups should you focus on when you want to have successful support for a change? - CORRECT ANSWER Focus on the early and late majority adopters to support change for success as majority of the general population tends to fall in the middle categories Non-maleficence - CORRECT ANSWER doing no harm beneficence - CORRECT ANSWER to do good to others Steps of Diffusion of innovation theory - CORRECT ANSWER 1. Knowledge (exposure to innovation, they lack information) 2. Persuasion (interested in innovation and seeks information about it) 3. Decision (advantages vs disadvantages, accept or reject) 4. Implementation (usefulness of intervention) 5. Confirmation (either continue to use or not) Diffusion of Innovation Theory - CORRECT ANSWER Roger's theory - explain how a new idea or product gains acceptance and diffuses/spreads through a specific population or subset of an organization. Some people are more apt to adopt the innovation than others - initial rejection does not necessarily mean the change will never be adopted Includes: innovators, early adopters, early majority, late majority, laggards Looks like a bell curve in that majority of the general population tends to fall in the middle categories NDNQI (National Database of Nursing Quality Indicators) - CORRECT ANSWER Helps give benchmarks and hospital specific measurements of nursing indicators Falls (with and without injury) Pressure ulcers RN surveys/satisfaction, pain assessment Restraints Nurse turnover HAI (VAPs, CLABSIs, CAUTIs) MORAL model - CORRECT ANSWER helps make ethical decisions M: massage the dilemma - identify and define issues, consider opinions of others and their value system O: outline the options - examine all options fully, make a list of pros and cons R: resolve the dilemma, review issues/options, apply ethical principles to each option, decide best option A: act on chosen option, actual implementation L: look back and evaluate entire process Refreezing - CORRECT ANSWER 3rd step of lewin's change model establishing change as the new habit Moving - CORRECT ANSWER The second step in Lewin's change model, in which new attitudes, values, and behaviors are substituted for old ones Question: A small group has been formed on the medical-surgical unit to implement change. Team members also have struggles over decision making and clarity of purpose. What stage of the Tuckman and Jensen's model is represented by members communicating their feelings but still viewing themselves as individuals rather than part of the team? A. Performing B. Norming C. Forming D. Storming - CORRECT ANSWER Storming Rationale: The storming phase is where competition and conflict are at their highest. Leadership behavioral theory - CORRECT ANSWER Based upon belief that leaders can be made and can learn to be successful leaders through teaching and observation Leadership trait theory - CORRECT ANSWER Based on the assumption that leaders are born with certain traits and characteristics (inherited character traits suited to leadership) that make them ideal leaders Belief people are born leaders or not Horizontal leadership - CORRECT ANSWER Leadership focus on collaboration and equality within group, everyone involved in objectives and protocols Vertical Leadership - CORRECT ANSWER top down style leadership organizational objectives, protocols, etc. are crafted at highest leadership level and transmitted down without seeking others input in design Unfreezing - CORRECT ANSWER first step of Lewin's change model - finding a method to let go of old pattern that was counterproductive in some way Motivating others and encouraging buy in (time for assessing and motivating) Sentinel event - CORRECT ANSWER Unintended event that results in SIGNIFICANT harm, physical or psychological to patient 6 aims of quality care by the IOM - CORRECT ANSWER 1. safe, 2. timely, 3. patient centered, 4. effective, 5. efficient 6. and equitable 8 steps of Quality Improvement - CORRECT ANSWER 1. Establish clear aim/purpose 2. Review the literature 3. Examine resources 4. Map current processes 5. Analyze root cause 6. Appropriate tools selected for analysis 7. Measures and metrics selected to measure success of initiative 8. Rapid Cyclical Review of plan, data, interventions, and outcomes Question: Failure mode-effect analysis is best used as follows: A. In response to a critical or sentinel event B. Prior to a process implementation or change C. As part of a random audit process D. In response to malfunctioning tools or equipment - CORRECT ANSWER B. Prior to a process implementation or change Rationale: The purpose of a failure mode-effect analysis is to anticipate potential problems; by virtue, this is best conducted prior to a process implementation. What are the 5 Ps of microsystem assessment? - CORRECT ANSWER Patients (characteristics) Professionals (who delivers care) Purpose (mission of setting) Processes (for delivering care) Patterns Complexity theory - CORRECT ANSWER belief that system self regulates and all things are connected. Rapidly changing, & unpredictable health care environment = expect the unexpected Focus on continual improvement roots in Chaos Model and quantum physics AKA quantum leadership? Complexity theory has developed from the field of: A. Nursing B. Business C. Industry D. Quantum Physics - CORRECT ANSWER Quantum Physics - chaos theory Quantum leadership - CORRECT ANSWER States that leaders must work together with subordinates to identify common goals and empower staff to make decisions for organizational productivity to occur based off chaos theory - getting employees involved in decision making, is outcomes based, and appreciates that the world is fluid and constantly changing. Public Policy Formation Phases - CORRECT ANSWER 1. Issue identification and agenda setting 2. Policy formation 3. Policy adoption 4. Policy Implementation 5. Policy Evaluation 6. Policy revision/amendment Logos - CORRECT ANSWER logical arguments - Thorough analysis: EBP, ensuring attention to detail Pathos - CORRECT ANSWER psychological appeal - emotions, needs, values Life long learner - CORRECT ANSWER CNLs role to pursue knowledge/skills Member of profession role - CORRECT ANSWER CNLs role accountable for ongoing skills/knowledge of profession, network, learning activities each year, etc. Question: The diabetes liaison on an adult medical-surgical unit informed the team that the unit was only 45% compliant with checking blood sugars within 15 minutes after a hypoglycemic event. The team decided to implement a process change to ensure the blood sugar recheck is completed within 15 minutes. The change was implemented and there was an increase to 85% compliance of hypoglycemic rechecks. What is the next step for the team in the PDSA cycle? A. Plan B. Do C. Study D. Act - CORRECT ANSWER Act Rationale: After analysis of the results of the trial (also known as study), the team will then act by devising the next steps based on the analysis. Healthy People 2020 - CORRECT ANSWER A set of disease prevention and health promotion objectives to meet to improve health of all Americans published by the US department of Health and Human Services (USDHHS) - 10 year national objectives 3 key beliefs for a person to take a health related action when utilizing the Health Belief Model - CORRECT ANSWER 1. person feels that a negative health condition could be avoided by doing new action 2. Have a positive expectation that by following new action, they will avoid a negative health condition 3. Believe that they can successfully take that new health action Health Belief Model - CORRECT ANSWER model for explaining how beliefs may influence behaviors focused on perceived susceptibility, severity, benefits, barriers, cues to action/readiness, and self efficacy Helps for motivating people to take positive health actions for those that use the desire to avoid a negative health consequence as the primary motivation (such as exercising to avoid an MI or condoms to avoid HIV) Question: The CNL has been requested to assist with end-of-life care decision making for an elderly homeless patient who has no family; he was deemed incompetent and is now unresponsive. The best decision- making guide that the CNL could use in this situation is: A. Plan-Do-Study-Act (PDSA) B. Autonomy model C. Orem's self-care theory D. MORAL model - CORRECT ANSWER MORAL model [Show Less]
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CNL certification Review Exam 117 Questions with Verified Answers,100% CORRECT
CNL certification Review Exam 117 Questions with Verified Answers A team charter includes all except which of the following? A. Clearly defined goals... [Show More] B. Specific outcomes C. Team member roles D. Time allotted for each activity - CORRECT ANSWER D. Rationale: A team charter is an essential written agreement defining what the team is going to accomplish, how success will be measured, and defining team member roles. As a clinical nurse leader (CNL), you know a potential use of a patient's individual electronic health record is its use in A. Finding relevant evidence-based literature B. Performing a root cause analysis C. Implementing a best practice change D. Reviewing unit practice trends - CORRECT ANSWER B. Rationale: Each is a potential use of healthcare information technology, but only the root cause analysis involves the use of a patient's medical record. Lateral integration is based on the understanding of which of the following? A. Patient-specific healthcare needs B. The interdependency of all healthcare disciplines C. The variety of healthcare delivery settings D. Changes in patient care needs over time - CORRECT ANSWER B. Rationale: Lateral integration is based on the understanding that all disciplines of healthcare are interdependent and essential in providing complete care to the patient. When performing ongoing assessment of a process or system, the clinical nurse leader (CNL) should include all of the following, except: A. Efficacy B. Satisfaction C. Efficiency D. Ease of change - CORRECT ANSWER D. Rationale: Ease of change may be considered; however it should not prevent the CNL from taking action to improve a system or process that improves safety, efficacy, satisfaction, efficiency, or quality of care. As a clinical nurse leader (CNL) on an acute care floor, you recognize the importance of lateral integration. Which of the following examples of your role as a CNL illustrates the role of ongoing evaluation in lateral integration? A. Performing risk analysis to ensure client safety B. Assessing the appropriateness and relevancy of current or newly emerging healthcare information C. Synthesizing data to find a common goal D. Fostering rapport across professional boundaries - CORRECT ANSWER B. Rationale: Assessing new or current information is key to the process of ongoing evaluation. Performing a risk analysis to ensure client safety is part of the early coordination stages. Synthesizing data is the role of collaboration. Fostering rapport is a key aspect of communication. As a clinical nurse leader (CNL) on an acute care floor, you recognize the importance of lateral integration. Which of the following examples of your role as a CNL illustrates the role of collaboration in lateral integration? A. Monitoring the plan of care for specific patients and populations B. Clearly delegating tasks and responsibilities within a team C. Translating from discipline-specific language to a common message and goals D. Keeping all members of the team informed of current status and process - CORRECT ANSWER C. Rationale: Translating the message to form a common goal exemplifies collaboration within a team. Monitoring involves ongoing evaluation; clear delegation of tasks is an important aspect of coordination; updating on status is clear communication. Monitoring involves _____________ _______________. - CORRECT ANSWER ongoing evaluation clear delegation of tasks is an important aspect of _____________. - CORRECT ANSWER coordination updating on status is clear _______________. - CORRECT ANSWER communication Performing a risk analysis to ensure client safety is part of the early _____________ stages. - CORRECT ANSWER coordination In order to practice horizontal leadership, the clinical nurse leader (CNL) needs a "tool kit" of skills. These include all except which of the following? A. Vertical integration B. Use of feedback C. Healthcare outcomes D. Guiding EBP practice - CORRECT ANSWER A. Rationale: Critical skills in order to practice horizontal leadership include guiding evidence-based practice, healthcare outcomes, lateral integration, use of feedback, coaching, and leading teams. The clinical nurse leader (CNL) facilitates, coordinates, and oversees care provided by the healthcare team. This best describes which of the following roles? A. Risk anticipator B. Lateral integrator C. Team manager D. Outcomes manager - CORRECT ANSWER B. Rationale: Lateral integration of care involves the CNL as the leader of care; overseeing care provided by the healthcare team; identifying barriers; and working with the team to proactively manage potential problems. Fostering rapport is a key aspect of _________________ - CORRECT ANSWER communication synthasizing data is ___________ - CORRECT ANSWER collaboration A male patient seen at your clinic says he has recently purchased a gym membership and requests information about what types of exercises he should start with when beginning. As the clinical nurse leader (CNL) for the clinic, you recognize this patient is most likely in which of Prochaska and DiClemente's Transtheoretical Model for stages of change: A. Contemplation B. Preparation C. Action D. Maintenance - CORRECT ANSWER B. Rationale: Based on Prochaska and DiClemente's Transtheoretical Model, this patient is in the preparation stage; he has taken some steps toward action showing he is seriously planning change in the near future through financial commitment and research. He has not yet reached the action phase because he has not yet modified the behavior Irene is a clinical nurse leader (CNL) in a small community hospital. Irene was tasked with leading an interdisciplinary team to improve the transition from emergency room (ER) to the medical unit. During a meeting, the ER nurses and the medical unit nurses argue over the cause of delays, blaming one another. The team is now disruptive and not focused on the goals of this group. Which of the following should the CNL do first to resolve this conflict? A. Define the problem. B. Develop plan of action. C. Evaluate underlying causes. D. Determine an approach. - CORRECT ANSWER A. Rationale: The first step in problem solving is to define the problem. Diane is a 43-year-old female who has been readmitted three times in the past 6 months with chronic obstructive pulmonary disease (COPD) exacerbations. Diane has been described as noncompliant with taking her medications and she continues to smoke half a pack of cigarettes daily. Which of the following best describes the first critical step when developing a plan of care for Diane? A. Refer Diane to a smoking cessation class. B. Coordinate with respiratory therapy to teach Diane correct technique for inhalers. C. Auscultate Diane's lungs to evaluate for wheezing. D. Ask Diane what she feels is causing her to come back to the hospital. - CORRECT ANSWER D. Rationale: Developing a therapeutic relationship is the first step in a clinical assessment. It is important to obtain information from the patient, including his or her perspective and goals. The clinical nurse leader (CNL) is asked to lead an interdisciplinary team in developing a pathway to help improve the discharge process. The CNL helps the team create an agreement that focuses on goals, outcomes, and team member roles. Which of the following best describes the team leader tool the CNL is creating? A. Team agenda B. Team ground rules C. Team charter D. Team evaluation - CORRECT ANSWER C. Rationale: team charter is an essential written agreement defining what the team is going to accomplish, how success will be measured, and defining team member roles. There are three dimensions of safety: safety climate (compliance with rules and no-fault error reporting); teamwork climate (collaboration and communication); and which of the following? A. Employee climate (teamwork and engagement) B. Positive perceptions of management (working conditions, opinions of management) C. Positive perceptions of coworkers (engagement and low turn-over rates) D. Caring climate (values, ethics, and patient experience) - CORRECT ANSWER B. Rationale: Hudson et al identified position perception of management as the third dimension. A 24-bed critical care unit has experienced an increase in ventilator-associated pneumonia (VAP) within the past year. The clinical nurse leader (CNL) is asked to facilitate a workgroup focused on developing a plan to prevent VAP. Which of the following best exhibits how the CNL promotes communication within the team? A. Assigns each member a role, ensuring everyone understands his or her job. B. Engages the team in shared decision making before finalizing a plan. C. Shares clear goals, messages, and plans with the team throughout the process. D. Synthesizes the input from the team to find common themes and goals. - CORRECT ANSWER C. Rationale: The CNL communicates within a team by fostering the flow of information and serving as a translator. The CNL actively solicits input and shares information with the team. Which of the following defines horizontal leadership? A. It is a leadership style that depends on high levels of communication from management to meet goals. B. Managers and team members set predetermined goals together, and employees agree to follow the direction and leadership of the manager to accomplish those goals. C. It values the input of team members and peers, but the responsibility of making the final decision rests with the participative leader. D. It is a philosophy of organizational leadership whereby the structure promotes equality and an "open-door policy." - CORRECT ANSWER D. Rationale: It allows team members to voice their opinions and to provide feedback freely. As a clinical nurse leader (CNL), it is important to share outcomes and disseminate findings. Which of the following do you recognize as the most appropriate outlet for your findings? A. Journal and conferences only B. Founder of journal and conference C. Journal, conference, TV, and radio D. Journal, conference, founder of journal, TV, and radio - CORRECT ANSWER D. Rationale: All of the above are appropriate places to disseminate results. Which of the following are Hallmarks of a Healthy Work Environment? A. Skilled communication, true collaboration, meaningful recognition, and authentic leadership B. Autonomy, patient- and self-advocacy, collaborative teamwork, and professional communication C. Transformational leadership, efficient decision making, high staffing, and at least 80% of nurses having a BSN degree and/or certification D. Meaningful recognition, transformational leadership, collaborative teamwork, and professional communication - CORRECT ANSWER A. Rationale: The six American Association of Colleges of Nursing (AACN) Hallmarks of a Healthy Work Environment are: skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership. LATERAL INTEGRATION & THE CNL ROLE Seeking input from other members of the healthcare team is ____________ - CORRECT ANSWER collaboration LATERAL INTEGRATION & THE CNL ROLE Ensuring role identity is _____________. - CORRECT ANSWER coordination LATERAL INTEGRATION & THE CNL ROLE Evaluating processes is part of ____________ ______________ - CORRECT ANSWER ongoing evaluation As a clinical nurse leader (CNL) on an acute care floor, you recognize the importance of lateral integration. Which of the following examples of your role as a CNL illustrates the role of communication in lateral integration? A. Seeking other members of the healthcare team to provide their input on a new nursing process B. Ensuring that each member of the interdisciplinary team knows his or her role and workflow C. Asking questions to clarify and restate information D. Evaluating communication strategies and processes within a team - CORRECT ANSWER C.Rationale: Clarifying verbal and nonverbal messages is a major aspect of communication. Seeking input from other members of the healthcare team is collaboration; ensuring role identity is coordination; while evaluating processes is part of ongoing evaluation. Alex, a clinical nurse leader (CNL) in a pediatric clinic, is conducting a gap analysis in order to compare best practices with the current processes. After determining the state of the microsystem, Alex should do which of the following next? A. Determine desired state based on benchmark data. B. Prioritize needs and determine importance. C. Analyze the gap between the current state and desired state. D. Identify potential solutions and opportunities for improvement - CORRECT ANSWER A. Rationale: A gap analysis is conducted by determining the state of the microsystem and then determining the desired state based upon benchmark data. As you begin to investigate the sentinel event, what is one way you can present a GRAPHICAL representation of the different factors that contributed to the issue? A. an RCA B. a fishbone diagram C. a concept map D. a cinical decision tree - CORRECT ANSWER B. a fishbone diagram The team wants to implement the process change and observe what happens, but they are unsure what method to use. What method do you suggest? A. 5S B. 5P C. FMEA D. PDSA - CORRECT ANSWER D. PDSA Value-based purchasing is the method of payment by CMS for in-hospital stays, which pays on the basis of hospital scores in patient experience of the _______________. - CORRECT ANSWER HCAHPS HCAHPS, the "A" stands for _______________. - CORRECT ANSWER Assessment HCAHPS, the "HP" stands for ___________ _______________. - CORRECT ANSWER Healthcare Provider HCAHPS, the "H" stand for ______________ . - CORRECT ANSWER Hospital HCAHPS, the "S" stands for _____________. - CORRECT ANSWER Systems The CNL is aware of the _________, ___________, and ___________ messages that are being portrayed to the team members. - CORRECT ANSWER verbal, nonverbal, and written A new graduate nurse, Jenny, approaches you and states she needs help removing a PICC line. Which of the following is the best response when acting as a horizontal leader? A. Remove the PICC line yourself B. Tell Jenny to find the policy and then remove the PICC C. Help Jenny find the policy and review it with her. Coach Jenny while she removes the PICC line and provide feedback D. Help Jenny find the policy and refer her to a nurse with 12 years of experience for assistance - CORRECT ANSWER C. Rantional: horizontal leadership What organizational theory is used with rapid, unpredictable, and constant change? A. Systems theory B. Chaos Theory C. Change Theory D. Traditional Theory - CORRECT ANSWER B. Rationale: suitable for healthcare systems Your hospital is currently trialing the integration of the CNL role. At the end of the trial implementation period how can you, as the CNL, best illustrate the effectiveness of your role during this trial? A. Refer to increased patient satisfaction scores over the course of the trial B. Present data that demonstrates the effect of the CNL and outcomes over the course of the trial C. Present a list of projects and tasks completed over the course of the trial D. Refer to your performance review over the course of the trial - CORRECT ANSWER B. rationale: present effects and outcomes A CNL evaluates a 17-year old patient who has been sexually assaulted. The patient has visible bruising and head laceration. After the CNL's assessment, law enforcement officials have contacted the CNL requesting information regarding the attack and the visible injuries. The CNL knows the priority is to take what initial action? A. The pictures and complete the rape kit B. Provide law enforcement with a record as requested C. Call the patient's parents first D. Explain to the patient in order to obtain consent for release of records - CORRECT ANSWER D. rationale: HIPPA A CNL in the NICU is collecting data on the hours worked weekly by the staff nurses. The CNL wants to see if there is a normal distribution of hours worked. What techniques is the best to display the distribution of the data collected? A. Run chart B. Fishbone chart C. FMEA chart D. Histogram chart - CORRECT ANSWER D. Rationale: graphic illustation for distribution of data without timelines (run chart) or sentinel events (fishbone) The CNL is performing RCA for spike in number of CAUTIs over the last 6 months. Realizing CMS operates on a pay-for-performance basis, you develop a CAUTI task force in an effort to reduce costs. This is an example of A. Implementing cost reduction and savings B. Anticipating risk and designing plans of care to Improve outcomes C Evaluating the effect of the health care financing on care access and patient outcomes D. Applying basic business and economic principles to the microsystem - CORRECT ANSWER B. rationale core competencies The CNL notices increased number of CLBSI on your unit. You conduct a literature search and, after critiquing and synthesizing the available evidence, you find that central line bundles have been shown to decrease CLBSI. You want to implement this bundle on your unit, and plan to evaluate the effect of this change. Which of the following best describes this process? A. PDSA B. Research C. QI D. EBP - CORRECT ANSWER D. Rationale: EBP involves applying research evidence to clinical practice in order to improve patient outcomes The CNL successfully implemented an EBP project utilizing music therapy to help with pain control in sickle cell patients on a medical-surgical unit. The CNL was asked by the CNO to implement the project within the medical division. What system will the CNL be working in? A. mesosystem B. macrosystme C. microsystem D. unit-based system - CORRECT ANSWER A. rationale: multiple microsystems A mother presents to ED with 8-month infant who has the following symptoms: coughing, recurring respiratory infections, fatty stools, and failure to thrive. Upon examination, the infants vitals are as follows: T 99.4 HR 150, RR 65, BP 88/50. A CNL in the ED receives a phone call from the lab stating that Staphylococcus aureus was found coloniezed in the patient's airway. A As the CNL in the ED, you associate the patients condition with which following disease? A. Asthma B. Lobar pneumonia C. Cystic fibrosis D. Croup - CORRECT ANSWER C. rationale: respiratory infections, FFT, and fatty stools What is the best tool utilized by the CNL to implement change? A. research study B. Meta-analysis C. PDSA D. SDSA - CORRECT ANSWER C. quickly test ideas A group composed of unit-based council members was put on a task force to improve discharge planning b/c pts reported feeling rushed and unprepared at discharge. A decision was made to create a discharge planning nurse position to educate patients the night before the discharge. Even though the new nurses did not like this solution, they deferred to the senior nurses of this group who were adamant about implementing this posiiton. Which barrier to effective teamwork does this exemplify? A. Physical threats B. Groupthink C. Team dysfunction D. Authority gradient - CORRECT ANSWER B. rationale: phenomenon that occurs when group members try to minimize conflict and reach consensus too ealry without fully vetting all ideas and consequences While QI efforts can yield many benefits in health care, as the CNL you recognize which of the following to be the most important potential effect of a nursing QI effort? A. Increased hospital cash flow/decreased expense B. Increased competitiveness with other facilities C. Reduction in lawsuits/liability D. Improvement of nursing quality indicators - CORRECT ANSWER D. patient-centered Team coordination skills can help avoid all of the following except: A. Undefined team member roles B. Poor membership involvement C. Member conflict D. Confusion regarding next steps - CORRECT ANSWER C. conflict usually arises in groups at some point The CNL of the heart failiure unit encourages the staff to earn advanced degrees, obtain certifications, and present and publish EBP projects. The CNL exhibitis which type of leadership style? A. Relational B. Transactional C. Situational D. Transformational - CORRECT ANSWER D. motivates to higher performance You are a CNL on a busy surgical unit. Recently, several nurses reported confusion regarding their patient's discharge process. The nurses stated that they often were unaware of all communications between interprofessional care team. As a result, the nurses were often unaware of their patient discharge plans. As a CNL, how can you best improve this process? A. Educate nurses on how to access progress notes from other providers within the current electronic health record (EHR). B. Discuss with each health care team member the clinical issue regarding the discharge process and suggest the creation of a daily interdisciplinary team meeting C. Communicate to the surgeons the nurses' concerns, and advocate for the nurses' needs for communication in their role D. Assume responsibility for the coordination of all discharge needs for patients on the unit - CORRECT ANSWER B. advocate for the role of the nurse as an equal part of the interprofessional team How can the CNL best provide and educate staff on giving culturally competent care within the unit? A. Educate staff on assessment questions/phrases in the most common secondary language present In the community or seen within the hospital B. Educate staff on varying cultural perceptions and beliefs surrounding the concepts of health C. Provide an in-service on accessing patient education and handouts in another language D. Ensure that nurses are assigned to the most culturally appropriate patients currently on the unit - CORRECT ANSWER B. ideal is intervention as education on cultural differences A 40-year old postpartum patient with chronic HTN and GDM who is gravida 5 para 4 is transferred from labor and delivery to the postpartum unit with lactated Ringer's at 125 mL/hr. Upon assessment of the patient, the nurse notices the patient's fundus is three finger breaths above umbilicus and to the right of midline and her bladder is palpable. The nurse also notes moderate to heavy bleeding and a full bladder and notifies the CNL. As a CNL, what is the most important intervention? A. Encourage the nurse to massage the fundus and heplock the patient B. Encourage the nurse to call the physician stat to order Methergine C. Encourage the nurse to monitor the patient over the next hour b/c there are no risk factors for a postpartum hemorrhage D. Encourage the nurse to straight catherize the patient to decrease the likelihood of a postpartum hemorrhage - CORRECT ANSWER D. multipara and full bladder are risk factors for postpartum hemorrhage A 6-year-old boy is in critical condition following a car accident. The patient has head trauma and internal bleeding. The patient's parents have stated multiple times that they are Jehovah's Witnesses and do not want their son to receive blood. The CNL knows that the blood transfusion is needed immediately and could save the boy's life. Which of the following statements is the best thing for the CNL to do? A Listen to the parents, as US minors have no legal rights and remain under parental jurisdiction B. Obtain court order in the best interest of the child to receive blood, based on the avoidance of physical harm C. Based on religious beliefs, do not give blood D. Follow the physician's decision to give blood since the physician's decision overrides the parental decision - CORRECT ANSWER B. Rationale: child's interests as well as state policies outweigh the parental rights; a court order is needed to override parent's decision Which stage of Lewin's change theory involves explaining that the current situation must change? A. Unfreezing B. Adoption C. Evaluation D. Change - CORRECT ANSWER A. rationale: method of letting go of counterproductive patterns [Show Less]
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CNL Exam Questions 1-50 with Verified Answers,100% CORRECT
CNL Exam Questions 1-50 with Verified Answers *A new graduate nurse approaches you and states she needs help removing a PICC. Which of the following i... [Show More] s the best response when acting as a horizontal leader?* a. remove the PICC yourself b. tell her to find the policy and then remove the PICC c. help jenny find the policy and review it with her. Coach her while she removed the PICC and provide feedback. d. help jenny find the policy and refer her to a nurse with 12 years of experience for assistance. - CORRECT ANSWER c. help jenny find the policy and review it with her. Coach her while she removed the PICC and provide feedback The clinical nurse leader (CNL) acts as a horizontal leader by helping the new graduate nurse to learn through sharing knowledge and coaching, rather than doing the task for the nurse. *What organizational theory is used with rapid, unpredictable, and constant change?* a. Systems theory b. Chaos theory c. Change theory d. Traditional theory - CORRECT ANSWER b. Chaos theory Chaos theory is used to understand rapidly changing, unpredictable health care environments. *a 65 YO AA male was admitted to your microsystem with hyperglycemia. The patient has a history of HTN, gout, obesity, and smoking. The patient has a family history of DM and HTN. Which statement by the patient demonstrates his understanding of modifiable risk factors for DM?* a. "As I get older, my risk for DM increases" b. "I know that a family history of DM is a risk factor, so I will educate my children on DM prevention." c. "I will keep a record of all my blood sugars to take to my doctor's appointments." d. I will attend a smoking cessation class, because I know smoking increases my risk for DM." - CORRECT ANSWER d. I will attend a smoking cessation class, because I know smoking increases my risk for DM." Modifiable risk factors are lifestyle factors that a person can alter in order to prevent disease. Smoking cessation class is an intervention for modifying the risk factor of smoking. *Your hospital is currently trialing the integration of the clinical nurse leader (CNL) role. At the end of the trial implementation period how can you, as the CNL, best illustrate the effectiveness of your role during this trial?* a. Refer to increased patient satisfaction scores over the course of the trial b. Present data that demonstrates the effect of the CNL and outcomes achieved over the course of the trial. c. Present a list of projects and tasks completed over the course of the trial. d. Refer to your performance review over the course of the trial. - CORRECT ANSWER B The CNL should present the effect and outcomes to illustrate the importance of the integration of his or her role. Increased patient satisfaction is not necessarily directly related to the CNL. Presentation of projects and tasks completed does not address measurable outcomes. Performance review of the individual does not indicate outcomes were affected. *You are a CNL on an oncology unit. Recently, there has been an increase in the number of CAUTIs on your unit. After shadowing nurses and aides you observed a variety of* *practices, techniques, and expectations surrounding daily catheter care. Your hospital does not have a current policy or procedure regarding catheter care. As the CNL, what should you do next?* a. review current evidence for catheter care practice and disseminate evidence to the staff b.form an interdisciplinary team meeting to evaluate current hospital catheter care policies c. create a rubric for educating patients and staff on catheter care d. discuss with the unit manager the clinical issue and create a set of evidence-based unit expectations and practices for the unit. evaluate the need to address this issue with a hospital wide policy or procedure. - CORRECT ANSWER d. discuss with the unit manager the clinical issue and create a set of evidence-based unit expectations and practices for the unit. evaluate the need to address this issue with a hospital wide policy or procedure. CNLs should gather and disseminate evidence to solve clinical problems; however, that should not be the initial step. Further review of hospital practices and policies may come after this issue is addressed. Creation of a rubric for educating patients and staff on catheter care may come after reviewing evidence. The CNL should act to solve the clinical issue in the short term, and evaluate the need for a larger policy to address gaps in practice hospital-wide. *A 50 YO F with stage 3 COPD presents tot he ED with increased SOB. Based on these lab results, what is the acid-base disorder* pH 7.25 PaCO2 50 mmHg HCO3 22 mEq/L PO2 75 SpO2 88% Na + 136 BUN 18 a. uncompensated respiratory acidosis b. metabolic acidosis c. respiratory acidosis d. uncompensated respiratory acidosis - CORRECT ANSWER a. uncompensated respiratory acidosis Based on the clinical scenario, the pH is decreased (less than 7.35); therefore, the patient has acidosis. The PaCO2 is elevated (more than 45 mmHg), which is also consistent with the pH. The HCO3 is within normal limits, which suggests the kidneys are not compensating. COPD is commonly associated with respiratory acidosis. *A CNL evaluates a 17YO patient who has been a victim of rape. The patient has visible bruising and a head laceration. After the CNL's assessment, law enforcement officials have contacted the CNL requesting* *information regarding the attack and the visible injuries seen during the visit. The CNL knows she must first:* a. take pictures and complete the rape kit b. provide law enforcement with records as requested c. call the patient's parents first d. explain to the patient in order to obtain consent for release of records - CORRECT ANSWER d. explain to the patient in order to obtain consent for release of records Rationale: Legally, there must be consent from the patient to share information with law enforcement and to abide by Health Insurance Portability and Accountability Act (HIPAA) regulations. *A CNL in the NICU is collecting data on the hours worked weekly by the staff nurses. The CNL wants to see if there is a normal distribution of hours worked. What technique is the best to display the distribution of the data collected?* a. run chart b. fishbone chart c. failure modes and effects analysis (FMEA) chart d. histogram - CORRECT ANSWER d. histogram Histogram is a graphical representation, showing a visual impression of the distribution of data. *Your peds onc unit is considering the implementation of a social/activity program for clients that would provide volunteer social interactions and age-appropriate activities to admitted clients. As the CNL for this unit, you recognize this intervention as a way to:* a. Be helpful to the floor staff by distracting clients b. Be a wasteful expenditure c. meet the psychosocial needs of clients d. prevent poor client experience rating on d/c surveys. - CORRECT ANSWER c. meet the psychosocial needs of clients While social interaction and activities may provide distraction to clients and prevent poor client experiences, such a program would most importantly meet the holistic needs of young clients that may otherwise be neglected during a lengthy hospital stay. They also act to integrate such services with the medical care being delivered, meeting the CNL's call to develop and integrate services across settings in a holistic manner. *When assessing a new microsystem, the CNL will often use a tool known as the "5 Ps." As a CNL, you recognize the "5 Ps" to include are:* A. Purpose, patients, process, patterns, professionals B. Patients, providers, policies, patterns, prevention C. Purpose, patients, providers, patterns, prevention D. Patients, process, professionals, policies, patterns - CORRECT ANSWER A. Purpose, patients, process, patterns, professionals *Mr. J is an 80YO who lives alone. He had fallen and was found by his neighbors. Mr. J has a history of multiple falls, CHF, MI,DM, and asthma. Mr. J is admitted to the hospital with a hip fracture. Using an interdisciplinary approach, who should the CNL include in the plan of care initially?* A. Clinical care manager, medical social worker, clinical nutritionist, CNL, and physician B. Clinical care manager, medical social worker, clinical nutritionist, physical therapist, registered nurse, CNL, and physician C. Speech therapist, clinical care manager, medical social worker, CNL, registered nurse, and nursing supervisor D. Clinical care manager, medical social worker, CNL, registered nurse, and nurse manager - CORRECT ANSWER B. Clinical care manager, medical social worker, clinical nutritionist, physical therapist, registered nurse, CNL, and physician An interdisciplinary team is composed of many disciplines who work together toward a patient's and family's common goals, such as safe discharge coordination. Learning to advocate for clients occurs by communicating effectively with other interdisciplinary team members, including nurses in other settings. The opportunity to learn and work in an interdisciplinary team will provide the best opportunity to give patients the best outcome. *As the CNL on a telemetry unit, you are performing a root cause analysis (RCA) due to the high volume of CAUTIs over the last 6 months. Realizing that the Centers for Medicare & Medicaid are on a pay-for-performance basis, you develop a CAUTI task force in an effort to reduce cost. This is an example of which of the following?* A. Implementing cost reduction and savings B. Anticipating risk and designing plans of care to improve outcomes C. Evaluating the effect of the health care financing on care access and patient outcomes D. Applying basic business and economic principles to the microsystem - CORRECT ANSWER B. Anticipating risk and designing plans of care to improve outcomes CNLs must have the ability to critically evaluate and anticipate risks to client safety; this is a critical component role. *You notice a trend of increased central line bloodstream infection (CLBSI) on your unit. You conduct a literature search and, after critiquing and synthesizing the available evidence, you find that central line bundles have been shown to decrease CLBSI. You want to implement this bundle on your unit, and plan to evaluate the effect of this change. Which of the following best describes this process?* A. Plan-Do-Study-Act (PDSA) B. Research C. Process improvement D. Evidence-based practice (EBP) - CORRECT ANSWER D. Evidence-based practice (EBP) EBP involves applying the best available research evidence, clinical expertise, and patient preferences to improve a clinical outcome. *A CNL rounds with Dr. Camper on a Spanish-speaking patient. The CNL asks the physician to call an interpreter, but the MD states that it is not necessary because the patient's daughter speaks English. However, the CNL insists and ensures an interpreter is present. What CNL role was fulfilled?* A. Educator B. Team manager C. Clinician D. Client advocate - CORRECT ANSWER D. Client advocate Client advocacy is a hallmark of the CNL's role. As a client advocate, the CNL assumes accountability for the delivery of high-quality care, including the evaluation of care outcomes and provision of leadership in improving care. *During the policy formulation phase, all of the following are correct except:* A. Possible solutions are offered. B. Political circumstances are considered. C. A problem is identified. D. Policy decisions are adjusted to accommodate changing circumstances or needs. - CORRECT ANSWER D. Policy decisions are adjusted to accommodate changing circumstances or needs. Policy formulation is the development of effective and acceptable courses of action in order to address what has been placed on the policy agenda. This should include the following characteristics: (a) The problem is identified, (b) possible solutions are offered, (c) political circumstances are considered, and (d) policy makers, stakeholders, and legislative staff are involved. *The unit implemented bedside reporting 6 months ago, but the change has not been sustained. As a CNL, you begin to participate in bedside reporting and provide constructive, immediate feedback to the nurses for improvement. What best describes this situation?* A. Mentoring B. Transformational leadership C. Coaching D. Precepting - CORRECT ANSWER C. Coaching The CNL coaches by evaluating team members and providing constructive feedback. Mentoring is a long-term relationship between two individuals focused on clinical advancement. *Jane, a CNL, successfully implemented an evidence-based practice (EBP) project utilizing music therapy to help with pain control in sickle cell patients on a medical-surgical unit. Jane was asked by the CNO to implement the project within the medical division. What system will Jane be working in?* A. Mesosystem B. Macrosystem C. Microsystem D. Unit system - CORRECT ANSWER A. Mesosystem The mesosystem encompasses multiple microsystems, such as a medical division within a hospital. *Judy has a family history of type 2 diabetes. After education, Judy knows she can help to prevent diabetes by maintaining a healthy weight, healthy eating habits, and daily physical activity. Judy is exhibiting what type of prevention strategies?* A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention - CORRECT ANSWER A. Primary prevention The purpose of primary prevention is to prevent the onset of chronic illness, focusing on healthy lifestyle habits and behaviors. *You are a CNL on a surgical unit. Your unit has just hired several new graduate nurses. As the CNL, what is your role in relationship to these new team members?* A. Provider of all clinical education B. Evaluator for performance reviews C. Coach and mentor D. Individual with a hands-off approach to allow new nurses to develop skills independently - CORRECT ANSWER C. Coach and mentor The role of the CNL is to mentor and support all nurses on the unit, especially new nurses. Although the CNL may act as an educator, he or she does not guide the education and training of nurses on the unit. The CNL is not a member of management and does not complete employee performance reviews. While the CNL may take a hands-off approach, he or she should still offer support and mentorship to his or her peers. *You are the CNL on a surgical unit. You have noticed that readmission rates for your orthopedic patients have increased steadily over the last several months. Upon investigation, you find that patients are reporting that they do not believe they are receiving adequate education on postoperative wound management. As the CNL, you recognize that one way you can act to promote the health of your patients is:* A. Provide direct, culturally appropriate education to all patients on your unit B. Arrange post-op visits at the outpatient surgical clinic for all patients upon discharge C. Educate the nursing staff regarding how they can evaluate patient health literacy, provide education at an appropriate level for each patient, and evaluate patient understanding of education provided D. Discuss with pre-op staff beginning patient education much earlier in this hospital process - CORRECT ANSWER C. Educate the nursing staff regarding how they can evaluate patient health literacy, provide education at an appropriate level for each patient, and evaluate patient understanding of educationprovided Although the CNL may do direct patient teaching, it may not be possible to coordinate the discharge education for all patients on the unit; this would depend upon the patient's nurse. Post-op visits are important follow-ups for patients, but do not need to be scheduled by the CNL. Valuable teaching may occur preoperatively; however, demonstration of wound care and dressings cannot occur until after the surgery. CNLs should educate nurses on how to best provide education to their patients, and ensure that nurses understand how to evaluate health literacy. *An 8-month-old presents to the ED with following symptoms: coughing, recurring respiratory infections, fatty stools, and failure to thrive. Upon examination, the infant's vitals are as follows: Temp 99.4°F, pulse 150, respirations 65, blood pressure 88/50 mmHg. A CNL in the ED receives a phone call from the laboratory stating that Staphylococcus aureus was found colonized in the patient's airway. As a CNL in the ED you know that the preceding symptoms and laboratory results are consistent with which of the following diseases?* A. Asthma B. Lobar pneumonia C. Cystic fibrosis D. Croup - CORRECT ANSWER C. Cystic fibrosis Cough, recurring respiratory infections, fatty stool, and failure to thrive are all symptoms of cystic fibrosis. Many children with cystic fibrosis have colonizing Staphylococcus aureus in their airways *An elderly Chinese woman has just been diagnosed with terminal cancer. While discussing end-of-life care decisions with the family, patient, and CNL, the CNL notices there are conflicting viewpoints between the family and patient regarding advance directives. Which of these is the best answer regarding advance directives?* A. In the Chinese culture, the family makes the decisions regarding end-of-life care in order not to burden the patient. B. It is best not to fully inform the patient of his or her condition so that he or she will remain positive. C. The patient has the right to enact his or her own advance directive to guide his or her medical treatments according to the Patient Self-Determination Act. D. The interdisciplinary team has the most information on palliative care to make the best decision. - CORRECT ANSWER C. The patient has the right to enact his or her own advance directive to guide his or her medical treatments according to the Patient Self-Determination Act. The Patient Self-Determination Act explains the patient's right to accept or the right to refuse medical or surgical treatment. The patient is also entitled to receive information about the right to create his or her own advance directive. *A CNL in the ED is auditing stroke patients' charts and the administration of tPA and notices that only 83% of patients who are eligible to receive tPA are receiving it. The CNL knows that the 83% administration rate is below the national benchmark. The CNL identifies that there is a time lag in MRI. The CNL creates a stroke team to develop a guideline implementation action plan to improve the process of timing of the MRI. What is the best tool utilized by the CNL in implementing change?* A. Research study B. Meta-analysis C. Plan-Do-Study-Act (PDSA) D. Standardize-Do-Study-Act (SDSA) - CORRECT ANSWER C. Plan-Do-Study-Act (PDSA) PDSA is a model for quickly and easily testing ideas that could lead to improvement, based on existing ideas, research, feedback, theory, reviews, audits, or evidence of what has worked elsewhere. *A group composed of unit-based council members was put on a task force to improve the discharge planning process because patients felt unprepared and rushed at discharge. A decision was made to create a discharge planning nurse position to educate patients the night before the discharge. Even though the new nurses did not like this solution, they deferred to the senior nurses of this group who were adamant about implementing this position. Which barrier to effective teamwork does this exemplify?* A. Physical threats B. Groupthink C. Team dysfunction D. Authority gradient - CORRECT ANSWER B. Groupthink Groupthink is a phenomenon that occurs when group members try to minimize conflict and reach consensus too early without fully vetting all ideas and consequences. *You are a CNL on a peds unit. You are doing chart audits on attending physicians' daily charting and assessment notes and notice that a small number of attending physicians are not seeing patients daily. They are putting in discharge orders days prior to discharge. As a CNL, you know the hospital has a policy that attending physicians must see their patients every 24 hours. The CNL waits to see what happens during the next scheduled chart audits. What conflict resolution is demonstrated?* A. Compromise B. Accommodate C. Compete D. Avoidance - CORRECT ANSWER D. Avoidance *Attending physicians have noted that on your unit nurse communication by telephone has been scattered, disjointed, lengthy, and often contains erroneous information. As the CNL, good interdisciplinary communication is a priority. To best address this issue, the CNL would:* A. Wait to see if the issue persists B. Encourage floor nurses to provide less information when calling physicians to limit the length and complexity of their calls C. Ask physicians to provide their feedback directly to individual nurses D. Refamiliarize staff nurses with the use of situation background assessment recommendation (SBAR), your hospital's communication standard - CORRECT ANSWER D. Refamiliarize staff nurses with the use of situation background assessment recommendation (SBAR), your hospital's communication standard Rationale: While professionals should provide direct feedback to each other in a meaningful, constructive manner and limiting communication to key information is an important aspect of clear communication, the use of a standardized tool, already a standard at this hospital, would most readily help to guide nurses to communicate in a clear, concise, efficient manner to ensure high-quality communication between care team members. *Quality improvement (QI) is a key function of the CNL. While QI efforts can yield many benefits in health care, as the CNL you recognize which of the following to be the most important potential effect of a nursing QI effort?* A. Increased hospital cash flow/decreased expense B. Increased competitiveness with other facilities C. Reduction in lawsuits/liability D. Improvement of nursing quality indicators - CORRECT ANSWER D. Improvement of nursing quality indicators While a QI effort may yield any of these potential answers, only the improvement of nursing quality indicators is patient centered. *While assisting Dr. Smith with a central line insertion you notice she did not properly execute sterile technique. What is the most appropriate way to provide feedback?* A. Stop Dr. Smith while she is talking to the patient and provide feedback B. Ask Dr. Smith to stop the procedure so you can get her another central line insertion kit C. Refer Dr. Smith to the policy and procedure manual and ask that she read the section on using aseptic technique D. Debate with Dr. Smith at the bedside and tell her errors like this are the reason patients acquire hospital-acquired conditions - CORRECT ANSWER B. Ask Dr. Smith to stop the procedure so you can get her another central line insertion kit The most important action is to protect the patient by providing another sterile central line insertion kit. *Which of the following is the best description of health care economics?* A. Understanding run charts B. Competence demonstrated by knowledge and ability to articulate federal, state, and private payer system regulations and issues, as well as the impact on organizations C. Identifying the number of patient falls per patient day D. The number of staff assigned to work on a given shift on a given day - CORRECT ANSWER B. Competence demonstrated by knowledge and ability to articulate federal, state, and private payer system regulations and issues, as well as the impact on organizations The CNL has a very powerful role to fill when it comes to economics and health care finance. The CNL must understand finance to make the most appropriate decisions in regard to services provided, by whom, and for the length of time. *Amy, a nurse on your unit, is interested in implementing a project to improve health literacy and diabetes using follow-up phone calls. She asks the CNL for help in initiating the project. What would be her first step?* A. Identify the clinical problem B. Implement follow-up phone calls C. Determine outcomes of the project D. Review literature for evidence - CORRECT ANSWER A. Identify the clinical problem According to the EBP process, identifying the clinical problem is the first step. *Mrs. Jones, a patient with multiple comorbidities, has been hospitalized for over 3 months due to her recent stroke. During this period, she has not progressed and has had a trach and PEG tube placed. Two of the daughters refused to make her a DNR, while the son and husband want the patient to be a DNR. As a CNL, you are conflicted and want the best outcome for the patient. What is the best step for you to take?* A. Find out if the patient has an advance directive or wants to be a DNR B. Prevent the patient from being a DNR C. Call the physician to make the decision D. Make the patient a DNR according to the husband's wishes - CORRECT ANSWER A. Find out if the patient has an advance directive or wants to be a DNR You, as the CNL, are acting as a client advocate. You are taking the next step to ensure appropriate care is provided for the patient. You assume accountability for the delivery of high quality care, including the evaluation of care outcomes and provision of leadership in improving care. *Team coordination skills can help avoid all of the following except:* A. Undefined team member roles B. Poor membership involvement C. Member conflict D. Confusion regarding next steps - CORRECT ANSWER C. Member conflict In most working groups, conflict arises at some point. In addition to sound team coordination skills, the CNL must also possess effective conflict management skills. *The CNL of the heart failure unit encourages the staff to earn advanced degrees, obtain certifications, and present and publish EBP projects. The CNL exhibits which type of leadership style?* A. Relational leadership B. Transactional leadership C. Situational leadership D. Transformational leadership - CORRECT ANSWER D. Transformational leadership a transformational leader motivates others to higher performance. *A CNL works in an inpatient unit that provides health care to medical-surgical patients. This best describes which of the following?* A. Macrosystem B. Mesosystem C. Microsystem D. Megasystem - CORRECT ANSWER C. microsystem Rationale: The microsystem is used to describe the small, functional, frontline unit that provides the most health care to the most people. *M is a 45YO who is undergoing chemo for ovarian cancer. She complains of increased nausea, vomiting, and abdominal pain uncontrolled by medications prescribed by her oncologist. M expresses that she wants to continue chemotherapy, but she is unable to eat and maintain her weight due to her symptoms. She describes the pain as unbearable and at times she is unable to get out of bed. What would be the best step for the CNL to take next?* A. Discuss code status and health care power of attorney with Maureen B. Contact hospice care to arrange a meeting with Maureen C. Call the physician and suggest a palliative care consult D. Suggest alternative methods for pain relief such as meditation, healing touch, and aromatherapy - CORRECT ANSWER C. Call the MD and suggest a palliative care consult Rationale: Palliative care focuses on improving the quality of life for individuals by concentrating on pain and symptom management, communication, and coordinated care. Palliative care would help M control symptoms of nausea, vomiting, and pain while she continues treatment. *You are a CNL on a busy surgical unit. Recently, several nurses have reported confusion regarding their patients' d/c process. The nurses stated that they were often unaware of all communications between the surgeon, discharge planners, social workers, and pharmacists. As a result, the nurses were often unaware of their patient discharge plans, status, and needs. As a CNL, how can you best improve this process?* A. Educate nurses on how to access progress notes from other providers within the current electronic health record (EHR) B. Discuss with each health care team member the clinical issue regarding the discharge process and suggest the creation of a daily interdisciplinary team meeting C. Communicate to the surgeons the nurses' concerns, and advocate for the nurses' needs for communication in their role D. Assume responsibility for the coordination of all discharge needs for patients on the unit - CORRECT ANSWER B. Discuss with each health care team member the clinical issue regarding the discharge process and suggest the creation of a daily interdisciplinary team meeting CNLs should advocate for the role of the professional nurse as an equal part of the interdisciplinary team. Education for nurses on accessing progress notes does not address the issue of nurses not being communicated with as part of the team. Communication to surgeons may improve communication to the nurse, but does not necessarily improve communication between each rovider equally. The CNL should not assume all of the responsibility of patient discharge planning. *How can the CNL best provide and educate staff on giving culturally competent care within the unit?* A. Educate staff on assessment questions/phrases in the most common secondary language present in the community or seen within the hospital B. Educate staff on varying cultural perceptions and beliefs surrounding the concept of health C. Provide an in-service on accessing patient education and handouts in another language D. Ensure that nurses are assigned to the most culturally appropriate patients currently on the unit - CORRECT ANSWER B. Educate staff on varying cultural perceptions and beliefs surrounding the concept of health Nurses should never attempt to use a family member or their own limited ability for conversation in another language; a certified medical interpreter should be used. An in-service on accessing education in multiple languages would likely be very useful to staff, but is not as good an intervention as education on cultural differences. Staffing and patient assignment should not be based on only cultural associations; individual preferences may also need to be considered. *A 40-year-old postpartum patient with chronic HTN and gestational DM who is gravida 5para 4 is transferred from L&D to the postpartum unit with LR at 125 mL/hr. * *Upon assessment of the patient, the nurse notices the patient's fundus is three fingerbreathsabove umbilicus and to the right of midline and her bladder is palpable. The nurse also notes moderate to heavy bleeding and a full bladder and notifies the CNL. As a CNL, the most important nursing intervention is to:* A. Encourage the nurse to massage the fundus and heplock the patient B. Encourage the nurse to call the physician stat to order Methergine (methylergonovine maleate) C. Encourage the nurse to monitor the patient over the next hour because there are no risk factors for a postpartum hemorrhage D. Encourage the nurse to straight catherize the patient to decrease the likelihood of a postpartum hemorrhage - CORRECT ANSWER D. Encourage the nurse to straight catherize the patient to decrease the likelihood of a postpartum hemorrhage The patient is at risk for a hemorrhage due to being a multipara and having a full bladder. Methergine is contraindicated in patients with hypertension. *A 6-year-old boy is in critical condition following a car accident. The patient has head trauma and internal bleeding. The patient's parents have stated multiple times that they are Jehovah's Witnesses and do not want their son to receive blood. The CNL knows that the blood transfusion is needed immediately and could save the boy's life. Which of the following statements is the best thing for the CNL to do?* A. Listen to the parents, as U.S. minors have no legal rights and remain under parental jurisdiction B. Obtain a court order in the best interest of the child to receive blood, based on the avoidance of physical harm C. Based on religious beliefs, do not give blood D. Follow the physician's decision to give blood since the physician's decision overrides the parental decision - CORRECT ANSWER B. Obtain a court order in the best interest of the child to receive blood, based on the avoidance of physical harm The child's interests as well as the state policies outweigh the parental rights to refuse medical treatment for a minor. A court order is needed to enforce this. *The group known as "Maternal Child Health" has many subunits such as pediatrics, well baby nursery, NICU, and maternity. This collection of units belongs to which system?* A. Microsystem B. Mesosystem C. Macrosystem D. Megasystem - CORRECT ANSWER B. mesosystem A mesosystem is a collection of other microsystems that facilitate processes. *Which stage of Lewin's change theory involves explaining that the current situation must change?* A. Unfreezing B. Adoption C. Evaluation D. Change - CORRECT ANSWER A. Unfreezing Unfreezing is a process that involves finding a method of making it possible for people to let go of an old pattern that was counterproductive in some way. *A client with complex behavior concerns is getting ready to be discharged to a skilled nursing facility. However, the client has expressed that he wishes to stay in the hospital and not be discharged. As the CNL, your best action would be to:* A. Inform the patient and his or her family that they must go and remaining on the unit is not an option B. Advocate letting the client stay on the unit one extra day, then discharge tomorrow C. Identify the client's concerns and collaborate with the care team to see they are addressed D. Ask the family to help encourage the client to discharge to the skilled nursing facility - CORRECT ANSWER C. Identify the client's concerns and collaborate with the care team to see they are addressed Clients can often experience apprehension when changing care settings. Identifying specific concerns and working rapidly to ensure they are addressed in collaboration with other members of the care team can greatly reduce a client's hesitation. Additionally, such collaboration ensures other members of the care team are aware of the clients' concerns, possibly providing additional information and insight regarding the clients and their care needs *A healthy work environment is an important factor in supporting ongoing quality and safety. As the CNL, you recognize that the hallmarks of a healthy work environment include all of the following except:* A. Skilled communication B. Upward mobility C. Effective decision making D. Appropriate staffing - CORRECT ANSWER B. Upward mobility Upward mobility is not a hallmark of a healthy work environment or area of focus for the CNL. *While rounding on your cohort of patients, you are informed by one of your patients that she does not have health care insurance. As a CNL, you know that interdisciplinary communication is very important. What member of the team is most effective in helping with this matter?* A. The care management team: medical social worker, clinical case manager (CCM), and medical team B. Pastoral care C. The business office of the hospital D. Nursing staff - CORRECT ANSWER Answer A—Rationale: The case management team works closely with the medical team to ensure that patients have the means to pay for their medication. *Who can function as an important ally to the CNL in engaging frontline staff in a major initiative?* A. Content expert B. Unit champion C. Initiative sponsor D. Senior leadership - CORRECT ANSWER B. Unit champion B is the best answer because as a CNL implementing a major initiative, you want individuals who will help advocate and support your initiative. A champion is someone who fights or speaks publicly in support of a person, belief, cause, or initiative. *Which of the following best utilizes the PICOT method of developing a clinical question?* A. Will a preoperative class for coronary artery bypass graft (CABG) surgery patients decrease anxiety? B. What is the effect of early mobility in patients 65 years and older on length of stay? C. Will the implementation of quiet time and employee education of harmful effects of noise reduce peak levels and improve patient satisfaction of patients on a medical-telemetry unit over a 1-month period? D. Will the use of secret shoppers increase compliance with hand washing and PPE in a large hospital in the Southeast? - CORRECT ANSWER C. Will the implementation of quiet time and employee education of harmful effects of noise reduce peak levels and improve patient satisfaction of patients on a medical-telemetry unit over a 1-month period? C is the best choice as it addresses the population, intervention, outcome, and time period. *Which of the following is the best example of a CNL protecting patient autonomy?* A. The CNL ensures the patient understands how to use an incentive spirometer. B. The CNL ensures the patient has all information and understands the procedure forEGD/colonoscopy scheduled for the morning. C. The CNL discusses the plan of care for treatment of pneumonia with the daughter and the doctor. D. The CNL closes the door to protect the patient's privacy when discussing her diagnosis. - CORRECT ANSWER B. The CNL ensures the patient has all information and understands the procedure for esophagogastroduodenoscopy (EGD)/colonoscopy scheduled for the morning. Answer B—Rationale: The CNL protects patients' autonomy by keeping them well informed and ensuring they understand their decision about their plan of care. *You are a CNL on a surgical unit. Your manager has asked you to review and update the current patient skin prep procedure as needed. After reviewing the evidence, you determine the current surgical skin prep does not match current evidence suggesting a need for chlorhexidine gluconate wipes. At your next meeting with your manager, how do you best advocate for change?* A. Provide a list of resources for the new CHG skin prep, costs, and available vendors B. Interpret the evidence of effectiveness of the CHG wipes prep and the related patient outcomes for patients receiving this skin prep; present the findings and suggest how this could be best used to change practice on the unit C. Present feedback from the nursing staff on the current practices on the unit D. Alert the manager that there is a discrepancy between the current practice and evidence, and await further instructions before proceeding - CORRECT ANSWER B. Interpret the evidence of effectiveness of the CHG wipes prep and the related patient outcomes for patients receiving this skin prep; present the findings and suggest how this could be best used to change practice on the unit Answer B—Rationale: As the CNL, you should assess evidence, interpret research for policy makers or stakeholders, and offer suggestions for improvement to practice. Providing a list of resources to the manager does not create buy-in for the change. Feedback from nurses does not address evidence. CNLs should always provide suggestions for practice improvement. *The new hospital CNO works hard to cultivate a shared vision of leaders and followers motivating each other toward their highest potential. This is an example of which type of leadership?* A. Transformational leadership B. Transactional leadership C. Situational leadership D. Hierarchical leadership - CORRECT ANSWER Answer A—Rationale: A transformational leader believes that leaders and followers motivate each other toward the end goal of developing followers into leaders. This is accomplished by leading and motivating by example. *The CNL's role is to lead frontline staff in line with the organization's core competencies. Which of the following best describes how a CNL can promote a high-performing clinical microsystem?* A. Support an atmosphere for learning and redesign supported by continuous monitoring of care, use of benchmarking, and frequent tests of change B. Promote a microsystem that is in silo from the community and does not cross professional boundaries C. Encourage staff to provide opinions and feedback, though the manager will make the final decision D. Promote engagement by sharing positive outcomes with the staff and having celebrations, but keep negative outcomes confidential in order to keep the staff from feeling defeated - CORRECT ANSWER A. Support an atmosphere for learning and redesign supported by continuous monitoring of care, use of benchmarking, and frequent tests of change Answer A—Rationale: The CNL can promote high quality in high-performing clinical microsystems by providing a supportive atmosphere for continuous process improvement. [Show Less]
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CNL Test Bank 331 Questions with Verified Answers,100% CORRECT
CNL Test Bank 331 Questions with Verified Answers The CNL role includes: a. client and community advocacy. b. evidence-based practice. c. oversite ... [Show More] of care delivery and outcomes. d. all of the above - CORRECT ANSWER a. client and community advocacy. Which statement is true about practice settings for the CNL? a. The CNL role is designed for the acute-care hospital setting. b. CNLs practice in all healthcare settings. c. The design of the CNL curriculum is such that CNLs cannot move from one practice setting to another. d. The CNL's quality improvement and care coordination training is applicable only to acute-care settings. - CORRECT ANSWER b. CNLs practice in all healthcare settings. The clinical nurse leader role is the first new nursing role in a. the last 5 years b. the last decade. c. 25 years. d. over 40 years. - CORRECT ANSWER d. over 40 years. The first regular administration of the CNL Certification Examination occurred in a. 1993. b. 2002. c. 2007. d. 2012. - CORRECT ANSWER c. 2007. For the CNL, the measure of quality practice a. is client care outcomes. b. has not yet been articulated by the AACN. c. nursing satisfaction. d. healthcare team member approval. - CORRECT ANSWER a. is client care outcomes. A 2012 U.S. Department of Labor report projected that the number of employed nurses would change from 2.74 million in 2010 to ________ in 2020. a. 2.34 million b. 3 million c. 3.45 million d. over 8 million - CORRECT ANSWER c. 3.45 million In The Future of Nursing, the Institute of Nursing called for ________ of the nursing workforce to have at least a baccalaureate degree by 2020. a. 45% b. 60% c. 80% d. 95% - CORRECT ANSWER c. 80% The CNL graduate education program assumes that a. the graduate does not meet the criteria for advanced practice registered nursing scope of practice. b. the education program culminates in a baccalaureate degree. c. the graduate is not eligible to matriculate to a doctoral program. d. graduates require additional education before being eligible to sit for the CNL Certification Examination. - CORRECT ANSWER a. the graduate does not meet the criteria for advanced practice registered nursing scope of practice. How many models for graduate CNL education programs have emerged? a. 2 b. 5 c. 8 d. 15 - CORRECT ANSWER b. 5 In what settings are CNLs currently practicing? a. Outpatient clinics b. School health c. Acute-care hospitals d. All of the above - CORRECT ANSWER d. All of the above Nursing is discipline that a. is relationship-based. b. was evidence-based since its inception. c. is slightly outmoded. d. tends to shun problem solving. - CORRECT ANSWER a. is relationship-based. With changes in the Affordable Care Act, ________ Americans will have access to health services. a. fewer b. all c. more d. the same number of - CORRECT ANSWER c. more It could be said that nursing ________ the work of physicians. a. best complements b. goes against c. is unrelated to d. corrects - CORRECT ANSWER a. best complements Which of the following is a CNL role? a. Leader b. Advocate c. Educator d. All of the above - CORRECT ANSWER d. All of the above Accountability is a CNL a. core competency. b. role. c. professional value. d. both a and b, above - CORRECT ANSWER c. professional value. The CNL role is involved in organizational improvements that are a. relationship based. b. outcome based. c. evidence based. d. both b and c, above - CORRECT ANSWER d. both b and c, above In The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine a. specifically addresses the CNL role at 15 different points. b. is compatible with the CNL role. c. calls the CNL role "experimental." d. was written by CNLs. - CORRECT ANSWER b. is compatible with the CNL role. In terms of practice setting, the CNL works in a. acute settings only. b. all practice settings. c. public health only. d. settings distant from clinical practice. - CORRECT ANSWER b. all practice settings Core competencies of the CNL include a. communication. b. delegation. c. interpretation and analysis. d. all of the above - CORRECT ANSWER d. all of the above The IOM report indicates that the nursing workforce should be: a. more educated. b. receiving the same education as today. c. less educated, to produce graduates more quickly in order to fill the nursing shortage. d. completely educated at the doctoral level. - CORRECT ANSWER a. more educated. A partnership is between a. individuals only. b. groups only. c. cooperating parties with a common goal. d. legally recognized entities. - CORRECT ANSWER c. cooperating parties with a common goal. Which is a CNL professional value? a. Defiance b. Altruism c. Rigidity d. Anonymity - CORRECT ANSWER b. Altruism One type of assessment analyzes the ________ between current and desired states. a. partnership b. guilty individuals responsible for the difference c. gap d. equivalency - CORRECT ANSWER c. gap Which of the following would signal an unmet need in the education arena? a. Increased population diversity b. A surplus of faculty members c. Ample space d. Adequate supply resources - CORRECT ANSWER a. Increased population diversity CNL roles include a. data interpreter. b. care coordinator. c. communicator. d. all of the above - CORRECT ANSWER d. all of the above Partnerships ________ interdependencies. a. reject b. represent the viable alternative to c. embrace d. avoid - CORRECT ANSWER c. embrace Gap analysis is a(n) a. form of partnership. b. type of needs assessment. c. an alternative to partnership. d. none of the above - CORRECT ANSWER b. type of needs assessment. In order for a partnership to move forward, ________ must be present. a. trust b. respect c. shared values d. all of the above - CORRECT ANSWER d. all of the above A core competency of the CNL is a. business acumen. b. altruism. c. integrity. d. microsystems and gap analyst - CORRECT ANSWER a. business acumen. The term "partnership" has origins in the: a. 6th century. b. 14th century. c. 19th century. d. 21st century. - CORRECT ANSWER . 14th century. The first element in the McKinsey 7-S framework is a. style. b. superiority. c. structure. d. simplicity. - CORRECT ANSWER c. structure. Measurable improvement with economic value is shown by a a. system readiness. b. business case. c. risk anticipation. d. strategic plan. - CORRECT ANSWER b. business case. A core competency of the CNL is: a. communication. b. analysis. c. information management. d. all of the above - CORRECT ANSWER d. all of the above Crucial to the success of the CNL role immersion are: a. operational control. b. creation of a scorecard. c. regularly scheduled meetings. d. all of the above - CORRECT ANSWER d. all of the above A role of the CNL is a. risk taker. b. ethicist. c. risk anticipator. d. do-it-yourself person (no delegation). - CORRECT ANSWER c. risk anticipator. Metrics must be ________ and produce the ________ gain. a. measurable, largest b. subjective, largest c. measurable, smallest d. hidden, unknown - CORRECT ANSWER a. measurable, largest The important thing about metrics is to a. choose them wisely. b. use as many as possible, to impress people. c. avoid them if possible, as they cloud the issue. d. none of the above - CORRECT ANSWER a. choose them wisely. The chief nurse executive must have ________ for how the CNL will be immersed in the care delivery model. a. some idea, even if vague, b. a gut feeling but no defined idea c. a clear vision d. no plan - CORRECT ANSWER c. a clear vision Professional values of the CNL include a. advocacy. b. ethics. c. accountability. d. all of the above - CORRECT ANSWER d. all of the above In the McKinsey 7-S framework, a soft element is a. supervision. b. skills. c. secrecy. d. systems. - CORRECT ANSWER b. skills. A purpose of the CNL Spread Plan was to a. integrate the CNL role into the patient care model. b. gradually phase out the CNL role. c. separate the CNL role from the patient care model. d. sever collaborative partnerships. - CORRECT ANSWER a. integrate the CNL role into the patient care model. A ________ identifies communication needs for both internal and external stakeholders. a. measurable outcome b. microsystem c. communication plan d. value - CORRECT ANSWER c. communication plan AIM stands for: a. Alternative Integral Management. b. Approach to Internal Methods. c. Academy for the Improvement of Microsystems. d. Academy for Important Matters. - CORRECT ANSWER c. Academy for the Improvement of Microsystems. The Office of Nursing Services (ONS) of ________ launched its CNL Spread Plan in 2010. a. Ford Motor Company b. the VHA c. the Affordable Care Act d. the Centers for Disease Control and Prevention - CORRECT ANSWER b. the VHA Roles of the CNL include: a. leadership. b. risk anticipation. c. evidence-based practice. d. all of the above - CORRECT ANSWER d. all of the above The importance of approaching CNL implementation by first developing a ________ cannot be overemphasized. a. vision of the CNL role imposed from authorities outside the organization b. statement excluding stakeholders from the planning phase c. shared vision and understanding of the CNL role d. none of the above - CORRECT ANSWER a. vision of the CNL role imposed from authorities outside the organization The CNL Spread Plan was designed to cover a ________ - year period. a. 1 b. 5 c. 10 d. 25 - CORRECT ANSWER b. 5 Stakeholders were ________ the CNL Spread Plan. a. an important part of b. not involved in c. deliberately avoided in creating d. eventually eliminated from - CORRECT ANSWER a. an important part of The professional values of a CNL include: a. collaboration. b. accountability. c. advocacy. d. all of the above - CORRECT ANSWER d. all of the above The CNL is a(n) ________ with a practice focus on the ________. a. interim consultant, macrosystem b. point-of-care generalist, microsystem c. interim consultant, microsystem d. point-of-care specialist, macrosystem - CORRECT ANSWER b. point-of-care generalist, microsystem ________ is often referred to as "lean thinking." a. Six sigma b. Communication c. Lean six sigma d. Organizational trust - CORRECT ANSWER c. Lean six sigma Therapeutic use of self is an example of a CNL: a. professional value. b. core competency. c. role. d. all of the above - CORRECT ANSWER b. core competency. Incorporating a "4-D" cycle, "AI" stands for a. appreciative inquiry. b. absolute integrity. c. artificial input. d. active inquiry. - CORRECT ANSWER a. appreciative inquiry. ________ occurs when two or more values, beliefs, and opinions are incongruous and reconciliation of differences has not occurred. a. Increased productivity b. Appreciative inquiry c. Conflict d. Higher morale - CORRECT ANSWER c. Conflict The interactive behaviors of individuals within the context of a group refers to ________. a. crucial conversations b. lean six sigma team c. group dynamics d. essential qualities - CORRECT ANSWER c. group dynamics ________ is built on predictable behavior associated with keeping promises and being accountable, even when expectations are not achieved. a. Altruism b. Trust c. Communication d. Appreciative inquiry - CORRECT ANSWER b. Trust CNL roles include a. clinician. b. member of a profession. c. outcome manager. d. all of the above - CORRECT ANSWER d. all of the above ________ is often associated with empathy, patience, kindness, and concern for others. a. Conflict b. Warmth c. Genuineness d. Maturity - CORRECT ANSWER b. Warmth High self-esteem, sense of self-worth, self-awareness, and confidence are the matrix of ________. a. assertiveness. b. miscommunication. c. bullying. d. personal agendas. - CORRECT ANSWER a. assertiveness. ________ involves acknowledging and understanding personal strengths, attributes, shortcomings, and vulnerabilities. a. Acceptance b. Empathy c. Resignation d. Self-awareness - CORRECT ANSWER d. Self-awareness Generally speaking, the nurse manager must demonstrate ________ competence. a. clinical b. administrative c. clinical nurse leader d. all-inclusive - CORRECT ANSWER b. administrative CNL roles include a. leadership. b. design and implementation. c. life-long learner d. all of the above - CORRECT ANSWER d. all of the above A major competency for nurse managers is: a. communication and relationship building. b. critical thinking. c. assessment. d. illness and disease management. - CORRECT ANSWER a. communication and relationship building. Member of a profession, or professionalism, is a competency of: a. the CNL. b. the nurse manager. c. both the CNL and the nurse manager. d. neither the CNL nor the nurse manager. - CORRECT ANSWER c. both the CNL and the nurse manager. A major competency for the CNL is: a. critical thinking. b. knowledge of the healthcare environment. c. business skills. d. all of the above - CORRECT ANSWER a. critical thinking. As a rule, the clinical nurse leader must demonstrate ________ competence. a. administrative b. clinical c. every nurse leader d. both b and c, above - CORRECT ANSWER b. clinical To be most effective, the CNL and the nurse manager should form a: a. somewhat uneasy partnership. b. team so that one can substitute for the other. c. creatively adversarial relationship. d. leadership dyad. - CORRECT ANSWER d. leadership dyad. Global healthcare is a . competency of the a. CNL. b. nurse manager. c. both the CNL and the nurse manager. d. neither the CNL nor the nurse manager. - CORRECT ANSWER a. CNL. A core competency of the CNL is risk: a. avoidance. b. elimination. c. anticipation. d. aversion. - CORRECT ANSWER c. anticipation. CNL and nurse manager roles ________ each other. a. conflict with b. complement c. work against d. are identical to - CORRECT ANSWER b. complement The CNL clinical immersion is a ________ hour concentrated practicum. a. 50-75 b. 100-200 c. 300-400 d. 500-750 - CORRECT ANSWER c. 300-400 The first step in selecting a project plan would be a. seeking feedback. b. determining buy-in. c. completing an organization overview. d. listening. - CORRECT ANSWER c. completing an organization overview. A preceptor is a(n) a. instructor. b. teacher. c. professor. d. any of the above - CORRECT ANSWER d. any of the above The ________ is the only place that success comes before work. a. real world b. dictionary c. business world d. healthcare profession - CORRECT ANSWER b. dictionary The final step of project plan selection would be a. listening. b. conducing thorough literature research. c. seeking feedback. d. determining buy-in. - CORRECT ANSWER d. determining buy-in. The individual who observes, listens, learns, engages, and transforms in the immersion process is the a. preceptee. b. counselor. c. preceptor. d. client. - CORRECT ANSWER a. preceptee. The preceptee is a a. teacher. b. student. c. professor. d. nurse manager. - CORRECT ANSWER b. student. In a clinical immersion, the ________ has the responsibility of assuming accountability for the learning process. a. preceptee b. advocate c. preceptor d. observer - CORRECT ANSWER a. preceptee CNL professional values include a. integrity. b. human dignity. c. advocacy. d. all of the above - CORRECT ANSWER d. all of the above Requisites for ensuring successful immersions between schools of nursing and healthcare settings include a. collaborative partnerships and agreements. b. thoughtful planning and pairing of preceptor and preceptee. c. both a and b, above d. random assignment of preceptees to preceptors. - CORRECT ANSWER c. both a and b, above The ________ drives the advisory council's organization and development. a. consultant b. leader c. facilitator d. lawyer - CORRECT ANSWER b. leader The first important step in setting up an advisory council is developing a a. membership. b. facilitator. c. charter. d. group of interprofessional stakeholders. - CORRECT ANSWER c. charter. Annual assessment of the council should be made by the ________. a. leader b. newest council member c. outside consulting firm chosen by the facilitator d. auditor - CORRECT ANSWER a. leader CNL professional values include a. critical thinking. b. membership in a profession. c. integrity. d. all of the above - CORRECT ANSWER d. all of the above An advisory council can provide both the authority and influence for a. organizational change. b. keeping faculty, students, and other stakeholders separate. c. defeating organizational change. d. eliminating subcommittees. - CORRECT ANSWER a. organizational change. A charter a. formally establishes a council. b. identifies a council's goals. c. both a and b, above d. recruits members. - CORRECT ANSWER c. both a and b, above Facilitators are part of ________ advisory councils. a. all b. some c. dysfunctional d. no - CORRECT ANSWER b. some A role of the CNL is a. consultant. b. group leader. c. professional leader. d. all of the above - CORRECT ANSWER d. all of the above Involving interprofessional stakeholders to facilitate meetings can help promote the CNL role: a. beyond the nursing domains. b. to council members. c. within the nursing domains. d. in the charter. - CORRECT ANSWER a. beyond the nursing domains. The responsibilities of members of an advisory council include: a. planning programs. b. marketing. c. communication. d. all of the above - CORRECT ANSWER d. all of the above The Joint Commission says that high-reliability organizations need to focus on: a. costs. b. mindfulness and perfection. c. audits. d. none of the above - CORRECT ANSWER b. mindfulness and perfection. Financial stewardship is a ________ of the CNL. a. core competency b. professional value c. role d. factor outside the scope - CORRECT ANSWER b. professional value HROs have a(n) a. preoccupation with success. b. aversion to expertise. c. preoccupation with failure. d. insensitivity to operations. - CORRECT ANSWER c. preoccupation with failure. Roles of the CNL include a. catalyst. b. data analysis. c. integrity. d. all of the above - CORRECT ANSWER a. catalyst. As assumption of the AACN for preparing the CNL is that: a. practice is at the microsystems level. b. client-centered practice is intra- and interdisciplinary. c. information will maximize self-care and client decision-making. d. all of the above - CORRECT ANSWER d. all of the above In the five-step model of EBM/EBP of Sackett and colleagues, the first step is to: a. ask the question. b. acquire the evidence. c. assess the patient. d. apply. - CORRECT ANSWER c. assess the patient. The healthcare economic model is undergoing a transition from a focus on ________ to a focus on ________. a. volume, high-value outcomes. b. value, cost c. EBP, cost-containment d. quality, quantity - CORRECT ANSWER a. volume, high-value outcomes. CNL core competencies include a. data analysis. b. critical thinking. c. ethical decision-making. d. all of the above - CORRECT ANSWER d. all of the above A microsystem is defined as the ________ unit on the frontline of healthcare delivery systems. a. only b. smallest c. largest d. least important - CORRECT ANSWER b. smallest A core principle of HROs is a. resilience. b. suspicion of expertise. c. obsession with success. d. isolation from operations. - CORRECT ANSWER a. resilience. CNL competencies include a. critical thinking. b. team leader. c. ethical decision-making. d. all of the above - CORRECT ANSWER d. all of the above The key feature of quality improvement is the ________ nature of the process. a. one-time b. isolated c. cyclical d. time-limited - CORRECT ANSWER c. cyclical Historically, risk management focused on a. quality improvement. b. compassion. c. reducing liability. d. risk anticipation. - CORRECT ANSWER c. reducing liability. A professional value of the CNL is a. social justice. b. member of a profession. c. systems analyst. d. team manager. - CORRECT ANSWER a. social justice. The domains of enterprise risk management (ERM) include a. clinical operations. b. finance. c. technological risks. d. all of the above - CORRECT ANSWER d. all of the above In quality improvement methodologies, the step of mapping the current processes occurs before a. literature review. b. root cause analysis. c. examining current resources. d. defining the aim. - CORRECT ANSWER b. root cause analysis. A characteristic of continuous quality improvement is a. exclusive focus on stakeholders. b. organizational rigidity. c. systems perspective. d. ignoring organization values to obtain organization results. - CORRECT ANSWER c. systems perspective. A CNL role is a. member of a profession. b. accountability. c. critical thinking. d. all of the above - CORRECT ANSWER a. member of a profession. Irrespective of the quality improvement methods that an organization selects, they all have common steps. The first step is: a. having a clear and defined aim or purpose. b. root cause analysis. c. selecting the right analytical tools. d. cyclical review of the plan. - CORRECT ANSWER a. having a clear and defined aim or purpose. Brainstorming, cause and effect diagrams, and Pareto charts are common ________ used in quality improvement efforts. a. metrics b. tools c. plan-do-check-acts (PDCAs) d. immersions - CORRECT ANSWER b. tools The first step in solving problems is a. designing intervention strategies. b. identifying and documenting the problems. c. analyzing outcome data. d. analyzing processes. - CORRECT ANSWER b. identifying and documenting the problems. In collecting data, the CNL should be sure to collect the ________ data. a. least granular b. smallest quantity of c. most granular d. least detailed - CORRECT ANSWER c. most granular Most inferential statistics are built on the model of the ________. a. pie chart b. normal curve c. bar chart d. free sketch - CORRECT ANSWER b. normal curve A core competency of the CNL is a. data analysis. b. catalyst. c. accountability. d. broker. - CORRECT ANSWER a. data analysis. Data are critical for a. documenting the existence of a problem. b. documenting the processes that result in the problematic outcome. c. demonstrating that an improvement initiative resulted in actual improvement. d. all of the above - CORRECT ANSWER d. all of the above True experimental, quasi-experimental, and pre-experimental are types of a. databases. b. feedback. c. basic design options. d. data errors. - CORRECT ANSWER c. basic design options. The first step in problem identification is: a. collecting data on the problem. b. formulating solutions. c. hiring a consultant. d. finding the cause. - CORRECT ANSWER a. collecting data on the problem. Roles of the CNL include a. advocate. b. catalyst. c. risk averter. d. all of the above - CORRECT ANSWER d. all of the above With inferential statistics, remember that the conclusions are always: a. probability statements. b. true. c. false. d. due to chance. - CORRECT ANSWER a. probability statements [Show Less]
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Chapter 26 Leader 26 Questions with Verified Answers,100% CORRECT
Chapter 26 Leader 26 Questions with Verified Answers The primary focus of the care provider role for the nurse involves: a. using the nursing process... [Show More] to provide guidance to the patient in recovery. b. encouraging consumer self-responsibility and emphasizing health promotion/maintenance. c. focusing on increasing satisfaction among professional nurses. d. advancing nursing practice through research. - CORRECT ANSWER A. A nurse researcher is attempting to describe the demographics of today's RNs and reports that: a. less than half of all RNs work in hospital settings. b. due to aging of workforce, less than 40% continue to work full time. c. Approximately 80% of RNs are employed in nursing. d. most nurses are initially graduating with a bachelor's degree. - CORRECT ANSWER C. A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing? a. Infection control b. Quality management c. Coordinator position d. Counselor - CORRECT ANSWER B. The nurse who organizes screenings for employees, assesses the work environment for hazards, and teaches health-promoting activities is employed in the field of: a. infection control. b. occupational health. c. informatics. d. transportation specialization. - CORRECT ANSWER B. The RN who identifies the best resources at the lowest cost to achieve optimal health outcomes for the client is fulfilling the role of: a. informatics specialist. b. educator. c. case manager. d. quality manager. - CORRECT ANSWER C. A patient is admitted for a hip replacement complicated by uncontrolled diabetes and early dementia. The nurse coordinates referrals to an endocrinologist to establish an insulin protocol and organizes out-patient physical therapy in an Alzheimer's assisted living facility upon discharge. The role of this nurse is the: a. informatics specialist. b. educator. c. case manager. d. quality manager. - CORRECT ANSWER C. An RN testifies at a trial where domestic violence is being investigated. She had previously assisted with specimen collection and had assessed the victim. The nurse is involved in _____ nursing. a. triage b. forensic c. flight d. entrepreneurial - CORRECT ANSWER B. The forensic nurse would most likely be involved in: a. performing an assessment of rape victim and collecting specimens needed for court. b. assigning a patient with chest pain to be seen first, followed by a patient with an insect bite of unknown origin with red streaks but no respiratory distress. c. assessing a patient at home by asking the patient to place a receiver over the pacemaker to evaluate capture of pacing stimuli and transmitting the results to another state where nurse located. d. performing pediatric life support at the scene of an accident to stabilize then transport via helicopter to the nearest trauma center. - CORRECT ANSWER A. A nurse in an acute care facility helps patients understand how to prevent diabetic neuropathies. This nurse is functioning in the role of: a. change agent. b. educator. c. manager. d. coordinator. - CORRECT ANSWER B. A nurse notices that care is often withheld until an interpreter arrives, if the nurse is not multilingual. The nurse discusses this with the management team and suggests a three-part series be presented to the nursing staff to teach some commonly used medical terms in Spanish. This nurse is involved in the role of: a. change agent. b. educator. c. manager. d. coordinator. - CORRECT ANSWER A. A nurse tallies the patient satisfaction surveys and approves the use of an agency nurse because of the high census. This nurse is involved in which nursing role? a. Change agent b. Educator c. Manager d. Coordinator - CORRECT ANSWER C. In differentiating between interprofessional and multidisciplinary: a. multidisciplinary refers to the care of many diverse patients by one discipline. b. interprofessional involves members of many disciplines working together to provide patient care to a distinct population. c. interprofessional refers to members of the same discipline working together to provide patient care to a distinct population. d. interprofessional is the use of multiple interventions by nurses with varying levels of education. - CORRECT ANSWER B. A person from an underrepresented background in nursing is interested in entering nursing school and researches the ethnicity, age, and gender make-up of the nursing profession and finds: a. nursing is a career field that is primarily made up of women younger than 30 years. b. the number of male RNs has steadily increased and is equal to the number of female RNs. c. the majority of RNs are Caucasian or non-Hispanic. d. more than half of all RNs are ages 55 through 65. - CORRECT ANSWER C. A nurse who is participating in a health fair asks, "Other than nursing, what are some opportunities for careers in the health care professions, and what education is required?" The nurse informs participants that a baccalaureate degree is required as the minimum standard for the role of: a. speech therapist. b. occupational therapist c. nurse-midwife d. nurse anesthetist. - CORRECT ANSWER B. A nurse is interested in practicing in a faith-based community; when researching the role of the parish nurse, the nurse finds that: a. certification is available at a basic level after a qualifying examination is completed and a set number of practice hours have been worked, as defined by the state's nurse practice act. b. this advanced practice role focuses on health promotion and disease prevention. c. this role has no set standards or scope of practice but instead follows the doctrine of the denomination being served. d. this role is recognized by the American Nurses Association (ANA) as a specialty with a defined set of practice guidelines. - CORRECT ANSWER D. A nurse is responsible for determining the incidence rates of hospital-acquired diarrhea on a pediatric ward after receiving reports that five children admitted with uncontrolled asthma had developed diarrhea while hospitalized. The nurse is working in the role of: a. quality management. b. infection control. c. occupational health. d. forensics. - CORRECT ANSWER B. A nurse working in a factory performs routine hearing tests for employees. The factory uses 90 dB as the safe limit for an 8-hour day's exposure to machine noise rather than 85 dB as recommended by the Occupational Safety and Health Administration. The nurse is functioning in the role of: a. quality management. b. informatics nurse specialist. c. occupational health nurse. d. case manager. - CORRECT ANSWER C. People are living longer and with older age comes a higher risk of terminal illness. Many individuals have chosen to maximize their quality of life but stop aggressive life-sustaining treatments. Nurses who work with terminally ill patients and their families to provide end-of-life care, pain management, and family support are practicing in which role? a. Hospice b. Infection control c. Coordinator d. Case manager - CORRECT ANSWER A. A nurse explaining the above graph indicates the frequency of falls in 2011 to detect and possibly explain causes of variation. The peaks in June were attributed to regular staff vacations during which agency nurses were used. The nurse is employed in which role? a. Case Manager b. Quality Manager c. Forensic Nurse d. Occupational Health Nurse - CORRECT ANSWER B. A new graduate desires a position in labor and delivery; however, no position is available. What is the best advice for this nurse? a. Continue to study to keep skills current and wait for desired position. b. Return to college until a position in labor or delivery opens. c. Accept another nursing position and transfer into labor and delivery when a position is available. d. Practice obstetrical skills in a simulation lab then present evidence of competency to potential employer. - CORRECT ANSWER C. A nurse has critical care experience and is proficient in advanced cardiac life support. She often helps to lead "codes" and is an expert clinician with superior health assessment skills. Enjoying a challenge of a fast-paced environment with autonomy, this nurse would best be suited for which nursing role? a. Flight nurse b. Home health nurse c. Hospice nurse d. Occupational health nurse - CORRECT ANSWER A. The role of the Clinical Nurse Leader (CNL) would include: a. diagnosing a patient with pneumonia and prescribing antibiotics. b. teaching members of a faith community how to avoid skin cancer and referring those with suspicious lesions. c. participating in the team who is investigating possible abuse of elderly persons by members of a gang known to sell illegal drugs. d. coordinating care of a patient admitted 4 days ago with stage IV heart failure and chronic bronchitis by revising care plan to include ambulation 50 feet with assistance. - CORRECT ANSWER D. A nurse wants to become an advanced practice nurse and investigates the requirements for a: (select all that apply) a. nurse practitioner. b. nurse executive. c. certified nurse-midwife. d. certified registered nurse anesthetist. - CORRECT ANSWER A, C, D Advanced practice nurses are prepared minimally at the master's degree level with prescriptive privileges; these professionals include: (select all that apply) a. clinical nurse leader. b. nurse practitioner. c. nursing administrator. d. certified nurse-midwife. e. clinical nurse specialist. - CORRECT ANSWER B, D, E What characteristics are associated with the clinical nurse leader? (select all that apply) a. Is a generalist prepared at the master's level. b. Provides care at the bedside for complex patients. c. Identifies the best resources at the lowest price to achieve best health outcomes for a client. d. Serves as care coordinator whose practice is limited to acute care settings. e. Is an advanced practice nurse with an earned doctorate in nursing. - CORRECT ANSWER ANS: A, B [Show Less]
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Leadership exam #2|50 Questions with Verified Answers,100% CORRECT
Leadership exam #2|50 Questions with Verified Answers A clinical nurse leader (CNL) enters the workforce and hopes to use her interdisciplinary skills... [Show More] to participate on a quality improvement committee. The coordinator of the quality group invites the CNL to join the group. Which type of power is demonstrated by the coordinator of the group?CORRECT ANSWER Legitimate The healthiest form of communication is the __________ style.CORRECT ANSWER Assertive The son of the deceased person arrives at the hospital and asks, "Can I just please stay and hold my dad's hand? He was so afraid of dying alone." Which response by the nurse shows empathy?CORRECT ANSWER "I'll close the door so you can spend time with your dad. I will check back in a few minutes." The nurse manager meets with upper administration and learns that the strategic plan for nursing is to have 80% BSN staff within the next 3 years. The nurse manager then built her budget to meet the organization's strategic goal by providing tuition reimbursement and flexible work hours, which required some agency staffing. Which approach to budgeting is used?CORRECT ANSWER Iterative A nurse gives Dilantin intravenously with lactated Ringer's solution containing multivitamins. The drug precipitates and obstructs the only existing line. When the team leader informs the nurse that these drugs cannot be mixed, the nurse states, "Everyone just pushes the medicine slowly. No one checks for compatibility. There isn't even a compatibility chart on the unit." Which type of logical fallacy has influenced the nurse?CORRECT ANSWER Appeal to common practice A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating..CORRECT ANSWER Blocking A director of nursing (DON) asks the staff to list how their nursing unit can help the organization meet its goal to "provide quality patient care with attention to compassion and excellence." An ad hoc committee is formed to develop a timeline of identified actions. The DON coaches the committee to reach desired outcomes. This DON is demonstrating which other role of leadership and management?CORRECT ANSWER Corporate Supporter A hospital recently learned that their scorecard did not meet the national benchmark for patient satisfaction and brought in a professional change agent to determine what their issues were and how they could improve their score. The agent collected data and recommended that nurses participate in interdisciplinary walking rounds and allow the patient and family to be participants. Nurses now round every shift and perform "huddles to update the team" as needed throughout the shift as part of best practices. Random visits are made to nursing units to ensure all nurses are participating and patients are interviewed for their involvement. This stage of Lewin's change is:CORRECT ANSWER refreezing Which component of an e-mail would be both effective and concise?CORRECT ANSWER Body: The next staff meeting is scheduled for Tuesday, January 19, at 5:00 PM in the first floor auditorium. Please send items for the agenda. Sally Smith, MSN, RN, smith@hospital.org or ext. 5582 A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager's approach to improve their own units. This nurse is which type of leader?CORRECT ANSWER Transformational In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change?CORRECT ANSWER unfreeze An RN is consistently late to work, causing reassignment of patient care and the need for repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, "My husband left me, I have no car, no family close by, and the bus is always late, which makes me late. The nurse manager doesn't care how hard I try to get here, and I am raising a child by myself." The nurse is using which type of logical fallacy?CORRECT ANSWER appeal to emotion A licensed practical nurse (LPN) has been practicing for 25 years on a unit where a newly graduated RN with a bachelor's degree is hired. Before the RN arrives on the unit, the LPN is heard saying, "She'll try to tell everyone what to do because she makes more money. She'll sit at the desk and let us do all the work." This is an example of a(n):CORRECT ANSWER preconceived idea The nurse caring for a patient states, "Your blood pressure is dangerously high. Are you taking antihypertensive medicine?" The patient states, "I can't afford my medicine. I have no insurance." The nurse states "I feel really sorry for that patient. I wish it wasn't against policy to give her money." The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that "She was so sick last evening when she came to the ED. I can't believe they don't provide insurance. I can't give her money but you all can help." This nurse:CORRECT ANSWER is at risk for HIPAA violations. A nurse is asked to "float" to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, "I'll come back and eat lunch with everyone here." When she enters the elevator she hits the wall and mutters, "Always me. Don't I have any rights"? The nurse is demonstrating which communication style?CORRECT ANSWER passive-aggressive A nurse has recently been appointed to the position of nurse manager. To become successful in managing the unit's budget, the new nurse manager should: (Select all that apply.)CORRECT ANSWER read the financial policy manual to learn more about the organization's budgeting process. communicate regularly with a person in the hospital's finance office about interpreting budget reports. discuss the process of developing budgets with other members of the management team. After a meeting given by the hospital CEO on the state of the hospital, employees are asked to "budget wise." Of the following, which is true of...?CORRECT ANSWER Documenting the use of 2 IV catheters to start an IV allows for the item charge of both catheters. Documenting the assist of 2 staff members to safely move a patient allows for the reimbursement of both personnel Recruiting an agency staff member to work a shift so the staff nurse can take an unplanned PTO day has a negative impact on the budget. A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D5W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?CORRECT ANSWER The nurse states, "You are just upset because I am certified in chemotherapy administration and you are not." A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which action would demonstrate positive reinforcement?CORRECT ANSWER Give spur-of-the-moment recognition to an employee who has accomplished a goal. A nurse is preparing an exercise program as part of a health promotion program for older adults with osteoporosis. Which question would retrieve the most valuable information about health practices?CORRECT ANSWER "What exercise practices do you participate in?" A nurse wants to apply open communication to obtain a thorough history and to determine cognitive function. Which question represents the use of open communication?CORRECT ANSWER Tell me what day of the week today is A group of nurses are meeting to decide how to staff the upcoming holidays. Each of the four members freely expresses thoughts about fair staffing but is willing to listen to others thoughts and reconsider their first recommendations. The nurses are avoiding conflict and supporting professional communication through:CORRECT ANSWER supportiveness A nurse is overhead saying, "I don't mind working during the election and holiday. My parents are divorced, money is tight, and honestly I don't trust any politicians anyway. I plan to take a few weeks off next month." She works independently to research strategies to improve patient-centered care for the large number of immigrants that arrived in the area and then works with the team to share ideas. She recommends, "Let's think the suggestions over and come back together next week." This nurse's communication style is consistent with which generation?CORRECT ANSWER generation X A new mother is experiencing pain after delivering an infant with Down syndrome. The staff nurse states, "I don't think she is really hurting. Let the next shift give the pain medication." The team leader notices the staff nurse looks agitated and anxious and asks about any concerns in providing care to this new mom. The staff nurse admits having a stillborn infant with Down syndrome. This is an example of which component of communication?CORRECT ANSWER past experiences Registered nurses who are entering the workforce will have expanded leadership responsibilities that include: (Select all that apply.)CORRECT ANSWER serving on interdisciplinary care teams. attending a meeting to plan advanced training for unlicensed assistive personnel. evaluating outcomes of care that are reported to a standing committee. managing units with higher acuity, shorter lenghts of stay, and more diverse patients and staff The nurse is demonstrating active listening when:CORRECT ANSWER eye contact is maintained while focusing on the patient as the patient describes the current pain level and location. A nurse asks, "what is meant by 'internal' customers?" the correct response is (Select all that apply)CORRECT ANSWER x-ray technicians clinical pharmacist Chief financial officer A manager just finished the last annual performance review of the staff, reviews the unexpected expenditures for the month due to use of agency nurses, and shares the latest quality indicators with the staff nurses. This manager is performing which management function?CORRECT ANSWER controlling A patient's spouse was just diagnosed with lung cancer although there was no history of tobacco use. The spouse states, "I am so mad, how can you get cancer without smoking?" Which statement by the nurse represents empathy?CORRECT ANSWER "I understand how you could feel angry about the diagnosis." Nurses on a unit met with the nurse manager as part of participatory budgeting. They ask, "What exactly is the difference between fixed and variable costs? Understanding this will help us better understand the budgeting process." The manager provides a definition and asks the staff to list types of direct and indirect cost. Which example would indicate a need for further teaching?CORRECT ANSWER Variable cost would include the salary expense for registered nurses. A nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse?CORRECT ANSWER transactional A staff nurse states, "I really enjoyed having dinner with the Chief of Medical Staff and the President of the hospital. We hope to meet again soon." Which source of power does this nurse possess?CORRECT ANSWER connection An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation?CORRECT ANSWER autocratic The nurse manager meets with upper management to share strategic goals agreed upon by her staff for their individual nursing unit as the first step to begin budget negotiations. One strategic goal is that staff will have access to technology that will allow them to incorporate point-of-care devices for all RNs. The second goal is to improve RNs' ability to recognize critical indicators that a patient's health status is deteriorating through advanced health assessment skills. During the meeting the manager discusses the strategy options and selecting the one that works for the unit. Which type of budget development is used?CORRECT ANSWER participatory One difference between a leader and a manager is that a:CORRECT ANSWER manager focuses on coordinating resources A nurse manager is working with the financial officer to develop the budget of the nursing unit for the next fiscal year. The nurse manager tells the financial officer that which of the following pieces of information will affect budget assumptions?CORRECT ANSWER The patient census likely will increase during the next fiscal year because two large physician groups have transferred their admission privileges to this hospital. During a health history interview, the nurse listens to a patient relating the precipitating events that led to the onset of chest pain. She focuses her attention on the patient, makes eye contact, and acknowledges what the patient has to say. The nurse is exhibiting:CORRECT ANSWER active listening Which statement accurately describes communication?CORRECT ANSWER When the receiver becomes the sender, the subcomponent of communication that is in use is feedback. During height and weight assessments at a school's health fair, a child admits to drinking a cup of coffee with his mother every morning, and another child reports enjoying a morning cup of coffee on the commute to school. These two children are both below average on the height chart, and the nurse states, "Drinking coffee stunts a child's growth." This logical fallacy is referred to as:CORRECT ANSWER confusing cause and effect. The new director of nurses has instituted "walking rounds" on all nursing units, rather than the usual taped shift reports. A veteran nurse exclaims, "She doesn't know how we do things here!" The nurse is demonstrating:CORRECT ANSWER appeal to tradition An RN with excellent assessment and psychomotor skills would derive power on the basis of which source?CORRECT ANSWER Expert A nursing unit's census consists primarily of long-term residents with a high risk for falls. To meet new safety regulations, the nurse manager must plan to replace all 50 patient beds with new beds equipped with Fall Watch electronic sensors that will detect when patients get out of bed. The manager will be involved in which type of budgeting to replace the beds?CORRECT ANSWER capital Which component of budgeting might normally be addressed in the annual performance evaluation for a nurse manager?CORRECT ANSWER Managing variances in nursing overtime costs and supply usage Which action represents the key management function of strategic planning?CORRECT ANSWER Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society's perception of nursing). Those who depict her as a leader on the basis of these qualities are practicing which leadership theory?CORRECT ANSWER trait The first step in the nursing process and in the problem-solving process is to:CORRECT ANSWER gather information A nurse on the unit is heard saying, "I am not going to document that I used four catheters to start that IV; it doesn't matter anyway." What action can help the staff nurse understand the financial budget goals of the unit?CORRECT ANSWER Ask the nurse to represent the unit on the budget planning committee. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?CORRECT ANSWER Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication. A nurse manager is preparing a budget that does not base annual budgets on the revenue and expenditures of the prior year and has the advantage that outdated information is not integrated into the budget. The manager is using which budget method?CORRECT ANSWER zero-based Managers who exhibit the authoritative behavioral style are most likely to use which source of power?CORRECT ANSWER coercive [Show Less]
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Leadership CH 1-6 Exam 30 Questions with Verified Answers,100% CORRECT
Leadership CH 1-6 Exam 30 Questions with Verified Answers The clinical nurse leader (CNL) is best prepared to assume which of the following nursing role... [Show More] s? A. Responsibility for the evaluation of a client's plan of care B. Preoperative assessments on clients requiring surgical interventions C. Research to provide evidence-based practice regarding neonatal feeding practices D. Acting as advocate for an elderly, cognitively impaired client hospitalized with gastrointestinal pain - CORRECT ANSWER Responsibility for the evaluation of a client's plan of care The CNL is a master's-prepared RN who designs, implements, and evaluates client care by coordinating, delegating, and supervising the care provided by the health care team, including licensed nurses, technicians, and other health professionals. A Clinical Nurse specialist (CNS) is an advanced practice nurse who has expertise in a defined area of nursing practice such cardiac or infant and child care. The CNS engages in care as an expert clinician, educator, consultant, researcher, and administrator. The professional nurse (RN) addresses the humanistic and holistic needs of patients, acting as a care provider, advocate, and educator. What event in American history influenced the role African-American women have played in the nursing profession? A. The creation of the U.S. Marine Hospital Service in 1798 B. The Civil War, beginning in 1861 C. The Army Nurse Corps, established in 1901 D. The North Carolina Nurse Practice Act of 1903 - CORRECT ANSWER The Civil War, beginning in 1861 The American Civil War allowed and encouraged African-American women to volunteer as nurses, thus setting the stage for their ultimate involvement in the profession of nursing. The U.S. Marine Hospital Service was the forerunner of today's U.S. Public Health Service. The Army Nurse Corps was an outcome of the Army Reorganization Act. North Carolina was the first state to implement the registration of nurses through its nursing practice act. In the Middle Ages (467 BCE to 1450 AD), women delivered food, medicine, and care to the community's ill based on the: A. Christian concepts of charity and the sanctity of human life. B. need to make offerings to the gods in exchange for good health. C. emphasis being placed on the patient-centered approach to health care. D. emerging understanding of the importance of hygiene and sanitation. - CORRECT ANSWER Christian concepts of charity and the sanctity of human life. The Middle Ages saw the Christian church as the central figure in the organization and management of health care, and its concepts of charity and sanctity of human life were influential in the practice of caring for the sick. Beginning in prehistoric times, there was a belief that illness was a direct outcome of displeasing the gods, which gave rise to the practice of making offerings to the gods. In many cultures, it is still believed that illness is related to punishment from the god(s). The concept of patient-centered care and use of the scientific method of problem solving originated with the Greeks (1500 to 100 BCE). The Romans (27 BCE to 476 AD) are credited with the concepts of good hygiene and sanitation being vital to good health Which of the following interventions best demonstrates that a nursing administrator understands the challenges currently facing the professional nurse regarding patient safety? A. Supporting nursing interventions directed towards providing holistic care to both the client and his/her support system B. Requiring representation of the nursing staff in any discussion related to the redesign of patient care environments C. Requiring that staffing and schedules accommodate the attendance at mandatory in-services focusing on interprofessional care collaboration D. Supporting the right of the registered nurse to appropriately act as an advocate when a family disagrees with a client's wishes to limit visitors. - CORRECT ANSWER Requiring that staffing and schedules accommodate the attendance at mandatory in-services focusing on interprofessional care collaboration The changing duties, responsibilities, and conflicts amid nursing shortages and public concern over patient safety and quality of care characterize present-day practice. These changes require professional nurses to have core competency in critical thinking and communication as well as interprofessional collaboration, assessment, leadership, and technical skills, in addition to their knowledge of health care. Although nurses support providing holistic care to both client and family and providing for appropriately designed patient rooms and common areas, ,interprofessional care collaboration has a much greater impact on the delivery of appropriate and safe client care. Although client advocacy is a nursing responsibility, the focus in this situation is on client autonomy, not safety. There is increasing evidence that nursing needs to address the ability of its members to provide high-quality, effective care as patient-centered care needs intensify. Which nursing behavior demonstrates an understanding of how these needs will be best initially met? A. Enrolling in a Masters of Nursing Education graduate program B. Volunteering to provide community health screening at a senior citizen center C. Becoming politically active regarding the delivery of health care on the national level D. Regularly speaking to groups of high school students regarding the profession of nursing - CORRECT ANSWER Enrolling in a Masters of Nursing Education graduate program The need for nurses to provide the care for the influx of clients projected in the future is best addressed initially through the increase in nurses with graduate degrees. This allows for the education and training of future nurses who are introduced to nursing through effective recruiting targeted at various populations. Health screening is directed towards the early detection of health care needs. Political activism is directed towards health care policy change and enactment on national and even local government levels. The image that best serves today's profession of nursing is one that portrays: A. skill and caring. B. trust and belief. C. honesty and loyalty. D. dependability and charity. - CORRECT ANSWER trust and belief. The image most important to today's nursing professional is one that supports the public's need to trust and believe in the nurse caring for them. The individual actually providing the care often changes with each shift change and so the perception of the profession as a whole is vitally important. Although the other options represent positive traits, they all seem to be embodied in the image of trust and belief in the public's collective mind. The play Miss Evers' Boys was one of the first literary presentations that depicted nurses as: A. trained professionals. B. caring and charitable. C. client advocates. D. self-sacrificing. - CORRECT ANSWER client advocates. The play and eventual television movie Miss Evers' Boys tells the story of the now-infamous Tuskegee experiment that focused on the treatment of syphilis among African-American men between1932 and 1972. Miss Evers was the nurse in charge of recruiting subjects. The play describes how her request for the inclusion of penicillin into the treatment plan was denied, even though penicillin was the treatment of choice for the disease after 1947. Which of the current perceptions of nursing most likely accounts for the lagging numbers of males in the profession? A. Poor income potential B. Work is routine and boring C. Lack of professional autonomy D. Viewed as a female profession - CORRECT ANSWER Viewed as a female profession Nursing continues to be viewed as a female profession although the number of males entering the profession is steadily increasing. The public views nursing as an interesting and meaningful profession that provides good job security but does not provide job independence. The perception of job independence affects both male and females equally. The ability to maintain appropriate professional boundaries and preserve nurse-client confidences has been most severely impacted by: A. the misuse of social media forums by nurses. B. the hesitation of state boards of nursing to discipline offenders. C. the courts' reluctance to uphold legal decisions involving professional boundaries. D. the nursing profession's inability to adequately define unacceptable behaviors. - CORRECT ANSWER the misuse of social media forums by nurses. The ramifications of inappropriate posting of information by nursing professionals as well as nursing students via the various forms of social media has created serious problems affecting confidentiality and professional boundaries. State boards of nursing take these breaches of nursing practice seriously, revoking nurses' license to practice and expelling students from nursing programs. Currently the courts have upheld legal decisions involving such actions. A staff nurse routinely finds it difficult to receive clarification on prescriptions and orders written by a particular member of the medical staff. When numerous attempts to deal directly with the physician fail, the nurse most appropriately manages the problem by: A. making it known to the nurse manager that they will no longer accept the physician's clients as patients. B. documenting the problem in terms of client safety concerns and forwarding the information to both the nursing manager and chief of medical staff. C. informing the clients that any dissatisfaction with their care should be directed towards their physician for resolution. D. presenting the issues to the unit's entire nursing staff so that a unified plan can be developed to ensure the safety of the physician's clients. - CORRECT ANSWER documenting the problem in terms of client safety concerns and forwarding the information to both the nursing manager and chief of medical staff. The problem will best be addressed as a medical staff problem with appropriate documentation of the problem as it affects client safety being forwarded to both nursing and medical staff administration. Refusing to treat a particular physician's clients or discussing the situation with the clients themselves is not professional behavior and so not a viable option. Involving the entire nursing staff may seem effective but it merely identifies the situation as a nursing problem rather than what it truly is—a medical problem. Which educational intervention demonstrates the most acceptable application of technology as a trend that is currently influencing nursing education as well as client safety? A. Scheduling an orientation session on computer-based documentation for each freshman nursing student B. Providing a list of acceptable Internet sites to use as resources for medication administration C. Requiring each student to have access to a personal laptop computer installed with all required software D. Allowing pre- and postclinical written assignments to be submitted electronically - CORRECT ANSWER Providing a list of acceptable Internet sites to use as resources for medication administration The ever-expanding need for rapid, accurate information has presented a problem for both faculty and student. Appropriate Internet sites can serve as effective sources of information when faculty plays a role in identifying these sites. Such faculty involvement also helps ensure client safety because this information is used to provide client care. Scheduling time for the students to become familiar with computer-based documentation systems is helpful but is not as safety oriented as is the correct option. Requiring personal computers for classroom work and testing and allowing electronic submission of written assignments is student focused rather than client focused. Increasing professional and personal responsibility has been identified as an issue influencing the education of today's nursing professional. Which of the following has the greatest impact on client safety in the acute care setting? A. Requiring all nurse managers to possess at least a Bachelor's degree in nursing (BSN) B. Scheduling mandatory competency assessments on all shifts to facilitate compliance C. Offering monetary incentives to nursing staff who earn appropriate certifications D. Providing nursing staff with classes that focus on effective communication skills - CORRECT ANSWER Scheduling mandatory competency assessments on all shifts to facilitate compliance Although all the options contribute to safe nursing care, regular, rigorous assessment of clinical skills has the greatest impact on client safety. A nurse manager recognizes which of the following as an example of a desirable practice-based competency outcome for a recently licensed registered nurse? The novice nurse: A. demonstrates excellent communication and interpersonal skills. B. meets orientation expectations 1 week ahead of schedule. C. has no absences during the required probationary employment period. D. asks for a work schedule that supports enrollment in an advanced nursing program. - CORRECT ANSWER meets orientation expectations 1 week ahead of schedule. The outcomes of practice-based competency relate to clinical practice. Demonstrating the ability to achieve the goals of the facility's orientation program 1 week ahead of schedule shows clinical expertise and professional confidence, both reflective of practice-based competency. An excellent attendance record and an interest in earning an advanced nursing degree reflect professionalism, and although effective communication and interpersonal skills are desirable, they are not considered among the necessary clinical care skills. The nursing faculty incorporates which practice-based learning activity in order to meet the students' need to learn about the sociodemographics currently present among today's population? A. Inclusion of a geriatric experience as a clinical requirement of all nursing students B. Participation in a panel discussion on the political agendas of several national nursing organizations C. Creation of a poster that compares and contrasts Medicaid and private insurance health care coverage D. Preparing a care plan that addresses the needs of an immigrant client with limited English language skills - CORRECT ANSWER Inclusion of a geriatric experience as a clinical requirement of all nursing students The sociodemographics of a population includes descriptions of the sociological and statistical information represented among a population. Age-related information would be included and thus bring attention to the growing population of older adults in the United States and their health needs. The political agenda of nursing organizations and health care delivery systems are considered political and economic rather that sociodemographic in nature. Language barriers would be considered cultural in nature. A social issue that is currently having a very negative impact on the learning environment in classrooms can be best minimized by initially: A. presenting information using a variety of methods so that all learning styles will be addressed. B. requiring that electronic devices be turned off when entering a classroom or other learning environment. C. presenting information on the proper use of social media by nursing students as it impacts client confidentiality. D. defining behaviors that will not be tolerated in the classroom since they do not demonstrate respect or civility. - CORRECT ANSWER defining behaviors that will not be tolerated in the classroom since they do not demonstrate respect or civility. The decline of respectful, civil interpersonal behavior is a social problem that impacts even the learning environment. The initial defining of unacceptable behaviors is most effective in setting expectations of classroom etiquette. While the other options may represent reasonable requests, they are not as directed towards the primary issue of effective learning environments. The primary purpose of nursing licensure is to: A. raise nursing to the level of a profession. B. recognize the knowledge and skills of the professional nurse. C. provide the public with protection against poorly trained nurses. D. identify all persons who have graduated from a school of nursing - CORRECT ANSWER provide the public with protection against poorly trained nurses. When it became evident that nursing programs varied greatly in their entry criteria and academic requirements, it became necessary to address the resulting confusion and so licensure was adapted as a means of protecting the public. It is true the licensure acknowledges the skills and academic expertise of those who have successfully graduated from a school of nursing, but those are not the primary purpose of the license. Licensure is not the only criteria for attaining professional status. The right to identify oneself as a registered nurse (RN) is defined and protected by which component of a state's nurse practice act? A. Purpose of the act B. Licensure requirements C. Definition of nursing practice D. Description of the nurse's scope of practice - CORRECT ANSWER Purpose of the act The first purpose of a nurse practice act is to protect the health and safety of the public, the second purpose is to protect the title of RN. The legal title RN is reserved for those meeting the requirements to practice nursing. Only those licensed may use the designation of RN. Licensure requirements describe qualifications and procedures necessary for initial entry into nursing practice. The definition of nursing is of utmost importance because it delineates the scope of practice for nurses within the state, that is, each act outlines the activities nurses may legally perform within the jurisdiction. The mutual recognition model of nursing regulation has been adopted by many states. Which of the following situations was an initial factor in the formation of that model? A. The introduction of the associate degree nursing program B. The growing presence of nurse-managed telehealth services C. The legal need to ensure nurses due process under the law D. The need to clarify the responsibilities and rights of professional nurses - CORRECT ANSWER The growing presence of nurse-managed telehealth services Through this model, individual state boards formed the NLC, a collection or compact of states that recognize a nurse's right to practice in all involved states as long as they are licensed in at least one of the compact states. This form of regulation was motivated by the increased mobility of nurses, the telehealth movement, and the necessity of caring for patients across long distances. Concerns have emerged relating to monitoring nurses' practice in multiple jurisdictions, nurse privacy, and due process rights. Where can a registered nurse (RN) find the most reliable guidelines regarding the appropriate delegation of activities or tasks to unlicensed nursing personnel? A. The National Council of State Boards of Nursing (NCSBN) B. The American Nurses Credentialing Center (ANCC) C. The American Nurses Associate (ANA) D. That state's Nurse Practice Act - CORRECT ANSWER That state's Nurse Practice Act Guidelines for delegation have been developed by many nursing organizations, including the ANA and NCSBN. Although the professional organizations' guidelines are helpful, it is the nurse practice acts of individual states that establish the legal definitions of appropriate delegation practices. Because regulations differ among states, each nurse must identify and understand the regulations for the state in which he or she practices. The ANCC is an organization that focuses on the certifications of nurses in various areas of nursing practice. Although requirements governing the practice of advance practice nursing may vary significantly, all states require: A. a master's degree in nursing. B. certification in the specialty area. C. 10 years of practice in the specialty area. D. a supervisory relationship with a physician. - CORRECT ANSWER certification in the specialty area. All states require evidence of certification in the specialty area. A master's degree is not required in all states. Requirements concerning supervisory and collaborative practices vary, as do requirements for years of practice in the specialty. What factor qualifies nursing to be defined as a profession? A. Existence of a substantial body of nursing knowledge B. Regular collaboration with members of the medical profession C. Implementation of the nursing process in the delivery of care D. Engagement in the management of unlicensed nursing care givers - CORRECT ANSWER Existence of a substantial body of nursing knowledge Only when a substantial body of nursing knowledge is collected, organized, and developed will the profession be defined and its scope of practice differentiated. The other options, although true of nursing, are not criteria for profession status. The question that is being focused on during the implementation of the scientific process is referred to as the: A. method. B. theory. C. result. D. hypothesis - CORRECT ANSWER hypothesis The hypothesis asks the question that is to be the main focus of the process. The method decides what data will be collected to answer the hypothesis while the result is the conclusion arrived at after the data is analyzed. A theory is a collection of knowledge that is specific while addressing a phenomenon or the relationship between phenomena. A theory meets the criteria of fruitfulness when it: A. includes all concepts related to the area of interest. B. generates new directions for future research. C. is easily understood and replicated. D. is reflective of its scientific basis. - CORRECT ANSWER generates new directions for future research. The theory meets the criteria of fruitfulness when it is able to generate avenues for new research. When all related concepts are represented in the theory it is said to have inclusiveness. Simplicity refers to the theory's ability to be replicated. Relevance is represented in a theory's reflection of its scientific basis. When a nurse places clean linen on the bed of a comatose client, which nursing theory is being implemented? A. Roy's Adaptation Model B. Nightingale's Theory of Practice C. Rogers' Science of Unitary Human Beings D. Peplau's Interpersonal Relations as a Nursing Process - CORRECT ANSWER Nightingale's Theory of Practice The Nightingale theory investigates the effect of the environment on healing. Roy focuses on the client's adaptation to conditions using environmental stimuli to adjust perception. The interpersonal relationship of the nurse and the client is the focus of Peplau's work. Energy fields, openness, reorganization, and patterns are components of Rogers' theory. The primary benefit nursing theories have provided the profession is to: A. add additional information to the body of nursing knowledge. B. guide the nursing process in the effective delivery of nursing care. C. encourage the use of scientific inquiry when planning client care. D. focus on future research related to nursing care. - CORRECT ANSWER guide the nursing process in the effective delivery of nursing care. The theoretic models that have been conceptualized to guide nursing actions, interventions, and implementation have improved the nursing process. Although research is a process encouraged by a theory, it is not the primary benefit. The scientific process is used to help develop the theory. Theory is based on knowledge. The primary reason nurses engage in research is to: A. achieve equal status with other health care sciences. B. provide the most appropriate evidence-based client care. C. advance the profession of nursing in the eyes of the public. D. collaborate with other members of the science community. - CORRECT ANSWER provide the most appropriate evidence-based client care. The main outcome of a research activity for a nurse is to put the knowledge gained to work in health care delivery. Although engaging in research may achieve the other outcomes, they are not the primary reason behind nursing research. f a nursing research project strives to discover new information concerning client care practices, this project is said to be a model of: A. quantitative design. B. qualitative design. C. a pilot study. D. triangulation. - CORRECT ANSWER qualitative design. Qualitative research is designed for discovery rather than verification. It is used to explore little-known or ambiguous phenomena. The most common intent of quantitative study is to apply or generalize knowledge from a smaller sample of subjects to a larger population. A pilot study is a small-scale study used to identify the strengths and weaknesses of a planned large-scale study. Triangulation is the use of various research methods or different data collection techniques in the same study. When researching an aspect of human grief response, the nurse researcher will likely select which method of qualitative design? A. Ethnography B. Meta-analysis C. Phenomenology D. Needs assessment - CORRECT ANSWER Phenomenology Phenomenology is designed to provide understanding of the participants' "lived experience." This method is a valuable approach for studying intangible experiences, such as grief, hope, and risk taking. Ethnography is a method used to study phenomena from a cultural perspective. Ethnographers spend time in the cultural setting with the research participants to observe and better understand their experience. Meta-analysis synthesizes quantitative data from multiple similar studies, thus enlarging the power of the results and allowing more confident generalizations than a single study. Needs assessments is a quantitative design used to determine what is most beneficial to a specific aggregate group. This design can be used by organizations, communities, or groups to establish priorities for their respective client groups Regarding nursing research, the role of the clinical nurse specialist (CNS) is best utilized when: A. recruiting participants for specific studies. B. identifying clinical care problems. C. designing research studies. D. collecting research data. - CORRECT ANSWER designing research studies The CNS is in an ideal position to link research to practice by assessing an agency's readiness for research utilization, consulting with staff to identify clinical problems, and helping staff to discover, implement, and evaluate findings that improve health care delivery. The other roles are those assumed by a clinical nurse researcher who is a doctorally prepared nurse with clinical and research experience. A novice nurse reading a research article should first concentrate on which sections of the article? A. Abstract and discussion B. Study design and methods C. Future implications and acknowledgment D. Introduction and results - CORRECT ANSWER Abstract and discussion The abstract section of the article gives an overview of the study, and the discussion section offers suggestions for nursing practice based on the findings of the research study. These two sections often are the easiest for the novice to interpret. The remaining sections can be confusing, and consulting a CNR to help interpret results is suggested. [Show Less]
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CNL Exam 56 Questions with Verified Answers,100% CORRECT
CNL Exam 56 Questions with Verified Answers CNL Roles - CORRECT ANSWER Systems analyst/risk anticipator Team manager Outcomes manager Information man... [Show More] ager Clinician Client advocate Member of a profession Educator Lifelong learner Organizational Theories - CORRECT ANSWER Classical: focus on structure Neoclassical: structure with human component Systems: everything is interrelated Contingency: organization is contingent on environment Chaos: organization is adapting to environment Leadership Theories - CORRECT ANSWER Quantum: fluid leadership (chaos theory) Charismatic: lead by personality attractiveness (e.g. Hitler) Transactional: focuses on tasks, short-term goals, policies and procedures Transformational: strong commitment to organization, empowers followers to reach full potential, visionary Relational/connective: teamwork, collaboration to reach common goal Leadership Theories 2 - CORRECT ANSWER Servant: followers desire to serve leader Shared: everyone is responsible Autocratic: leader makes all decisions Bureaucratic: follows organizational policies only Directive: gives guidance and directions Supportive: focuses on needs of followers Leadership Theories 3 - CORRECT ANSWER Trait theory: leaders are born Behavioral theory: leaders can be made Contingency theory: leadership is contingent on internal and external factors, changes with situation Relationship Oriented Structures - CORRECT ANSWER Shared governance: nurses have control over their own practice Heterarch structure: lateral connections only, opposite of hierarch Self-organizing: ppl mutually change behaviors w/internal or external demands Ethical Theories - CORRECT ANSWER Deontology: motives determine value of act Teology: outcomes determine value of act (e.g. Machiavelli) Justice and Equity: action that is fair to all Relativism: ethics are relative to person, place, time, culture Virtue Ethics: ppl must be developed to act virtuously Virtues of Nursing - CORRECT ANSWER Compassion: desire to alleviate suffering Discernment: acuteness of judgement Trustworthiness: trust is well-founded or deserved Integrity: firm adherence to code of conduct or ethical value Ethical Principles - CORRECT ANSWER Beneficence: do good to others, maintain balance of benefit & harm Non-maleficence: do no harm Justice: fairness Autonomy: respect for other's rights to self-determination Fidelity: keeping one's promise Respect for others Veracity: telling the truth Decision Making - CORRECT ANSWER Group Think: all members think alike Rational/normative: logical, well-rounded choices Descriptive/bounded rationality: limited ability of decision maker to act on decision Delphi: opinions gathered not face to face Normative: elicits questions, ideas, reactions from a group Conflict Management Techniques - CORRECT ANSWER Avoiding: ignore conflict Accommodating: 1 side gives in to other Competing: 2 or 3 sides compete for goal Compromising: each side gets and gives up something Negotiating: agreement, but not consensus Collaborating: both sides win - best outcome Confronting: stops conflict immediately Power - CORRECT ANSWER Referent: admiration/respect for person Connection: based on person's links to other influential people (e.g. son of senator) Information: based on access to valued data Reward: based on rewards offered by manager Coercive: based on penalties offered by manager Legitimate: based on hierarchical rank Expert: based on possession of skills/knowledge/competence (e.g. IT guy) Delegation - CORRECT ANSWER Responsibility: obligation to do task Accountability: accepting results of actions Budgeting - CORRECT ANSWER Direct costs: $ that directly affects pt care (e.g. nurse salaries) Indirect costs: $ that doesn't directly affect pt care (e.g. lighting, water, paint) Cost centers: smallest unit of area of cost in an organization (e.g. a department in a company; a unit in a hospital) Fixed costs: $ set regardless of changes Variable costs: $ changes based on census, supplies, revenues, etc. Financial Information - CORRECT ANSWER Operating budget: cost of doing business Capitol budget: cost of growing business Cash flow budget: amount going in and out over a time period Zero-based budgeting: all expenses are justified, no $ left at the end of each period Change Theories - CORRECT ANSWER PDSA - Plan Do Study Act: cycle of evaluating change Lewin's Unfreeze-Change/Move-Refreeze - change agent, driving forces, restraining forces Roger's Diffusion of Innovation - innovators, early adopters, early majority, late majority (largest group), laggards (will never change) Roger's Diffusion of Innovation - CORRECT ANSWER Knowledge: 1st exposed, but not inspired (e.g. hears about harmful effects of smoking) Persuasion: interested and seeking info (e.g. asks HCP about effects of smoking/steps to quitting) Decision: decides whether to adopt or reject change (e.g. tells HCP decision to quit smoking) Implementation: uses the innovation (e.g. stops buying packs of cigarettes, chewing gum instead) Confirmation: decides to use innovation fully (e.g. lung capacity increased, pt reports being smoke-free for 3 months) Change Agent Strategies - CORRECT ANSWER Power-coercive: applies power from authority, economic sanctions, or political clout (e.g. don't text and drive or you'll get a ticket) Empirical-rational: assumes ppl are rational and will follow self-interest (e.g. don't text and drive or you will get hurt) Normative-reeducative: assumes ppl act in accordance with social norms and values (e.g. don't text and drive - "everyone's doing it') Research Terms - CORRECT ANSWER Internal validity: results are not due to bias or confounding factors Confounding: distortion due to mixing of effects External validity: results are applicable in other populations Confidence Interval (CI): the reliability of an estimate, usually 95% Odds Ratio (OR): ratio of two odds (e.g. odds of exposure in cases vs odds of exposure in controls) Relative Risk (RR): absolute risk of disease among exposed vs absolute risk of disease among unexposed Quantitative Researh - CORRECT ANSWER Descriptive Correlation Quasi-experimental Experimental Qualitative Research - CORRECT ANSWER Phenomenological: captures the "lived experience" Grounded Theory: explores how ppl define reality and how their beliefs are related to their actions Ethnographic: describes culture Historical: examines past Measurement Tools - CORRECT ANSWER Root Cause Analysis (RCA): process to evaluate potential causes after a serious/sentinel event occurs Failure Models and Effects Analysis (FMEA): studies potential failures in process and analyzes consequences of those failures; done prior to serious event occurrence Tables & Charts - CORRECT ANSWER Bar graph: displays categorical data (e.g. demographics of area) Histogram: displays continuous data, usually bars are touching (e.g. weight of adults 18-35 in an area) Pareto chart: have descending bars (individual values) and ascending line graph (totals) Fishbone diagram: cause and effect analysis Control chart: upper and lower control limits are horizontal lines, data is plotted as dots and a line is drawn connecting the mean values Scatter diagram: data is plotted as dots Types of preventable errors - CORRECT ANSWER Medications-nurse last line of defense Surgery-wrong site Diagnostic inaccuracy-wrong treatment Equipment failure-IV pump System failure-lack of double check Transfusion error Laboratory-mislabeled Security-child abduction Crossing the Quality Chasm - CORRECT ANSWER Recommends reinvention of the health care system to foster innovation and improve delivery of care. What is a Clinical Nurse Leader? - CORRECT ANSWER A generalist, expert nurse who: Is accountable for clinical and cost outcomes for a specific group of patients on a unit Designs, implements and evaluates plans of care Coordinates, delegates and supervises the care provided by the interdisciplinary health care team Ten Assumptions of the CNL role - CORRECT ANSWER 1.Practice at the microsystems level 2.Client care outcomes are the measure of Quality Practice 3.Practice guidelines are based on evidence 4.Client-centered care is intra- and interdisciplinary 5.Information will maximize self-care and client decision making 6.Nursing assessment is the basis for theory and knowledge development 7.Good fiscal stewardship is a condition of quality care 8.Social justice is an essential nursing value 9.Communication technology will facilitate the continuity and comprehensiveness of care 10. The CNL must assume guardianship for the nursing profession Practice at the microsystems level - CORRECT ANSWER Accountable for outcomes of clinical populations Coordinates direct care activities of nursing staff & other care providers Lateral integration of care services Leadership skills Unit & systems level 2. Client care outcomes are the measure of Quality Practice - CORRECT ANSWER Improve › Safety › Effectiveness › Timeliness › Efficiency › Quality › Client-centeredness Compare outcomes to benchmarks › Nurse-sensitive indicators- Practices that nurses "own", such as falls, pressure ulcers, restraints 3. Practice guidelines are based on evidence - CORRECT ANSWER Application of research to the clinical setting Resolution of clinical problems Dissemination of results Seek evidence that challenges current practice 4. Client-centered care is intra- and interdisciplinary - CORRECT ANSWER CNL coordinates variety of team members › Includes nurses in other areas Effective communication 5. Information will maximize self-care and client decision making - CORRECT ANSWER CNL responsible for educating clients & families CNL must teach other care providers 6. Nursing assessment is the basis for theory and knowledge development - CORRECT ANSWER Assess individual, health problem, & context in which those problems are manifested Assessment data are classified, stored, retrieved, analyzed & integrated into information systems 7. Good fiscal stewardship is a condition of quality care - CORRECT ANSWER CNL accountable for cost-effective & efficient use of human, environmental & material resources Understand context of practice › Identify high cost/high volume activities › Compare to benchmarks 8. Social justice is an essential nursing value - CORRECT ANSWER Social justice addresses health disparities CNL responsible for addressing variations in clinical outcomes among various groups May influence policy at the systems level or higher 9. Communication technology will facilitate the continuity and comprehensiveness of care - CORRECT ANSWER Use of distance technologies › Sustain therapeutic relationships › Monitor the course of illness & health on a continuous basis › Provide care 10. The CNL must assume guardianship for the nursing profession - CORRECT ANSWER CNL expected to assume positions in › Professional, policy & regulatory organizations › Leadership positions in healthcare facilities & practice plans › Faculty Clinical Nurse Leader role - CORRECT ANSWER Clinician Outcomes manager Client advocate Educator Information manager Systems analyst/Risk anticipator Team manager Member of a profession Lifelong learner Types of Medical Errors - CORRECT ANSWER Medications-nurse last line of defense Surgery-wrong site Diagnostic inaccuracy-wrong treatment Equipment failure-IV pump System failure-lack of double check Transfusion error Laboratory-mislabeled Security-child abduction what is crossing the quality of chasm - CORRECT ANSWER Recommends reinvention of the health care system to foster innovation & improve delivery of care What is a CNL? - CORRECT ANSWER A generalist, expert nurse clinician who: >Designs, implements and evaluates plans of care >Coordinates, delegates and supervises the care provided by the interdisciplinary health care team Who are CNL's accountable for? - CORRECT ANSWER for clinical and cost outcomes for a specific group of patients on a unit What are the ten assumption of the CNL Role? - CORRECT ANSWER 1. practice at the Microsystem levels 2. Client care outcomes are the measure of quality practice 3 Practice guidelines are based on evidence 4. client centered care is intra & interdisciplinary 5. Information will maximize self-care and client decision-making 6. Nursing assessment is the basis for theory and knowledge development 7.Good fiscal stewardship is a condition of quality care 8.Social Justice is an essential nursing value 9.Communication technology will facilitate the continuity and comprehensiveness of care 10.The CNL must assume guardianship for the nursing profession Describe Practice at the microsystem levels? - CORRECT ANSWER Accountable for outcomes of clinical populations Coordinates direct care activities of nursing staff & other care providers Lateral integration of care services Leadership skills Unit & systems level nurse sensitive indicators? - CORRECT ANSWER something related to nursing care - practices that nursing owns i.e. IV filtration; pressure ulcers; fall risk; braden test Describe Client care outcomes are the measure of quality practice - CORRECT ANSWER Improve › Safety › Effectiveness › Timeliness › Efficiency › Quality › Client-centeredness Compare outcomes to benchmarks › Nurse-sensitive indicators Describe Practice guidelines are based on evidence - CORRECT ANSWER Application of research to the clinical setting Resolution of clinical problems Dissemination of results Seek evidence that challenges current practice describe client centered care is intra & interdisciplinary - CORRECT ANSWER CNL coordinates variety of team members › Includes nurses in other areas Effective communication Describe - Information will maximize self-care and client decision-making - CORRECT ANSWER CNL responsible for educating clients & families CNL must teach other care providers Describe - Nursing assessment is the basis for theory and knowledge development? - CORRECT ANSWER Assess individual, health problem, & context in which those problems are manifested Assessment data are classified, stored, retrieved, analyzed & integrated into information system Describe- Good fiscal stewardship is a condition of quality care - CORRECT ANSWER CNL accountable for cost-effective & efficient used of human, environmental & material resources Understand context of practice › Identify high cost/high volume activities › Compare to benchmark Describe - Social Justice is an essential nursing value? - CORRECT ANSWER Social justice addresses health disparities CNL responsible for addressing variations in clinical outcomes among various groups May influence policy at the systems level or higher Describe - Communication technology will facilitate the continuity and comprehensiveness of care - CORRECT ANSWER Use of distance technologies › Sustain therapeutic relationships › Monitor the course of illness & health on a continuous basis › Provide care Describe - The CNL must assume guardianship for the nursing profession - CORRECT ANSWER CNL expected to assume positions in › Professional, policy & regulatory organizations › Leadership positions in healthcare facilities & practice plans › Faculty Describe the Clinical Nurse Leader Role - CORRECT ANSWER Clinician Outcomes manager Client advocate Educator Information manager Systems analyst/Risk anticipator Team manager Member of a profession Lifelong learner Healthcare should be: - CORRECT ANSWER safe effective patient-centered timely efficient equitable [Show Less]
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Nurse Leader, Manager, and Care Coordinator Exam 46 Questions with Verified Answers,100% CORRECT
Nurse Leader, Manager, and Care Coordinator Exam 46 Questions with Verified Answers Leadership - CORRECT ANSWER Type of power. Ability to direct or mo... [Show More] tivate a person or group to achieve set goals. Explicit Power - CORRECT ANSWER Power by virtue of position. Implied Power - CORRECT ANSWER Power due to other factors, such as personality. Have the power to influence. Leadership Qualities - CORRECT ANSWER Charismatic Dynamic Enthusiastic Poised Confident Self-directed Flexible Knowledgeable Politically aware. Leadership Skills - CORRECT ANSWER Commitment to excellence Problem-solving skills Commitment and passion for one's work Trustworthiness and integrity Respectfulness Empathy and caring Responsibility to enhance personal growth of all staff. Achieving Self-Knowledge - CORRECT ANSWER -Identify your strengths -Evaluate how you accomplish your work -Clarify your values -Determine where you belong and what you can contribute -Assume responsibility for relationships. Leadership Styles - CORRECT ANSWER *Autocratic* *Democratic* *Laissez-faire* *Quantum* *Transactional* *Transformational.* Autocratic - CORRECT ANSWER Also known as authoritarian leadership. Leader has complete control of group decisions and activities. Democratic - CORRECT ANSWER Also known as participative leadership. Decision making is shared among leader and group members. Laissez-faire - CORRECT ANSWER Also known as non directive leadership. Power is given to the group making it hard to distinguish the leader of the group. Depends on strength of followers to direct group activities. Effective when staff are clinical experts. Quantum - CORRECT ANSWER Moves beyond traditional modes previously experienced by all levels of workers. Transactional - CORRECT ANSWER Also known as managerial leadership. Leaders promote compliance through rewards and punishment. Unlike transformtional leaders, they're not looking for change but rather for things to remain the same. Transformational - CORRECT ANSWER Leader creates an intellectual stimulating practice environment and challenge themselves and others to grow personally and profesionally and to learn. leadership involves a firm, insistent, self-assured leader who keeps at the center of attention. 1). Autocratic 2).Democratic 3). In laissez-faire leadership, 4). Transformational - CORRECT ANSWER Autocratic leadership is characterized by a sense of equality among the leader and other participants. 1). Autocratic 2).Democratic 3). In laissez-faire leadership, 4). Transformational - CORRECT ANSWER Democratic the leader relinquishes power to the group. 1). Autocratic 2).Democratic 3). In laissez-faire leadership, 4). Transformational - CORRECT ANSWER laissez-faire leadership leadership can create revolutionary change instituted by charismatic leaders. 1). Autocratic 2).Democratic 3). In laissez-faire leadership, 4). Transformational - CORRECT ANSWER Transformational Role of Nurse Manager - CORRECT ANSWER Planning: Identifying problems, developing goals, objectives, and related strategies to meet the demands of the clinical arena. Organization: Acquiring, managing, and mobilizing resources to meet both clinical and financial objectives. Directing: Leading others in achieving goals within the constraints of the current fiscal and workforce shortage scenarios. Controlling: Implementing mechanisms for ongoing evaluation, particularly in areas of clinical quality and financial accountability. Management Structures - CORRECT ANSWER Centralized -Senior managers generally make decisions with little input from group Decentralized -Decisions made by those knowledgeable about issue being decided -Nurses are thus intimately involved in decisions concerning patient care. Conflict Resolution Strategies - CORRECT ANSWER Avoiding; Collaborating; Competing; Compromising; Cooperating/Accommodating; Smoothing. Avoiding - CORRECT ANSWER Issue is known but is not resolved. Group ignores it or postpones resolution. Collaborating - CORRECT ANSWER Joint effort to resolve problem with win-win solution. Parties set aside previous goals, determine common goal and accept responsibility for achieving this goal. Competing - CORRECT ANSWER One party wins at the expense of others. Utilized when one party is more knowledgeable about situation or when resistance is appropriate because of ethical concerns and unsafe patient care. Cooperating/Accomodating - CORRECT ANSWER One party gives in. Compromising - CORRECT ANSWER Both parties relinquish something of equal value. Smoothing - CORRECT ANSWER An effort to complement other party and focus on agreement rather than disagreement thus reduce emotion in conflict. Issue is swept under the rug. Lewin's Theory of Change - CORRECT ANSWER 1). Unfreezing: The need for change is recognized. 2). Moving: Change is initiated after a careful process of planning. 3). Refreezing: Change becomes operational. Considerations for Planned Change - CORRECT ANSWER -What is amenable to change? -How does the group function as a unit? -Is the group ready for change and at what rate? -Are the changes major or minor? Planned Change: An Eight-Step Process - CORRECT ANSWER -Recognize symptoms that indicate that change is needed and collect data -Identify a problem to be solved through change -Determine/analyze alternative solutions to the problem -Select a course of action from possible alternatives -Plan for making the change -Implement the selected course of action to effect change -Evaluate the effects of change -Stabilize the change. Reasons for Resistance to Change - CORRECT ANSWER -Threat to self -Lack of understanding -Limited tolerance for change -Disagreements about the benefits of change -Fear of increased responsibility. Overcoming Resistance to Change - CORRECT ANSWER -Explain proposed change to all affected -List the advantages of the change -Relate the change to the person's existing beliefs and values -Provide opportunities for open communication and feedback -Indicate how change will be evaluated -Introduce change gradually -Provide incentives. Factors Increasing the Power Base of Nursing - CORRECT ANSWER -Right timing -Size of the nursing profession -Nursing's referent power -Increasing knowledge base and education for nurses -Nursing's unique perspective -Desire of consumers and providers for change. Evidence Based Strategies to Improve Leadership Skills - CORRECT ANSWER -Strive to become an authentic leader -Develop leadership skills -Promote a healthy work environment -Engage staff to commit to their best effort at work -Assist new graduates to transition into the RN roles. Clinical Nurse Leader Role - CORRECT ANSWER -Created by AACN (American Association of Colleges of Nursing) as a leadership role -CNL works with healthcare team to oversee, facilitate, coordinate patient care. -CNL should communicate with other health care professionals, integrate evidence based practices and evaluate patient risks and outcomes -Person centered focus of CNL include: patient advocate, educator, and provider of patient care in complex situations. Considerations When Delegating Nursing Care - CORRECT ANSWER -Patient's condition -Complexity of the activity -Potential for harm -Degree of problem solving and innovation necessary -Level of interaction required with the patient -Capabilities of the UAP (Unlicensed Assistive Personnel) -Availability of professional staff to accomplish workload. ANA Principles for Delegating Care - CORRECT ANSWER -The nursing profession determines the scope of nursing practice -The nursing profession defines and supervises UAPs involved in providing direct nursing care -The RN is responsible and accountable for nursing practice -The RN supervises any assistant providing direct patient care -The purpose of UAP is to work in supportive role to the RN. Developing Leadership Responsibilities - CORRECT ANSWER *Mentorship* *Preceptorship* Nursing organizations Continuing education. Mentorship - CORRECT ANSWER A relationship in which an experienced individual (mentor) advises and assists a less experienced individual (protege). Preceptorship - CORRECT ANSWER The preceptor (experienced nurse) is selected (generally paid) to introduce and employee to new responsibilities through teaching and guidance. Communication - CORRECT ANSWER Interpretation -How we process and analyze information, influenced by environment, opinions, past experiences, personal perceptions. Verbal vs. Nonverbal -Facial expressions, eye contact. Not spoken; expressed. Communication Techniques - CORRECT ANSWER -Develop trust -Use "I" statements -Eye contact -Empathy -Open communication, open ended questions -Clarify information -Body language -Use touch -Active listener -Special circumstances. Written and Electronic Communication - CORRECT ANSWER -State what is observed, not judgmental -Quantify -Don't include irrelevant information. what is car coordination? - CORRECT ANSWER defined as the organization of patient care activities to facilitate the delivery of quality health care services in an efficient person-centered manner (ANA) True or false: A good example of explicit power is a class bully who gets his way by intimidating his classmates - CORRECT ANSWER False True or false: It is increasingly difficult for the nurse manager to be both clinical and managerial expert - CORRECT ANSWER True Which style of leadership describes a nurse leader who assumes control over the decisions and activities of the group? a) autocratic leadership b) democratic leadership c) laissez-faire leadership d) Transformational leadership - CORRECT ANSWER A [Show Less]
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RNSG 1413 - Nursing Leadership Exam 48 Questions with Verified Answers,100% CORRECT
RNSG 1413 - Nursing Leadership Exam 48 Questions with Verified Answers Which statements are true about leaders? - CORRECT ANSWER - Their power lies in... [Show More] building relationships. - They share a common vision with followers. - They use interpersonal skills to influence others. Which leadership theory is dependent on personality? - CORRECT ANSWER - Trait Trait leadership theory relies on traits and personality characteristics, such as strength, organization, or confidence. A nurse leader who rewards health care team members in order to gain their cooperation is which type of leader? - CORRECT ANSWER - Transactional A transactional leader is one who rewards or punishes health care team members to gain their cooperation. Which leader believes that employees want to participate in decision-making - CORRECT ANSWER - democrat Which leadership style is most useful in a health crisis situation? - CORRECT ANSWER - Autocratic The autocratic leadership style is most useful in crisis situations. They do exert strong control over subordinates, but in a crisis such as CPR, an autocratic leader who is in control fits the situation well, particularly if inexperienced nurses are working at that time Which statement is true about democratic leadership? - CORRECT ANSWER - Decision-making can be time consuming. With democratic leadership, decisions take time due to schedules, consensus building, and participant agreement on decisions. Effective nurse leaders possess which qualities? (Select all that apply) - CORRECT ANSWER Integrity Integrity refers to having clear ethical principles and aligning one's actions with stated values; this is a quality of an effective nurse leader. Humility Humility refers to the ability to recognize that no one person is superior to another; it is a quality of an effective nurse leader. Openness Openness refers to the leader's ability to listen to other points of view without prejudging or discouraging others; itis a quality of an effective nurse leader. When a nurse gives credits to those who achieve their goals which leadership quality does the nurse possess? - CORRECT ANSWER Magnanimity Magnanimity is a quality of effective leadership that means giving credit where credit is due. This type of leader recognizes subordinates' ideas and accomplishments, rather than taking credit for them. When a nurse leader proposes multiple solutions to a problem, even though some solutions seem unrealistic, which leadership quality is the nurse leader exhibiting? - CORRECT ANSWER Creativity Creativity is an ability to consider multiple approaches or solutions to a situation, such as a problem or patient care. Creativity is a willingness to consider different ideas or combinations of ideas that may seem unrealistic. Which function of a manager is similar to the nursing process? (Select all that apply) - CORRECT ANSWER Planning The planning function is similar to the nursing process of assessing, diagnosing, and planning; a nurse assesses and plans with a patient and family, as a manager makes plans to reach goals. Which level of managerial work does Mintzberg's Contemporary Model describe? (Select all that apply) - CORRECT ANSWER Information Information is a level in Mintzberg's Contemporary Model. This involves communicating and controlling. Information is used to accomplish work. People People is a level in Mintzberg's Contemporary Model. The leader focuses on leading and linking people. Action Action is a level in Mintzberg's Contemporary Model. The focus is doing and accomplishing objectives. Which management skill is the foundation for nursing practice? - CORRECT ANSWER Communication Communication is the management skill that is the foundation for nursing practice. Communication skills are essential for a leader to accomplish work. Which does the X-style manager believe? - CORRECT ANSWER Employees are motivated by punishment. X-style managers believe employees are motivated by punishment. Employees are believed to be motivated by external rewards and punishment. Which nurse leader requires certification? - CORRECT ANSWER Clinical nurse leader A clinical nurse leader requires a master's degree and certification from the American Association of Colleges of Nursing (AACN). A clinical nurse leader provides and oversees patient care. The nurse serving in which role helps prevent waste and misuse of patient supplies? - CORRECT ANSWER Financial resource manager The nurse serving in the role as financial resource manager is responsible for supply usage, cost containment, and prevention of waste. Which nurse updates patient care plans based on patient outcomes and evidence-based findings? - CORRECT ANSWER Clinical nurse leader Clinical nurse leaders evaluate patient outcomes and update care plans based on evidence-based practice guidelines. Which statement is the third principle of delegation? - CORRECT ANSWER The person to whom the assignment was delegated cannot delegate it to someone else. This statement is from the third principle of delegation. If the person to whom the assignment was delegated cannot complete it, the RN should be notified so the assignment can be delegated to someone else. The ANA describes delegation as the transfer of responsibility. What does the transfer of responsibility allow the competent person such as the UAP to do? - CORRECT ANSWER Perform a selected task in a selected situation The transfer of responsibility as described by the ANA gives a competent individual, such as the UAP, the authority to perform a selected nursing task in a selected situation. The nurse, however, retains accountability for the delegation. Which are useful to nurses learning how to safely delegate to others in the employment setting? (select all that apply) - CORRECT ANSWER Job descriptions Job descriptions are resources for safe delegation because they include or list appropriate skills for the respective job. Skills that are listed in a job description are skills that can be performed by someone in that job. Nurse practice acts The nurse practice acts are resources for safe delegation because they define the scope of practice for registered nurses and other nursing roles. The nurse practice act is the authoritative statement for scope of nurses' practice in a state. Hospital policy manual Organizational policies are resources for safe delegation because they describe who may perform procedures and skills. For example, an RN or GN may be able to perform a task. Other procedures may require a nurse practitioner. Which question should the RN ask before delegating the task of ambulating the patient to a UAP? - CORRECT ANSWER Is the assignment within the UAP's ability to perform safely? This is a question the nurse should ask prior to delegating this task: Is the task within the scope and abilities of the person to whom it is being delegated? It is one of the first principles of delegation. When the RN gives the UAP specific instructions about an assignment, which right of delegation is the nurse demonstrating? - CORRECT ANSWER Communication The right communication does involve clear, concise, correct, and complete communications to the UAP about all aspects of the assignment, including any patient-specific instructions and limitations, possible complications, and timelines for completion. Which aligns with the delegation right of circumstance? - CORRECT ANSWER A patient is acutely ill with a high acuity level. Patient acuity aligns with the right of circumstance. Patient acuity and type of unit is part of a situation that can affect whether or not delegation can occur. Which rights are included in the Five Rights of Delegation? (select all that apply) - CORRECT ANSWER Task The right task is one of the Five Rights of Delegation. A task should match the person's skill and scope of practice. Circumstance The right circumstance is one of the Five Rights of Delegation. Circumstance and situation, such as patient acuity and unit type, affect delegation. Supervision The right supervision is one of the Five Rights of Delegation. Supervision means to oversee a task to make sure it is carried out correctly, such as performing hygiene care for a patient. Which responsibilities are involved in the right of supervision when the RN delegates to a UAP? - CORRECT ANSWER Monitoring, evaluation, and feedback Supervision during delegation includes: monitoring to ensure the task is complete; evaluation to ensure the quality of the work; and feedback, or how well the task that was delegated was performed. Intervention is also part of supervision. A nurse manager who informs a nurse about a salary increase for excellent performance is demonstrating a concept from which leadership theory? - CORRECT ANSWER Contemporary Contemporary theories include concepts based on punishments and rewards. An increase in salary is a reward that, according to this theory, could motivate similar practice by the nurse in the future. Which nurse leader uses coercion to ensure staff members accomplish unit goals? - CORRECT ANSWER Autocratic Autocratic leaders exercise strong control over subordinates, often using coercion to ensure accomplishment of goals. Which leadership theory adapts to a management style to different groups and populations? - CORRECT ANSWER Situational Adjusting leadership styles to different circumstances and people is a characteristic of situational leadership theory, such as changing the leadership style based on the level of experience of the nurse. A leader suggests to staff members the formation of a shared governance council related to professional practice. This leader is exhibiting which leadership style? - CORRECT ANSWER Democratic Democratic leaders believe in shared decision-making and view themselves as equal to their followers. Shared governance is an opportunity for nurses to share in decision-making with leadership. The nurse who takes responsibility for coordinating the staff schedule is demonstrating which type of leadership? - CORRECT ANSWER Informal The informal leader emerges outside the structure of the formal organization. Informal leaders exhibit strong interpersonal skills and easily build relationships with others. Which leadership style is demonstrated when a nurse manager relates to staff members impersonally and relies heavily on policies and procedures to direct work processes? - CORRECT ANSWER Bureaucratic A hallmark of bureaucratic leadership style is impersonal relationships with followers, and relies heavily on policies and procedures to direct work processes. Which quality is displayed when a new nurse approaches the manager with an idea about how to solve a problem with the dietary department, and the manager encourages the nurse to schedule a meeting to discuss over coffee? - CORRECT ANSWER Openness Openness involves listening to another's view without judging. By being willing to listen to a new nurse's idea, the manager is open to ideas from subordinates. If a nurse manager complains within hearing distance of a patient's family, which leadership quality does the manager need to develop? - CORRECT ANSWER Integrity The manager needs to develop integrity. Violating patient privacy and confidentiality shows a lack of integrity. Having clear ethical principles and integrity is part of the ANA Code of Ethics. The nurse exhibits which role when actively monitoring patient costs and preventing waste? - CORRECT ANSWER Resource manager The nurse is exhibiting the role of resource manager, which involves evaluating and controlling costs for patients and organizations. The nurse is in a unique position to manage financial resources A nurse is very busy caring for five patients. Which tasks can the nurse delegate to a UAP? (Select all that apply) - CORRECT ANSWER -Shampooing a 23-year-old's hairShampooing is part of patient hygiene and can be delegated, as it does not go beyond the UAP's scope of practice. -Bathing a 41-year-old who is incontinentBathing is part of personal hygiene and can be delegated; it does not go beyond the UAP's scope of practice. -Ambulating a 50-year-old after surgeryAssisting a patient in ambulation does not go beyond the UAP's scope of practice and can be delegated. Who is ultimately accountable when delegated patient assignments are not completed? - CORRECT ANSWER Nurse The nurse is ultimately accountable for the care that is delegated. The person, in this case the nurse, is responsible for the assignment being completed. Which is the best resource for nurses to access when unsure about assignments that can be legally delegated to UAPs? - CORRECT ANSWER Employee job descriptions Job descriptions outline specific skills and limitations of employees. Job descriptions are based on scope of practice and provide guidelines about skills that can be legally delegated to UAPs. This is the best resource to access for this information. The nurse consults with the UAP to determine if an assigned task was completed. Which of the Five Rights of Delegation does this represent? - CORRECT ANSWER Supervision This represents the right of supervision because the nurse followed up with the UAP, even though the nurse did not actually watch the UAP perform the assignment. Prior to delegating an assignment to an LPN/LVN or UAP, the nurse must identify which factors? (select all that apply) - CORRECT ANSWER - Task required Prior to delegating an assignment to an LPN/LVN or UAP, the nurse must identify the task to be performed and the specific time frame in which the task must be completed. - Patient stability Patient stability is an assessment that must be made by the nurse before an assignment can be delegated. - Care complexity The complexity and frequency of care required are assessments that must be made by the nurse before an assignment can be delegated. Type of care The type of nursing care needed is an assessment that must be made by the nurse before an assignment can be delegated. The nurse who determined that the patient's care was too complex to delegate to the UAP demonstrated which right of delegation? - CORRECT ANSWER Circumstance Circumstance refers to delegation depending on the patient's care situation. When the nurse determined the patient's care was too complex to delegate, the nurse demonstrated the right of circumstance. When the nurse manager stays longer than needed to ensure staff members have appropriate resources for their shift, the manager is displaying which leadership quality? - CORRECT ANSWER Dedication Dedication is making time to accomplish a task and persevering through difficult situations. Which leadership function is demonstrated when the nurse manager determines a set of actions to address hospital-acquired pressure ulcers? - CORRECT ANSWER Planning Planning entails assessing the current situation and deciding on a plan of action. Planning for a leader or manager is similar to the nursing process and can include an action plan. The nurse manager reviews monthly urinary tract infection rates to determine if rates have declined after implementing new infection control procedures. Which management function is the nurse demonstrating? - CORRECT ANSWER Controlling Controlling involves comparing expected results of the planned work with the actual results, similar to evaluation in the nursing process. After implementing new infection control procedures, the nurse manager expects to see a decline in urinary tract infections. The nurse manager recognizes staff members are busy and assists with admissions and discharges. Which function was the nurse manager demonstrating? - CORRECT ANSWER Directing Directing ensures that the work of the organization is done. The manager was ensuring the work of admitting and discharging patients was accomplished by assisting with the work while staff members were busy Staff members recognize which competency in nurse managers who ensure patients are at the center of decisions in health care organizations? - CORRECT ANSWER Professionalism Professionalism refers to the ability to hold others and one's self accountable for actions and outcomes. The manager is exhibiting professionalism through ensuring patients are at the center of decisions in health care organizations. The manager who makes threats of punishment to motivate staff members is exhibiting which management style? - CORRECT ANSWER Theory X Theory X-style is consistent with this manager's style. The manager motivates through treats or punishments, which is characteristic of this management style. When the nurse improves a patient's knowledge of and compliance with the treatment plan, what role has the nurse performed? - CORRECT ANSWER Patient advocate When the nurse improves patient knowledge, cooperation, and compliance with the treatment plan, the nurse is performing the role of patient advocate. What role did the nurse exhibit by following the family's request of labeling a child's favorite blanket, and communicating the request to others both verbally and in the child's EHR? - CORRECT ANSWER Patient advocate The nurse is speaking and acting on the patient's behalf and, therefore, advocating for the patient. What role did the nurse manager exhibit by giving the patient his wound care supplies that would have been otherwise discarded when he was discharged? - CORRECT ANSWER Financial resource manager The nurse leader is managing financial resources in this scenario. By giving the patient supplies he was already charged for, the nurse was attempting to control costs for the patient. [Show Less]
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Nursing Leadership Final Exam 115 Questions with Verified Answers,100% CORRECT
Nursing Leadership Final Exam 115 Questions with Verified Answers Leadership - CORRECT ANSWER ability to guide, influence, or direct others. also the... [Show More] ability to motivate and influence others while maintaining relationships to achieve a goal. Management - CORRECT ANSWER the process of coordinating others and directing them toward a common goal. task-oriented Trait theories - CORRECT ANSWER Early leadership theories focused on the traits of leaders proposed that leaders were born with the personality traits necessary for leadership, which few people were thought to possess. classified into three categories: intelligence, personality, and ability Specific qualities of good leaders included good interpersonal skills, self-confidence, and a willingness to take risks. Behavioral theories - CORRECT ANSWER proposed that leaders learned certain behaviors. focused more on what leaders did, rather than on the characteristics they innately possessed. Task-oriented behavior and consideration of others Situational theories - CORRECT ANSWER proposed that leaders changed their approach depending on the situation, taking into account factors such as group characteristics, type of business, and the economic climate Transactional leaders - CORRECT ANSWER use reward and punishment to gain the cooperation of followers. An advantage is that employees know exactly what is expected. A reward such as a salary increase or bonus is given if employees meet or exceed job expectations. Employee failure can lead to negative consequences such as reprimands, or position and/or job loss. This type of leadership focuses on getting the job done or making change happen. Rewards other health care team members who provide safe and effective care. Reprimands are given to those who do not meet safe patient care performance goals. Transformational leaders - CORRECT ANSWER inspire people to follow their lead work toward transforming an organization with the help of others. These individuals think the interaction between leaders and followers can raise both to higher levels of morality and motivation Which statements are true about leaders? They hold formal positions of authority Their power lies in building relationships Their position involves coordinating others They share a common vision with followers They use interpersonal skills to influence others - CORRECT ANSWER Their power lies in building relationships They share a common vision with followers They use interpersonal skills to influence others Which leadership theory is dependent on personality? Behavioral Trait Contemporary Situational - CORRECT ANSWER Trait A nurse leader who rewards health care team members in order to gain their cooperation is which type of leader? Transactional Charismatic Transformational Behavioral - CORRECT ANSWER Transactional Kurt Lewin (1951) - CORRECT ANSWER identified three basic styles of Leadership: Autocratic Democratic Laissez-faire Fourth Leadership style - CORRECT ANSWER Bureaucratic Autocratic Leader (Authoritarian) - CORRECT ANSWER exercises strong control over subordinates assumes that external forces, such as the need for approval from the supervisor and the need to avoid punishment, motivate employees. demands respect and obedience from employees. If necessary, uses coercion to ensure goal accomplishment. This is a strict form of leadership that is useful in crises. A nurse may use this style when taking charge after a patient is found unresponsive. (In this situation, it is helpful to have a leader who takes control and directs other members of the health care team.) Democratic Leader - CORRECT ANSWER believes that employees are motivated by internal means and want to participate in decision-making. The primary function of the leader in this situation is to foster communication and develop relationships with followers. view themselves as equal to their followers, even if they hold formal positions of authority. Followers usually are satisfied with this type of leadership and feel that their ideas are valued. However, this type of leadership is not appropriate in a crisis environment, when decisions must be made rapidly and without debate. Nurses who are in charge during a shift may have patient assignments and work with other health care team members to provide care. These nurses may see themselves as equals with other team members and may consult with other nurses. This style of leadership can be utilized in unit council meetings, where nurses collaborate to identify solutions to common problems. bureaucratic leader - CORRECT ANSWER assumes that employees are motivated by external forces. This type of leader relies on policies and procedures to direct goals and work processes. The nurse tends to relate impersonally to staff and exercises power based on established rules. laissez-faire leader - CORRECT ANSWER thinks that employees are motivated by their own desire to do well. provides little or no direction to followers, who develop their own goals and make their own decisions. Few policies and procedures are in place. usually does not succeed in highly structured organizations such as hospitals. most useful in situations in which employees are highly educated, trustworthy, motivated, and experienced. A nurse in a leadership position who uses this style of leadership assigns patient care and expects all team members to set goals for the day and manage their time to complete the assignment. Successful implementation of this leadership style in nursing requires a highly efficient and reliable staff, such as a specialized operating room nursing team with a history of working together on a set type of cases. Which leader believes that employees want to participate in decision-making? Bureaucratic Laissez-Faire Autonomous Democratic - CORRECT ANSWER Democratic Which leadership style is most useful in a health crisis situation? Autocratic Bureaucratic Democratic Laissez-Faire - CORRECT ANSWER Autocratic Which statement is true about democratic leadership? Decision-making can be time consuming. Collaboration is infrequent. Leaders make the decisions. Conclusions are rarely reached. - CORRECT ANSWER Decision-making can be time consuming. Six qualities of effective leaders identified by Bennis (2003) are: - CORRECT ANSWER Integrity Dedication Magnanimity Humility Openness Creativity Integrity - CORRECT ANSWER the quality of having clear ethical principles and aligning one's actions with the stated values. Dedication - CORRECT ANSWER is the ability to spend the time necessary to accomplish a task. Effective leaders persist in working toward accomplishment of a goal even when doing so is difficult. They encourage others to continue working toward the goal. Persevere through difficult situations to provide care that helps patients reach their goals. Magnanimity - CORRECT ANSWER giving credit where credit is due. Good leaders reflect the work and success of accomplishing a goal by crediting those who helped reach it. accept personal responsibility for failure to accomplish objectives. gives credit to other health care team members who were instrumental in reaching goals. Humility - CORRECT ANSWER is the ability to recognize that no one is superior to another. Effective leaders recognize their own worth while respecting the worth of those around them. The nurse in a leadership position recognizes the valuable contributions made by others and thus helps foster community. Openness - CORRECT ANSWER refers to the leader's ability to listen to other points of view without prejudging or discouraging them. An effective leader considers other's opinions with an open mind because a wider variety of solutions to problems is offered. nurse leader encourages creative solutions by providing an environment in which people feel comfortable "thinking outside the box." A nurse leader maintains approachability for others when questions arise. Creativity - CORRECT ANSWER is the ability to think differently. leader examines all possible solutions to a problem, even if at first glance they appear to be unrealistic or outside the norm. This ability allows the nurse leader to inspire followers to consider broader visions and goals. Effective nurse leaders possess which qualities? Select all that apply. Integrity Humility Openness Education Charisma - CORRECT ANSWER Integrity Humility Openness When a nurse gives credits to those who achieve their goals which leadership quality does the nurse possess? Magnanimity Dedication Integrity Openness - CORRECT ANSWER Magnanimity When a nurse leader proposes multiple solutions to a problem, even though some solutions seem unrealistic, which leadership quality is the nurse leader exhibiting? Creativity Dedication Integrity Openness - CORRECT ANSWER Creativity Manager's Position - CORRECT ANSWER includes accountability and responsibility for completing tasks in the work environment. exhibit accountability when they are ultimately answerable and responsible for their own actions and the actions of those directly under their supervision. Fayol's Functions of Management - CORRECT ANSWER provide a framework to help nurses understand how effective managers function. functions of management, including: planning, organizing, directing, and controlling. planning function of a manager - CORRECT ANSWER comparable to the assessment, diagnosis, and planning steps of the nursing process. Planning includes four stages: Setting goals Assessing the current situation and future trends Setting the plan Converting the plan into an action statement The nurse assesses the patient during the planning function of management. The patient's medical diagnosis and prognosis are considered. The nurse works with the family to decide on the best course of action in light of the information gathered, and a plan is formulated, which includes the list of nursing interventions necessary to accomplish the goals. organizing - CORRECT ANSWER After the plan has been developed, the manager coordinates the work to be done while avoiding duplication of effort. In a hospital setting, the RN organizes the care to be delivered to patients. The RN delegates care to other health care team members, including LPNs and UAPs, matching team member's skills to the patient's needs to ensure care is delivered in the most expedient and cost-effective manner. Directing - CORRECT ANSWER the management function that ensures the work of the organization is done. Clear direction is essential for smooth operation of any nursing unit. Examples can be seen on nursing units as the charge nurse or unit manager coordinates admissions, discharges, and patient assignments, while the RN often directs the work of LPNs and UAPs in the course of patient care. Skills required for efficient and clear direction include: good communication organization delegation. controlling - CORRECT ANSWER involves comparing expected results of the planned work with the actual results. In the nursing process, evaluation is comparable to controlling. Evaluation is the process by which outcomes are compared with goals. In the situation of patient care, the patient's progress is measured on the basis of goals set forth in the nursing care plan. The nurse manager participates in organization-wide monitoring of quality of care through the hospital's quality management processes. These processes help to determine care standards and monitor the quality of care delivered. Mintzberg's Behavioral Model of Management - CORRECT ANSWER based on two assumptions: first, that the majority of a manager's time is spent in human relations second, that managers are more reactive than proactive. These two assumptions provided the basis for three behavioral categories: Interpersonal roles informational roles decision roles Interpersonal Roles - CORRECT ANSWER Figurehead Leader Liaison Informational Roles - CORRECT ANSWER monitor disseminator spokesperson Decisional Roles - CORRECT ANSWER entrepreneur disturbance handler resource allocator negotiator Mintzberg's Contemporary Model of Management - CORRECT ANSWER incorporates knowledge, experience, and managerial values. also describes managerial work at three different levels rather than by role. The three different levels are: information people action. Information - CORRECT ANSWER the manager brings to the role a collection of experiences, knowledge, values, and competencies. The manager then develops a framework for the job, which includes the purpose of the job, the work to be done, and the way it should be performed. includes communicating and controlling. The manager gives and receives information and then uses that information to manage the work of others. The nurse manager accomplishes this through staff meetings, message boards, and one-on-one interactions with staff. People - CORRECT ANSWER the manager focuses on leading and linking people. Leading entails motivating and encouraging others to take action. Linking occurs when the manager networks with individuals outside the work unit to communicate needs and to develop liaisons. Nurse managers motivate the staff to provide high-quality patient care, and they network through multidisciplinary meetings in the hospital and in the community. Action - CORRECT ANSWER the manager directs the work of others and works with other departments to gain the resources necessary to achieve the work unit's objective. Example: manager contacts the central supply department to get additional dressing supplies when the unit runs short. Qualities of Effective Managers - CORRECT ANSWER self-belief, self-awareness, self-management, personal integrity, and motivation for improvement (Hiscock and Shuldham 2008) Additionally, Hiscock and Shuldham describe how important it is for nurse leaders to concentrate on the patients, rather than themselves, to deliver quality patient-focused care. Nurses also need to have the passion and drive to improve the current state of things in order to provide higher levels of quality in the care delivered to patients. skill - CORRECT ANSWER developed aptitude managers must have those needed to carry out a specific task or job in a work environment. The American Organization of Nurse Executives (AONE, 2005) has outlined the necessary skills that nurse leaders and managers must possess: - CORRECT ANSWER Communication and relationship building Health care environment knowledge Leadership Professionalism Business skills Communication - CORRECT ANSWER the foundation of nursing practice. essential for the nurse manager and each nurse working with patients. The development of this skill is important because the nurse must be able to obtain information, relay a plan, delegate, and evaluate a plan of care. The nurse develops relationships with patients, families, co-workers, other health care professionals, and managers as necessary for functioning in the work environment. Leadership - CORRECT ANSWER not only a quality but also a skill. the application of personal traits to promote change. It is the willingness to take action, motivate others with words, and lead by example. Professionalism - CORRECT ANSWER the ability to hold others and oneself accountable for actions and outcomes. aware of and holds high standards of ethics. Patient advocacy is part of this skill. The nurse manager is responsible for ensuring that the patient is the center of all decisions in the health care organization. business skills and business sense - CORRECT ANSWER Part of quality care is ensuring that the care patients receive is cost-effective. The nurse manager must understand concepts of budgeting, staffing, marketing, and information management. Human resource management is equally important. The skillful nurse manager understands the interactions between these elements and their influence on achieving expected outcomes in an economically responsible manner. Knowledge - CORRECT ANSWER of the health care environment is essential for the nurse manager. This environment includes trends in the local market area as well as state and national trends. The nurse manager's awareness of regulations and patient care standards is vital so that clinical policies and procedures implemented at the unit level are in compliance with regulatory body expectations. Douglas McGregor (1960) identified and categorized managers as having - CORRECT ANSWER Theory X or Theory Y characteristics Theory X-style managers believe: - CORRECT ANSWER the average person dislikes work and will avoid it if given the opportunity. subordinates must be closely supervised, directed, and coerced into doing their work. threatening punishment helps motivate employees. most workers value job security and have little ambition beyond it. Theory Y-style managers think: - CORRECT ANSWER if employees are satisfied in their work, they will view it as being as acceptable as play. that satisfied workers are capable of self-direction, self-control, and initiative. given the proper conditions, employees will accept and seek out responsibility on the job. Which function of a manager is similar to the nursing process? Planning Organizing Directing Coordinating - CORRECT ANSWER Planning Which level of managerial work does Mintzberg's Contemporary Model describe? Select all that apply. Role Information People Action Identity - CORRECT ANSWER Information People Action Which management skill is the foundation for nursing practice? Communication Professionalism Business skills Humility - CORRECT ANSWER Communication Which does the X-style manager believe? Personnel consider work like play. Workers are capable of self-direction. Staff members take initiative. Employees are motivated by punishment. - CORRECT ANSWER Employees are motivated by punishment. The nurse's leadership roles consist of: - CORRECT ANSWER Patient Care Provider Patient Advocate Case Manager Clinical Nurse Leader Financial Resource Manager Collaborative Team Member A primary nursing role is that of - CORRECT ANSWER patient care provider. Nurses must be able to plan, organize, deliver, and evaluate nursing care for patients. Effective communication with other members of the health care team (providers, certified nurse aides, etc.) is another essential nursing role. An example of this role is an RN who assesses, plans, coordinates, and provides care for a group of patients on a hospital unit. The RN also delegates certain tasks to other members of the health care team. The RN acts as a patient advocate during the course of treatment (ANA, 2010b). The knowledge and relationship the nurse has with the patient makes the nurse responsible for speaking on the patient's behalf. - CORRECT ANSWER As a patient advocate, the RN educates patients about their conditions, purposes, and expected treatment outcomes. This education can: Empower patients to act as their own advocates. Improve their knowledge, cooperation, and compliance with their treatment plan. Facilitate their interest in seeking further information on their own and discussing treatment options with their health care provider. Provide patients the awareness they need about medication purposes, side effects, and treatment responses that need to be reported in a timely manner to prevent harmful consequences. Case managers - CORRECT ANSWER assist patients in the health care process as they move through the health care system. The bedside nurse also acts as a case manager by beginning discharge planning on admission. During the admission process, data is gathered from the patient and family, which contains important information regarding the patient's existing conditions, functional ability, and areas of difficulty or lack of function, as well as disease knowledge. QSEN Focus Alert - The nurse exhibits teamwork and collaboration when - CORRECT ANSWER recognizing the contributions of other team members in helping the patient achieve health goals and when assuming the role of a team member or leader, depending on the situation. The clinical nurse leader (CNL), a newer nursing role, has - CORRECT ANSWER a master's degree and a certification from the American Association of Colleges of Nursing (AACN) Commission on Nurse Certification. Oversees patient care or provides direct patient care using evidence-based practice, evaluates patient outcomes, and updates care plans. Financial Resource Manager - CORRECT ANSWER using supplies wisely, preventing waste, and controlling costs to manage charges for the patient. For example, a nurse who is going to perform a dressing change on a patient in the hospital should only use the necessary supplies needed for that procedure. Once supplies are taken from the clean utility room into a patient's room, they cannot be returned if not used because they are considered contaminated even if unopened. The nurse has a responsibility to the patient to be aware of the costs incurred for prescribed therapies. In order for this to occur, nurses must have financial awareness and understanding of Medicare, Medicaid, and insurance provisions. Collaborative Team Member - CORRECT ANSWER works in collaboration with other health care team members such as health care providers and other allied health colleagues for the patient's benefit. The American Nurses Credentialing Center (ANCC, 2014) recognizes the importance of nursing collaboration with other health care disciplines along with health care organizations to develop the Magnet Recognition Program. Which nurse leader requires certification? Clinical nurse leader Case manager Financial resource manager Collaborative team leader - CORRECT ANSWER Clinical nurse leader The nurse serving in which role helps prevent waste and misuse of patient supplies? Financial resource manager Collaborative team member Clinical nurse leader Case manager - CORRECT ANSWER Financial resource manager Which nurse updates patient care plans based on patient outcomes and evidence-based findings? Nurse manager Clinical nurse leader Case manager Patient care coordinator - CORRECT ANSWER Clinical nurse leader In a joint statement by the ANA and NCSBN in 2005, the ANA describes delegation as - CORRECT ANSWER the transfer of responsibility, and the NCSBN calls it a transfer of authority. This transfer allows a competent individual the authority to perform a selected nursing task in a certain situation. The nurse maintains accountability - in that the nurse is ultimately responsible for making certain the care was completed. Additionally, any significant findings during the performed task such as skin integrity alterations, shortness of breath, or changes in a patient's condition should be reported to the nurse. The nurse is responsible for assessing patient alterations or changes and addressing them in the plan of care as well. first principle of delegation is that - CORRECT ANSWER nurses must have knowledge of the Nurse Practice Act in the state where they are licensed. Each state's Nurse Practice Act defines the RN scope of practice and defines appropriate delegation. The employing organization's policy and procedure manual is a second resource that addresses delegation. Employers must have job descriptions for each job that states the limitations and responsibilities of each position. Delegation information is also located in journal articles and on the NCSBN website. Before delegation of nursing tasks, the nurse must consider and ask these questions: - CORRECT ANSWER Is this task within the RN scope of practice, knowledge, and skill? Is this task within the scope and abilities of the person to whom it is being delegated? Is this task something that can be delegated? Are there adequate resources available to the delegate to complete the task? Does the patient's condition require ongoing or frequent assessment or intervention? What are the potential risks to patient safety related to this task? Does this task entail assessment, evaluation, or nursing judgment? The second principle of delegation is that - CORRECT ANSWER the RN cannot delegate assessment, planning, evaluation, or accountability of an assigned task. Even though the task has been assigned, the RN is ultimately responsible for making certain the delegatee has performed the task in a safe, satisfactory, and appropriate time frame and manner. Even if certain tasks are delegated to others, the RN is ultimately responsible for patient assessments. The third principle of delegation is that - CORRECT ANSWER the person to whom the assignment was delegated cannot delegate that assignment to someone else. The delegating RN needs to be notified immediately if the person cannot carry out the assigned task. This ensures that the task is either reassigned to another team member or is completed by the delegating RN. Prior to delegating the nurse should: - CORRECT ANSWER Identify the task to be performed and the specific time frame for the task to be completed. Assess the patient, type of nursing care needed, complexity and frequency of care needed, patient stability, and assessments of other providers. Determine that all of these apply: The task requires no nursing judgment outcomes are reasonably predictable there is no need to alter the procedure for task completion the task does not require critical decisions and complex observations repeated nursing assessments are not required the consequences of delegating the task are not a risk to the patient. It is important to remember to follow up with the delegatee to ensure task completion and proper documentation. Which statement is the third principle of delegation? The person to whom the assignment was delegated cannot delegate it to someone else. The assignment must be within the delegatee's scope of practice, knowledge, and skill level. The patient's condition must be such that it does not require ongoing or frequent assessment or intervention. If the delegatee does not carry out the assignment in a satisfactory manner, the RN is responsible. - CORRECT ANSWER The person to whom the assignment was delegated cannot delegate it to someone else. The ANA describes delegation as the transfer of responsibility. What does the transfer of responsibility allow the competent person such as the UAP to do? Perform a selected task in a selected situation Make decisions about tasks to be delegated. Reassign tasks to other qualified persons. Complete similar tasks without supervision. - CORRECT ANSWER Perform a selected task in a selected situation Which are useful to nurses learning how to safely delegate to others in the employment setting? Select all that apply. Job descriptions Nurse practice acts Hospital policy manual Personnel policy manual Legal department manual - CORRECT ANSWER Job descriptions Nurse practice acts Hospital policy manual The ANA and NCSBN (2005) identified Five Rights of Delegation. - CORRECT ANSWER Right task: a task that is within the scope of practice for the delegatee. Right circumstances: appropriate patient setting, available resources, and other relevant factors are considered. Right person: the right person is delegating the right task (RN) to the right person (Certified Nurse Aide) to be performed on the right patient. Right direction or communication: a clear, concise description of the task, including its objective, limits, and expectations. Right supervision: appropriate monitoring, evaluation, intervention, and feedback. Right Task - CORRECT ANSWER Wise use of skills and knowledge available through support staff frees the RN to perform the aspects of care that only a nurse can do. The RN must remember to delegate tasks that do not require nursing judgment. Only tasks that are routine and do not require variation from a standardized procedure should be delegated, such as bathing or obtaining vital signs on stable patients. Right Person - CORRECT ANSWER The definition of delegation states that a task must be assigned to a competent person in a selected situation. Most states have a certification process for UAP. LPNs or licensed vocational nurses (LVNs) are licensed. Work settings have job descriptions and approved skills or competency lists as part of the hiring and orientation process. In working with a group of people, the nurse becomes knowledgeable about individual UAP or LPN skills, strengths, and weaknesses. Right Circumstance - CORRECT ANSWER Delegation depends on the patient care situation. The nurse evaluates a situation and determines whether it is appropriate for delegation. Depending on the unit type and patient acuity, the nurse may elect to negotiate a modified assignment or a different staffing combination. Right Communication - CORRECT ANSWER The first component of supervision is communication. The ANA and NCSBN (2005) state that communication regarding delegation should be clear, concise, correct, and complete. The information that needs to be communicated includes the specific data to be collected, along with methods for reporting; the activities to be carried out, along with patient-specific instructions and limitations; and the expected outcomes, possible complications, and specific timelines for reporting the information. Cultural differences should be considered when communicating tasks. Right Supervision - CORRECT ANSWER Supervision means monitoring an activity being carried out by someone else and making sure that it is performed correctly. Supervision does not mean that the nurse has to directly observe the delegate carry out the assigned task. However, the nurse does conduct periodic follow-up inquiries with the individual to ascertain that the task is being completed, that instruction clarification is provided, and that the assignment is adjusted if necessary. Which question should the RN ask before delegating the task of ambulating the patient to a UAP? Can the UAP complete the task by the end of the nursing shift? Will the UAP be able to judge the patient's ability to walk without falling? Is the assignment within the UAP's ability to perform safely? Has the patient ambulated to the bathroom before today? - CORRECT ANSWER Is the assignment within the UAP's ability to perform safely? When the RN gives the UAP specific instructions about an assignment, which right of delegation is the nurse demonstrating? Circumstance Supervision Communication Person - CORRECT ANSWER Communication Which aligns with the delegation right of circumstance? A patient is acutely ill with a high acuity level. The patient assignment is routine and includes standardized care. The nurse conducts a follow-up inquiry about a completed task. A nurse states that a patient may have low blood pressure. - CORRECT ANSWER A patient is acutely ill with a high acuity level. Which rights are included in the Five Rights of Delegation? Select all that apply. Task Circumstance Supervision Condition Assignment Scope of Practice - CORRECT ANSWER Task Circumstance Supervision Which responsibilities are involved in the right of supervision when the RN delegates to a UAP? Monitoring, evaluation, and feedback Assessment, planning, and visualization Direction, management, and observation Communication, inspection, and follow-up - CORRECT ANSWER Monitoring, evaluation, and feedback Leadership and management are used interchangeably. - CORRECT ANSWER However, although the concepts are related, they are different in definition and in practice. The necessary competencies that nurse leaders and managers must possess are - CORRECT ANSWER communication and relationship building, health care environment knowledge, leadership, professionalism, and business skills. A nurse manager who informs a nurse about a salary increase for excellent performance is demonstrating a concept from which leadership theory? Behavioral Contemporary Trait Situational - CORRECT ANSWER Contemporary Which nurse leader uses coercion to ensure staff members accomplish unit goals? Autocratic Behavioral Trait Situational - CORRECT ANSWER Autocratic Which leadership theory adapts to a management style to different groups and populations? Situational Behavioral Trait Contemporary - CORRECT ANSWER Situational A leader suggests to staff members the formation of a shared governance council related to professional practice. This leader is exhibiting which leadership style? Democratic Autocratic Laissez-Faire Bureaucratic - CORRECT ANSWER Democratic The nurse who takes responsibility for coordinating the staff schedule is demonstrating which type of leadership? Informal Appointed Formal Assumed - CORRECT ANSWER Informal Which leadership style is demonstrated when a nurse manager relates to staff members impersonally and relies heavily on policies and procedures to direct work processes? Bureaucratic Democratic Laissez-Faire Autocratic - CORRECT ANSWER Bureaucratic Which quality is displayed when a new nurse approaches the manager with an idea about how to solve a problem with the dietary department, and the manager encourages the nurse to schedule a meeting to discuss over coffee? Openness Integrity Dedication Humility - CORRECT ANSWER Openness When the nurse manager stays longer than needed to ensure staff members have appropriate resources for their shift, the manager is displaying which leadership quality? Dedication Openness Integrity Magnanimity - CORRECT ANSWER Dedication If a nurse manager complains within hearing distance of a patient's family, which leadership quality does the manager need to develop? Integrity Humility Magnanimity Openness - CORRECT ANSWER Integrity Which leadership function is demonstrated when the nurse manager determines a set of actions to address hospital-acquired pressure ulcers? Planning Organizing Directing Controlling - CORRECT ANSWER Planning The nurse manager reviews monthly urinary tract infection rates to determine if rates have declined after implementing new infection control procedures. Which management function is the nurse demonstrating? Controlling Planning Organizing Directing - CORRECT ANSWER Controlling The nurse manager recognizes staff members are busy and assists with admissions and discharges. Which function was the nurse manager demonstrating? Directing Planning Controlling Organizing - CORRECT ANSWER Directing The nurse exhibits which role when actively monitoring patient costs and preventing waste? Resource manager Formal leader Financial officer Case manager - CORRECT ANSWER Resource Manager Staff members recognize which competency in nurse managers who ensure patients are at the center of decisions in health care organizations? Professionalism Business sense Leadership aptitude Patient advocate - CORRECT ANSWER Professionalism The manager who makes threats of punishment to motivate staff members is exhibiting which management style? Situational Transformational Theory X Theory Y - CORRECT ANSWER Theory X When the nurse improves a patient's knowledge of and compliance with the treatment plan, what role has the nurse performed? Patient advocate Case manager Nurse manager Team member - CORRECT ANSWER Patient advocate What role did the nurse exhibit by following the family's request of labeling a child's favorite blanket, and communicating the request to others both verbally and in the child's EHR? Patient advocate Case manager Resource manager Clinical supervisor - CORRECT ANSWER Patient advocate What role did the nurse manager exhibit by giving the patient his wound care supplies that would have been otherwise discarded when he was discharged? Financial resource manager Clinical nurse leader Case manager Patient care provider - CORRECT ANSWER Financial resource manager A nurse is very busy caring for five patients. Which tasks can the nurse delegate to a UAP? Select all that apply. Assessing a 17-year-old's pain Shampooing a 23-year-old's hair Bathing a 41-year-old who is incontinent Ambulating a 50-year-old after surgery Vital signs on a 35-year-old with hypertension - CORRECT ANSWER Shampooing a 23-year-old's hair Bathing a 41-year-old who is incontinent Ambulating a 50-year-old after surgery Who is ultimately accountable when delegated patient assignments are not completed? Unit manager Delegatee Nursing supervisor Nurse - CORRECT ANSWER Nurse Which is the best resource for nurses to access when unsure about assignments that can be legally delegated to UAPs? Immediate supervisor Chief nursing officer Facility legal manual Employee job descriptions - CORRECT ANSWER Employee job descriptions The nurse consults with the UAP to determine if an assigned task was completed. Which of the Five Rights of Delegation does this represent? Supervision Person Task Circumstance - CORRECT ANSWER Supervision Prior to delegating an assignment to an LPN/LVN or UAP, the nurse must identify which factors? Select all that apply. Task required Patient stability Care complexity Type of care Medical diagnosis - CORRECT ANSWER Task required Patient Stability Care complexity Type of care The nurse who determined that the patient's care was too complex to delegate to the UAP demonstrated which right of delegation? Circumstance Supervision Task Person - CORRECT ANSWER Circumstance [Show Less]
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CNL EXAM 3|113 Questions with Verified Answers,100% CORRECT
\CNL EXAM 3|113 Questions with Verified Answers How does Stanhope define the advanced practice nurse? - CORRECT ANSWER The advanced practice nurse is a ... [Show More] licensed professional nurse prepared at the master's level or doctoral level to take leadership roles in applying the nursing process and public health sciences to achieve specific health outcomes for the community. What organization offers the certification examinations for the advanced practice nurse? - CORRECT ANSWER American Nurses Credentialing Center (ANCC). What are the roles of the advanced practice nurse? - CORRECT ANSWER Clinician, educator, administrator, consultant, and researcher What is a clinical nurse leader and how is their role different from the BSN prepared - CORRECT ANSWER The clinical nurse leader is defined as a nurse who is a master's prepared generalist who function at the micro-system level and assumes accountability for health care outcomes for a specific group of clients within a unit or area. Their role is different from the BSN prepared nurse in the manor of the clinical nurse leader will take on the role of outcomes-based practice, and quality improvement strategies. The clinical nurse leader will collect and evaluate patient outcomes, assess cohort risk, and has the decision-making authority to change care plans when necessary. What is the nurse role and responsibility in creating a new future for healthier communities? - CORRECT ANSWER These nurses have the responsibility to provide leadership in creating a new future for healthier communities. Nurse leaders act as change agents because they foster agency adaptation. Roles include: nurse leaders, managers, and consultants. What are some of the theories community health nurse can use to explain group and individual behavior? - CORRECT ANSWER Systems theories and systems thinking emphasize the interdependence of multiple parties- dynamics of rapid interconnected change and the emergence of patterns of activity. Complex adaptive systems theory- accounts for the unpredictability of behavior of people and organizations. What are some of the competencies nurse leaders need and why do they need these? - CORRECT ANSWER Nurse leaders need the following competencies: empowerment, delegation, critical thinking, decision making, and communication skills. Empowerment is insuring nurses have the necessary knowledge, skills, and resources to effectively make the decision for which they are held accountable. This is needed as it allows for the clinical nurse leader to make their own decision about patient care, but also ensures they are held responsible for what occurs with the care given. Delegation is used to for time management. This can help the clinical nurse leader to effectively do the work that is within their scope of practice. If they are able to give a task to a position below them, it can allow for work to be done more efficiently. Critical thinking is used for the analysis and synthesis of data, using knowledge and values in making judgements, and using creative approaches in decision making and problem solving. The clinical nurse leader is responsible for evaluating client outcomes and changes plans when necessary. Critical thinking is needed to perform this task. Decision making is used when the clinical nurse leader must decide on plan of care for a client. The clinical nurse leader will have the knowledge and skill to evaluate what will work best with the patient to have best overall care. Decision making is used to help in the performance of this task, as it gives effective decisions. Communication skills are very effective in a leadership position. The clinical nurse leader needs communication skills as it allows for proper conflict resolution. The clinical nurse leader will talk with many people throughout the day either in person or through media. Communication skills will give the clinical nurse leader the ability to talk with clients effectively and resolve conflicts. What is the difference between a home health and hospice nurse? - CORRECT ANSWER A home health nurse is a specialized nurse who delivers care in the residence of the client. A hospice nurse is a specialized nurse who provides "evidence-based physical, emotional, psychological, and spiritual or existential care to individuals and families experiencing life-limiting, progressive illness". p.890 How important is the involvement of family in home health care and hospice? - CORRECT ANSWER The involvement of family in home health care and hospice is very important. Family caregivers provide many aspects of care in the home that previously provided in hospitals or in home by professional caregivers. What is transitional care and why has it become a new area for care delivery? - CORRECT ANSWER Transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as clients transfer between different locations and different levels of care in the same location. Transitional care consistently shows cost saving and improvements in clinical and quality outcomes for clients receiving the intervention compared with the usual care. The most common outcome across all populations is a consistent reduction in readmission to a hospital. What is the Omaha System model of problem-solving and what is included in the system? - CORRECT ANSWER The Omaha System model of problem-solving was developed to operationalize the nursing process and provide a practical, easily understood, computer-compatible guide for daily use in the community. The system includes the Problem Classification Scheme, the Intervention Scheme, and the Problem Rating Scale for Outcomes. When does Stanhope state that school nursing began? - CORRECT ANSWER Stanhope states that school nursing began in the late 1800s in England, where the Metropolitan Association of Nursing provided medical exams for children in the schools of London. What are key legislative acts that promoted school nursing in the U.S.? - CORRECT ANSWER What are key legislative acts that promoted school nursing in the U.S.? Key legislative acts that promoted school nursing in the U.S. include: PL 93-112 Section 504 of the Rehabilitation Act, PL 94-142 Education for All Handicapped Children Act, Americans with Disabilities Act, PL 105-17 Individuals with Disabilities Education Act (IDEA), No Child Left Behind Act, and the Child Nutrition and WIC Reauthorization Act of 2004. What is the professional body that developed standards of practice for the school nurse and what are the 11 criteria the professional standards rely on? - CORRECT ANSWER The National Association of School Nurses (NASN) is the professional body that developed standards for the school nurse. The professional standards rely on nurses to give care based on the following 11 criteria: 1. Develop school health policies and procedures 2. Evaluate their own nursing practice 3. Keep up with nursing knowledge 4. Interact with the interprofessional health care team 5. Ensure confidentiality in providing health care 6. Consult with others to provide complete care 7. Use research findings in practice 8. Ensure the safety of children, including when delegating care to other school personnel 9. Have good communication skills 10. Manage a school health program effectively 11. Teach others about wellness What are school nurse roles? - CORRECT ANSWER Direct caregiver, health educator, case manager, consultant, counselor, community outreach, and researcher Risk in epidemiology means what? - CORRECT ANSWER Risk means that some people have a higher probability of getting an illness than others. For example, people who smoke are at risk to lung cancer due to the cellular changes from smoking. What is a vulnerable population group? - CORRECT ANSWER A vulnerable population group is a subgroup within a population that is more likely to develop health problems as a result of exposure to risk or to have worse outcomes from these health problems than the rest of the population. Provide some examples of vulnerable population groups. - CORRECT ANSWER A few examples of vulnerable population groups are: the poor and homeless, pregnant adolescents, migrant workers and immigrants, the mental health population, those who abuse addictive substances, abuse victims or victims of violence, persons with communicable disease at those at risk of contracting said communicable disease, HIV positive persons, and those who have Hepatitis B or STDs. What are disadvantaged populations? - CORRECT ANSWER Disadvantaged populations are those who experience health disparities due to having fewer resources for promoting health and treating illness than the average person in the United States. Define outreach. - CORRECT ANSWER Outreach is an approach to making healthcare more easily available to certain populations by implementing health education, counseling, or support services in places where people normally congregate, such as places of worship, schools, workplaces, and community centers. What is case finding related to vulnerable populations? - CORRECT ANSWER Case finding is when nurses design methods to find these vulnerable populations and individuals especially in need of service. What is a safety net provider, and please give an example. - CORRECT ANSWER A Safety net provider is a term applied usually to community health centers or nurse-managed clinics that increase access to health and social services for vulnerable populations and those with limited financial ability to pay for care. What is food insecurity? - CORRECT ANSWER Food insecurity is an issue that those living in extreme poverty such as the homeless or those living in marginal housing face. It can be described as a state where one does not know when or where their next meal will come from. These individuals do not have a steady supply or surplus of food to rely on throughout each day. To be an effective nurse one must recognize and acknowledge what? - CORRECT ANSWER To be an effective nurse, one must recognize and acknowledge the beliefs, values, and knowledge that influence one's practice and worldview. What were the Elizabethan poor laws and how did they impact society? - CORRECT ANSWER These laws were established in the 17th century, and said that persons who were born within the boundaries of the community should be given assistance by that community. Define poverty. - CORRECT ANSWER Poverty is defined as having insufficient financial resources to meet basic living expenses. In the western cultures, poverty is most often viewed negatively; alternatively, poverty is respected in other cultures. How is poverty determined in the U.S.? - CORRECT ANSWER The official poverty level in the United States in 2011 was $22, 350. near poor mean? - CORRECT ANSWER Near poor refers to persons whose income is above the federal guidelines, yet is inadequate to meet basic needs. What is neighborhood poverty? - CORRECT ANSWER This type of poverty is based on geographically defined areas of high poverty, characterized by dilapidated housing and high levels of unemployment. These areas also have higher mortality and morbidity rates, compared to higher income neighborhoods. How is poverty related to health? - CORRECT ANSWER Poverty is associated with higher rates of chronic illness; higher infant morbidity and mortality rates; shorter life expectancy; more complex health problems; more significant complications and physical limitation from chronic diseases such as asthma, diabetes, and hypertension; and higher hospitalization rates. homelessness? - CORRECT ANSWER Homelessness is defined as "lacking a fixed, regular, and adequate night-time residence and...has a primary nighttime residency that is: (a) a supervised publicly or privately operated shelter designed to provide temporary living conditions (b) an institution that provides a temporary residence for individuals intended to be institutionalized (c) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings" (p.743). causes of homelessness? - CORRECT ANSWER A trend in a growing shortage of affordable housing, along with an increase in poverty, are the two main causes of homelessness. Deinstitutionalization of chronically mentally ill individuals from the public psychiatric hospitals is also a major cause of homelessness. What effects does homelessness have on health? - CORRECT ANSWER Homeless people suffer greater incidences of acute and chronic illnesses, AIDS, and trauma. This population has limited access to adequate health care resources. Furthermore, this population often give lower priority to health promotion and health maintenance than to obtaining food and shelter. What is the role of the nurse with homeless and poor populations? - CORRECT ANSWER The nurse creates a trusting environment; shows respect compassion, and concern; does not make assumptions; coordinate a number of services and providers; advocate for accessible health care services; focus on prevention; know when to walk beside the client and when to encourage the client to walk ahead; and develops a network of support for oneself. What is the definition of the migrant farm worker? - CORRECT ANSWER An individual whose principal employment within the past 24 months is in agriculture on a seasonal basis and who establishes for the purpose of such employment a temporary abode. What is the definition of the seasonal farm worker? - CORRECT ANSWER A seasonal farmworkers work cyclically in agriculture but do not migrate. Migrant Health Act? - CORRECT ANSWER The Migrant Health Act was signed in 1962 and provides funds for primary and supplemental health services to migrant workers and their families. These funds are disbursed to 154 migrant health centers in 42 states that serve as models for delivery of services to a difficult-to-reach migrant population. What are some of the occupational health risks for migrant farm workers? - CORRECT ANSWER Working conditions, such as standing on ladders, being exposed to chemicals, and using machinery, produce occupational health risks for the migrant farmworkers who may be inadequately protected or educated. Lack of a comprehensive surveillance system makes it difficult to know the extent of all injuries within the migrant population. Injuries such as sprains and strains, fractures, and lacerations are the most common. Other injuries include amputations; crush injuries from tractors, trucks, or other machinery; acute pesticide poisoning; electrical injuries; drowning in ditches; chronic back pain; and dermatitis or conjunctivitis caused from irritation from the chemicals. Pesticide exposure is common because the migrant farmworker;s dwell near fields or orchards and they may not have access to protective clothing or unable to afford it. ● Acute health effects of pesticide exposure include mild psychological and behavioral deficits such as memory loss, difficulty with concentration, mood changes, abdominal pain, nausea, vomiting, diarrhea, headache, malaise, skin rashes, and eye irritation. ● Chronic exposure might lead to cancer, blindness, Parkinson disease, infertility or sterility, liver damage, and polyneuropathy and neurobehavorial problems. What impact does migrant farm work have on children in these families? - CORRECT ANSWER ● Malnutrition (vitamin A and iron deficiencies) ● Infectious diseases (upper respiratory tract infection, gastroenteritis) ● Dental caries (from prolonged bottle-feeding, bottle-propping, and limited access to fluoride and dental care) ●Inadequate immunization status ● Pesticide exposure, injuries, overcrowding and poor housing conditions ● Disruption of their social and school life, lead to anxiety-related problems. How does Mexican cultural beliefs' concerning health differ from the U.S. culture? - CORRECT ANSWER Mexican clients may not seek care with health professionals first. Instead they may consult with knowledgeable individuals in their family or community or with folk healers. They would consult issues with the wise older woman living in the community such as their grandmother or local parish priest. Often time love for their children, rather than concern for their own health may encourage migrant parents to adopt healthier lifestyles. For example, when the parents of a child with asthma choose to stop smoking. Mexican clients may be more willing to following the advice of another Mexican individual with a similar health problem rather than advice of the health professional. The Mexican individual may not follow up with a clinic appointment because their perception of health is that a healthy person is one who can continue to work and maintain daily activities independent of symptoms or diagnosed diseases. Mexican individuals may believe that illnesses are a punishment from God and may cite this belief as a rationale for why therapies have not cured them. This often leads to more chronic conditions. What are the main causes of teen mortality in the U.S.? - CORRECT ANSWER Motor vehicle accident (usually including alcohol), homicide, suicide, and accidental injuries (such as falls, fires, or drowning) What are the reasons that teens may not seek help for their problems? - CORRECT ANSWER 1. Access to health care may be hindered due to a limited number of professionals with expertise in dealing with teenagers 2. Cost of care or availability of insurance may limit services 3. Adolescents need to believe that their visits are confidential before they will honestly reveal information 4. Health care professionals must be able to discuss sensitive topics in a non-judgemental and supportive manner and demonstrate a desire to work with youths. What are two reasons teens seek out healthcare assistance? - CORRECT ANSWER Concerns about a possible pregnancy or to find a birth control method Describe the teens that have children and explain the difference in this population. - CORRECT ANSWER Teen parents often lack self-confidence and knowledge about proper infant care. They may have unrealistic expectations for the child, and lack knowledge about infant growth and development. Due to limited knowledge about normal child development, abusive parenting is more likely to occur. The nurse can play an important role in educating the teen mother about proper infant care, expectations, and normal growth and development. The reason for the difference in this population may be related to the developmental stage of the teen mother and lack of preparedness--minimal prenatal care, lack of knowledge about infant care, etc. Name some issue for teenage mothers and what is the nurse's role with these issues. - CORRECT ANSWER Violence Nurse must observe for physical signs of abuse, as well as for controlling or intrusive partner behavior Initiation of Prenatal Care Cooperation between nurse and clinical staff can maximize client compliance with special health or nutritional needs. Nurse who makes home visits can provide additional assemssnet of the ten's condition and can solve problems about self-care, hygiene, meals, and schooling. Nutrition Nurse can reinforce the need for teen to take prenatal vitamins during pregnancy and after baby's birth. The nurse should also educate about iron-rich foods and foods that promote iron absorption, such as those containing vitamin C. Infant care Nurse observe mother response to infant cues. Specific techniques can be instructed to use in early child care. Begin early education as early as possible. Repeat pregnancies Nurses should review contraceptive options and help identify methods teen most likely use. After birth, follow up on woman's plan and identify obstacles and help problem solve with new mother. How does Healthy People 2020 define mental health? - CORRECT ANSWER Mental health is defined by Healthy People 2020 as encompassing the ability to engage in productive activities and fulfilling relationships with other people, to adapt to change, and to cope with adversity What is the National Alliance for the Mentally Ill - CORRECT ANSWER The National Alliance for the Mentally Ill is a consumer advocacy group that worked to establish education and self-help services for individuals and families with mental illness. How does managed care impact mental illness? - CORRECT ANSWER Managed care impacted mental illness by providing a method to control costs and access to mental health care in the private insurance sector, managed care became a significant factor to public mental health, and more than half of the Medicaid recipients were enrolled in a managed mental health care plan. How has the treatment of the mentally ill changed in the last 50 years? - CORRECT ANSWER First psychiatric hospital was built in Virginia, and approximately 50 years passed before widespread construction of facilities in other states. Even after the development of hospitals and site of treatment, persons with mental disorders were neglected and mistreated. There has been continued development of research and education programs, early intensive treatment for acute mental illness, and shifting the care of severely mentally ill persons away from the large hospitals to psychiatric wards in general hospitals and to community mental health clinics. Along with prevention and intervention, community services were to include aftercare services following hospitalization for individuals with major mental illness. What did deinstitutionalization do to the mentally ill and how has this impacted healthcare and nursing? - CORRECT ANSWER Deinstitutionalization involved transitioning large numbers of people from state psychiatric hospitals to communities. The goal was to improve the quality of life for people with mental disorders by providing services in the communities where they lived rather than in large institutions. To change the locus of care, large hospital wards were closed and persons with severe mental disorders were returned to the community to live. What is ATOD and why the change? - CORRECT ANSWER ATOD refers to 'alcohol, tobacco, and other drug'. The change in term was to remind the public that alcohol and tobacco are the major drugs of abuse when discussing chemical dependency. How have attitudes shifted about the use of alcohol, tobacco, and drug use in the U.S. over the last 100 years? - CORRECT ANSWER Prior attitudes were formed around the way society categorized drugs. Drugs used to categorized to be either good or bad, in which good drugs were OTC drugs and those prescribed by a doctor, but these can be just as dangerous and addictive as the 'bad drugs'. Bad drugs were those that low-life irresponsible people used including alcohol, tobacco, and other drugs. However, in 1954 the AMA listed alcohol addiction as an illness and tobacco addiction followed years after. Now these problems are viewed as medical diagnoses that require treatment. Also, previous methods to control the war on drugs aimed at criminalizing those caught using drugs that were banned in the United States. However this has led to increase money spent on law enforcement than actual treatment and eradication of the drugs. Therefore, new methods are aimed and treating addicts and helping them get over their addiction to lead to eradication of drug use. What is the role of the nurse in primary, secondary, and tertiary prevention in the use of alcohol, tobacco, and drugs? - CORRECT ANSWER Primary prevention role: Primary prevention focuses on the promotion of healthy lifestyles and resiliency factors, along with education about drugs and guidelines for their use. Nurses utilize many health promotion strategies including education on alternatives and drugs altogether to prevent the use of harmful drugs. Secondary prevention role: The nurse uses screening tools to detect ATOD problems, followed by educating the individuals to understand the connection between their drug use and the negative consequences they have. Also, early intervention can be used to treat the problems to avoid needing further more intensive treatment. Tertiary prevention role: The nurse focuses on supporting the patient along with their family through the treatment process while connecting them to all the possible resources to ensure proper treatment and care. Many addicts can get lost in the process of detox or smoking cessation programs, leading to giving up altogether. It is the nurse's role to follow the patient throughout the process to support them and keep them on track to complete treatment. What is violence? - CORRECT ANSWER Violence is non-accidental acts that occur interpersonally and intrapersonally that result in physical or psychological injury. Violence is predictable therefore preventable with community action. How has religion played a role in violence in families? - CORRECT ANSWER Although religion can help those experiencing anguish get through times, it can also lead to continuation of violence. Due to religions that do not accept divorce, men and women being abused by their partner will stay in the violent relationship to uphold their religious beliefs. Also, religious affiliation and religious conservatism have been identified as risk factors for family violence, especially child abuse. What is homicide, assault, and rape and what might be a nurse's role in dealing with victims, families, and communities of these acts? - CORRECT ANSWER Homicide: Intentional killing of one person by another. Nurse have a role in preventing homicide in families where abuse is present and detected. Nurses who understand how upbringing, living conditions, and increased stress contribute to IPV are more equipped to manage abusive families. 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Leadership Exam 1 More Practice 65 Questions with Verified Answers,100% CORRECT
Leadership Exam 1 More Practice 65 Questions with Verified Answers Nurses who challenge assumptions, consolidate a purpose, build the culture, and mov... [Show More] e a vision forward are more likely within which role? A. Nurses B. Nurse managers C. Clinical nurse leaders D. Nurse executives - CORRECT ANSWER D. Nurse executives What healthcare person coordinates, integrates, provide cares, restore health and nurtures human beings in their experiences of health and illness? A. Nurses B. Nurse managers C. Clinical nurse leaders D. Nurse executives - CORRECT ANSWER A. Nurses What healthcare person concentrates on day-to-day administration and coordinate services provided by a group of nurses by integrating human, fiscal, and other nursing resources to accomplish nursing practice with 24-hour accountability for client care units or areas? A. Nurses B. Nurse managers C. Clinical nurse leaders D. Nurse executives - CORRECT ANSWER B. Nurse managers What healthcare person provides leadership in the care transitions of individuals and populations while providing expertise in specialty areas to guide other nurses through process, measurement, and evidence-based practice changes? A. Nurses B. Nurse managers C. Clinical nurse leaders D. Nurse executives - CORRECT ANSWER C. Clinical nurse leaders The difference between the focus of managers and leaders is best described by which one of the following statements A. The processes and strategies look similar and are employed for different goals. B. The manager focuses on people, and the leader focuses on systems and structure. C. The manager focuses on systems and structure, and the leader focuses on people. D. Management and leadership are not equally important processes to accomplish outcomes. - CORRECT ANSWER C. The manager focuses on systems and structure, and the leader focuses on people. Management is often described in three core roles. Select the statement that is true. A. Allocating resources, negotiating contracts, handling disturbances, and proposing new services are decision-making roles. B. Monitoring processes, disseminating guidelines, and motivating nurses in organizations, states, and nationally or internationally are interpersonal roles. C. Representing nurses, leading nurses, and associating information technologies are informational roles. D. Providing care, coordinating time for patients, and interacting with physicians, pharmacists, and clients are caregiving roles. - CORRECT ANSWER A. Allocating resources, negotiating contracts, handling disturbances, and proposing new services are decision-making roles Which process best describes leadership? A. Giving people the authority, responsibility, and freedom to act on their expert knowledge and skills B. Planning, organizing, coordinating, directing, and controlling resources to accomplish specific institutional goals C. Influencing behavior of either an individual or a group in an effort to achieve goals in a given situation D. Working with and through individuals and groups and other capital and technology resources to accomplish organizational goals - CORRECT ANSWER C. Influencing behavior of either an individual or a group in an effort to achieve goals in a given situation In one research-based model, which of the following behaviors were core to clinical leadership success? A. Visioning, interactive planning, workload complexity analysis, interdisciplinary team building, work process analysis, stakeholder analysis, and trust B. Interdisciplinary team building, strategic planning, data mining, motivating workers, developing culture, and trust C. Analysis of process and outcomes, trust and honesty, performance management, continuous improvement, and communicating the vision D. Interdisciplinary team building, trust and honesty, motivating workers, performance management, analysis of processes and outcomes, stakeholder analysis, and strategic planning - CORRECT ANSWER A. Visioning, interactive planning, workload complexity analysis, interdisciplinary team building, work process analysis, stakeholder analysis, and trust In one research-based model, which of the following behaviors were core to clinical leadership success? A. Challenge the process, inspire a shared vision, model the way, enable and trust others to act and encourage others work-outcomes B. Build an interdisciplinary team, engage in strategic planning and data mining, motivate workers, develop culture and trust. C. Analyze processes and outcomes, model trust and honesty, engage in performance management and continuous improvement, and communicate the vision D. Build interdisciplinary team, model trust and honesty, motivate workers, guide performance management, analyze processes and outcomes, conduct stakeholder analysis, and strategically plan. - CORRECT ANSWER A. Challenge the process, inspire a shared vision, model the way, enable and trust others to act and encourage others work-outcomes A situational leader can best be described by which of the following statements? A. This leader tailors his or her leadership style based on the employee, experience, and circumstances. B. This leader requires minimal participation and directing, resulting in high productivity. C. This leader is one who motivates employees to their full potential. D. This leader advances innovative changes and sustains good care delivery processes. - CORRECT ANSWER A. This leader tailors his or her leadership style based on the employee, experience, and circumstances. Nurse leaders must possess competency in five domains: (1) leadership, (2) communication and relationship management, (3) professionalism, (4) knowledge of the health care environment, and (5) business skills and principles. Which of the following statements best describes the domain of professionalism? A. Guiding, directing, teaching, and motivating to set and achieve goals B. An approach to an occupation that distinguishes it from being merely a job, focuses on service as the highest ideal, follows a code of ethics, and is seen as a lifetime commitment C. Coordination and integration of resources to accomplish specific goals D. Ethical fitness and moral courage form the backbone of making necessary and hard—but right and unpopular—decisions. - CORRECT ANSWER B. An approach to an occupation that distinguishes it from being merely a job, focuses on service as the highest ideal, follows a code of ethics, and is seen as a lifetime commitment Principles of leadership and management are best described by which of the following statements? A. Followership is a process whereby leaders participate in group decisions. B. Empowerment is the ability to lead a group successfully. C. Important skills for leading include diagnosing, adapting, and directing. D. Critical skills in leadership are interpersonal, decision making, and problem finding and solving. - CORRECT ANSWER D. Critical skills in leadership are interpersonal, decision making, and problem finding and solving. Five competencies were identified by nurse leaders in recent research. What are those competencies? A. Building effective teams, empowering workers, decision making, communicating, and managing conflict B. Communicating vision and strategy internally, translating vision into strategy, building effective teams, managing patient-centered customer focus, and managing conflict C. Managing conflict, analyzing performance, guiding and empowering workers, sharing a vision with workers, and directing operations D. Focusing on patient and customer, directing and guiding workers, building effective teams, managing conflict, and analyzing performance - CORRECT ANSWER B. Communicating vision and strategy internally, translating vision into strategy, building effective teams, managing patient-centered customer focus, and managing conflict Which is the statement that best defines management? A. A process of coordination and integration of resources through group activities of planning, organizing, coordinating, directing, and controlling to accomplish specific institutional goals and objectives B. A process of planning and directing human effort to attain established objectives C. A process by which organizational goals are met through the use of the right resources D. A process of working with executives to allocate capital, technology, and equipment resources to accomplish organizational goals - CORRECT ANSWER A. A process of coordination and integration of resources through group activities of planning, organizing, coordinating, directing, and controlling to accomplish specific institutional goals and objectives Which management theory's principle is to consider the situation and all elements when making a management decision? A. Complexity theory B. Chaos theory C. Systems theory D. Contingency theory - CORRECT ANSWER D. Contingency theory Effective leadership is exemplified by values, confidence in employees, and a sense of security in the face of uncertainty. This aspect of leadership is known as: A. Relationship management. B. Self-awareness. C. Social awareness. D. Self-management. - CORRECT ANSWER B. Self-awareness. The areas where leadership and management overlap are explained by which of the following statements? (SATA) A. Bring teams together. B. Spark innovation. C. Inspire a vision. D. Direct activities. - CORRECT ANSWER A. Bring teams together. D. Direct activities. The Institute of Medicine (IOM) identified 5 areas of management practice for leaders to attend to during turbulent times. Which of the following are included in those areas? (SATA) A. Maintaining and sustaining quality and safety in service delivery B. Balancing reliability and efficiency in service delivery C. Creating and sustaining a trustworthy, learning, and evidence-based organization D. Managing change through manager involvement and bi-directional communication E. Involving workers to manage and sustain change - CORRECT ANSWER B. Balancing reliability and efficiency in service delivery C. Creating and sustaining a trustworthy, learning, and evidence-based organization E. Involving workers to manage and sustain change Hersey and colleagues identified three skills needed for leading or influencing workers. Identify three skills leaders must possess to influence people. (SATA) A. Diagnosing B. Directing C. Adapting D. Communicating - CORRECT ANSWER A. Diagnosing C. Adapting D. Communicating Great leaders possess four essential skills. Identify two statements that describe those skills. (SATA) A. Great leaders possess popularity to establish followers to engage. B. Great leaders are visible, set examples, and share responsibility. C. Great leaders possess a sense of integrity with a distinctive and compelling vocal tone to engage others in shared meaning. D. Great leaders possess a combination of hardiness and the ability to grasp context, called "adaptive capacity." - CORRECT ANSWER C. Great leaders possess a sense of integrity with a distinctive and compelling vocal tone to engage others in shared meaning. D. Great leaders possess a combination of hardiness and the ability to grasp context, called "adaptive capacity." The research of which team states that the leader needs to be flexible in behavior, able to diagnose the leadership style appropriate to the situation, and able to apply the appropriate style? A. Fiedler's contingency model B. Hersey and Blanchard's model C. Blake and Mouton's attitudinal model D. Ohio State model - CORRECT ANSWER B. Hersey and Blanchard's model Managers who proceed with a change can best engage staff and prevent resistance by doing which of the following? A. Assisting the executives with controlling change communication and limiting the staff involvement B. Communicating accurate information to engage staff and overcome misunderstanding regarding the need for change C. Expecting that frustration, aggression, or indifference is a phenomenon of the change experience for staff D. Determining what the resistant person is trying to protect, such as employment or control of processes - CORRECT ANSWER B. Communicating accurate information to engage staff and overcome misunderstanding regarding the need for change Leaders are change agents and have a role in change that includes which of the following? A. Motivating staff through posting notes and expectations on the change for others to read in the usual communication place B. Avoiding having the groups participate with details until they have to implement the change C. Providing reliable information and details to those who are to implement the change and understand their view of expectations and plan adequate, timely education on the changed. D. Posting the change steps for others to read in the usual communication place and avoid setting expectations or promises. - CORRECT ANSWER C. Providing reliable information and details to those who are to implement the change and understand their view of expectations and plan adequate, timely education on the changed. Porter-O'Grady and Malloch (2015) emphasized four practices for current workplaces that foster learning organizations. Examples of practices would include: A. Population-based care, case management, patient-centered care, and patient safety initiatives. B. Medical home payment for physicians, relative value units, pay-for-performance, and pay based on outcomes. C. Electronic health records (EHRs), health information exchange (HIE) networks, and clinical decision support. D. Empowerment, shared governance, shared decision making, and self-direction. - CORRECT ANSWER D. Empowerment, shared governance, shared decision making, and self-direction. Trends in 21-century health care in the US are described as revolutionary by Longenecker and Longenecker (2014). Leaders will innovate and change toward preventive and wellness health care services because of which of these trends? a. New laws and regulations from the Affordable Care Act (ACA) to cut costs and improve indicators of quality and staffing challenges. b. Aging population, increased numbers of veterans with posttraumatic stress disorder (PTSD) and traumatic brain injury, pay-for-performance, focus on safety and quality, and medical home c. Advances in genomics, integrative medicine, and increased emphasis on evidence-based interventions d. Advances in technology with HIE networks, personal health records, EHRs, and telehealth e. Strain on emergency services, "never events," accountable care organizations, pay-for-performance, the Human Genome Project, and nurse shortages followed by a flood of new nurses have all affected and led to changes in the health care system over the last decade. - CORRECT ANSWER a. New laws and regulations from the Affordable Care Act (ACA) to cut costs and improve indicators of quality and staffing challenges. Change is inevitable in health care, just as it is in life. Which two statements are true about change? (SATA) A. Change is a linear process requiring a series of discrete steps. B. Change occurs in a logical, planned manner. C. Change is inevitable and is necessary for organizational viability. D. Individuals become aware of the need for change when needs are unmet. - CORRECT ANSWER C. Change is inevitable and is necessary for organizational viability. D. Individuals become aware of the need for change when needs are unmet. Change behaviors displayed in a variety of ways. Identify the two correct statements on how leaders identify, support, and promote innovators. (SATA) A. Resistance to questioning common practices B. Resistance most commonly arises because individuals are trying to gain more power. C. Changing individual behavior requires less time and energy. D. Seeks out knowledgeable experts E. Comfortable with uncertainty - CORRECT ANSWER D. Seeks out knowledgeable experts E. Comfortable with uncertainty Change behaviors displayed in a variety of ways. Identify the two correct statements (SATA). A. Resistance can be useful and should be listened to and analyzed. B. Resistance most commonly arises because individuals are trying to gain more power. C. Changing individual behavior requires less time and energy. D. Too much change is disruptive and can result in disorganization. - CORRECT ANSWER A. Resistance can be useful and should be listened to and analyzed. D. Too much change is disruptive and can result in disorganization. The distinction between change and innovation is best described in which of the following statements? (SATA) A. Leaders are necessary to help create the environments that encourage creativity to innovate, whereas the opportunities for change can be accomplished in most environments. B. Innovation refers to the process of bringing any new or problem-solving idea into use, whereas change is a process for reducing variation within an existing process with a problem. C. Innovation is often linked with creativity and viewed as the use of a new idea to solve a problem, whereas change means improving incrementally. D. Change is a disruption - CORRECT ANSWER innovation is systematic, takes hard work, and has little to do with genius and inspiration. E. Change is a new practice that can be implemented quickly and an innovation is a new device or medication that is added to existing services. ; B. Innovation refers to the process of bringing any new or problem-solving idea into use, whereas change is a process for reducing variation within an existing process with a problem. C. Innovation is often linked with creativity and viewed as the use of a new idea to solve a problem, whereas change means improving incrementally. D. Change is a disruption; innovation is systematic, takes hard work, and has little to do with genius and inspiration. Rogers (2003) described five factors to determine successful planned change: relative advantage, compatibility, complexity, trialability, and observability. The statements below relate to these success factors. Leaders will present information on two of these to explain the necessity for the change and the expectations. Which of the following are those two? (SATA) A. The degree to which the change is thought to be better than the status quo B. The degree to which the change is compatible with existing values of the individuals or group C. The degree to which a change is perceived as difficult to use and understand D. The degree to which a change can be tested out on a limited basis E. The degree to which the results of a change are visible to others - CORRECT ANSWER A. The degree to which the change is thought to be better than the status quo B. The degree to which the change is compatible with existing values of the individuals or group Culture is a concept that is best portrayed in nursing with which of the following statements? A. Culture provides a common bond so members know how to relate to one another and what is valued. B. A relationship-based nursing care model is used, which represents a belief in patient-centered care. C. Culture is a multifaceted phenomenon, difficult to comprehend. D. Culture is a set of values, beliefs, and assumptions that are shared by members of an organization. - CORRECT ANSWER D. Culture is a set of values, beliefs, and assumptions that are shared by members of an organization. Climate is often confused with culture. Which statement best describes aspects of climate? A. Culture is the perceptions of the work environment, and climate is the personality of the organization. B. Climate is the shared beliefs, values, and assumptions that exist in an organization. C. Climate enhances the stability of a social system, and culture is the voice of the organization. D. Culture and climate can both be measured. - CORRECT ANSWER D. Culture and climate can both be measured. Identify the statements about organizational culture that impact nursing practice. (SATA) A. Organizational culture affects the quality of nursing care and patient outcomes. B. Mission statements provide a view of strategic priorities for a nursing organization and work setting. C. Culture is developed over time with the shared values that guide members on how to problem solve and manage relationships. D. Organizational culture means there are hidden assumptions about care that should not be questioned. - CORRECT ANSWER A. Organizational culture affects the quality of nursing care and patient outcomes. B. Mission statements provide a view of strategic priorities for a nursing organization and work setting. C. Culture is developed over time with the shared values that guide members on how to problem solve and manage relationships. The research leading to the gold standard for nursing excellence has produced which of the following findings? (SATA) A. The effects of nursing interventions are facilitated by organizational characteristics at the unit level. B. A health care administrator can nurture a professional nursing environment and advocate for excellence in nursing practice. C. Mortality rates in Magnet hospitals had a significantly lower mortality rate for Medicare patients than that of control hospitals. D. Magnet hospitals' cultures provided lower levels of autonomy and control of practice and fostered stronger professional relationships among nurses and physicians than did those of non-Magnet-designated hospitals. - CORRECT ANSWER A. The effects of nursing interventions are facilitated by organizational characteristics at the unit level. C. Mortality rates in Magnet hospitals had a significantly lower mortality rate for Medicare patients than that of control hospitals. The 14 Forces of Magnetism has directed research on Hospital Magnet Standards, which measure certain characteristics. Select the answers that best reflect those measures of Magnet standards. (SATA) A. Clinically competent peers, education support, adequate staffing, and nurse manager support B. Perceptions of work environment, nursing hours per patient day, and medication errors and near misses C. Customer satisfaction, patient discharge disposition, and patient complaints D. Clinical autonomy, control of nursing practice, and collaborative nurse-physician relationships - CORRECT ANSWER A. Clinically competent peers, education support, adequate staffing, and nurse manager support D. Clinical autonomy, control of nursing practice, and collaborative nurse-physician relationships The culture of patient care must transition from care that is driven by providers to care that is patient-centered & family-centered in which patient & family norms, values, and preferences are respected. This direction in health care services has been sited within: (SATA) A. the Affordable Care Act (2009). B. The Future of Nursing: Leading Change, Advancing Health (2011). C. the Institute of Medicine's Crossing the Quality Chasm (2001). D. National Healthcare Quality Report from the Agency for Healthcare Research and Quality (2002). - CORRECT ANSWER A. the Affordable Care Act (2009). B. The Future of Nursing: Leading Change, Advancing Health (2011). C. the Institute of Medicine's Crossing the Quality Chasm (2001). D. National Healthcare Quality Report from the Agency for Healthcare Research and Quality (2002). Quality & Safety Education for Nurses (QSEN) was initiated to accomplish which of the following? (SATA) A. Implementing patient-centered care, teamwork, and collaboration that support quality improvement, safety, and informatics on nursing units B. Geared toward nurses who have been practicing 20 years and need new competencies through continuing education C. Creating nursing curriculum that emphasizes evidence-based practices, quality improvement, safety, and informatics D. Preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care system - CORRECT ANSWER C. Creating nursing curriculum that emphasizes evidence-based practices, quality improvement, safety, and informatics D. Preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care system Which of the following statements is true about problem solving? A. Problem solving is a high-level skill used primarily by health care professionals. B. Critical thinking and problem solving are the foundation of effective decision making. C. The team problem-solving method is a slow process and is a poor method for making decisions. D. Problem solving is a rational and logical thought process. - CORRECT ANSWER D. Problem solving is a rational and logical thought process. Any decision in a chaotic health care delivery environment may cause an unanticipated future problem. Identify the true statement about decision making. A. Decision-making strategies are interchangeable and can be used effectively in any situation. B. Decision making is used to solve problems. C. Decision making must be even more deliberative when problems require urgent action. D. Decision making is not a behavior but rather a method in selecting and implementing a course of action from alternative courses of action for dealing with a situation or problem. - CORRECT ANSWER B. Decision making is used to solve problems. Select the statement that describes how clinical decision making differs from managerial decision making. A. Professional nurses in clinical practice are making clinical decisions about client diagnoses and care plan orders, whereas technical nurses are making managerial decisions about containment of costs and maximizing health care delivery. B. Clinical decision making involves the collection of information, selection, and evaluation of an action, whereas managerial decision making involves the processing of existing information to select an action. C. Clinical decision making by nurses is far less sophisticated than managerial decision making by nursing executives, nurse managers, and directors. D. Clinical decision making focuses on diagnosing client health issues, risks, or problems and planning or coordinating nursing interventions, whereas managerial decision making focuses on resolution of organizational problems and the plans to achieve organizational goals. - CORRECT ANSWER D. Clinical decision making focuses on diagnosing client health issues, risks, or problems and planning or coordinating nursing interventions, whereas managerial decision making focuses on resolution of organizational problems and the plans to achieve organizational goals. Decision-making tools and strategies support the process for decisions. Select the one statement that is true. A. Group decision making tends to be more ineffective for system problems. B. All decision tree questions have a yes or no answer. C. Managers who use trial and error as the usual strategy for decision making often are effective. D. Critical pathways are a type of decision tree. - CORRECT ANSWER D. Critical pathways are a type of decision tree. A transformative leadership style influences the effectiveness of group decision making. The rational group decision-making model is based on which of the following? A. Power, influence, negotiation, bargaining, and interest group influence B. Economic perspective of decision making and maximum utility C. Difficulty identifying and resolving problems due to ambiguity, complexity, and illogical step taking D. Use of standard operating procedures and guidelines - CORRECT ANSWER B. Economic perspective of decision making and maximum utility Critical thinking is central to decision making. Which of the following is a true statement? A. Critical thinking and creative problem solving are the same. B. Two cognitive processes, intuition and analysis, are used in critical thinking for nursing judgments. C. A critical thinker sustains the norm or status quo. D. Clinical decision making is the same thing as diagnostic reasoning. - CORRECT ANSWER B. Two cognitive processes, intuition and analysis, are used in critical thinking for nursing judgments. A number of decision-making strategies have been identified for clinical and managerial decision making. An effective strategy for nurse managers to select in examining possible causes related to delivery of services would be: A. pilot projects B. cost-benefit analysis C. scenario planning D. fish bone charts - CORRECT ANSWER D. fish bone charts What habits are characteristics of critical thinking by nurses? (SATA) A. Questioning, reflection, contextual perspective B. Confidence, creativity, flexibility C. Open-mindedness, perseverance D. Quick, concise, purposeful, systematic, within a frame of reference, grounded in information E. Experience, uses database resources and searches - CORRECT ANSWER A. Questioning, reflection, contextual perspective B. Confidence, creativity, flexibility C. Open-mindedness, perseverance Important decisions are made by nurses. Which of the following are examples of collaborated decisions? (SATA) A. Devise an array of plans to optimize client recovery, mobility, and self-care - CORRECT ANSWER maintain airway patency and hemodynamic stability; and prevent the development of decubitus ulcers. B. Plan steps to achieve organizational goals, implement multisystem change processes, and improve service delivery and client outcomes. C. Address complicated and difficult client care risks and problems regarding infection, injury, and contamination. D. Diagnose and document client needs for health promotion, risks, and problems. E. Smart alerts and drug alerts within health information systems. ; B. Plan steps to achieve organizational goals, implement multisystem change processes, and improve service delivery and client outcomes. C. Address complicated and difficult client care risks and problems regarding infection, injury, and contamination. A business approach that ensures a competitive advantage over similar enterprises involves conducting an environmental scan, knowing the competition, establishing goals, setting targets, developing an action plan, implementing the plan, and evaluating success. Which of the following statements is correct? A. The best strategic planning is from the top down. B. The strategic planning process is threatening to employees and creates decreased job satisfaction. C. A basic form of strategic planning is a detailed written business plan with a comprehensive market analysis. D. Strategic management involves strategic planning and implementation. - CORRECT ANSWER D. Strategic management involves strategic planning and implementation. What is the administrative and systematic process to be responsive to environment-related and future-oriented changes that are sensitive to the correct positioning of the organization known as? A. Strategic management B. Tactics C. Strategy D. Performance effectiveness - CORRECT ANSWER A. Strategic management Implementation of a strategic plan can be accomplished when a priority order for achieving the strategic objectives or outcomes exists, responsibility for achieving these objectives has been determined, and some available financial support is provided within an expected timetable. The role of nurses would include: A. Finding out who is responsible for the implementation. B. Waiting to implement until administration develops an action plan that breaks the plan into manageable parts. C. Integrating the strategy into daily activities and keeping the strategy a major agenda item for their nursing department or service. D. Waiting until the workable action plan is presented by nurse leaders. - CORRECT ANSWER C. Integrating the strategy into daily activities and keeping the strategy a major agenda item for their nursing department or service. Similarities between the nursing process and the strategic planning process allow nurses to shortcut the learning curve and begin to move forward with the implementation phase. Strategic management involves: A. Assessing the nursing mission, diagnosing outcomes for needed services, developing a plan to achieve the outcomes, implementing the strategies, and evaluating the changes toward the outcome. B. Identifying the organization's needs, establishing the purpose for new services, planning the action steps, and evaluating the outcomes for the new services. C. Developing a strategic mission or vision, setting objectives, developing strategies to achieve the objectives, implementing the strategies, and evaluating the results. D. Assessing the service needs, planning goals and objectives, implementing the action plan, and evaluating the goals and objectives. - CORRECT ANSWER C. Developing a strategic mission or vision, setting objectives, developing strategies to achieve the objectives, implementing the strategies, and evaluating the results. New policies, programs, projects, and services are developed to meet the needs of patients. Which statements are descriptions of when nurses take steps to use these items? (SATA) A. Strategic management is the processing of an organization's vision or mission. B. Strategic planning is a process of developing an action plan for actualizing the mission. C. Strategic management is nurses making decisions about the delivery of care. D. Nurses use strategic planning to help them meet personal and professional goals. E. Nurses use the principles of strategic planning with other stakeholders to explore programs, projects or services to promote population health, patient satisfaction, and decreased health care costs. - CORRECT ANSWER A. Strategic management is the processing of an organization's vision or mission. B. Strategic planning is a process of developing an action plan for actualizing the mission. E. Nurses use the principles of strategic planning with other stakeholders to explore programs, projects or services to promote population health, patient satisfaction, and decreased health care costs. When clients are grouped together and cared for by one nurse, this is known as: A. Functional nursing B. Team nursing C. Group nursing D. Primary nursing. - CORRECT ANSWER C. Group nursing A collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet multiple service needs of clients and families is known as: A. Case management B. Total client care C. Private duty nursing D. Managed care - CORRECT ANSWER A. Case management Nurse managers, in collaboration with nursing leadership, design nursing systems for the provision of client care and the betterment of the organization. Nurse managers should consider which of the following as important? A. Two factors that nurse managers must consider when designing a care delivery system are the type of nursing skilled staff and turnover. B. Mixed model approaches offer a confusing type of nursing care delivery system, with trying to balance nurse's needs with those of clients, physicians, and organizations. C. Models that promote professional practice have implications for job satisfaction, the character of professional practice, and the amount of control staffing leading to turnover. D. They should include staff nurses in the development and selection process of the professional practice model. - CORRECT ANSWER D. They should include staff nurses in the development and selection process of the professional practice model. Variables that influence nursing practice & client care delivery include A. Client-centered versus task-focused versus provider-focused perspective. B. Skill mix for client condition severity, nurse-to-client ratio, use of temporary staff, workload, nursing education and experience, and technology level. C. Medical home structure for more integrated or coordinated between acute and primary care. D. RN preparation, critical thinking, and delegation skills. - CORRECT ANSWER B. Skill mix for client condition severity, nurse-to-client ratio, use of temporary staff, workload, nursing education and experience, and technology level. Nurses involved in the selection or development of a nursing care delivery system should consider which of the following as important? (SATA) A. Fiscal accountability, client characteristics, staffing composition, case mix severity, and clinical service intensity B. Practice guidelines and new medication information and technology C. Role of the RN, practice expectations, accountability of nurses, decision making about care, and provider competencies and experience D. Direct and indirect client nursing care interventions, end of shift reporting, physician-prescribed care, and communication E. Reimbursement models within the Affordable Care Act and American Health Care Act that cover preexisting diseases and other illness across a larger insured population - CORRECT ANSWER A. Fiscal accountability, client characteristics, staffing composition, case mix severity, and clinical service intensity B. Practice guidelines and new medication information and technology C. Role of the RN, practice expectations, accountability of nurses, decision making about care, and provider competencies and experience D. Direct and indirect client nursing care interventions, end of shift reporting, physician-prescribed care, and communication Empowerment and shared decision making are practices found in: A. Small organizations. B. Learning organizations. C. Innovative organizations. D. Stagnant organizations. - CORRECT ANSWER B. Learning organizations. Which of the following statements regarding organizational culture is true? A. Staff are unaffected by organizational climate. B. Staff retention, workplace safety, and patient outcomes are directly affected by the organizational climate. C. Organizational leadership does not affect organizational culture. D. Working in an organizational culture that values continuous learning has been found to decrease nurses' job satisfaction. - CORRECT ANSWER B. Staff retention, workplace safety, and patient outcomes are directly affected by the organizational climate. Resolving conflict requires interventions. One type of intervention requires preparation and planning, ground rules, clarification and justification, bargaining and a closure with implementation. Which of the following is this type of conflict management? A. Negotiation B. Win-win strategy with problem solving C. Restrict or isolate the conflict D. Compromise - CORRECT ANSWER A. Negotiation The type of power exhibited when providing the opportunity for others to take responsibility and accountability for their work is: A. referent power B. empowerment. C. expert power. D. legitimate power. - CORRECT ANSWER B. empowerment. All of the following are true about strategic management except: A. It involves establishing goals and setting targets. B. It allows an organization to obtain and maintain a competitive advantage. C. It includes only financial goals. D. It requires implementation and evaluation. - CORRECT ANSWER C. It includes only financial goals. The registered nurse performs assessment, the licensed practical nurse administers medications, while the certified nursing assistant bathes the patient. This is an example of what type of nursing care delivery model? A. Private duty nursing B. Group nursing C. Functional nursing D. Primary nursing - CORRECT ANSWER C. Functional nursing Which statement regarding leadership and management is false? A. Leadership focuses on people while management focuses on systems and structures. B. Both leadership and management processes seek to accomplish goals. C. Strategies used to accomplish goals may be different in leadership and management. D. Leadership and management have discrete skill sets. - CORRECT ANSWER D. Leadership and management have discrete skill sets. Relationship management is a key leadership skill because: A. Being liked by staff makes it easier to get things done. B. Patient care requires a high degree of interdependence on other care providers. C. Transferring negative moods to staff can decrease productivity. D. Helping staff cope with change is important. - CORRECT ANSWER B. Patient care requires a high degree of interdependence on other care providers. SBAR is used in health care institutions to improve health team communication. Which patient population benefits most from clinicians who use SBAR? A. Acute care patients B. Long-term care patients C. Surgical patients D. Rehabilitation patients - CORRECT ANSWER B. Long-term care patients [Show Less]
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CNL Exam 213 Questions with Verified Answers,100% CORRECT
CNL Exam 213 Questions with Verified Answers 1. The CNL role includes: - CORRECT ANSWER client and community advocacy. The first administration of th... [Show More] e CNL certification exam occurred in - CORRECT ANSWER 2007 The clinical nurse leader role is the first new nursing role in - CORRECT ANSWER over 40 years CNLs can practice - CORRECT ANSWER in all healthcare settings For the CNL, the measure of quality practice is - CORRECT ANSWER client care outcomes A 2012 U.S. Department of Labor report projected that the number of employed nurses would change from 2.74 million in 2010 to ________ in 2020 - CORRECT ANSWER 3.45 million In The Future of Nursing, the Institute of Nursing called for ________ of the nursing workforce to have at least a baccalaureate degree by 2020. - CORRECT ANSWER 80% The CNL graduate education program assumes that - CORRECT ANSWER the graduate does not meet the criteria for advanced practice registered nursing scope of practice. How many models for graduate CNL education programs have emerged? - CORRECT ANSWER 5 In what settings are CNLs currently practicing? - CORRECT ANSWER Outpatient clinics School health Acute-care hospitals Nursing is discipline that is - CORRECT ANSWER relationship-based 12. With changes in the Affordable Care Act, ________ Americans will have access to health services. - CORRECT ANSWER more 13. It could be said that nursing ________ the work of physicians. - CORRECT ANSWER best complements CNL Roles - CORRECT ANSWER Leader Advocate Educator Data interpreter Care Coordinator Communicator Risk anticipator Evidence-based practice Clinician Member of a profession Outcome Manager Design and Implementation Life-long learner Accountability is a CNL - CORRECT ANSWER professional value The CNL role is involved in organizational improvements that are - CORRECT ANSWER outcome and evidence based In The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine - CORRECT ANSWER is compatible with the CNL role The CNL works in - CORRECT ANSWER all practice settings. Acute care/public health etc. Core competencies of the CNL include - CORRECT ANSWER Communication Delegation Interpretation and analysis Business acumen Information management Therapeutic Use of Self Critical Thinking Assessment Nursing technology and Resource management Health promotion, risk reduction, disease prevention Illness and disease management Ethics Global Health care Human Diversity Member of a Profession Provider and manager of care The IOM report indicated that the nursing workforce should be - CORRECT ANSWER more educated. A partnership is between - CORRECT ANSWER cooperating parties with a common goal CNL professional value - CORRECT ANSWER Altruism Advocacy Ethics Accountability Collaboration Human Dignity Advocacy Social Justice Integrity One type of assessment analyzes the ________ between current and desired states. - CORRECT ANSWER gap An unmet need in the education arena - CORRECT ANSWER Increased population diversity Partnerships ________ interdependencies. - CORRECT ANSWER embrace Gap analysis is a - CORRECT ANSWER type of needs assessment. In order for a partnership to move forward, ________ must be present. - CORRECT ANSWER trust respect shared values The term "partnership" has origins in the - CORRECT ANSWER 14th century The first element in the McKinsey 7-S framework is - CORRECT ANSWER structure Measurable improvement with economic value is shown by a - CORRECT ANSWER business case Crucial to the success of the CNL role immersion are - CORRECT ANSWER -operational control. -creation of a scorecard. -regularly scheduled meetings. Metrics must be ________ and produce the ________ gain. - CORRECT ANSWER measurable, largest The important thing about metrics is to - CORRECT ANSWER choose them wisely The chief nurse executive must have ________ for how the CNL will be immersed in the care delivery model. - CORRECT ANSWER a clear vision In the McKinsey 7-S framework, a soft element is - CORRECT ANSWER skills A purpose of the CNL Spread Plan was to - CORRECT ANSWER integrate the CNL role into the patient care model. A ________ identifies communication needs for both internal and external stakeholders. - CORRECT ANSWER communication plan AIM stands for - CORRECT ANSWER Academy for the Improvement of Microsystems. The Office of Nursing Services (ONS) of ________ launched its CNL Spread Plan in 2010 - CORRECT ANSWER the VHA The importance of approaching CNL implementation by first developing a ________ cannot be overemphasized. - CORRECT ANSWER vision of the CNL role imposed from authorities outside the organization The CNL Spread Plan was designed to cover a ________ - year period. - CORRECT ANSWER 5 Stakeholders were ________ the CNL Spread Plan. - CORRECT ANSWER an important part of The CNL is a(n) ________ with a practice focus on the ________. - CORRECT ANSWER point-of-care generalist, microsystem ________ is often referred to as "lean thinking." - CORRECT ANSWER Lean six sigma Therapeutic use of self is an example of a CNL - CORRECT ANSWER core competency. Incorporating a "4-D" cycle, "AI" stands for - CORRECT ANSWER appreciative inquiry. ________ occurs when two or more values, beliefs, and opinions are incongruous and reconciliation of differences has not occurred. - CORRECT ANSWER Conflict The interactive behaviors of individuals within the context of a group refers to ________. - CORRECT ANSWER group dynamics ________ is built on predictable behavior associated with keeping promises and being accountable, even when expectations are not achieved. - CORRECT ANSWER Trust ________ is often associated with empathy, patience, kindness, and concern for others. - CORRECT ANSWER Warmth High self-esteem, sense of self-worth, self-awareness, and confidence are the matrix of ________. - CORRECT ANSWER assertiveness. ________ involves acknowledging and understanding personal strengths, attributes, shortcomings, and vulnerabilities. - CORRECT ANSWER Self-awareness Generally speaking, the nurse manager must demonstrate ________ competence. - CORRECT ANSWER administrative CNL roles include - CORRECT ANSWER -leadership. -design and implementation. -life-long learner -clinician -information manager A major competency for nurse managers is - CORRECT ANSWER communication and relationship building. Member of a profession, or professionalism, is a competency of - CORRECT ANSWER both the CNL and the nurse manager. A major competency for the CNL is - CORRECT ANSWER critical thinking. As a rule, the clinical nurse leader must demonstrate ________ competence. - CORRECT ANSWER clinical To be most effective, the CNL and the nurse manager should form a - CORRECT ANSWER leadership dyad. Global healthcare is a competency of the - CORRECT ANSWER CNL. A core competency of the CNL is risk - CORRECT ANSWER anticipation. CNL and nurse manager roles ________ each other. - CORRECT ANSWER complement The CNL clinical immersion is a ________ hour concentrated practicum. - CORRECT ANSWER 300-400 The first step in selecting a project plan would be - CORRECT ANSWER completing an organization overview. A preceptor is a(n) - CORRECT ANSWER instructor. teacher. professor. The ________ is the only place that success comes before work. - CORRECT ANSWER dictionary The final step of project plan selection would be - CORRECT ANSWER determining buy-in. The individual who observes, listens, learns, engages, and transforms in the immersion process is the - CORRECT ANSWER preceptee The preceptee is a - CORRECT ANSWER student In a clinical immersion, the ________ has the responsibility of assuming accountability for the learning process. - CORRECT ANSWER preceptee CNL professional values include - CORRECT ANSWER integrity. human dignity. advocacy. -accountability Requisites for ensuring successful immersions between schools of nursing and healthcare settings include - CORRECT ANSWER collaborative partnerships and agreements. thoughtful planning and pairing of preceptor and preceptee. The ________ drives the advisory council's organization and development. - CORRECT ANSWER leader The first important step in setting up an advisory council is developing a - CORRECT ANSWER charter 83. Annual assessment of the council should be made by the ________. - CORRECT ANSWER leader CNL professional values include - CORRECT ANSWER integrity. An advisory council can provide both the authority and influence for - CORRECT ANSWER organizational change. A charter - CORRECT ANSWER -formally establishes a council. -identifies a council's goals. Facilitators are part of ________ advisory councils. - CORRECT ANSWER some A role of the CNL is - CORRECT ANSWER -consultant. -group leader. -professional leader. Involving interprofessional stakeholders to facilitate meetings can help promote the CNL role - CORRECT ANSWER beyond the nursing domains. The responsibilities of members of an advisory council include - CORRECT ANSWER -planning programs. -marketing. -communication. The Joint Commission says that high-reliability organizations need to focus on - CORRECT ANSWER mindfulness and perfection. Financial stewardship is a ________ of the CNL. - CORRECT ANSWER professional value HROs have a(n) - CORRECT ANSWER preoccupation with failure. Roles of the CNL include - CORRECT ANSWER catalyst. As assumption of the AACN for preparing the CNL is that - CORRECT ANSWER -practice is at the microsystems level. -client-centered practice is intra- and interdisciplinary. -information will maximize self-care and client decision-making. In the five-step model of EBM/EBP of Sackett and colleagues, the first step is to - CORRECT ANSWER assess the patient. The healthcare economic model is undergoing a transition from a focus on ________ to a focus on ________. - CORRECT ANSWER volume, high-value outcomes. CNL core competencies include - CORRECT ANSWER -data analysis. -critical thinking. -ethical decision-making. -communication -disease prevention -risk reduction -human care systems and policy -health promotion design/management/coordination of care. A microsystem is defined as the ________ unit on the frontline of healthcare delivery systems. - CORRECT ANSWER smallest A core principle of HROs is - CORRECT ANSWER resilience. CNL competencies include - CORRECT ANSWER a. critical thinking. b. team leader. c. ethical decision-making. The key feature of quality improvement is the ________ nature of the process. - CORRECT ANSWER cyclical Historically, risk management focused on - CORRECT ANSWER reducing liability. A professional value of the CNL is - CORRECT ANSWER social justice The domains of enterprise risk management (ERM) include - CORRECT ANSWER a. clinical operations. b. finance. c. technological risks. In quality improvement methodologies, the step of mapping the current processes occurs before - CORRECT ANSWER root cause analysis. A characteristic of continuous quality improvement is - CORRECT ANSWER systems perspective. A CNL role is - CORRECT ANSWER member of a profession. Irrespective of the quality improvement methods that an organization selects, they all have common steps. The first step is - CORRECT ANSWER having a clear and defined aim or purpose. Brainstorming, cause and effect diagrams, and Pareto charts are common ________ used in quality improvement efforts. - CORRECT ANSWER tools The first step in solving problems is - CORRECT ANSWER identifying and documenting the problems. In collecting data, the CNL should be sure to collect the ________ data. - CORRECT ANSWER most granular Most inferential statistics are built on the model of the ________. - CORRECT ANSWER normal curve A core competency of the CNL is - CORRECT ANSWER data analysis. Data are critical for - CORRECT ANSWER a. documenting the existence of a problem. b. documenting the processes that result in the problematic outcome. c. demonstrating that an improvement initiative resulted in actual improvement. True experimental, quasi-experimental, and preexperimental are types of - CORRECT ANSWER basic design options. The first step in problem identification is - CORRECT ANSWER collecting data on the problem. Roles of the CNL include - CORRECT ANSWER -advocate -catalyst -risk averter life-long learner -information manager -clinician With inferential statistics, remember that the conclusions are always - CORRECT ANSWER probability statements. A profssional value of the CNL is - CORRECT ANSWER integrity human dignity accountability genuineness advocacy Clinical ________ refers to the process of enhancing health-related decisions and actions through the use of relevant, organized clinical knowledge and patient information to improve health and healthcare quality and outcomes. - CORRECT ANSWER decision support A benefit of the use of informatics for care delivery is - CORRECT ANSWER access to timely information ________ is concerned with data, information, knowledge, and wisdom. - CORRECT ANSWER Nursing informatics According to Albert Einstein, imagination is ________ knowledge. - CORRECT ANSWER more than Educator is a ________ of the CNL. - CORRECT ANSWER role CNL core competencies - CORRECT ANSWER -resource management -assessment -information and healthcare technologies -diversity -communication -nursing technology The centerpiece in leveraging information technology is generally - CORRECT ANSWER Electronic medical record ________ is a multidisciplinary science that involves the integration of healthcare science, computer science, information science, and cognitive science to support management of healthcare information. - CORRECT ANSWER Healthcare informatics ________ is the extent to which people have the ability to obtain, process, and understand basic health information needed to make appropriate health decisions. - CORRECT ANSWER Health literacy In the 6S model, the goal is to start ________ and work ________. - CORRECT ANSWER high downward Client advocate is a ________ of the CNL. - CORRECT ANSWER role Google ___________PubMed - CORRECT ANSWER does index In healthcare, with its multicomponent interventions, ________ research methods are used. - CORRECT ANSWER both quantitative and qualitative For those in clinical practice who may want to carry out a fairly rapid appraisal of a systematic review, an appropriate choice might be - CORRECT ANSWER AMSTAR EndNote, RefWorks, and Procite are examples of - CORRECT ANSWER d. reference management software packages. Qualitative research covers approaches arising out of fields such as - CORRECT ANSWER anthropology Original studies from journals are found ________ the 6S pyramid. - CORRECT ANSWER at the lowest level of Meta-analyses would be found at the ________ of the evidence pyramid. - CORRECT ANSWER top In the PICOT question-writing format, the "C" stands for - CORRECT ANSWER comparison Case reports and quality improvement data are ________ sources of evidence. - CORRECT ANSWER non-research 2. Consensus and textbooks would be found at the ________ of the evidence pyramid. - CORRECT ANSWER bottom The ________ is often described as the "gold standard" research design. - CORRECT ANSWER randomized controlled trial (RCT) The final step in the EBP process is - CORRECT ANSWER assess the outcomes The first step in the EBP process is - CORRECT ANSWER ask a question The clinical nurse leader and nurse manager should work - CORRECT ANSWER in a dyad Observing the behaviors of leadership and staff can provide insight into the ________ and its/their underlying values, beliefs, and norms. - CORRECT ANSWER culture In a ________, traditionally an article of interest is chosen and then discussed. In an EBP culture, the focus might broaden to include critiques of systematic reviews. - CORRECT ANSWER jounal club Risk anticipator/averter is a ______ of the CNL. - CORRECT ANSWER role 1. The microsystem and macrosystem are - CORRECT ANSWER linked integrally An EBP ________ is a person who serves to implement and sustain EBP despite competing priorities. - CORRECT ANSWER mentor Dignity is a ___________of the CNL - CORRECT ANSWER professional value Infrastructure includes - CORRECT ANSWER -human resources -material resources -computer access to EBP Strategies to support an EBP culture include - CORRECT ANSWER -nursing rounds -journal club -education At present there are _______ improvement scientists - CORRECT ANSWER few Accountability is a ________ of the CNL. - CORRECT ANSWER professional value ________ can use their understanding of improvement science to advance their roles. - CORRECT ANSWER CNLs ________ has raised the bar in translating research evidence at the bedside and at the point of care. - CORRECT ANSWER Improvement science Ethical decision making is - CORRECT ANSWER a core competency of the CNL. The widespread, often glaring, problems in healthcare quality - CORRECT ANSWER often have causes that remain unclear. The terms "complexity science," "science of change," "implementation science," and "improvement science" are - CORRECT ANSWER interrelated and overlapping Today, improvement research tends to be - CORRECT ANSWER Opportunistic The Institute of Medicine found that one barrier to progress in improvement research was - CORRECT ANSWER absence of a scientific "home" for improvement science. Community ________ require(s) interprofessional communication, collaboration, and being able to prioritize. - CORRECT ANSWER assessment Complexity theory maintains that the experience of community is - CORRECT ANSWER an outcome and the context of informal networking. The epidemiological ________ is central to community diagnosis. - CORRECT ANSWER triad Discharge planning begins - CORRECT ANSWER with the first encounter with the patient The natural history of ________ model describes the progression of disease. - CORRECT ANSWER disease The roles of the CNL include - CORRECT ANSWER -outcomes manager -educator -client advocate ________ Maps provide an excellent tool for leading teams through innovation. - CORRECT ANSWER Mind According to Coleman, the Care Transitions Program - CORRECT ANSWER supports patients and families. Three rules of __________ , according to Loehr, are purpose, truth, and action. - CORRECT ANSWER storytelling With the Patient Protection and Affordable Care Act, the national health care agenda is focused on - CORRECT ANSWER wellness About what percentage of healthcare costs is spent on health promotion in the United States? - CORRECT ANSWER 5% Provide and manage care is a ________ of the CNL. - CORRECT ANSWER core competency WHO's plan to improve health outcomes includes - CORRECT ANSWER a. promoting socioeconomic development. b. enhancing collaboration. c. applying research, information, and evidence A Readiness to Change ________ is a tool to help healthcare providers understand patient thinking about behavioral change. - CORRECT ANSWER Ruler Human dignity is a ________ of the CNL. - CORRECT ANSWER professional value From 2002 to 2012, employers paid a ________ increase in healthcare premiums - CORRECT ANSWER 97% CNL core competencies include - CORRECT ANSWER -communication -disease prevention -risk reduction -data analysis. -critical thinking. -ethical decision-making. The increased cost of insurance and health care in the United States can be attributed to - CORRECT ANSWER a. healthcare technology. b. overtreating patients. c. an older population. ________ and adherence to treatment are more likely when patient and provider have a collaborative partnership. - CORRECT ANSWER Self-care Evidence of outcomes in the LTC setting is - CORRECT ANSWER sparse Transformer is a __________ of the CNL - CORRECT ANSWER role One way to gauge the success of the CNL role is through reduced - CORRECT ANSWER turnover The ________ Data Set (MDS) collects information about the type of care need for an individual LTC resident. - CORRECT ANSWER Minimum CNL core competencies include - CORRECT ANSWER -human care systems and policy -health promotion design/management/coordination of care. Practice care settings of the CNL include the - CORRECT ANSWER a. ambulatory care setting. b. long-term care setting. c. acute specialty care setting. Historically, CNLs have practiced mainly in ________ settings. - CORRECT ANSWER inpatient acute care When patients are receiving both specialty and primary care services, issues include - CORRECT ANSWER a. care transition. b. responsibility for care. c. patient autonomy. Altruism and integrity are _______ of the CNL - CORRECT ANSWER professional values Helping a patient obtain needed health care—perhaps dealing with cost, language, and geographical barriers—is a part of ________. - CORRECT ANSWER advocacy The time for CNL students to start keeping a portfolio is - CORRECT ANSWER right from the beginning of their coursework. After identifying ________, a CNL student can organize a clinical immersion project. - CORRECT ANSWER gaps The business case for a CNL project must be supported by ________ - based data. - CORRECT ANSWER evidence When a CNL accepts a position, a performance ________ is often used to define role expectations and markers of impact and success. - CORRECT ANSWER contract The ideal clinical experience should - CORRECT ANSWER a. be creatively developed. b. be meaningful to the student. c. add value for the organization. How many components does a business model have? - CORRECT ANSWER 3 Design/management/coordination of care is ________ of the CNL. - CORRECT ANSWER core competency When developing an immersion project, the CNL will find - CORRECT ANSWER multiple resources available to help. 5 P's - CORRECT ANSWER Purpose Patients Professionals Processes Patterns Among the CNL's many roles is - CORRECT ANSWER life-long learner Elements of a CNL transition to practice program include - CORRECT ANSWER a. the framework. b. curriculum development. c. program structure. Compared to an RN residency, CNL transition to practice programs - CORRECT ANSWER may differ considerably The VHA example given in the chapter of a CNL transition to practice program is based upon - CORRECT ANSWER self-study Characteristics of preceptor support are ________ novice nurse performance. - CORRECT ANSWER predictors of Facilitation is a CNL - CORRECT ANSWER core competency Curriculum of the CNL transition to practice program should - CORRECT ANSWER a. not duplicate academic coursework. b. extend learning beyond the clinical immersion experience. CNL professional values include - CORRECT ANSWER a. accountability. b. integrity. ________ is a form of reflective observation that can serve as a basis for CNL praxis. - CORRECT ANSWER Journaling Measures of program success may include - CORRECT ANSWER a. the number of novice CNLs successfully completing the program. b. evaluation feedback from the CNLs. c. evaluation feedback from the preceptors. Communicator, educator, and advocate are CNL __________. - CORRECT ANSWER roles Which one of the following is not one of the 10 principles of servant leadership - CORRECT ANSWER Servitude As clinical leaders, CNLs are - CORRECT ANSWER action oriented The CNL ________ stakeholders in understanding the improvement process. - CORRECT ANSWER engages Which of these questions is more to the point? - CORRECT ANSWER b. "Should we be doing what we're doing?" Roles of the CNL include - CORRECT ANSWER -communicator -advocate -outcomes manager ________ leaders focus on completion of tasks, and try to carry out decisions with little disruption or conversation. - CORRECT ANSWER Transactional The CNL can serve as a clinical leader by - CORRECT ANSWER a. setting direction. b. improving services. c. developing personal qualities. ________ is about the coevolutionary search for the best in people, their organizations, and the relevant world around them. - CORRECT ANSWER Appreciative Inquiry (AI) Collaboration is a CNL - CORRECT ANSWER core competency In Lippitt's theory, the final stage is - CORRECT ANSWER terminate the helping relationship. [Show Less]
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CNLs 5540 Exam 1 (King & O'Toole Ch. 5, 6, 7, 8, 9, 10, 11, 12, 13) Questions with Answers,GRADED A
CNLs 5540 Exam 1 (King & O'Toole Ch. 5, 6, 7, 8, 9, 10, 11, 12, 13) Questions with Answers Which of the following defines horizontal leadership? - COR... [Show More] RECT ANSWER It is a philosophy of organizational leadership whereby the structure promotes equality and an "open-door policy." Explanation It allows team members to voice their opinions and to provide feedback freely. Clinical nurse leaders (CNLs) have shown a positive effect on numerous healthcare outcomes. Which of the following outcomes is least affected by CNLs? A Changing practice to be based on staff preference B Financial savings C Improvement in various quality processes D Increased patient and staff satisfaction - CORRECT ANSWER A Changing practice to be based on staff preference Explanation Evidence has demonstrated that CNLs have a positive effect on numerous outcomes. This includes increasing patient and staff satisfaction, financial savings, and quality processes. Which of the following is not considered a Change theory? A Lewin's Model B Transactional leadership theory C Kotter's Theory D D. Lippitt's Theory - CORRECT ANSWER B Transactional leadership theory Explanation Offering rewards to others in return for compliance is defined as transactional leadership theory. This involves motivating and directing followers by appealing to their own self-interests. A patient for whom you are caring is unable to maintain the ideal nutrition related to inadequate intake and knowledge deficit. You work with this patient to mutually plan and identify the objectives. The patient is made to understand the required changes in behavior so as to have the requisites met. Which of the following is operative here? A Complexity Theory B Change Theory C Orem's Self-Care D Leininger's Culture Care Diversity and Universality - CORRECT ANSWER C Orem's Self-Care Explanation Orem's Self-Care enables the planning of nursing care to be systemic, predictable, and purposeful. In the theory of self-care, Orem explains self-care as the activities carried out by individuals to maintain their own health. The following describes a horizontal organization: A One which allows managers to make decisions alone without the input of others B Top-down style of leadership whereby team members are not encouraged to question or provide feedback C One of decentralization of power and/or control, at least within specific departments D One that values the input of team members and peers, but the responsibility of making the final decision rests with the participative leader - CORRECT ANSWER C One of decentralization of power and/or control, at least within specific departments Explanation Horizontal organization is one of decentralization of power and/or control, at least within specific departments. The emphasis is placed on horizontal collaboration. In order to practice horizontal leadership, the clinical nurse leader (CNL) needs a "tool kit" of skills. These include all except which of the following? A Vertical integration B Use of feedback C healthcare outcomes D Guiding EBP practice - CORRECT ANSWER A Vertical integration Explanation Critical skills in order to practice horizontal leadership include guiding evidence-based practice, healthcare outcomes, lateral integration, use of feedback, coaching, and leading teams. How does a clinical nurse leader (CNL) best promote a culture of safety? A The CNL evaluates various nursing interventions when applicable. B The CNL develops the skills to lead teams to reach the desired goal. C The CNL evaluates and assesses risks to patient safety and works within a team to design and implement systems that support safe patient care. D The CNL continues to act as a mentor in the design of care, as well as in the professional development of individual nurses. - CORRECT ANSWER C The CNL evaluates and assesses risks to patient safety and works within a team to design and implement systems that support safe patient care. Explanation To promote a culture of safety, the clinical nurse leader (CNL) learns how to evaluate and assess risks to patient safety and then works within the team to design and implement systems that support safe patient care. As a clinical nurse leader (CNL), you are assigned to be a team leader for a specific project within your microsystem. Which of the following is not considered a tool for success? A Establishing team ground rules B Creating conflict on sensitive issues prior to the meeting C Developing an agenda D Providing members with meeting-minutes - CORRECT ANSWER B Creating conflict on sensitive issues prior to the meeting Explanation Leader tools for success include agendas, meeting-minutes, as well as team ground rules for CNLs to use. Discussion-sensitive issues that create conflict are not an effective method for leading a team that will need to work collaboratively on a project. What best describes the difference between mentoring and coaching? A Mentoring involves a long-term relationship as compared to coaching which is short-term. B Coaching focuses on learning, more complex ways of thinking, and problem solving. C Mentoring evaluates team members and constructively criticizes team members' performances. D Coaching helps other nurses achieve desired professional goals. - CORRECT ANSWER A Mentoring involves a long-term relationship as compared to coaching which is short-term. Explanation Mentoring involves a long-term relationship oriented toward nurses who are focused on advancing clinically. Coaching involves evaluating team members and constructively criticizing team members' performances. The process of designing quality improvement requires the clinical nurse leader (CNL) to develop and lead a team of individuals toward what type of goal? A Short-term B Common C Time-oriented D Long-term - CORRECT ANSWER B Common Explanation The process of designing quality improvement requires the CNL to develop and lead a team of individuals toward a common goal. A patient for whom you are caring has a complicated medical history with a multitude of acute problems. As the clinical nurse leader (CNL), you ensure that everyone caring for that patient understands the entire plan of care. This is an example of which type of leadership or CNL role? A Horizontal leadership B Vertical leadership C Coordinator D Lateral integration - CORRECT ANSWER D Lateral integration Explanation The CNL lateral integrator role can be compared to that of the air traffic controller who has a balcony view of what is happening with the patient and healthcare team and system. What does the clinical nurse leader (CNL) use to guide decisions regarding care and leadership decisions as well as to improve the quality of patient care in the microsystem? A Research B Patient satisfaction scores C healthcare outcomes D Evidence-based practice - CORRECT ANSWER D Evidence-based practice Explanation The CNL uses evidence-based practice to guide decisions regarding care and leadership decisions and to improve the quality of patient care in the microsystem. Which of the following skills is not included when providing feedback? A Clearly stating what you plan to say B Using "you" statements rather than "I" statements C Avoiding giving advice D Avoiding generalization - CORRECT ANSWER B Using "you" statements rather than "I" statements Explanation Giving and receiving feedback are part of horizontal leadership. Feedback should include the use of "I" statements rather than "you" statements. Which of the following is not an example of how the clinical nurse leader (CNL) uses effective communication? A Conveying clear and detailed messages B Active listening C Nonverbal communication D Assertiveness - CORRECT ANSWER A Conveying clear and detailed messages Explanation Effective communication includes verbal and nonverbal communication, active listening, assertiveness, conveying clear and simple messages, and being specific. Care provided by multiple interdependent and independent disciplines across a continuum of patient admission or experience is known as which of the following? A Horizontal leadership B Coaching C Mentoring D Lateral integration - CORRECT ANSWER D Lateral Integration Explanation Lateral integration is defined as the integration of care provided by multiple interdependent and independent disciplines across a continuum of patient admission or experience. What is the best way for the clinical nurse leader (CNL) to integrate evidence-based practice (EBP) into patient care? A Post EBP articles throughout the unit. B Ask staff members to research articles about EBP. C Use EBP principles to design care for individuals or populations. D Educate the staff on the definition of EBP and how it can be applied to practice. - CORRECT ANSWER D Educate the staff on the definition of EBP and how it can be applied to practice. Explanation In order for evidence-based practice (EBP) to be integrated into care, the CNL may need to educate the staff on the definition of EBP and how it can be applied to practice. With whom should the clinical nurse leader (CNL) collaborate in order to promote an environment of safety and ethical care? A Charge nurse B Nurse Manager C Administration, nurse manager, and nursing team D Staff members - CORRECT ANSWER C Administration, nurse manager, and nursing team Explanation The CNL collaborates with the administration and/or nurse manager as well as all members of the team (e.g., nurses, aides) to promote an environment of safety and ethical care. Which of the following best describes the essential critical listening concept of ethos? A Speaker credibility, expertness, and trustworthiness B Interactive engagement requiring full, focused attention C Logical arguments, valid inferences, and conclusions D Psychological appeal to needs and values of audience - CORRECT ANSWER A Speaker credibility, expertness, and trustworthiness Explanation Ethos refers to the credibility of the speaker including expertness and trustworthiness. James is a clinical nurse leader (CNL) working with congestive heart failure patients at the local community health clinic. James works with the patients and interdisciplinary team to ensure safe, high quality, efficient, patient-centered care. Which of the following best describes what James is demonstrating? A Coordination B Communication C Collaboration D Evaluation - CORRECT ANSWER C Collaboration Explanation Collaboration is a joint effort of a team with a common goal to improve patient outcomes. The clinical nurse leader (CNL) observes nursing staff not utilizing purposeful hourly rounding on a cardiac unit. Which of the following best describes how the CNL can increase communication utilizing purposeful hourly rounding with the staff? A Develop a checklist for staff to utilize when performing purposeful hourly rounding. B Participate in a simulation exercise in which the staff performs purposeful hourly rounding. C Give the staff articles about the effectiveness of purposeful hourly rounding. D Develop a team to identify common barriers to purposeful hourly rounding. - CORRECT ANSWER B Participate in a simulation exercise in which the staff performs purposeful hourly rounding. Explanation The CNL can increase communication and provide constructive feedback to staff during simulation exercises. The clinical nurse leader (CNL) facilitates, coordinates, and oversees care provided by the healthcare team. This best describes which of the following roles? A Risk anticipator B Lateral integrator C Team manager D Outcomes manager - CORRECT ANSWER B Lateral integrator Explanation Lateral integration of care involves the CNL as the leader of care; overseeing care provided by the healthcare team; identifying barriers; and working with the team to proactively manage potential problems. Nina is a new graduate nurse on a medical-surgical unit and is caring for an 84-year-old male with diabetes mellitus. Nina asks the clinical nurse leader (CNL) on the unit how best to educate the patient on insulin administration. Which of the following is the best suggestion by the CNL? A Show the patient a video of insulin administration. B Have the patient practice the use of insulin administration using saline. C Provide the patient with a link to a You-Tube video for further education after discharge. D Give the patient a diabetes survival skills packet to read. - CORRECT ANSWER B Have the patient practice the use of insulin administration using saline. Explanation The best way to communicate with the patient is in person. By utilizing demonstration, the nurse will be able to ensure the patient is correctly administering insulin and communicate any corrections. A 24-bed critical care unit has experienced an increase in ventilator-associated pneumonia (VAP) within the past year. The clinical nurse leader (CNL) is asked to facilitate a workgroup focused on developing a plan to prevent VAP. Which of the following best exhibits how the CNL promotes communication within the team? A Assigns each member a role, ensuring everyone understands his or her job. B Engages the team in shared decision making before finalizing a plan. C Shares clear goals, messages, and plans with the team throughout the process. D Synthesizes the input from the team to find common themes and goals. - CORRECT ANSWER C Shares clear goals, messages, and plans with the team throughout the process. Explanation The CNL communicates within a team by fostering the flow of information and serving as a translator. The CNL actively solicits input and shares information with the team. [Show Less]
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Healthcare Systems and Nurse as a Leader Exam 22 Questions with Verified Answers,100% CORRECT
Healthcare Systems and Nurse as a Leader Exam 22 Questions with Verified Answers HCAHPS - CORRECT ANSWER initiative is to provide a standardized surve... [Show More] y instrument and data collection methodology for measuring patients' perspectives on hospital care. Hospital-Acquired Conditions - CORRECT ANSWER pressure ulcers, CAUTIs = not reimbursed Role of the Nurse in Hospitals - CORRECT ANSWER Direct care providers Manager of other members of health care team Administrator Nurse practitioner Clinical nurse specialist Patient educator In-service educator Researcher Nurses' Role in Health Care Reform - CORRECT ANSWER Changes taking place in health care give nurses the opportunity to help shape health care for the future. Nurses are becoming a stronger voice in addressing health-related problems in our nation and proposing solutions. Nurses in greater numbers are increasing their education and becoming APRNs. The focus of nursing care provided by all nurses is holistic care essential to promoting health and preventing illness. Explicit Power - CORRECT ANSWER Power by virtue of position Implied Power - CORRECT ANSWER power due to other factors, such as personality Leadership qualities - CORRECT ANSWER Charismatic Dynamic Enthusiastic Poised Confident Self-directed Flexible Knowledgeable Politically aware Achieving self knowledge - CORRECT ANSWER Identify your strengths. Evaluate how you accomplish work. Clarify your values. Determine where you belong and what you can contribute. Assume responsibility for relationships. Autocratic Leadership - CORRECT ANSWER involves a firm, insistent, self-assured leader who keeps at the center of attention. direct leader takes control of decisions. Democratic Leadership - CORRECT ANSWER characterized by a sense of equality among the leader and other participants; participative leader Laissez-Faire Leadership - CORRECT ANSWER the leader relinquishes power to the group; non directive leader Quantum Leadership - CORRECT ANSWER organization and members are interconnected and collaborative, impact of the info and technology Transactional Leadership - CORRECT ANSWER based on task and reward, reward good behavior and punish bad Tranformational - CORRECT ANSWER leader is inspiring, motivating, visionary Factors Prompting Change in Health Care Industry - CORRECT ANSWER Increase in the number of chronically ill patients, increased role of government, increased cost of care, changing patterns of healthcare delivery Conflict Resolution Strategies - CORRECT ANSWER Avoiding Collaborating Competing Compromising Cooperating/accommodating Smoothing Factors Increasing the Power Base of Nursing - CORRECT ANSWER Right timing Size of the nursing profession Nursing's referent power Increasing knowledge base and education for nurses Nursing's unique perspective Desire of consumers and providers for change Evidence-Based Strategies to Improve Leadership Skills - CORRECT ANSWER Strive to become an authentic leader. Develop leadership skills. Promote a healthy work environment. Engage staff to commit to their best effort at work. Assist new graduates to transition into the RN roles. Clinical Nurse Leader Role - CORRECT ANSWER Position was created by the American Association of Colleges of Nursing (AACN) as a leadership role. The CNL works collaboratively with the health care team to facilitate, coordinate, and oversee patient care. The CNL should be able to clearly communicate with other health care professionals, integrate evidence-based practices into patient care, and evaluate patient risks and outcomes. The person-centered focus of the CNL role includes functioning as a patient advocate, educator, and provider of patient care in complex situations. Considerations When Delegating Nursing Care - CORRECT ANSWER Patient's condition Complexity of the activity Potential for harm Degree of problem solving and innovation necessary Level of interaction required with the patient Capabilities of the UAP Availability of professional staff to accomplish workload ANA Principles for Delegating Care - CORRECT ANSWER The nursing profession determines the scope of nursing practice. The nursing profession defines and supervises UAPs involved in providing direct nursing care. The RN is responsible and accountable for nursing practice. The RN supervises any assistant providing direct patient care. The purpose of UAP is to work in supportive role to the RN. Factors to Consider Prior to Delegating Patient Care - CORRECT ANSWER Qualifications and capabilities of the UAP Stability of the patient condition Complexity of the activity to be delegated The potential for harm The predictability of the outcome The overall context of other patient needs [Show Less]
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CNL Week 6 Exam Questions with Verified Answers,100% CORRECT
CNL Week 6 Exam Questions with Verified Answers A doctorate level nurse is promoted to Director of Nursing. This nurse leader possesses which type of po... [Show More] wer? - CORRECT ANSWER Legitimate A nurse leader should utilize which types of power in managing staff members? - CORRECT ANSWER FormalA nurse leader has been given formal power and the ability to utilize sanctions in the form of rewards or punishment. Correct InformalA nurse leader can utilize their influence over others based on their track record of making good decisions. This is a type of informal power and may be even more influential than formal power. Correct Legitimate Which skills are important for a new nursing graduate to possess when attempting to earn informal power within an organization? - CORRECT ANSWER The ability to provide a sense of belonging and recognition to staff members The ability to persuade others by using positive communication skills, such as providing open discussion for concerns Which scenarios demonstrate a productive utilization of power? - CORRECT ANSWER Utilizing expert power when providing patient and family education Utilizing informational power to coach a new graduate on how to successfully complete a complex nursing procedure Utilizing connection power by identifying and maintaining relationships with individuals who are sources of advice, information, and support A clinical nurse manager is preparing a list of activities to discuss during a staff meeting. Which action by the nurse will promote professional staff development? - CORRECT ANSWER Implementing collaboration with staff nurses Which nurse manager enjoys an irreplaceable power? - CORRECT ANSWER A nurse manager who speaks fluent English, Spanish, and Chinese A nurse manager threatens to fire staff nurses who refuse to render overtime. In which manner does the nurse manager display power? - CORRECT ANSWER Abuse of power A clinical nurse manager has consistently received high performance ratings from the staff nurses on the unit. Which management style does the nurse leader exhibit? - CORRECT ANSWER Institutional The clinical nurse manager disciplines a newly hired staff nurse by implementing a mandatory extension in working hours after learning that the staff nurse prepared the wrong drug for a patient. Which physical symptoms would the staff nurse likely experience? - CORRECT ANSWER Insomnia Nervousness 1A nurse leader explains that starting the next day, a new process for orientation will be implemented. The new process requires all nurses to participate to reduce attrition of new nurses. According to Lewin's change theory, what should have been done differently to influence positive outcomes of this change? - CORRECT ANSWER Announce the change as it is developed Involve individuals who are affected by the change to help plan the change 2According to the American Organization for Nurse Executives (AONE), what should a new nurse manager do to effect change within an organization? - CORRECT ANSWER Use change theory to foster change Identify how one responds to change and keep an open mind Serve as a change agent and support staff during times of change 3Which attributes allow a nurse leader to advocate for and implement positive changes in patient care? - CORRECT ANSWER PersonaWith persona, an individual is self-motivated and generates enthusiasm, and this is an attribute of a nurse leader who is also a change agent. Correct CommitmentCommitment helps one to be excited, and this is an attribute of a nurse leader who is also a change agent. Correct ConsiderationConsideration and care for patients helps one be committed to the patients and patients' welfare. This is an attribute of a nurse leader who is also a change agent. Correct Sense of humor 4A nurse manager has accepted a new position on a labor and delivery unit on the Navajo Reservation. The nurse previously worked on a busy inner-city maternity floor. Which components of foundational expertise should the nurse include in this new transition? - CORRECT ANSWER Learn about the health care system in the communityKnowledge about current societal trends, especially when working in an institution that may use alternative care, is a component of foundational expertise. Correct Support the presence of traditional medicine on the unitIntegrating holistic care, such as permitting the practice of traditional medicine, is a component of foundational expertise. Correct Interact closely with nurses who have practiced at the hospital for years The nurse manager of the Medical-Surgical Unit has noted an increase in patient falls and medication errors over the last quarter. Using Kotter's model, which measures should the nurse manager implement? - CORRECT ANSWER Develop a plan for improving patient safetyCreating a vision to foster the change is one of Kotter's principles. Correct Celebrate small improvements in patient safetyOne of Kotter's principles is to celebrate small successes to motivate future successes; simply communicating these changes will not foster change. Correct Join forces with other nurses to help foster changeCreating a coalition group to improve patient safety will foster change and reflects one of Kotter's principles. This will also help to promote the change. Correct Identify barriers to improving patient safety and remove them A home health nurse visits a patient with newly diagnosed type 2 diabetes. During the nutritional assessment, the nurse notes that the patient regularly eats fast food. Which are appropriate actions for the nurse to take as a change leader? - CORRECT ANSWER Help the patient to plan weekly dietary intake Give the patient the phone number for a diabetes educator The nurse manager on an oncology unit is developing a new protocol that will improve documentation of patient care. Which action should the nurse manager take as a change agent? - CORRECT ANSWER Involve all staff members who are responsible for documentation of patient care 1Which motivating behaviors are important for nurse leaders to perform? - CORRECT ANSWER Motivating patients and family to ensure treatment plans are followedInspiring patients and family members is an important motivational skill that nurse leaders must display to encourage patients to attain their goal, such as to recover or maintain good health. Correct Providing staff with guidance to ensure they achieve the desired patient outcomeSupporting staff in achieving the goals and vision of the organization is a motivational skill for nurse leaders to inspire staff members. Correct Contributing time and knowledge to community outreach programs 2Which scenario represents an internal force of motivation? - CORRECT ANSWER Low morale of nursing staff in the unit due to frequent changes in management 3Which statements describe factors nurse leaders must know about their role in motivating staff? - CORRECT ANSWER "Motivation is an inner drive that controls behavior."Knowing the definition of motivation is one of the fundamental steps that nurse leaders should take to motivate staff. Correct "The nurse leader must be self-motivated in order to effectively motivate others." "Effective motivation helps to persuade and compel others into accomplishing tasks and reaching goals." 4Which actions by the nurse leader support a transformational leadership style? - CORRECT ANSWER Inspiring others to create a vision Allowing for input on decision-making among staff as part of providing purpose for subordinates Which motivational strategies are utilized by a nurse leader who displays a transformational leadership style? - CORRECT ANSWER Provide support and respectProviding support and respect is a strategy used in transformational leadership, which encourages leaders and followers to advance to a higher level of morale and motivation. Correct Provide training and orientationProviding training and orientation is an approach used in transformational leadership to prepare and equip employees to ensure they have the competencies required to perform the job satisfactorily. Correct Demonstrate good performance Which scenario characterizes transactional leadership in the nursing discipline? - CORRECT ANSWER The nurse leader imposes punishments that include progressive discipline. [Show Less]
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PrepU Chapter 1&Concept 41 – Leadership Questions with Answers,100% CORRECT
PrepU Chapter 1&Concept 41 – Leadership Questions with Answers A nurse wishes to advance his or her career and work as a clinical nurse specialist. Wh... [Show More] ich statement regarding scope of practice should the nurse keep in mind? - CORRECT ANSWER The nurse may teach advanced education for nurses. A clinical nurse specialist may offer advanced education for nurses. A clinical nurse leader, not a clinical nurse specialist, oversees the care coordination of a specific group of clients. A career as a clinical nurse specialist requires at least a master's degree in nursing, not a doctoral degree. Clinical nurse specialists do not practice with private practitioners only. They can also work in hospitals and community health agencies. The first nursing journal owned, operated, and published by nurses was: - CORRECT ANSWER American Journal of Nursing The American Journal of Nursing was first published in 1900 and was owned, operated, and published by nurses. It continues to provide information that may be of interest to nurses in all nursing specialties, and those who practice general nursing. Nurse Educator is a more recently developed journal which specializes in nursing education and targets nurse educators. Nursing Research is also a more recently developed nursing journal with a focus on nursing research and targets nurses interested in research. Standards of Clinical Nursing Practice are directives and guidelines that may be published as books available to nurses for purchase and review. It is not a nursing journal. The registered nurse communicates with the physical therapist that a client is now on strict bed rest due to bradycardia. Which statement best explains the standard exemplified by the nurse? - CORRECT ANSWER The RN coordinates care delivery. There are 12 Standards of Practice: assessment, diagnosis, outcomes identification, planning, implementation, evaluation, ethics, culturally congruent practice, communication, collaboration, leadership, and education. The standard exemplified by the nurse is 5a, implementation via coordination of care in which the RN coordinates care delivery. Standard 5b is health teaching and health promotion in which the registered nurse employs strategies to promote health and a safe environment. Standard 3 is outcomes identification, in which the registered nurse identifies expected outcomes for a plan individualized to the health care consumer or the situation. Standard 2, diagnosis, is when the registered nurse analyzes the assessment data to determine the actual or potential diagnoses, problems, and issues. Standard 1 is assessment, in which the registered nurse collects pertinent data and information relative to the health care consumer's health or the situation. The nurse conducts a home safety assessment for a client. Which statement best explains the standard of care being implemented? - CORRECT ANSWER The RN promotes a safe environment. The standard of care being exemplified is standard 5b: health teaching and promotion: The RN employs strategies to promote health and a safe environment. Standard 3, which is outcomes identification, involves the registered nurse identifying expected outcomes for a plan individualized to the health care consumer or the situation. Standard 12 is education, in which the registered nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking. Standard 4 is planning, in which the registered nurse develops a plan that prescribes strategies and alternatives to attain expected, measurable outcomes. The nurse is caring for a client with a new diagnosis of cancer, and allows the client to verbalize fears relating to how to tell the children. The nurse's intervention reflects which aspect of nursing? - CORRECT ANSWER art of nursing In this example, the nurse is utilizing a holistic approach to the provision of nursing care based on the knowledge of providing psychosocial interventions, such as allowing the client to verbalize feelings/fears. This application of knowledge is the art of nursing. The science of nursing is the knowledge base for the provision of care. Evidence-based practice and application of research are using research to make decisions on how to care for clients. The RN is working with hospital administrators to transform care at their facility. Which nursing competency will be critical for the nurse to utilize? - CORRECT ANSWER Work effectively in interdisciplinary teams The RN working with administrators to transform care will need to be able to work effectively as part of an interdisciplinary team. The nurse will need to work as a team member with members of the administration, as well as representatives from other health disciplines involved in the project. The ability to use and troubleshoot equipment and to navigate the electronic medical records are important to the nurse, but will not necessarily help when working with administration to transform care. Doing things the way they have always been done is a barrier to transformation of care. A nurse is providing care for clients in a long-term care facility. What should be the central focus of this care? - CORRECT ANSWER The client receiving the care The client receiving the care is always the central focus of the nursing care provided. The central focus is not the nurse, the nursing actions, or nursing as a profession. The nurse is helping the unlicensed assistive personnel (UAP) bathe the client, who is experiencing a lot of pain when repositioned in bed. Which nursing responsibility is the nurse demonstrating? - CORRECT ANSWER Client advocate Nurses act as client advocates in many situations. Examples include communicating the needs and concerns of clients and ensuring that clients understand their treatments. In this case, the nurse is advocating for the client by providing the client dignity of personal hygiene and cleanliness. The nurse is not teaching as in the role of the educator. The nurse is not deciding on what is best for the client as a decision maker. The nurse is not managing the client nor coordinating care with other health care providers. The nurse is caring for a postoperative client. The health care provider has written a prescription for a pain medication, and the prescription gives a dosage range for the amount the nurse may give depending on the severity of the client's pain. This type of functioning within the health care team is called: - CORRECT ANSWER collaborative functioning. Nurses manage collaborative problems using both nurse- and health care provider-prescribed interventions to reduce the risk of complications. In this situation, the nurse is not operating authoritatively or independently, but within the parameters established by the health care provider. The nurse is not merely acting in an assistive capacity, as the nurse is performing interventions in the absence of the health care provider. The primary aim of the Healthy People 2020 initiative is: - CORRECT ANSWER health promotion. Healthy People 2020 establishes health promotion guidelines for the nation as a whole. The guidelines contain Leading Health Indicators, which are used to measure the health of the nation over a 10-year period. Illness prevention, health restoration, and coping with disability are components of the Healthy People 2030 guidelines, but are not considered as the primary goal of the initiative. The nursing unit director exhibits the definition of leadership in which of the following responses? a. The nurse manager refers the concern to the director of the department. b. The nurse manager corrects the concern with the patient directly and does not communicate her actions to the staff. c. The nurse manager meets with the staff to discuss the concern and identify solutions. d. The nurse manager tells the staff that they need to correct the situation by tomorrow and leaves the meeting. - CORRECT ANSWER ANS: C Leadership is defined as an interactive process that provides needed guidance and direction which is present in the correct answer. The other choices do not involve an interactive process with staff to resolve the concern. The nurse who is certified as a Critical Care Registered Nurse (CCRN™) represents the unit on the organizational performance improvement team. This is an example of _____ leadership. a. formal b. unit c. organizational d. informal - CORRECT ANSWER ANS: D Informal leaders are recognized as leaders because of their capabilities and actions. Formal leaders are recognized because of the position they hold such as director or manager. Unit leadership refers to the leader of the particular unit. Organizational leadership refers to any leader within the organization. The hospital must reduce the number of readmissions from 11% to 8% in the next year. Which of the following best represents the transformational leadership style in accomplishing this goal? a. The director communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week. b. The organization charters three work teams to identify solutions for the top three causes for readmissions. These teams are given full authority to implement their solution. c. The director of quality develops a vision statement and action plan to achieve the goal. The director works directly with the involved departments to implement the action plan. d. The CEO communicates the goal to the organizational directors and managers and states that they are entrusted to solve the problem. - CORRECT ANSWER ANS: C Transformational leaders communicate a vision and motivate employees to accomplish the goal. The director who communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week leaves the solution to achieve the goal to the followers to develop without motivating them. The solution that is left to the work teams to resolve is not an example of transformational leadership. The CEO entrusts the managers and directors to solve the problem without giving them a vision or engaging in the solution with them. The new director of case management assessed the need to improve the organization's patient satisfaction with the discharge process. Which statement below illustrates the vision that would lead the team to this goal? a. "The department will deliver reliable, collaborative, and compassionate discharge planning services to all patients." b. "The department will hold weekly meetings every Tuesday at 11:00 AM." c. "There will be implementation of a new uniform policy so staff can be readily identified." d. "Staff are encouraged to complain about difficult patients, families, and physicians." - CORRECT ANSWER ANS: A A vision is a statement about the long-term desired state for the department. The other choices describe specific actions, not a long-term vision statement. The clinical nurse leader needs to identify the staff who must go home due to low census. Which answer below describes a democratic style of decision making? a. The clinical nurse leader identifies the staff person with the most vacation and asks them to go home. b. The clinical nurse leader tells the last person to show up for their shift to go home. c. The clinical nurse leader decides not to send anyone home because it is too difficult to decide who should lose hours. d. The clinical nurse leader asks the group if any of them would like the opportunity to go home and selects staff who volunteer. - CORRECT ANSWER ANS: D Democratic leaders use a participatory style of decision making. In the other choices, the clinical nurse leader makes the decision independent of the staff. According to situational and contingency theory, which of the following is true? a. The theory challenges the concept that one leadership style is always best. b. The theory supports employee feelings, morale, and feedback during the change process. c. Motivation through inspiration and recognition is the focus for transforming employee behavior. d. A leader is someone who possesses great intelligence and decision-making authority. - CORRECT ANSWER ANS: A Situational and contingency theory challenges the assumption that there is "one best way" to lead. "The theory supports employee feelings, morale, and feedback during the change process" describes behavioral leadership. "Motivation through inspiration and recognition is the focus for transforming employee behavior" describes transformational leadership. "A leader is someone who possesses great intelligence and decision-making authority" describes Great Man or Trait theory. The main features of complex adaptive systems that are relevant to nursing leadership are a. focused on creating organizational change and looking at the whole versus individual parts. b. defined by efforts of leadership to mandate organizational change. c. autocratic in nature with a top-down structure for change. d. dependent on employees knowing what change is necessary and acting independently. - CORRECT ANSWER ANS: A Complexity science posits that interactions of the parts within a system are more important than the individual parts. The autocratic top-down decision-making and mandates do not create a sustainable change. Being dependent on employees knowing what change is necessary and acting independently lacks interaction of leadership to stimulate change and adaptation among employees. To be an effective nursing leader today requires effective collaboration, which is modeled by which answer below? a. The nursing manager of the observation unit was certain the psychology department would assist the unit with a motivational plan, so she did not request their assistance. b. The nursing manager of the observation unit worked with the psychology department and physical therapy to develop a motivational plan for patients on the unit. c. The nursing director of behavioral health services followed the administrative directive to reduce services and refused to provide services for patients on other units. d. Frustrated by the trend of patients unwilling to work with therapy, the unit manager recommended that these patients be placed on another unit. - CORRECT ANSWER ANS: B The nursing manager works collaboratively with other departments to solve the patient care issue. In the other choices, the unit manager does not involve collaboration to resolve the patient concern. [Show Less]
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contemp chap 1 Exam 19 Questions with Verified Answers,100% CORRECT
contemp chap 1 Exam 19 Questions with Verified Answers Which of the following could eventually change the historical status of nursing as a female-dom... [Show More] inated profession? a.More men graduating from baccalaureate and higher degree programs b.The proportion of men in nursing beginning to increase c.More male graduates of basic nursing programs entering the workplace d.Salary compensation increasing to attract more men - CORRECT ANSWER c The racial and ethnic composition of the nursing profession will change to more accurately reflect the population as a whole when a. the increased numbers of racial and ethnic minorities enrolled in educational programs graduate and begin to practice. b. the number of Asians or Native Hawaiian-Pacific Islanders begins to increase. c. the percentage of African-American and Hispanic nurses decreases more than the percentage of white nurses. d. the nonwhite portion of the general population decreases. - CORRECT ANSWER a Which of the following is a correct statement about the registered nurse (RN) population? a. The racial/ethnic composition of RNs closely resembles that of the general population. b. The number of men entering nursing has decreased steadily over the last decade. c. The rate of aging of RNs has slowed for the first time in the past 30 years. d. The majority of employed RNs working full time must work a second position. - CORRECT ANSWER c Which of the following best describes trends in nursing education? a. Numbers of RNs with bachelors and higher degrees are increasing. b. Numbers of RNs with associate degrees are decreasing. c. Foreign-born nurses practicing in the United States are seen as less knowledgeable because of their lesser educational preparation. d. Numbers of RNs with diploma educations are increasing. - CORRECT ANSWER a Despite the variety of work settings available to the RN, data from 2008 indicate that the primary work site for RNs is a. ambulatory care settings. b. community health settings. c. long-term care facilities. d. acute care hospitals. - CORRECT ANSWER d One important advantage of clinical ladder programs for hospital-based RNs is that they a. allow career advancement for nurses who choose to remain at the bedside. b. encourage nurses to move into management positions in which they can influence patient care on a broader scale. c. encourage RNs to become politically active and guide the profession of nursing. d. provide training to staff nurses so they can move seamlessly across departments. - CORRECT ANSWER a Which of the following statements is correct about community health nursing (CHN)? a. Prevention and community education are the cornerstones of CHN. b. Nursing care is rapidly moving from the home setting to the institutional setting. c. High-tech care such as ventilators and total parenteral nutrition cannot be handled in the home. d. Assessment skills are less important in CHN because patients are not acutely ill. - CORRECT ANSWER a Which of the following is most essential for the nurse entrepreneur to be successful? a. Ability to take direction well b. Excellent time-management skills c. Avoidance of risks d. A college degree in business - CORRECT ANSWER b The major benefit of serving as a military nurse is a. broader responsibilities and scope of practice than civilian nurses. b. working with entirely baccalaureate-prepared peers on active duty. c. serving as an officer on active duty or in the reserves. d. the financial support to seek advanced degrees - CORRECT ANSWER d Which of the following statements explains why the school nurse of today is truly a community health nurse? a. The school nurse may be called on to care for a students family members in underserved areas. b. The school nurses primary responsibility is centered on the well child. c. The school nurses primary responsibility is to maintain immunization records. d. The school nurse must be certified in CHN. - CORRECT ANSWER a What has been found about the outcomes of patients cared for in hospitals with a higher percentage of BSN-prepared nurses as compared to patients in hospitals with a lower percentage of BSN-prepared nurses? a. Patient outcomes are more dependent on nurse-patient ratios. b. Outcomes were better in hospitals with more BSN-prepared nurses. c. Outcomes were similar in both types of hospitals. d. Medical patients had better outcomes, but surgical patients fared the same. - CORRECT ANSWER b Faith community nursing (FCN) was founded on which of the following premises? a. Nurses faith beliefs do not play a part in healing. b. The spiritual aspect takes precedence over the physical body in healing. c. Spiritual health is central to a persons well-being. d. Faith community nurses must receive formal training as a minister or clergy. - CORRECT ANSWER c One important advantage of the evolution of nursing informatics is that a. it allows any RN to become a certified informatics nurse. b. informatics nurses are best able to design systems with the needs and skills of nurses who use them. c. informatics nurses will reduce the need for direct caregivers to document care. d. benefits of informatics advancements include improved patient safety and increased variability of care. - CORRECT ANSWER b Which of the following nursing roles is not considered an advanced practice role? a. Certified nurse-midwife (CNM) b. Community health nurse c. Certified nurse practitioner (CNP) d. Clinical nurse specialist (CNS) - CORRECT ANSWER b NPs are advanced practice nurses who a. are required to have physician collaboration or supervision. b. function under a set of universal advanced practitioner laws. c. cannot receive direct reimbursement for their services. d. can diagnose and treat common and chronic conditions. - CORRECT ANSWER d The clinical nurse leader (CNL) is a recently proposed role. The responsibilities of the person in this role include which of the following? a. Oversee and manage care delivery in specific settings. b. Manage and streamline operations in multiple nursing units. c. Replace the outdated CNS role. d. Provide daily care to a specific subset of patients with similar needs. - CORRECT ANSWER a Hospice and palliative care nursing is a rapidly developing specialty in nursing. Which facts have contributed to this growth? (Select all that apply.) a. End-of-life care is largely the responsibility of nurses. b. End-of-life needs are expected to increase with the aging population. c. Nursing curricula have prepared nurses to deal effectively with dying patients and their families. d. Palliative care is a new focus of advanced practice nurses. e. Hospice and palliative care nurses work in a variety of settings - CORRECT ANSWER a, b, e CNSs may (Select all that apply.) a. manage an inpatient nursing unit. b. develop educational programs for nursing staff. c. conduct practice outcomes research. d. prescribe medications for common illnesses. e. attend or assist in the delivery of low-risk newborns. - CORRECT ANSWER a, b, c The clinical nurse leader (CNL) is a recently proposed role. The responsibilities of the person in this role include which of the following? a. Oversee and manage care delivery in specific settings. b. Manage and streamline operations in multiple nursing units. c. Replace the outdated CNS role. d. Provide daily care to a specific subset of patients with similar needs. - CORRECT ANSWER a [Show Less]
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CNL Previous Quiz 35 Questions with Verified Answers,100% CORRECT
CNL Previous Quiz 35 Questions with Verified Answers A nurse is having difficulty managing assignments at work, which results in a feeling of "failure" ... [Show More] and tasks that are not completed or that are not completed satisfactory. This mentor suggests some tips for time management. These include (select all that apply): A. Focusing on activities to be completed, rather than on objectives B. Planning for tomorrow today C. Making certain that the last hours are the most productive in tying up loose ends D. Maintaining a log of how the nurse spends time (no need to worry about using complete sentences) E. Picking five major objectives for the day and not stopping until they are achieved - CORRECT ANSWER B and D The nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as "B"? (select all that apply): A. Turn in time sheet due in 3 days B. Review dress code policy to give feedback before appointment in the morning C. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness D. Complete patient teaching prior to discharge in 2 hours E. Review procedure for inserting a PIC line to assist with procedure later this morning - CORRECT ANSWER B, D, and E A nurse takes a day to travel to a state park where she can sit by the river alone to reflect over recent events and put things into perspective. She recalls the time she was complimented for her ability to deal with a difficult patient and another time when she was criticized for lack of teamwork. This nurse is improving which source of energy? A. Emotional B. Spiritual C. Physical D. Mental - CORRECT ANSWER B A nurse is hoping for a promotion and seeks the help of a coach to improve time management skills. The first task assigned by the coach is for the nurse to list all external distractors this prevent organization and completion of tasks. The nurse would include (select all that apply): A. Waiting for oncoming shift to start walking rounds B. Failure to delegate tasks to the licensed practical nurse and unlicensed assistive personnel and instead, completing the task herself C. Talking with a patient's family member who is also a personal friend D. Spending time thinking about the vacation to the beach E. Using the Internet to read about a new drug that will be administered; then taking time to look for news about the profession, new legislation about the Patient Protection and Affordable Care Act, and new uniforms for the season - CORRECT ANSWER A and C only A nurse realized that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction? A. "Let's talk only about one movie you recently watched" B. "I like to know about department store sales, but we need to et through this report, so let's talk about sales as we walk between patient rooms" C. "I know your shift has been busy. What went wrong?" D. "I have the list of patients, let's start with revisions to the plan of care and scheduled activities for the next shift" - CORRECT ANSWER D A nurse in an acute care facility helps patients understand how to prevent diabetic neuropathies. This nurse is functioning in the role of: A. Change agent B. Educator C. Manager D. Coordinator - CORRECT ANSWER B The nurse who organizes screenings for employees, assesses the work environment for hazards, and teaches health-promoting activities is employed in the field of: A. Infection-control B. Occupational Healh C. Informatics D. Care coordination - CORRECT ANSWER B In differentiating between interprofessional and multidisciplinary: A. Multidisciplinary refers to the care of many diverse patients by one discipline B. Interprofessional involves members of many disciplines working together to provide patient care to a distinct population C. Interprofessional refers to members of the same discipline working together to provide patient care to a district population D. Interprofessional is the use of multiple interventions by nurses with varying levels of education - CORRECT ANSWER B The primary focus of the care provider role for the nurse involves: A. Using the nursing process to provide guidance to the patient in recovery B. Encouraging consumer self-responsibility and emphasizing health promotion/maintenance C. Focusing on increasing satisfaction among professional nurses D. Advancing nursing practice through research - CORRECT ANSWER A A nurse tallies the patient satisfaction surveys and approves the use of an agency nurse because of the high census. This nurse is involved in which nursing role? A. Change agent B. Educator C. Manager D. Coordination - CORRECT ANSWER C Advanced practice nurses are prepared minimally at the master's degree level with prescriptive privileges; these professionals include: (select all that apply) A. Nurse practitioner B. Nursing administrator C. Certified nurse-midwife D. Clinical nurse specialist - CORRECT ANSWER A, C, and D What characteristics are associated with the clinical nurse leader? (Select all that apply) A. Provide care at the bedside for complex patients B. Identifies the best resources at the lowest price to achieve best health outcomes for a client C. Serves as care coordinator whose practice is limited to acute care settings D. Is an advanced practice nurse with an earned doctorate in nursing - CORRECT ANSWER A and B A new graduate nurse desires a position in labor and delivery; however, no position is available. What is the best advice for this nurse? A. Continue to study to keep skills current and wait for desired position B. Return to college until a position in labor or delivery opens C. Accept another nursing position and transfer into ;labor and delivery when a position is available D. Practice obstetrical skills in a simulation lab then present evidence of competency to potential employer - CORRECT ANSWER C A patient is admitted for a hip replacement complicated by uncontrolled diabetes and early dementia. The nurse coordinates referrals to an endocrinologist to establish an insulin protocol and organizes out-patient physical therapy in an Alzheimer's assisted living facility upon discharge. The role of this nurse is the: A. Informatics specialist B. Educator C. Case manager D. Quality manager - CORRECT ANSWER C A person from an underrepresented background in nursing is interested in entering nursing school and researches the ethnicity, age, and gender make-up of the nursing profession and finds: A. Nursing is a career field that is primarily made up of women younger than 30 years B. The number of male RNs has steadily increased and is equal to the number of female RNs C. The majority of RNs are white or non-Hispanic D. More than half of all RNs are ages 55 through 65 - CORRECT ANSWER C Which trend is an effect of the nursing shortage on nursing education? A. Only devoted qualified nurses are continuing to provide bedside nursing because of the complexity of care required, resulting in excellent preceptorships for students B. The number of applicants to nursing programs has risen, but enrollment is limited because of a decrease in the number of available scholarships and grants C. With an increase in the number of nurses who are entering graduate school to escape bedside nursing, students will soon enjoy a lower faculty/student ratio D. Students may be assigned to preceptors who have not yet developed expertise in the field of interest - CORRECT ANSWER D The first university to offer nursing graduates a baccalaureate degree was: A. Columbia Teachers College B. Yale University C. Harvard University D. the New York Regents Program - CORRECT ANSWER B A new trend in nursing education that is consistent with real-world practice is focused on: A. Outcomes B. Objectives C. Goals D. Subjective appraisals - CORRECT ANSWER A The number of reported medical errors demonstrates a need for what priority intervention? A. Simulation experiences B. Performance competency exercises C. Comprehensive instructor-constructed examinations D. Detailed care planning exercises - CORRECT ANSWER B A current trend is for students to be evaluated to determine whether they demonstrate competence in the actual client care environment or with a standardized patient. This process occurs in addition to or instead of traditional pencil-and-paper evaluations. This type of evaluation is referred to as: A. Core practice competencies B. Continuing competence C. Distance learning D. Performance-based assessment - CORRECT ANSWER D A nursing student scores 95% on the written examination for the adult health course. To be successful in this course, this same student must then perform an indwelling catheter insertion and wound care in a simulated environment meeting core competencies. The student asks, "What are core competencies?" The nursing instructor replies, "Core competencies are: A. a trend used in nursing education to reduce attrition in prelicensure students" B. those skills necessary for safe, competent nursing practice" C. educational opportunities that provide remediation when student is unable to perform psychomotor skills correctly" D. critical thinking exercises aimed to improve reading and math skills" - CORRECT ANSWER B When preparing to complete a competency examination involving a neurologic assessment in a simulation laboratory, the nurse reviews the critical elements, which consists of: A. those steps that result in life or death of a client B. required criteria that must be incorporated into the assessment for the desired outcome C. fundamental strategies unique to complex dynamic care environments D. objective data that can be used to determine the likelihood that the client will recover - CORRECT ANSWER B Which experience is best designed to support a nursing student's preparation for interprofessional team participation? A. attending a seminar on interprofessional team cooperation B. completing a preceptorship with an advanced practice nurse C. carrying for three patients with varying medical diagnoses D. presenting patient information at the daily care planning meeting on a mental health unit - CORRECT ANSWER D A person interested in employment in the health care sector has less than 1 year to pursue his or her education and wants to focus on functional aspects of patient care. He/she desired to work in a long-term facility. Which type of nursing program should this person request information about? A. Bachelor's degree in nursing (BSN) B. Licensed practical nurse (LPN) C. Associates degree in nursing D. Master's degree in nursing - CORRECT ANSWER B A nurse is concerned that the policy of using povidone-iodine (Betadine) to clean foot ulcers may lead to unwarranted allergic reactions and drying of surrounding tissue. A literature review is performed to determine the "best practice" related to care of foot ulcers. This nurse: (select all that apply) A. is applying evidence-based practice to the clinical setting B. is using critical thinking to change procedures performed in the care of foot ulcers C. is minimally educated at the master's level and participating in research to provide cost-effective care (soap is less expensive that povidone-iodine) D. lacks clinical competence in health assessment and in application of theory to the clinical setting E. is using information to problem-solve and ensure safe, competent care - CORRECT ANSWER A, B, and E T/F: Nurse practice acts are written and passed by legislators - CORRECT ANSWER True T/F: A group of registered nurses with ADN degrees are concerned that the minimum educational standard for licensure as a registered nurse is being raised to the bachelor's (BSN) level. After contacting the American Nurses Association, they learn they will be "grandfathered" in . Under the "grandfather clause", nurses with associate degrees will continue to use the title of "registered nurse" - CORRECT ANSWER True T/F: A nurse holds a license in one state but wishes to practice in a second state that is not participating in a nurse licensure compact agreement. The nurse is granted licensure on payment of a fee but does not retake the licensure examination. The nurse obtains licensure in the second state through sunset legislation - CORRECT ANSWER False T/F: When participating in a nurse licensure compact, the nurse is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered - CORRECT ANSWER True T/F: A graduate of a nursing school in the United States plans to practice nursing in Paris, France. To request licensure to practice in Paris, the nurse must contact the Graduate of Foreign Nursing Schools to complete a special examination - CORRECT ANSWER False T/F: Individual state boards of nursing establish the "rules" for nursing practice - CORRECT ANSWER True T/F: The primary purpose of nursing licensure is to protect the public - CORRECT ANSWER True The advanced practice nurse who is seeking information about requirements for practice in a specialized area should contact the: A. American Nurses Association B. National League for Nursing C. American Nurses Credentialing Center D. National Council of State Boards of Nursing - CORRECT ANSWER C Current trends in telecommunications and increased mobility of nurses have led to the approval of a mutual recognition model of nursing regulation, in which nurses are allowed to practice in states that are compact states without obtaining a license in each state. On which website would a nurse find a list of current compact states? A. National League for Nursing B. National Council of State Board of Nursing C. American Associate of Colleges of Nursing D. Commission on Collegiate Nursing Education - CORRECT ANSWER B A nurse who wishes to practice in another state: (select all that apply) A. must retake the NCLEX-RN for that state B should determine whether that state is a compact state C. may obtain licensure by endorsement D. must revoke licensure in the current state because nurses cannot be licensed in more than one state concurrently - CORRECT ANSWER B and C [Show Less]
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