ANCC Study Guide Review of Test Questions

ANCC Study Guide: Review of Test Questions In assessing the philosophy for nursing services for possible revision, the nurse executive is most heavily influenced by the organization's: a. mission statement b. consumer surveys c. financial resources d. policy statements In planning for change, the successful change agent makes a commitment to: a. help followers arrive at total consensus regarding the change. b. encourage subgroup opposition to change so many viewpoints can be heard c. utilize change by drift if resistance to change is too strong d. be available to support those affected by change until refreezing occurs. Strategic planning: a. focuses on the long-range goals for the organization b. requires a broad range of management expertise c. is synonymous with tactical planning d. is generally a middle-management function. In planning for managed care, which of the folllowing goals would be most appropriate for the nurse manager? a. Clinical outcomes should occur within a prescribed time frame. b. Case managers should not function as providers of patient care. c. Managed care practice should be unit-based and unit-specific. d. Outcome management should be carried out for each patient. Critical pathways outline a patient's expected progress from admission to discharge and are part of: a. functional nursing b. primary care nursing c. case management d. team nursing. When using a patient classification system, the nurse executive should understand that such systems: a. are used to solve unit staffing shortages. b. use nonvariable nursing care hours. c. are designed to eliminate human error d. are periodically reevaluated When evaluating the nursing service philosophy, the most important thing to ascertain is that the philosophy: a. is congruent wit the mission of the organization b. can be implemented in a cost-effective manner c. flows from organizational goals d. is brief and simply worded. Critical pathways are: a. a patient's expected progress from admission to discharge based upon her or his diagnosis. b. mandated professional care standards. c. the essential feature of the Nursing Minimum Data Set (NMDS). d. prospective structure audits that look at costs as well as quality. Healthcare professionals have formed a state coalition to propose legislation to change the state's nursing practice act. Controversies have surfaced regarding entry into nursing practice, the role of the license practical nurse, and the definition of professional nursing. To communicate information about the proposed changes, it would be most effective for the coalition to: a. form a network of all categories of nurses in the state. b. mail minutes from coalition gorup meetings to all constituencies. c. work with groups that have lobbied in the past for changes in the nurse practice act. d. request that coalition members put the proposed changes on the meeting agendas of other groups to which they belong. The nurse executive attends all high-level meetings. However, he or she seems to have limited access to the organization's true power base and believes there is inequitable distribution of power among executives of the same rank. To change this situation, the nurse executive's most appropriate first step would be to: a. propose a plan for organizational restructuring. b. form a coalition within the organization to extend her or his network of power. c. improve her or his power base by creating a useful level of tension and competition. d. become sensitive to informal lines of communication in order to gain entry into informal power groups. The relationship between the operating room nurses and the surgical nurses at a large hospital has become competitive and uncooperative. The focus of the conflict is patient arrival times at the operating room. The nurse executive appoints a performance improvement team to resolve the conflict. Which of the following statements, if made by a team member, would best indicate that progress has been made toward conflict resolution? a. "I think it's pretty clear that some people are more responsible than others for this problem." b. "I think we should keep exact records of the time factors for 1 month. Then we will know where the disrepancy lies." c. "I hadn't realized how much time is involved in preparing patients for surgery." d. "It's always good to be able to vent your feelings. It helps when you can tell people what you think." In evaluating the nursing administration's philosophy statement, the nurse executive's most important step would be to: a. assess whether the statement provides for flexibility. b. assess whether there is consistency between the statement and actual practice. c. create a task force of registered nurses to review the statement d. solicit input from peers about the statement's relevance. The nurse executive at a hospital maintains contracts with affiliated educational institutions whose nursing students want to acquire clinical experience. The nurse executive should ensure that each contract includes a: a. copy of the nursing program curriculum b. provision that all nursing faculty members be licensed. c. provision that each student carry individual malpractice insurance d. provision that the hospital's nursing department retains responsibility for nursing care provided by the students. Which of the following use of limited resources would most likely result in increased reiumbursement revenues? Increasing the: a. number of clinical nurse specialists b. educational paid days for licensed staff c. educational programs on documentation d. mix and number of clinical staff Which of the following has the strongest potential for moving the United States toward a national healthcare system? a. Dissatisfaction Americans feel toward healthcare quality. b. The American Medical Association's dissatisfaction with the present system. c. Skyrocketing cost of private insurance premiums d. The rationing of services due to federal healthcare costs. In attempting to reduce costs, the nurse executive should remember that the largest share of financial resources will be found in: a. short-term capital acquisitions b. operating costs c. supplies and equipment d. personnel costs All department heads are required to re-justify their fiscal needs annually during the budget cycle. Budget allocations are made accordingly. This is a description of which of the following types of budgeting? a. Incremental budgeting b. Perpetual budgeting c. Zero-based budgeting d. Managed care budgeting. The nurse executive who is implementing a hospital's cost containment program should realize that the most important step is to: a. develop an inservice curriculum that focuses on cost containment. b. develop methods for determining nursing care costs for each patient category. c. Negotiate redistribution of non-nursing tasks to other departments. d. Ask nurses to become a part of the decision-making process in the areas of patient care, unit management, and hospital governance. Costs per unit of service will increase as: a. volume decreases below the break-even point. b. volume increases c. acuity increases d. management turnover occurs. When nurse executives examine job classifications as they plan salary adjustments, they must remember that there are equal-pay tests that must be met to justify such determinations. Therefore, they would examine jobs for which of the following? a. Equal danger on the job, equal intelligence for hire, equal responsibility, and indentical working conditions. b. Equal skill, equal effort, equal responsibility, and similar working conditions. c. Equal job requirements, same working conditions, equal job duties, and equal responsibilities. d. Equal effort, equal working conditions, identical job duties, and equal job requirements. Use of the ______________ is the most fiscally responsible method for determining daily staffing needs. a. maximum patient load b. patient classification system c. midnight census d. total bed capacity In order to stimulate the staff nurses's involvement in research within the organization, the nurse executive's best course of action would be to: a. hire a well-qualified researcher to conduct reserach studies. b. provide staff nurses with needed time for research activities. c. create a joint medical/nursing staff research committee d. ensure that research designs are well grounded and scientific. Of the following activities, which would be the most important for the nurse executive to personally carry out? a. Serve on the policy and procedure committee b. Interpret the job description for a newly hired registered nurse c. Facilitate the dissemination of research in nursing and management systems d. Review the orientation schedule for newly graduated registered nurses A staff nurse at a unionized agency reports that overtime pay for an after-duty class requiring mandatory attendance was coded as straight pay instead of time and one half as called for in the union contract. Unit managers certify the type and amount of overtime pay. Appropriate action by the nurse exectuive would be to: a. follow up with the nurse's manager to make certain she or he is familiar with the contractual overtime requirements b. accompany the nurse to the payroll office and tell them to make the adjustment c. request that the nurse file a grievance so that payroll adjustment can occur d. turn the matter over to the personnel department for corrective action. The union contract in the facility where you are a manager requires that discipline be progressive in all areas except for substance abuse and theft. When an employee commits a first offense of not coming to work as scheduled and neglecting to notify anyone regarding the absence, you would: a. give the employee a written reprimand b. counsel the employee verbally (verbal warning). c. suspend the employee with pay d. suspend the employee without pay A labor union is attempting to organize the employees of an institution. It would be considered an unfair labor practice if management: a. removed outside organizers from the institution's premises b. refused to allow employees to attend a meeting held by labor organizers during work hours c. supplied the union with information requested about specific employees of the institutions d. told employees that the nurse executive would rather deal directly with them than with the union when differences arise. Despite her family's requests to the contrary, Dr. Huang writes a "Do not resuscitate" order on Mrs. Bosko's chart following a conversation with the patient in which Dr. Huang affirmed the patient's wishes to forgo life-prolonging intervention in the presence of end-stage renal disease. The predominant ethical principle evident in this case is: a. beneficence b. autonomy c. justice d. veracity The predominant ethical belief underlying the requirements of the Health Insurance Portability and Accountability Act (HIPAA) is that of: a. truth-tellilng (veracity) b. confidentiality c. utility d. autonomy In terms of professional ethics, the nurse executive is responsible for ensuring that: a. ethics education programs are provided for the nursing staff on an ongoing basis. b. a nursing ethics committee is convened and meets regularly. c. each nurse is provided with a copy of the Code for Nurses with Interpretive Statements published by the American Nurses Association d. nursing's perspective is represented in the organization's formal mechanisms for addressing ethical dilemmas. Under Title VII of the Civil Rights Act, the employer: a. is not responsible for discrimination on the part of individual supervisors b. is responsible for discrimination on the part of individual supervisors c. can terminate a supervisor for practices determined to be discriminatory d. can se the individual supervisor to recover monetary loss suffered because of discrimination settlements against the organization because of a supervisor's behavior.