Organizational Issues and Quality Improvement
1. When conflict arises among the staff, which response by a nurse-manager is the most helpful?
[ ] A. To delegate the issue to assistants or clinical specialists
[ ] B. To invite an outside mediator to assist
[ ] C. To bring all conflicting parties together to resolve the problem with ample notification for each side to build coalitions
[ ] D. To help the staff clarify the issues and confront one another assertively and respectfully
View Answer
Correct answer—D. Rationales: Assisting the staff to resolve conflicts falls within the role of a nurse-manager. Encouraging confrontation and clarifying issues are the most helpful interventions. A response that overemphasizes the problem or leads to increased conflict and division of staff isn’t helpful. For most staff conflicts, the resolution of a problem best lies with the people who identified it. Nothing in the question suggests the need for a mediator.
Nursing process step: Intervention
2. To arrive at an appropriate nursing staff pattern in an emergency department, the manager must:
[ ] A. know the client volume and acuity levels by hour of the day, and take into consideration variability according to day of the week or time of year.
[ ] B. be aware of The Joint Commission (TJC) standard that emergency services shall be appropriately integrated with other units and departments within the organization.
[ ] C. realize that client visits are so unpredictable that a different staffing pattern will have to occur every day according to need.
[ ] D. for the sake of standardization, arrange staffing so that it closely corresponds with the rest of the organization.
View Answer
Correct answer—A. Rationales: Although exact volume and acuity levels can be somewhat unpredictable, the manager should track both over time so that numbers and type of staff are appropriately placed. Staffing patterns are unit-specific and standardization is irrelevant. TJC’s standard for integrating emergency services isn’t directly related to the question.
Nursing process step: Assessment
3. A team of nurses, physicians, and registration clerks met to address a departmental goal of decreasing total client time in the department. First, they collected data (sorted by triage category) on the length of time clients wait to be seen. The activity described above is an early step in:
[ ] A. descriptive research.
[ ] B. indicator relevance testing.
[ ] C. collaborative research.
[ ] D. quality improvement process.
View Answer
Correct answer—D. Rationales: The situation describes a quality improvement process. This reflects an interdisciplinary approach to process improvement for better client experience or outcome. It isn’t intended to generate or validate a scientific knowledge base. The element of data collection is found in research also. In the research process, however, data collection occurs later (after a literature review and after decisions have been made regarding conceptual or theoretical framework and research design). Indicator relevance testing isn’t a recognized entity in either process.
Nursing process step: Analysis
4. Which should the manager or peer recruitment team be certain to do when interviewing a prospective staff member?
[ ] A. Ascertain whether the applicant has health problems that have ever resulted in a workers’ compensation claim
[ ] B. Verify experience and qualifications by checking references
[ ] C. Ask primarily open-ended questions
[ ] D. Verify that the applicant has appropriate child-care arrangements
View Answer
Correct answer—B. Rationales: Checking references and verifying experience and education are common ways of ensuring that an applicant has the background for the job. Ascertaining whether the applicant has health or child-care problems is prohibited by federal laws addressing gender bias and disabled workers. Open-ended questions are useful for gleaning clues to personality and style. Direct questions, which have specific answers, are an efficient means of learning whether an applicant has the knowledge, experience, and attitude being sought.
Nursing process step: Assessment
5. An emergency department lobbies for a departmental pharmacist to function as a resource and consultant in toxicology and medication issues. What’s the correct budget for such a request?
[ ] A. Operational
[ ] B. Capital
[ ] C. Manpower or personnel
[ ] D. Overhead
View Answer
Correct answer—C. Rationales: Manpower or personnel budgets cover wages and benefits for regular and temporary workers. An operational budget covers supplies, unit equipment, repairs, and overhead. Capital budgets cover land, buildings, and expensive durable equipment (usually costing more than $500).
Nursing process step: Analysis
6. A client classification system that’s reliable, valid, and consistently used can be a management tool for determining:
[ ] A. staffing levels based on nursing workload.
[ ] B. quality of care rendered by nurses.
[ ] C. problem solving and conflict resolution.
[ ] D. mix of paying and nonpaying clients and thereby improving the budget.
View Answer
Correct answer—A. Rationales: Client classification systems measure workload, thereby determining staffing needs. They don’t measure comparative quality or relate to client payment and aren’t part of conflict resolution.
Nursing process step: Analysis
7. Brainstorming is a problem-solving method whereby a group rapidly generates which type of solutions?
[ ] A. As many as possible
[ ] B. As practical as possible
[ ] C. As wild and crazy as possible
[ ] D. As high-quality as possible
View Answer
Correct answer—A. Rationales: Brainstorming is a problem-solving method that rapidly generates a large number of alternatives. Quality and practicality are unimportant. Some wild and crazy solutions emerge and make the process fun; such unconventional ideas help participants unleash their creativity.
Nursing process step: Analysis
8. An emergency department nursing team found that clients whose discharge instructions were reviewed by a registered nurse had a much better understanding of their diagnosis and follow-up than clients whose discharge instructions weren’t reviewed. The team had evaluated which element?
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
