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Yoder Wise Test Bank Questions &
Answers 2024
- Nursing professionals in the twenty-first century will accomplish most of their work: a. Through teams of internationally prepared professionals. b. In teams and through group work. c. Through long-term, secure jobs. d. In competitive environments and work groups. - ✔ANS: B The future is about teams and group work. Competition will be out and collaboration will be in. Job security will be out and career options will be in. Our brightest and best may leave more often than they do at present to pursue career options internationally. REF: Page 567 | Page 572 TOP: AONE competency: Knowledge of the Health Care Environment
- Based on studies of workplace environments for nurses and future projections, the workplace of the future will be: a. Less intense because of more technology. b. About the same as it is now. c. More intense because of more technology. d. Fluctuating between intense periods and less intense periods. - ✔ANS: C Technology will continue to revolutionize health care and contribute to complexity compression. In addition to access to knowledge, electronic records, and current applications of technology, technology will include robotics, which will change how chronic disease can be managed, and bioengineering will make possible interventions that do not yet exist. REF: Page 572 TOP: AONE competency: Business Skills
- Which of the following actions is most representative of how health care of the future might be delivered? As a nurse leader, you: a. Refer families who require immediate help to a local food bank. You also work with local agencies and families to establish a mothers collective in which mothers learn about nutrition and prepare low-cost, nutritious meals that are shared with the mothers in the collective. b. Work together with a local agency to set up a free clinic in which addicts and the homeless can receive free health care and prescriptions for immediate needs. c. Ensure that individuals who are admitted to your unit are asked about their smoking history and that preoperative and postoperative planning takes into account how smoking will affect status during and after surgery. d. Address the health of those who are overweight and obese on your unit by ensuring that hospital meals offer nutritious, healthy food - ✔ANS: A
Referral to a food bank addresses the needs of a specific population, while exemplifying an important leadership strength: thinking long-term, acting short-term. The project that involves mothers will teach mothers about nutrition and engage them in preparation of low-cost, healthy meals while promoting longer-term changes in healthy eating. REF: Page 567 | Page 568 | Page 572 TOP: AONE competency: Leadership
- You notice that wait times in your Emergency Department are growing longer, because of factors such as increases in the numbers of persons with chronic disorders, discharge of patients into the community at a higher level of acuity, and limited resources for transfer of inpatients. You begin to think about an application that would use your knowledge of the Emergency Department but also software and business applications and wonder if this would reduce wait times. You have not encountered anything similar to this idea. According to the Wise Forecast Model©, you are in what phase? a. Wild thinking b. Act widely c. Think wildly d. Learn widely - ✔ANS: C The second step in the Wise Forecast Model© is to think wildly. Step two is designed to create connections among disparate thoughts. This thinking might be seen as the start of innovations. REF: Page 570 TOP: AONE competency: Knowledge of the Health Care Environment
- Your organization is in the middle of re-designing patient care units, with decisions based on best practices and various other sources of evidence. In the middle of the transition, there is a temporary halt called to the transition because of a re-design of the health care system and greater emphasis on primary care. What would be a healthy response to this situation? a. Salvage as much of the original planning as possible so as to reduce expenditures. b. Engage in consultation to create innovative solutions that bridge the existing plans and the new directions. c. Abandon the current planning in favor of addressing the new trends. d. Continue with the current planning because trends come and go. - ✔ANS: B Stability and total chaos are the ends of a continuum. Moving in some way between those two ends suggests that we live in a constant state of disequilibrium in which we strive toward stability while recognizing we experience chaos. As we continue to move from "traditional" practices to evidence-based ones and from a heavy focus on tertiary care to one that values primary care, we can assume that we might experience more chaos. Chaos can lead to new learning and new, innovative solutions. As nurses, it is important to be able to function in an evolving environment. REF: Page 571 TOP: AONE competency: Leadership
- Your organization is in the middle of re-designing patient care units, with decisions based on best practices and various other sources of evidence. In the middle of the
our minds, we are already addressing some other new change. This compression can be distracting or useful. REF: Page 572 TOP: AONE competency: Leadership
- Nursing research has indicated that the foundation for becoming a nursing leader is the ability to: a. Write effectively. b. Speak two or three languages. c. Focus on day-to-day priorities. d. Think futuristically. - ✔ANS: D Whether you are a leader, a follower, or a manager, being able to visualize in your mind what the ideal future is becomes a critical strategy. A vision can range from that of an individual to that of a group or to a whole organization. REF: Page 569 TOP: AONE competency: Leadership
- The chief nursing officer has been developing her portfolio for years. What is the chief nursing officer modeling? a. Her clinical expertise b. Affection for tradition c. Her employability d. Her busy professional life - ✔ANS: C Being employed is no longer sufficient; we must be employable. A portfolio outlines achievements and experiences that communicate employability. REF: Page 569 TOP: AONE competency: Leadership
- Your unit has a number of patients who have undergone limb amputation. In working with the clients, you begin to think beyond therapies such as pharmacotherapeutics and surgery and you explore biomechanics, robotics, mind-body approaches, and cognitive behavioral therapies as possibilities in working with these clients. You begin to amass information in a number of areas with which you previously had little familiarity. According to the Wise Forecast Model©, you are a. Acting wildly. b. Learning wildly. c. Engaging in interprofessional care. d. Increasing your complexity compression. - ✔ANS: B The first step, learn widely, means that we must extend our sources of knowledge beyond our role and clinical areas of interest. In fact we must extend our learning beyond nursing and health care. Widely might encompass another discipline such as architecture or engineering. REF: Page 570 TOP: AONE competency: Leadership
- The starfish analogy is exemplified in which of the following? a. A unit manager resigns after continued tension between the administration and her regarding implementation of primary nursing. The primary nursing project dies.
b. Nurses try to establish a clinic that provides ambulatory care to parents and young children in an impoverished neighborhood. Community members advocate for funding from political leaders and insurers. c. Alana, a new graduate, promotes continence care based on evidence. When she presents her ideas, senior staff refuses to consider it. d. The head of a community health service moves on to another position. Programs are disbanded. - ✔ANS: B The starfish analogy points to the connectivity that we have with one another and how we influence and are influenced by others all the time. This affords many opportunities for leadership that are dependent not on formal titles but on opportunities to shape the work at hand. REF: Page 568 TOP: AONE competency: Leadership
- Which of the following will require greater attention in the future? a. Chronic disorders b. Obstetrical outcomes c. Prevention of hospital-based errors d. Team conflict resolution strategies - ✔ANS: A Lifestyle choices, obesity, and an aging population will lead to an increased emphasis on prevention, personal accountability, and innovations such as robotics in the management of chronic illnesses. REF: Page 572 TOP: AONE competency: Knowledge of the Health Care Environment
- Which of the following strategies is most important in developing a strong vision? a. Seeking out evidence to support trends and out-of-the-box thinking b. Spending time with others with whom we discuss ideas c. Setting up focus groups to provide information on current realities d. Being honest and open about what we think for the future - ✔ANS: D Regardless of how we go about developing our vision (gathering evidence, testing ideas with others), honesty and openness are foundational to a strong vision. REF: Page 569 TOP: AONE competency: Leadership
- To move beyond stereotypical thinking and toward thinking about the future, which of the following would be most consistent with thinking wildly in the Wise Forecast Model©? a. Listing everything that we know about our current situation b. Defining which practices will remain unchanged and which will change c. Asking someone with a great deal of experience to share ideas about best practice d. Challenging current and future practices with questions of "what if?" - ✔ANS: D Thinking wildly includes creating wild questions. Sometimes they are what lead to a wild idea.
d. Building profit projects and sustainability into planning. - ✔ANS: C Stalk and Butman suggests that asking the customer for feedback on options may assist with forecasting. Adopting this strategy runs counter to current practice and would increase the complexity of healthcare planning and forecasting. REF: Page 572 TOP: AONE competency: Knowledge of the Health Care Environment
- A number of changes are introduced to a unit, including changes to familiar clinical procedures and the use of PDAs to enable bedside documentation. You, as unit manager, anticipate which of the following will contribute most to complexity compression? a. Meaning of the change b. Pace of changes c. Previous experiences with change d. Confidence of the leader in the value of the change - ✔ANS: B Complexity compression is a term that means that many changes are happening almost simultaneously and before one practice can be firmly implanted in our minds, we are already addressing some other change REF: Page 572 TOP: AONE competency: Leadership
- In order to plan long term, you consider what the client of the future will look like. Which of the following client profiles would best capture shifting demographics and trends in health care? a. Younger, knowledgeable about health options b. Female, uses emergency care services for parents and children c. Older, one or more chronic disorders, diverse background d. Male, various occupationally generated disorders, diverse ethnic background - ✔ANS: C The client base is aging and more people will be living with chronic disorders. Persons will travel more and there will be increased need to speak two or more languages to address the needs of a mobile global population. REF: Page 572 TOP: AONE competency: Leadership
- You have just hired a recent graduate. The graduate is thrilled with the opportunity that she has been given, as well as with the idea that "working means no more essays, tests, or assignments!" She indicates that she has no intention of touching a book, journal, or health information Website for a "long time." Which of the following would be your best response? a. The expectations and design of educational programs means that new graduates are better prepared for the workforce. b. The new graduate will still have to learn, but it will be job-specific learning. c. An ideal learning plan for nurses emphasizes followership. d. The amount and intensity of knowledge demands lifelong learning that includes assessment of relevancy of knowledge for practice. - ✔ANS: D
Knowledge will change dramatically, requiring that we all be dedicated learners. With or without state law, continuing education will be mandatory and essential. Knowledge will evolve from the intensity of the current information evolution so that we will access content with meaning and applicability for our work. REF: Page 572 TOP: AONE competency: Professionalism
- A necessary leadership strength for nurses of the future is: a. Inspiring others to work their best to create the future. b. Understanding the nuances of fundraising to make up funding shortfall. c. Guarding the tendency of other professions to encroach on nursing roles. d. Adapting work life to an aging nursing workforce. - ✔ANS: A Senge said that all leadership is really about is people working at their best to create the future. Predictions of the future highlight the importance of interprofessional teams and of a shift towards understanding the importance of health care. REF: Page 569 | Page 572 TOP: AONE competency: Leadership
- Nathan tells you that he has selected nursing as a career because many jobs are available and he will have job security. Your best response to Nathan is: a. "With many young people going overseas, many jobs and options will be available. Stable jobs and job security will be part of the nursing employment market." b. "The job market for nurses will be diminished with funding cuts to hospitals." c. "The employment prospects for nurses are positive with many options to choose from. Flexibility and adaptability are essential to income security." d. "It is unlikely that nursing will survive in the long term with funding cuts and a declining population of seniors." - ✔ANS: C Employment for nurses continues to be positive, although roles will change in a rapidly changing environment, which will increase options. With the number of options available and sporadic work opportunities, nurses will need to be flexible and able to adapt rapidly. Job security will be out; career options will be in. REF: Page 572 TOP: AONE competency: Business Skills
- In developing curricula that will address needs based on forecasts for the future, nursing educators need to contemplate (select all that apply): a. Prevention strategies. b. Leadership skills and knowledge. c. Violence de-escalation strategies. d. Strategies for job security. - ✔ANS: A, B, C Future forecasts suggest that health factors such as obesity that are implicated in the development of chronic disorders will increase, as will chronic disease. Leadership skills have been identified as a key competence for nurses of tomorrow, and competence with technology will be needed as technology continues to revolutionize health care. Rather than emphasizing job security, nurses will need to be prepared to be in an environment with many options and episodic employment.
teaching healthcare professionals. The PCN has requested that you provide a prioritized plan of action for marketing the manual on a regional and state basis. What is the first priority? a. Motivate the target market. b. Research the target market. c. Communicate benefits to the target group. d. Package the product. - ✔ANS: B To put a strategic plan into place for marketing, it is necessary to conduct an external assessment.
- The chief nursing officer has to write a strategic plan. The most difficult stage in the strategic planning process is: a. Assessment of the external and internal environment. b. Review of mission statement, goals, and objectives. c. Identification of strategies. d. Implementation of strategies. - ✔ANS: A Determination of strengths, weaknesses, opportunities, and threats requires openness to what is being said and observed and is critical to setting the stage for relevant responses in the latter phases of strategic planning.
- The reasons cited by nursing administrators for not planning in a systematic manner include: a. Lack of understanding of the planning process. b. Lack of knowledge regarding the internal and external operations of the organization. c. Not enough hours in the day for both day-to-day operations and planning. d. Delegation of the task to subordinates. - ✔ANS: A The nurse manager should participate in strategic planning and quality initiatives with the governing body. Lack of knowledge is a common reason for nonparticipation in planning initiatives.
- From your observation of planning activities in the organization, you have noticed that planning and decision making occur at various levels of the organization. The nurse manager has overall responsibility for which of the following? a. Sending out postcards b. Organizing a telephone follow-up c. Monitoring ongoing activities and projects d. Listing the patient population - ✔ANS: C The nurse manager should articulate organizational decision making for the criteria model adopted by the organization and monitor ongoing implementation of the plan.
- Which of the following represents a well-written objective? a. Hospital-acquired infections are reduced, and procedures to reduce infections are implemented. b. To increase staff satisfaction and to decrease burnout c. To increase the health of the community
d. To implement evidence-based practice on nursing units, as evidenced by adoption of evidence-based processes, by June 1, 2015 - ✔ANS: D Objectives are specific (begin with word to followed by an action word; specify single result to be achieved; and specify a target date for attainment) and measurable (provide level of accomplishment at the end).
- To conduct assessment of the internal environment, the strategic planning team for Pacific Hospital: a. Invites community members and staff of the hospital to an evening focus group session. b. Discusses what it sees as the primary threats and opportunities in demographic shifts affecting the hospital. c. Invites all levels of staff to focus groups on the effectiveness of the hospital environment, including information systems and staffing. d. Asks the board to provide a summary of major opportunities for the future. - ✔ANS: C Assessment of the internal environment should include all levels of staff and facilitates feedback on effectiveness of strengths and weaknesses of systems and processes within the institution.
- In assessing the internal environment, the strategic planning team at Pacific Hospital discovers that 90% of staff members have no idea what the current mission statement means. This is most likely related to: a. The level of abstraction inherent in mission statements. b. Development of the statement by the administration team with no other staff involvement. c. Outdated goals and objectives contained in the mission statement. d. Failure to provide action statements within the mission statement. - ✔ANS: B A mission statement reflects the beliefs of the organization in relation to those it serves and services it provides, and it communicates the direction of an organization. Covey (1990) believes that the process of developing the mission statement is vital to an organization's success and should involve everyone.
- Pacific Hospital's team develops a process to include staff in development of the mission statement. Which of the following statements would indicate that the staff has been able to develop an effective mission statement? a. Pacific Hospital will increase its sustainability by increasing revenue streams within the next three years. Revenue streams are important to our hospital and are a driving force in our sustainability in the face of insurer and government funding changes. b. Pacific Hospital has a desire to relate to its community to enable appropriate identification of programming needs by July 2012. c. Pacific Hospital will provide family-centered care to the community of Pacific Rim. It is committed to delivering a full spectrum of services that foster collaborative partnerships among clients, families, and the hospital, and it utilizes evidence-based practice to guide planning and interventions. d. To pro - ✔ANS: C
Assessment of needs takes into account needs of the consumer now and for the future, using a variety of data-gathering techniques. Future orientation aids in anticipating how marketing and programs will need to shift to meet those needs.
- After an extensive campaign to ensure that the community surrounding Pacific Hospital has been exposed to the emphasis of excellence in clinical care that occurs through the use of evidence, the marketing team finds that the public perception has changed little. This determination is made possible through: a. Marketing surveys. b. Focus groups. c. Informal feedback. d. Comparison of data against benchmarks. - ✔ANS: D Developing benchmark data at the beginning of a project enables comparison of later data against the benchmark to determine if a marketing plan has met its objectives.
- Nurses are valuable partners in marketing strategies because they: a. Are more likely than other members of the organization to use marketing tools. b. Have a strong background in using evidence to support decisions. c. Have close involvement with patients, who are the target group for marketing. d. Constitute the largest staff group in most healthcare organizations. - ✔ANS: C As nurses are directly involved with patients who use services and who are the target group for marketing efforts, nurses have excellent insights into patient needs.
- Shifts such as changes in the percentage of seniors in the population, governmental initiatives in health care, and the influence of income on health status are factors in the __________ environment. a. Public b. Macro c. Competitive d. Social - ✔ANS: B The external environment in strategic marketing planning includes the public, competitive, and macro environments. Demographic, social, and political factors are included in the macro environments.
- A private ambulance clinic established a few streets away from Pacific Hospital markets its services as quality-based within caring relationships. The clinic is part of the __________ environment. a. Public b. Macro c. Competitive d. Social - ✔ANS: C The competitive environment includes factors and elements that compete for resources with another organization. These elements may include those in public and macro environments.
- Which of the following represents an effective goal statement? a. Involve patients and families in planning health care.
b. To revise clinical guidelines for incontinence care from evidence within 6 months c. Patients and families are partners first in care planning. d. To acquire $4 million in additional funding within 12 months to support clinical education programs for dementia - ✔ANS: A Goal statements formalize targets for an organization. Objectives include the word to and an action word, and specify dates for attainment. Mission statements convey values and beliefs of the organization.
- After a year, the staff at Pacific Hospital is frustrated, and implementation of evidence-based practice has gone poorly. In responding to this situation, the strategic planning team at Pacific Hospital: a. Recommends that the mission, objectives, and goals of the hospital be reassessed. b. Revises the goal statements in the strategic plan. c. Consults an external team on preparation of materials on evidence-based practice. d. Holds focus groups with staff to determine what kinds of issues, challenges, and obstacles have occurred in implementation. - ✔ANS: D On a consistent basis, the strategic plan is reviewed at all levels to determine whether the execution of goals, objectives, and activities is on target. As stated, a sense of flexibility regarding the objectives is important to consider, and objectives may change as a result of legislation, budget changes, and change in structure or other environmental factors. Involving staff enables development of creative methods to ensure that necessary changes occur.
- Benchmarks in the strategic marketing planning process are useful in: a. Establishing programs. b. Setting targets. c. Rewarding employees. d. Measuring progress. - ✔ANS: D Establishing benchmarks enables measurement of the interim and final achievements of programs.
- The executive team at Hospital XYZ develops a polished strategic plan that includes a mission statement, goals, and objectives.. The executive team involves the marketing team, so that the plan can be communicated internally and externally. After 2 years, no significant progress has been made toward any of the goals. What has been omitted in the plan? a. Planning b. Marketing c. Integrated financial planning d. Customer focus - ✔ANS: C Without the inclusion of a business plan with the strategic plan and integration of financial planning and allocation of resources execution of the strategic plan can become paralyzed, even with the most effective communication of the strategic plan itself..
REF: Page 57 | Page 61 | Page 62 TOP: AONE competency: Leadership The nurse manager, as the leader of the unit's "customer (client) first" initiative, has asked the staff nurses to develop and administer a survey to every client before discharge. In asking the staff nurses to accomplish this task, the nurse manager is demonstrating: a. Accountability. b. Shared leadership. c. A common purpose. d. Independence in the nursing manager's role. - ✔ANS: B Healthy work environments are facilitated by involving staff and others in decision making; gaining access to information is one characteristic of shared decision making. Shared decision making enables staff to feel valued in policy development and in directing and leading. REF: Page 58 TOP: AONE competency: Communication and Relationship-Building A nurse manager is experiencing considerable conflict among staff members because of weekend staffing coverage. During a called staff meeting, the nurse manager asks the disgruntled staff to meet as a group and determine the best staffing practices. In doing this, the nurse manager is using the concept of collaboration to: a. Demonstrate interdependence. b. Depict flexibility and broadmindedness. c. Focus all energies of staff members on a best possible strategy. d. Defuse the possibility that staff members will escalate their discontent when staffing the unit on weekends - ✔ANS: C When collaboration is used to solve a conflict or to create new directions, the energies of all parties are focused on solving the problem versus defeating the opposing party and creating the "best possible" versus an "okay" direction. When groups come together and mutual expectations are discussed and fostered, communication and collaboration are enhanced, which results in a more structurally empowered workforce. REF: Page 62 | Page 67 TOP: AONE competency: Communication and Relationship-Building A nurse manager's responsibility for financial management involves making budgetary decisions. Budgets that allow the nurse manager to allocate resources at the unit level allow: a.
Minimal nurse manager input. b. Limited rationale for budgetary requests. c. Budgetary allocations at the executive nurse level. d. Budgetary decision making at the point-of-service (POS). - ✔ANS: D In organizational structures where decision making occurs at the POS, nurse managers are given some self-control, which includes preparing and implementing a budget that meets the long- and short-term needs of their unit without requiring hierarchical approval. REF: Page 64 TOP: AONE competency: Business Skills The nurse manager is anticipating changes on the unit because of managed care. It is up to the manager to "sell" the staff on this care concept. A goal of managed care that the staff must understand is that managed care is: a. Grounded in business theory. b. Useful for long-term patients only. c. Designed to reduce unit resources and staff. d. Not concerned with the best interests of clients. - ✔ANS: A Managed care combines delivery of needed care with business principles of efficiency and cost. Nurse managers who know business principles become conduits for ensuring safe, effective, affordable care. REF: Page 63 TOP: AONE competency: Knowledge of the Health Care Environment The hospital administrator approves a case management position for a new rehabilitation unit to help reduce costs. In developing the job description, the nurse manager understands that a key element of case management is: a. Managing of care by nurse managers. b. Coordination of resources for effective outcomes. c. Rapid discharge of clients to decrease costs. d. Managing of care for outpatient clients only. - ✔ANS: B The key to effective case management is proactive coordination of care from the point of admission to accomplish appropriate and effective outcomes. Case management involves components such as case selection, multidisciplinary assessment, collective
a. Measurable. b. Unrealistic. c. Attainable. d. Too low. - ✔ANS: B Nurse managers who are successful in motivating staff often provide an inclusive environment that facilitates clearly set, achievable goals that can result in both team and personal satisfaction. REF: Page 54 TOP: AONE competency: Leadership While interviewing for a nurse manager position, Ann is asked to give an example of a situation in which she demonstrated leadership. Which of the following examples exemplifies leadership? a. Through research and investigation of best practice and practice-based evidence, she proposed a change in the management of incontinence in elderly patients. b. She ensures that new policies related to parenteral infusions are implemented consistently within her team. c. When asked by her students about institutional policies, she readily and patiently interprets policies to facilitate quality care. d. She organizes the team and delegates responsibilities effectively in providing nursing care - ✔ANS: A Nurse managers have the responsibility of day-to-day decisions for their units and interpret established policy, procedures, and mandates. They meet their goals by organizing, staffing, controlling, and solving problems. By contrast, leaders develop a vision and translate that direction into action. REF: Pages 53-56 TOP: AONE competency: Knowledge of the Health Care Environment Budgeting and protection of revenues is a function of: a. Leadership. b. Management. c. Team leadership. d. Followers. -
✔ANS: B
Managers address complex issues such as planning, budgeting, and allocating resources, whereas leaders address change. REF: Page 54 | Page 55 TOP: AONE competency: Knowledge of the Health Care Environment Which of the following is not important in a positive work environment, as defined by the AONE? a. Clear, open, trustful communication b. Accountability and clarity of roles and responsibilities c. Participatory decision making d. Challenge and striving for excellence - ✔ANS: D Clear and open communication, accountability and clarity of roles, and participatory decision making are considered by the AONE to be important to a healthy environment. Challenge and excellence are not specifically identified by the AONE as important to healthy work environments. REF: Pages 60-63 TOP: AONE competency: Communication and Relationship-Building As a nurse manager on a urology unit, you note that there has been a marked increase in medication errors on the unit. Which of the following actions would be consistent with the National Database of Nursing Quality Indicators (NDNQI) measures? a. Staff are consulted regarding improvements in interprofessional approaches to patient care. b. Nursing staff are asked for input regarding the purchase of new medication carts. c. A recognition program is developed to acknowledge nurses who have provided safe and exemplary care utilizing skills in the staffing mix to optimize the delivery of patient care. d. Recent changes in staffing mixes are examined to determine if the timing of changes coincides with the increase in errors. - ✔ANS: D The NDNQI measures are specifically concerned with patient safety and aspects of quality of care that may be affected by changes in the delivery of care or staffing resources. The quality indicators address staff mix and nursing hours for acute-care settings, as well as other care components. The NDNQI project is designed to assist healthcare organizations in identifying links between nursing care and patient outcomes. REF: Page 64 | Page 65
