1. The chief nursing officer decides to establish a client advocacy position in an oncology unit. Advocacy is best represented by:
a. establishing private and professional networking systems.
b. asking social services to handle clients’ concerns.
c. identifying community support groups.
d. empowering others by promoting self-determination.
2. As part of performance appraisal, the nurse manager designs strategies to acknowledge staff members. What practices by the nurse manager best acknowledge staff accountability and contribution?
a. Providing new and varied learning experiences for staff members
b. Fostering group cohesiveness through standardization of unit activities
c. Allowing professionals greater influence over their practices
d. Giving recognition for success and support for failure to staff members
3. The nurse manager on a pediatric intensive care unit wants to evaluate patient satisfaction. The nurse manager understands that ultimately, positive relationships with consumers of care are evaluated by the:
a. cultural sensitivity of staff.
b. cost-effectiveness of care delivery.
c. economic value of service.
d. outcomes for clients and their perceptions of care.
4. The nurse manager must develop a patient satisfaction survey. What is one of the critical elements in selecting a patient satisfaction instrument?
a. Being able to use the same instrument for all clinical units
b. Including items that are important from the patient’s perspective
c. Being able to administer the instrument before a patient’s discharge from the hospital
d. Being sure that the reading level is no higher than third grade
5. In writing the patient satisfaction survey, the nurse manager is aware of the education levels of the families. What is the most critical element in the concept of health literacy?
a. Providing instructional materials at appropriate reading levels
b. Facilitating access to translators for persons with language barriers
c. Obtaining, processing, and understanding basic health information so appropriate decisions can be made
d. Knowing that most people have limited health literacy skills
6. The nurse manager analyzes the data from the patient satisfaction surveys. What can a nurse manager do to strengthen service recovery and improve consumer relationships?
a. Post comparisons of patient satisfaction scores with those of other units monthly.
b. Involve the staff in resolving consumer issues quickly and effectively.
c. Ensure that staff members apologize to patients when they complain about services
d. Ask that patients with complaints about services place them in a written format.
7. Based on data from the patient satisfaction survey, the nurse manager decides that a change should be made in communication with family members. What would be important for a nurse manager to consider when instituting a change to improve customer service?
a. Assess the perceptions of the nursing staff regarding the specific service problem.
b. Include community representatives on a planning committee to address the change.
c. Involve physicians, other healthcare professionals, and ancillary staff.
d. Review all patient complaints with the nursing staff.
8. The chief nursing officer is pleased with the nurse manager’s strategy of improving patient satisfaction in the pediatric intensive care unit. She decides to implement these changes throughout the hospital. What would be important to consider in implementing a new program focused on improving relationships with consumers?
a. Recognition of the nursing staff for excellence in promoting consumer relationships
b. Holding the staff accountable for resolving patient complaints
c. Selecting a staff nurse leader to implement the program
d. Identifying key staff members who have already demonstrated excellence in consumer relationships
9. In orienting new staff nurses to a pediatric intensive care unit, the nurse manager asks the staff nurses to answer the following question: “What is an important consideration in providing information to parents of a critically ill child?”
a. Making sure that they receive complete information during each encounter with a member of the nursing staff
b. Assessing parents’ preferences regarding the amount of information provided
c. Allowing parents to observe key aspects of their child’s nursing care
d. Making sure that patient education brochures explaining ICU protocols are readily available
10. In designing a program for young adults regarding safe sexual practices, which of the following might reach the greatest number in the target group?
a. Web-based applications
b. Print-based media such as newspapers
c. Television advertisements
d. Brochures in kiosks in malls
11. A nurse is admitted to a psychiatric unit. The staff expresses frustration with her because they have explained her medication regimen several times, and yet, when she leaves the unit with a pass, she fails to follow it. The staff believe that, as a nurse, she should be able to understand what is expected. The nurse’s failure to follow the regimen indicates:
a. early cognitive impairment.
b. lack of motivation.
c. lack of health literacy.
d. worsening health state.
12. John is an older adult patient who comes regularly to the multigroup practice in which you are a nurse practitioner. He says that he doesn’t understand what he is supposed to be doing about his medications, because every time he comes to the clinic, he sees a different provider. John’s experience represents what aspect of the current consumer experience?
a. Nurses are well-trusted members of the healthcare team.
b. Fragmentation of care results in lack of respect and trust.
c. Care providers often have conflicting ideas about care.
d. The public does not trust care providers other than nurses.
13. The complexity of the healthcare environment for consumers is increased by:
a. falling levels of education among the public.
b. increased levels of poverty.
c. complex compensatory systems and a variety of delivery systems.
d. increased numbers of uninsured or underinsured.
14. Corrine, a student nurse, often hears that nurses are gatekeepers and wonders what that term means. As a nurse leader, you explain that this is a reference to the:
a. assessment and admission of patients into care.
b. orientation of patients to services once they are admitted.
c. function of controlling which patients see the physician and which do not.
d. coordination of care, services, advocacy, and access for patients within the healthcare system.
5. A 27-year-old woman is admitted to your ICU in a coma, following an accident. The family of the patient, who is a Native American, places a medicine pouch in the bed with the young woman. As the nurse in this situation, it is important to:
a. explain to the family that the medicine pouch may contain herbs that may bother other patients.
b. ask the family about the significance of the medicine pouch for them.
c. remove the pouch when the family is not present.
d. put the medicine pouch on the shelf beside the bed.
16. You are involved in designing a clinic for women in an inner-city neighborhood. A goal of this clinic might be:
a. development of services that are identified in various studies as important for this target group.
b. partnership with area city councilors and health professionals to provide services that are consistent with their vision and funding sources.
c. provision of immunization and addictions services and health screening services for women in the area.
d. development of services that have been identified by the women and neighborhood advocates as necessary for their health care.
17. Which of the following exemplifies a service orientation for a facility?
a. Staff members on the unit are encouraged to chart details about family support networks.
b. Chart audit reveals that details related to assessment of family history are missing.
c. The palliative care unit organizes a “tree of light” fundraiser each year to highlight the importance of palliative care.
d. A children’s preoperative holding area is implemented in response to requests from families and staff nurses for development of an area.
18. As a head nurse, you are concerned about the service orientation on your unit. Which of the following findings and approaches might provide useful information for you?
a. Patients find nurses friendly and accessible; data are aggregated for the institution as a whole.
b. Data indicate that nurses are responsive to requests for assistance; data are available for the unit and the institution.
c. Specific questions related to management of comfort are included for the institution as a whole
d. The survey asks for a range of responses for the unit and the organization, with a focus on facilities, such as cleanliness and responsiveness of administrative services.
19. As a nurse manager, you see an opportunity for patients to be well serviced through the medical home concept. You recognize that the concept of medical homes:
a. currently does not include nurses in its vision of multifaceted primary care.
b. includes nurses as part of an interdisciplinary and multidisciplinary team.
c. restricts nurses to services related to direct care and procedures.
d. cannot encompass nurses within this framework.
20. Technology is integral to a cardiac ICU. Sue, the nurse manager, implements a patient-centered approach that focuses on the meaning of the experience for the patient and family, primary nursing, and a health literacy approach. Sue is:
a. using high-tech–low-touch approaches.
b. using high-tech–high-touch approaches.
c. providing products.
d. providing tangible products of satisfaction.
21. Which of the following actions best exemplifies advocacy?
a. Developing a list of agencies that will provide free services for the homeless
b. Working in a needle exchange program for individuals in an inner-city environment
c. Acting on behalf of a patient to promote end-of-life wishes to an ethics committee
d. Working in a free clinic for immigrant workers
22. During review of a patient’s progress, the healthcare team determines that a patient requires treatment that is generally accepted at that time in the usual illness trajectory of a patient. The patient is unable to pay. As the head nurse, you persist in ensuring that this patient receives the treatment. You are:
a. empowering the patient.
b. avoiding litigation.
c. advocating for the patient.
d. supporting the clinical pathway.
23. A nurse makes a medication error that is not serious and does not cause harm to the patient. As the charge nurse, your best action would be to
a. call attention to it by posting the critical incidents report at the nursing station.
b. include the mistake on the nurse’s performance appraisal.
c. apologize to the patient for the error and indicate that discipline has occurred.
d. educate the nurse on how to provide an apology to the patient.
24. An example of a factor that would impede a patient’s learning is:
a. poverty.
b. limited health insurance.
c. being an older adult.
d. heavy sedation.
1. Which of the following activities would represent a customer-friendly approach in a healthcare setting? (Select all that apply.)
a. Using a local anesthetic before inserting a needle into a child’s arm
b. Repeating patient history information to the admitting clerk, the admitting nurse, and the ultrasound technician
c. Ensuring that birthing preferences are on file and available in a laboring mother’s chart
d. Providing support to families when a family member is brought into trauma
