Test Bank For Leading and Managing in Canadian Nursing 1st Canadian Edition By Yoder-Wise
Chapter 02: Patient Focus
MULTIPLE CHOICE
1. In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross Hospital reduces the number of its nursing managers. Within a year, the number of adverse events on the units has doubled. This may be attributable to
a.
the overload of work for staff nurses.
b.
inability of staff at the bedside to make good choices.
c.
a change in reporting systems.
d.
fewer clinical leaders and advocates for necessary resources.
ANS: D
Strong leadership across the nursing profession is essential to ensure the delivery of safe care. Reducing nursing managers who provide support, consultation, and leadership in securing resources and in inspiring standards of excellence may increase the number of adverse events related to lack of leadership.
DIF: Cognitive Level: Understand REF: Page 28 TOP: Nursing Process: Evaluation
2. Traditional approaches to ensuring patient safety have focused on
a.
assigning blame.
b.
finding solutions to systems issues.
c.
instituting best practices in response to errors.
d.
hiding errors from potential litigation.
ANS: A
When healthcare facilities create a culture of safety, their staff are more willing to report adverse events because the focus is on addressing issues in the system and not blaming individuals.
DIF: Cognitive Level: UnderstandREF: Page 28
TOP: Nursing Process: Assessment
3. What is the primary purpose of nursing standards?
a.
To inform performance appraisals at the unit level
b.
To identify the desired level of performance
c.
To inform the courts in relation to negligence and malpractice cases
d.
To educate other health care professionals about the role of the nurse
ANS: B
The primary purpose of standards is to identify for nurses, the public, the government, and other stakeholders the desired and achievable level of performance expected of nurses in their practice, against which actual performance can be measured.
DIF:Cognitive Level: UnderstandREF:Page 24
TOP: Nursing Process: Assessment
4. During review of back injuries, it is determined that mechanical lifts and transfer belts are not being properly used. In addressing this concern, the unit manager
a.
meets individually with nurses who are observed to be using the lifts incorrectly to review the correct procedure.
b.
consults with the staff about the review to determine how best to proceed.
c.
blames the system for inadequate funding for resources.
d.
reviews the system of reporting adverse events to ensure that appropriate reporting is occurring.
ANS: B
Consulting with the staff enables the nurse manager to ascertain the root of the problem, inasmuch as the equipment may be faulty or unsafe because of its age and needs to be replaced. Client-focused provision of care requires the nurse administrator to communicate, collaborate, and consult with nurses and other members of the health care team about the provision of health care services.
DIF:Cognitive Level: ApplyREF:Page 25, Box 2-1
TOP: Nursing Process: Implementation
5. The nursing manager changed the current model of implementing nursing rounds of patients each day at 1200 hours to implementing interdisciplinary rounds of patients at 1000 hours. This change reflects
a.
a patient-centred care initiative.
b.
delegation of responsibility from nursing to other health care professionals.
c.
lack of consultation among the nursing staff.
d.
an inappropriate time to complete patient rounds and will probably not work.
ANS: A
Patient-centred care is a priority in two main roles for nursing managers: making policies and ensuring system accountability. A number of activities can be implemented to enact these two roles, and nurses can support or implement many of them. For example, nurses can lead changes that promote team-based and collaborative care, as demonstrated in this question.
DIF:Cognitive Level: AnalyzeREF:Page 26
TOP: Nursing Process: Implementation
6. Which of the following represents an activity that supports patient-centred care?
a.
Posting of visiting hours on the entrance way to each hospital unit
b.
Regular staff surveys to monitor organizational satisfaction
c.
Reserved parking spots at the main hospital entrance for physicians
d.
Creating e-health stations on each inpatient unit
ANS: D
Governance and management activities that support patient-centred care include e-health stations and other technologic devices that facilitate communication, efficiency, and convenience.
DIF:Cognitive Level: AnalyzeREF:Page 27, Box 2-4
TOP: Nursing Process: Assessment
7. After consulting with practice environments about quality and safety concerns in health care, the Dean of Health Programs at a Canadian university develops
a.
a nursing program that emphasizes the development of a strong disciplinary identity.
b.
programming that stresses discipline-based research.
c.
partnerships with health care professionals to develop software for reporting of adverse events.
d.
an interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.
ANS: D
Working within interprofessional teams optimizes patient safety and quality of the care that patients receive.
DIF:Cognitive Level: ApplyREF:Page 29, Box 2-6
TOP: Nursing Process: Implementation
8. In designing a high-quality, safe health care environment, the primary emphasis needs to be on
a.
evidence-informed practice.
b.
informatics.
c.
staffing.
d.
the patient.
ANS: D
Patient-centred care contributes to a safer health care environment. Patient focus is integrated in the entry-level competencies for nurses that guide nursing education programs. These entry-level competencies are developed through collaboration among nursing regulatory bodies in Canada. The competencies are grounded in a standards-based conceptual framework in which the patient is central.
DIF: Cognitive Level: Understand REF: Page 24 TOP: Nursing Process: Planning
9. As a patient care advocate, you regularly coach patients in how to stay safe in health care by educating them about
a.
the need to understand and record all medications being taken.
b.
bringing their own linens and other personal items to the hospital.
c.
washing hands frequently while in a health care environment and using a hand sanitizer.
d.
following closely the directions and orders of health care providers.
ANS: A
One of the patient outcomes includes self-care: that is, the patients’ perceptions and abilities to manage their care, including medication administration. It is important that a patient advocate educate patients about their medications and assess their ability to correctly take their own medications.
DIF:Cognitive Level: ApplyREF:Page 30
TOP: Nursing Process: Implementation
10. What is the focus in a culture of safety?
a.
Employee safety
b.
Investigating who is making health care errors
c.
Effective systems and team work
d.
Professional nursing standards and ethical codes
ANS: C
In a culture of safety, the focus is on effective systems and teamwork to accomplish the mutual goal of safe, high-quality performance. When something goes wrong, the focus is on what, rather than who, the problem is. The intent is to expose process failures and system issues and to solve them in a nonbiased, nonthreatening way.
DIF:Cognitive Level: UnderstandREF:Page 27
TOP: Nursing Process: Assessment
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