Question 1

A nurse manager is participating in the health care organization's strategic planning committee. Which factor is the primary driving force and controlling factor in new initiatives this committee might recommend?
A) Cost of care
B) Access to care
C) Availability of care
D) Quality of care

Accepted Answer

1. While all of the options given are driving forces in today's healthcare environment, the cost of providing care is still the primary issue. Cost of care controls access, availability, and quality.
2. Access to care is controlled by the ability to pay.
3. Care will not be available if it cannot be funded.
4. Healthcare providers do not like to correlate quality with cost, but the economic reality is that quality care must also be funded care.

Question 2

A graduating nurse student is deciding which nursing specialty would be a good place to begin a nursing career and ensure long-term stability. Which specialty is most likely to have the greatest growth in need?
A) Pediatric nursing
B) Psychiatric nursing
C) Geriatric nursing
D) Maternity nursing

Accepted Answer

Geriatric nursing is the specialty most likely to have the greatest growth in need. This is due to the aging population in many countries, which is leading to an increase in the number of older adults who require specialized care. As these individuals have more complex health needs, geriatric nurses are highly in demand and are expected to continue to be so in the coming years.

Question 3

The quality management director of a large health care conglomerate wishes to initiate benchmarking strategies to assess care. Which directive should this manager publish?
A) We will compare outcome indicators with other health care conglomerates of similar size and organization.
B) Outcome data of hospitals within the organization will be compared to assess quality.
C) Each client care unit in the organization will establish specific unit goals for quality.
D) Each unit in the organization will create a quality monitor to assess how well unit policies are followed.

Accepted Answer

Benchmarking involves comparing an organization's performance to that of other organizations in order to identify best practices and areas for improvement. Option A is the best choice as it specifically mentions comparing outcome indicators with other health care conglomerates, which is the essence of benchmarking. Option B only focuses on comparing hospitals within the same organization, which does not provide an opportunity for external comparison. Option C and D suggest establishing goals or monitors, which are important steps in quality improvement, but do not specifically address the benchmarking strategy.

Question 4

Which health care situations reflect the philosophy of quality management as designed by Deming?
A) A nurse asks visitors to leave because it is after visiting hours.
B) At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed from NPO status.
C) A nurse tells the manager that a housekeeper's work is not up to standards.
D) A nurse volunteers to take a Spanish language class to be able to communicate with clients.
E) A nurse who has not made a medication error in two years asks for a salary increase.

Accepted Answer

The answer of Which health care situations reflect the philosophy...

Question 5

A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client should choose which hospital for care during this procedure?
A) The hospital closest to the client's home
B) The hospital that has done the greatest number of these surgeries in the last two years
C) The hospital chosen by the client's primary care physician
D) The hospital with the highest performance ratings for this procedure

Accepted Answer

According to the Leapfrog Group, the best choice for a high-risk surgical procedure is the hospital with the highest performance ratings for that specific procedure. This indicates that the hospital has a track record of successful outcomes for patients undergoing this procedure. Choosing a hospital solely based on proximity, number of surgeries performed, or the recommendation of a primary care physician may not necessarily ensure the best outcome for the patient.

Question 6

Which organization would the hospital management team contact to pursue certification as a Magnet hospital?
A) Magnet Recognition Program
B) American National Magnet Commission
C) The Joint Commission
D) American Medical Association

Accepted Answer

The Magnet Recognition Program is the nationally recognized certification program for nursing excellence and would be the appropriate organization for a hospital management team to contact if they want to pursue certification as a Magnet hospital. Option B is not a real organization, Option C is a regulatory body that focuses on hospital accreditation but not specifically on nursing excellence, and Option D is a professional organization for physicians, not nurses.

Question 7

Hospital administration is considering the purchase of a robotic pharmacy system. What would be the advantage of this system to the nurses who work in the hospital?
A) The nurse will be able to leave out some of the six rights of medication administration because the robot checks the medications.
B) The nurse should get medications more quickly because the robot can work more consistently without breaks.
C) The nurse can delegate medication administration to the nursing assistant because the medications have already been checked.
D) The nurse can expect that medication administration will be easier and carry less potential for error.

Accepted Answer

1. The nurse must still complete the six rights of medication administration to ensure client safety.
2. Robots should be able to get medications to the floor more quickly.
3. The administration of medication cannot be delegated to the nursing assistant.
4. There is no assurance that medication administration will be easier.

Question 8

The nurse manager asks a staff nurse why a procedure is done in a certain manner. The nurse replies, "I don't know why I started doing it this way. I've never read any research on it, but this technique always works for me." The manager would place this technique into which category of evidence?
A) Case study
B) Anecdotal
C) Nonexperimental design research
D) Statistical

Accepted Answer

Anecdotal evidence is based on personal experience or observation rather than scientific analysis. In this scenario, the nurse is relying on their personal experience rather than evidence-based research.

Question 9

The organization that awards Magnet status would look for environments where which practices are the norm?
A) Nurses are involved in decision making.
B) Rewards are focused on ideas that save money.
C) Once a decision is made, it stands.
D) Nurses may be asked to work overtime.
E) Nurses are involved in educating the community about health.

Accepted Answer

Nurses are involved in decision making is a key component of Magnet status.

Question 10

A health care system is considering applying to the Magnet Recognition Program. The leaders of this health system should prepare to address ________ qualities or "Forces of Magnetism."

Accepted Answer

The answer of A health care system is considering applying...

Question 11

A health care organization has just achieved Magnet status. During the award ceremony the organization's chief executive officer should give primary praise for this achievement to which employees?
A) Medical staff
B) Nurse executive
C) Staff nurses
D) Managers in support services such as laboratory and radiology
E) Administrative professionals overseeing services such as accounting, billing, and medical records

Accepted Answer

The answer of A health care organization has just achieved...

Question 12

A nurse has been invited to discuss health care costs at a senior citizens' club. What information should the nurse plan to include in this discussion?
A) While health care costs continue to rise, the percentage of the U.S. economy spent on health care has slowly declined to less than 12%.
B) Regulations brought about by the Patient Protection and Affordable Care Act (PPACA) should bring financial relief to health care consumers.
C) The United States spends more money on health care than any other country.
D) Health care spending in the United States is slowly declining due to passage of bills such as the Patient Protection and Affordable Care Act (PPACA).

Accepted Answer

The nurse should plan to discuss how the United States spends more money on health care than any other country. This information is important for senior citizens to understand the significant costs associated with healthcare, especially as they may rely heavily on healthcare services as they age. Option A is incorrect, as although the percentage of the U.S. economy spent on health care has declined somewhat, the actual dollar amount spent on health care has continued to rise. Option B is partially correct, as the PPACA does contain measures to bring financial relief to health care consumers, but it may not necessarily bring significant relief to all seniors. Option D is incorrect, as health care spending in the United States has not shown evidence of declining since the passage of the PPACA.

Question 13

The nurse manager's expected outcome is to increase evidence-based practice on the nursing unit. To meet this outcome, the manager encourages nurses to base their practice on which technique?
A) Intuition
B) Personal clinical experience
C) Knowledge from nursing school
D) Current research

Accepted Answer

Evidence-based practice involves basing decisions on the most current and reliable research evidence. While intuition, personal experience, and knowledge from nursing school can be helpful, they should be used in conjunction with current research to ensure the best outcomes for patients.

Question 14

A 70-year-old client develops a catheter-induced urinary tract infection. Which statement by the nurse would indicate to the nurse manager a need for additional understanding of this situation?
A) "I wonder if there was a break of sterility when this catheter was inserted."
B) "Thankfully we can treat this with an antibiotic."
C) "This could potentially cost the hospital a lot of money."
D) "I will talk to my unlicensed assistants about proper urinary catheter care."

Accepted Answer

1. Wondering about a break in sterility indicates that the nurse is concerned about the process that might have contributed to this infection.
2. The nurse who focuses on taking care of the results of a potential medical mistake is not accepting the seriousness of the situation.
3. The Centers for Medicare and Medicaid Services no longer cover the costs incurred by medical mistakes. This urinary tract infection could cost the hospital the cost of treatment, including increased length of stay.
4. The nurse has identified that improper care may result in poor outcomes for the client.

Question 15

The nurse manager has decided to use evidence-based practice (EBP) to solve an issue and has called staff nurses together for input. Which question, as posed by the manager, reflects the first step of the EBP process?
A) "What outcomes are we expecting from this work?"
B) "Is anyone prepared to evaluate the statistics we will find?"
C) "What is the exact clinical issue with which we are dealing?"
D) "Where can we look for information?"

Accepted Answer

1. Assessing outcomes is the last step of the EBP process.
2. Evaluation of the evidence is step 3.
3. Identifying the clinical question is the first step in the EBP process.
4. Acquiring the evidence to answer the question is step 2.

Question 16

A client who was discharged yesterday is very upset about the quality of care received during hospitalization for gastric surgery. What options for reporting concerns does this client have?
A) There is no mechanism for complaint as the client is no longer hospitalized.
B) The client can indicate dissatisfaction on the survey often sent to clients after discharge.
C) The client can call the hospital administration.
D) The client can make a formal complaint through the American Nursing Association.
E) The client can make a public report through the Agency for Healthcare Research and Quality.

Accepted Answer

The answer of A client who was discharged yesterday is...

Question 17

A nurse manager is directing a team of staff nurses working to solve a clinical problem using evidence-based practice (EBP). Which manager statements would direct these nurses to the forms of strongest clinical evidence?
A) "We may find studies that use only one group of subjects."
B) "Look for articles that report on how to use evidence in other clinical situations."
C) "The studies we want are built around the scientific approach to solving problems."
D) "Our focus should be on studies that use both experimental and control groups to determine intervention effectiveness."
E) "Many articles will have information reported by someone who is an expert in the field."

Accepted Answer

The answer of A nurse manager is directing a team...

Question 18

The nurse manager overhears staff discussing the shortage of nurses. Which statement by a staff member would the manager evaluate as misinformation?
A) "There are more nurses retiring than are entering the profession."
B) "The demand for nurses is declining because of fewer hospital admissions."
C) "There are insufficient numbers of nursing faculty to teach interested students."
D) "Women still outnumber men in nursing."

Accepted Answer

The statement that the demand for nurses is declining because of fewer hospital admissions is incorrect. In fact, the demand for nurses is expected to continue to grow due to an aging population and an increase in chronic conditions requiring ongoing care. The other statements are all accurate and reflect the current nursing workforce and potential challenges with recruitment and retention.

Question 19

The nurse is trying to understand why it has taken so long for electronic health records (EHRs) to be used in health care. Which statement is a reason for this delay?
A) Medical-records professionals do not like these records.
B) The use of these records is more expensive than the use of paper records.
C) There have been concerns about privacy and confidentiality.
D) The transition to EHRs is time consuming and tedious.

Accepted Answer

One reason for the delay in adoption of EHRs is concerns about privacy and confidentiality. As health information is stored electronically, there is a higher risk of unauthorized access and breach of patient confidentiality. This has led to increased regulation and requirements for secure storage and sharing of electronic health records, which has further slowed down the adoption process.

Question 20

Which strategy is most likely to increase participation in the use of evidence-based practice in nursing?
A) Ensure adequate training and encourage its use by the nursing staff.
B) Elicit employee opinions of its use at least four times per year.
C) Give those nurses willing to use it extra recognition.
D) Ensure adequate training, recognition, and easy access to the Internet.

Accepted Answer

Ensuring adequate training, recognition, and easy access to the Internet is the most comprehensive strategy that addresses multiple barriers to the use of evidence-based practice in nursing. Adequate training ensures that nurses understand how to use evidence-based practice, recognition reinforces the importance of evidence-based practice, and easy access to the Internet allows nurses to easily access relevant and up-to-date research. Eliciting employee opinions and giving extra recognition to those willing to use evidence-based practice are important strategies, but alone they are not likely to be as effective as D.

Quiz 1: Introducing Nursing Management

A nurse manager is participating in the health care organization's strategic planning committee. Which factor is the primary driving force and controlling factor in new initiatives this committee might recommend?

A graduating nurse student is deciding which nursing specialty would be a good place to begin a nursing career and ensure long-term stability. Which specialty is most likely to have the greatest growth in need?

The quality management director of a large health care conglomerate wishes to initiate benchmarking strategies to assess care. Which directive should this manager publish?

Which health care situations reflect the philosophy of quality management as designed by Deming?

A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client should choose which hospital for care during this procedure?

Which organization would the hospital management team contact to pursue certification as a Magnet hospital?

Hospital administration is considering the purchase of a robotic pharmacy system. What would be the advantage of this system to the nurses who work in the hospital?

The nurse manager asks a staff nurse why a procedure is done in a certain manner. The nurse replies, "I don't know why I started doing it this way. I've never read any research on it, but this technique always works for me." The manager would place this technique into which category of evidence?

The organization that awards Magnet status would look for environments where which practices are the norm?

A health care system is considering applying to the Magnet Recognition Program. The leaders of this health system should prepare to address ________ qualities or "Forces of Magnetism."

A health care organization has just achieved Magnet status. During the award ceremony the organization's chief executive officer should give primary praise for this achievement to which employees?

A nurse has been invited to discuss health care costs at a senior citizens' club. What information should the nurse plan to include in this discussion?

The nurse manager's expected outcome is to increase evidence-based practice on the nursing unit. To meet this outcome, the manager encourages nurses to base their practice on which technique?

A 70-year-old client develops a catheter-induced urinary tract infection. Which statement by the nurse would indicate to the nurse manager a need for additional understanding of this situation?

The nurse manager has decided to use evidence-based practice (EBP) to solve an issue and has called staff nurses together for input. Which question, as posed by the manager, reflects the first step of the EBP process?

A client who was discharged yesterday is very upset about the quality of care received during hospitalization for gastric surgery. What options for reporting concerns does this client have?

A nurse manager is directing a team of staff nurses working to solve a clinical problem using evidence-based practice (EBP) . Which manager statements would direct these nurses to the forms of strongest clinical evidence?

The nurse manager overhears staff discussing the shortage of nurses. Which statement by a staff member would the manager evaluate as misinformation?

The nurse is trying to understand why it has taken so long for electronic health records (EHRs) to be used in health care. Which statement is a reason for this delay?

Which strategy is most likely to increase participation in the use of evidence-based practice in nursing?