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1. Katherine is a young Unit Manager of the Pediatric Ward. Most of her staff nurses are senior to her, very articulate, confident and sometimes aggressive. Katherine feels uncomfortable believing that she is the scapegoat of everything that goes wrong in her department. Which of the following is the best action that she must take?
A. Identify the source of the conflict and understand the points of friction
B. Disregard what she feels and continue to work independently
C. Seek help from the Director of Nursing
D. Quit her job and look for another employment.
2. As a young manager, she knows that conflict occurs in any organization. Which of the following statements regarding conflict is NOT true?
A. Can be destructive if the level is too high
B. Is not beneficial; hence it should be prevented at all times
C. May result in poor performance
D. May create leaders
3. Katherine tells one of the staff, “I don’t have time to discuss the matter with you now. See me in my office later” when the latter asks if they can talk about an issue. Which of the following conflict resolution strategies did she use?
A. Smoothing
B. Compromise
C. Avoidance
D. Restriction
4. Kathleen knows that one of her staff is experiencing burnout. Which of the following is the best thing for her to do?
A. Advise her staff to go on vacation.
B. Ignore her observations; it will be resolved even without intervention
C. Remind her to show loyalty to the institution.
D. Let the staff ventilate her feelings and ask how she can be of help.
5. She knows that performance appraisal consists of all the following activities EXCEPT:
A. Setting specific standards and activities for individual performance.
B. Using agency standards as a guide.
C. Determine areas of strength and weaknesses
D. Focusing activity on the correction of identified behavior.
6. Which of the following statements is NOT true about performance appraisal?
A. Informing the staff about the specific impressions of their work help improve their performance.
B. A verbal appraisal is an acceptable substitute for a written report
C. Patients are the best source of information regarding personnel appraisal.
D. The outcome of performance appraisal rests primarily with the staff.
7. There are times when Katherine evaluates her staff as she makes her daily rounds. Which of the following is NOT a benefit of conducting an informal appraisal?
A. The staff member is observed in natural setting.
B. Incidental confrontation and collaboration is allowed.
C. The evaluation is focused on objective data systematically.
D. The evaluation may provide valid information for compilation of a formal report.
8. She conducts a 6-month performance review session with a staff member. Which of the following actions is appropriate?
A. She asks another nurse to attest the session as a witness.
B. She informs the staff that she may ask another nurse to read the appraisal before the session is over.
C. She tells the staff that the session is manager-centered.
D. The session is private between the two members.
9. Alexandra is tasked to organize the new wing of the hospital. She was given the authority to do as she deems fit. She is aware that the director of nursing has substantial trust and confidence in her capabilities, communicates through downward and upward channels and usually uses the ideas and opinions of her staff. Which of the following is her style of management?
A. Benevolent –authoritative
B. Consultative
C. Exploitive-authoritative
D. Participative
10. She decides to illustrate the organizational structure. Which of the following elements is NOT included?
A. Level of authority
B. Lines of communication
C. Span of control
D. Unity of direction
11. She plans of assigning competent people to fill the roles designed in the hierarchy. Which process refers to this?
A. Staffing
B. Scheduling
C. Recruitment
D. Induction
12. She checks the documentary requirements for the applicants for staff nurse position. Which one is NOT necessary?
A. Certificate of previous employment
B. Record of related learning experience (RLE)
C. Membership to accredited professional organization
D. Professional identification card
13. Which phase of the employment process includes getting on the payroll and completing documentary requirements?
A. Orientation
B. Induction
C. Selection
D. Recruitment
14. She tries to design an organizational structure that allows communication to flow in all directions and involve workers in decision making. Which form of organizational structure is this?
A. Centralized
B. Decentralized
C. Matrix
D. Informal
15. In a horizontal chart, the lowest level worker is located at the
A. Left most box
B. Middle
C. Right most box
D. Bottom
16. She decides to have a decentralized staffing system. Which of the following is an advantage of this system of staffing?
A. greater control of activities
B. Conserves time
C. Compatible with computerization
D. Promotes better interpersonal relationship
17. Aubrey thinks about primary nursing as a system to deliver care. Which of the following activities is NOT done by a primary nurse?
A. Collaborates with the physician
B. Provides care to a group of patients together with a group of nurses
C. Provides care for 5-6 patients during their hospital stay.
D. Performs comprehensive initial assessment
18. Which pattern of nursing care involves the care given by a group of paraprofessional workers led by a professional nurse who take care of patients with the same disease conditions and are located geographically near each other?
A. Case method
B. Modular nursing
C. Nursing case management
D. Team nursing
19. St. Raphael Medical Center just opened its new Performance Improvement Department. Ms. Valencia is appointed as the Quality Control Officer. She commits herself to her new role and plans her strategies to realize the goals and objectives of the department. Which of the following is a primary task that they should perform to have an effective control system?
A. Make an interpretation about strengths and weaknesses
B. Identify the values of the department
C. Identify structure, process, outcome standards & criteria
D. Measure actual performances
20. Ms. Valencia develops the standards to be followed. Among the following standards, which is considered as a structure standard?
A. The patients verbalized satisfaction of the nursing care received
B. Rotation of duty will be done every four weeks for all patient care personnel.
C. All patients shall have their weights taken recorded
D. Patients shall answer the evaluation form before discharge
21. When she presents the nursing procedures to be followed, she refers to what type of standards?
A. Process
B. Outcome
C. Structure
D. Criteria
22. The following are basic steps in the controlling process of the department. Which of the following is NOT included?
A. Measure actual performance
B. Set nursing standards and criteria
C. Compare results of performance to standards and objectives
D. Identify possible courses of action
23. Which of the following statements refers to criteria?
A. Agreed on level of nursing care
B. Characteristics used to measure the level of nursing care
C. Step-by-step guidelines
D. Statement which guide the group in decision making and problem solving
24. She wants to ensure that every task is carried out as planned. Which of the following tasks is NOT included in the controlling process?
A. Instructing the members of the standards committee to prepare policies
B. Reviewing the existing policies of the hospital
C. Evaluating the credentials of all nursing staff
D. Checking if activities conform to schedule
25. Ms. Valencia prepares the process standards. Which of the following is NOT a process standard?
A. Initial assessment shall be done to all patients within twenty four hours upon admission.
B. Informed consent shall be secured prior to any invasive procedure
C. Patients’ reports 95% satisfaction rate prior to discharge from the hospital.
D. Patient education about their illness and treatment shall be provided for all patients and their families.
26. Which of the following is evidence that the controlling process is effective?
A. The things that were planned are done
B. Physicians do not complain.
C. Employees are contended
D. There is an increase in customer satisfaction rate.
27. Ms. Valencia is responsible to the number of personnel reporting to her. This principle refers to:
A. Span of control
B. Unity of command
C. Carrot and stick principle
D. Esprit d’ corps
28. She notes that there is an increasing unrest of the staff due to fatigue brought about by shortage of staff. Which action is a priority?
A. Evaluate the overall result of the unrest
B. Initiate a group interaction
C. Develop a plan and implement it
D. Identify external and internal forces.
29. Kevin is a member of the Nursing Research Council of the hospital. His first assignment is to determine the level of patient satisfaction on the care they received from the hospital. He plans to include all adult patients admitted from April to May, with average length of stay of 3-4 days, first admission, and with no complications. Which of the following is an extraneous variable of the study?
A. Date of admission
B. Length of stay
C. Age of patients
D. Absence of complications
30. He thinks of an appropriate theoretical framework. Whose theory addresses the four modes of adaptation?
A. Martha Rogers
B. Sr. Callista Roy
C. Florence Nightingale
D. Jean Watson
31. He opts to use a self-report method. Which of the following is NOT TRUE about this method?
A. Most direct means of gathering information
B. Versatile in terms of content coverage
C. Most accurate and valid method of data gathering
D. Yields information that would be difficult to gather by another method
32. Which of the following articles would Kevin least consider for his review of literature?
A. “Story-Telling and Anxiety Reduction Among Pediatric Patients”
B. “Turnaround Time in Emergency Rooms”
C. “Outcome Standards in Tertiary Health Care Institutions”
D. “Environmental Manipulation and Client Outcomes”
33. Which of the following variables will he likely EXCLUDE in his study?
A. Competence of nurses
B. Caring attitude of nurses
C. Salary of nurses
D. Responsiveness of staff
34. He plans to use a Likert Scale to determine
A. degree of agreement and disagreement
B. compliance to expected standards
C. level of satisfaction
D. degree of acceptance
35. He checks if his instruments meet the criteria for evaluation. Which of the following criteria refers to the consistency or the ability to yield the same response upon its repeated administration?
A. Validity
B. Reliability
C. Sensitivity
D. Objectivity
36. Which criteria refer to the ability of the instrument to detect fine differences among the subjects being studied?
A. Sensitivity
B. Reliability
C. Validity
D. Objectivity
37. Which of the following terms refer to the degree to which an instrument measures what it is supposed to be measure?
A. Validity
B. Reliability
C. Meaningfulness
D. Sensitivity
38. He plans for his sampling method. Which sampling method gives equal chance to all units in the population to get picked?
A. Random
B. Accidental
C. Quota
D. Judgment
39. Raphael is interested to learn more about transcultural nursing because he is assigned at the family suites where most patients come from different cultures and countries. Which of the following designs is appropriate for this study?
A. Grounded theory
B. Ethnography
C. Case study
D. Phenomenology
40. The nursing theorist who developed transcultural nursing theory is
A. Dorothea Orem
B. Madeleine Leininger
C. Betty Newman
D. Sr. Callista Roy
Answers and Rationale
Here are the answers and rationales for the exam. This exam is out of this world difficult so don’t feel bad if you got a low score but be sure to read the rationales below. If you need clarifications, direct them to the comments below.
1. Answer: A. Identify the source of the conflict and understand the points of friction
This involves a problem solving approach, which addresses the root cause of the problem.
2. Answer: B. Is not beneficial; hence it should be prevented at all times
Conflicts are beneficial because it surfaces out issues in the open and can be solved right away. Likewise, members of the team become more conscientious with their work when they are aware that other members of the team are watching them.
3. Answer: C. Avoidance
This strategy shuns discussing the issue head-on and prefers to postpone it to a later time. In effect the problem remains unsolved and both parties are in a lose-lose situation.
4. Answer: D. Let the staff ventilate her feelings and ask how she can be of help.
Reaching out and helping the staff is the most effective strategy in dealing with burn out. Knowing that someone is ready to help makes the staff feel important; hence her self-worth is enhanced.
5. Answer: D. Focusing activity on the correction of identified behavior.
Performance appraisal deal with both positive and negative performance; is not meant to be a fault-finding activity
6. Answer: C. Patients are the best source of information regarding personnel appraisal.
The patient can be a source of information about the performance of the staff but it is never the best source. Directly observing the staff is the best source of information for personnel appraisal.
7. Answer: C. The evaluation is focused on objective data systematically.
Collecting objective data systematically can not be achieved in an informal appraisal. It is focused on what actually happens in the natural work setting.
8. Answer: D. The session is private between the two members.
The session is private between the manager and the staff and remains to be so when the two parties do not divulge the information to others.
9. Answer: B. Consultative
A consultative manager is almost like a participative manager. The participative manager has complete trust and confidence in the subordinate, always uses the opinions and ideas of subordinates and communicates in all directions.
10. Answer: D. Unity of direction
Unity of direction is a management principle, not an element of an organizational structure.
11. Answer: A. Staffing
Staffing is a management function involving putting the best people to accomplish tasks and activities to attain the goals of the organization.
12. Answer: B. Record of related learning experience (RLE)
Record of RLE is not required for employment purposes but it is required for the nurse’s licensure examination.
13. Answer: B. Induction
This step in the recruitment process gives time for the staff to submit all the documentary requirements for employment.
14. Answer: B. Decentralized
Decentralized structures allow the staff to make decisions on matters pertaining to their practice and communicate in downward, upward, lateral and diagonal flow.
15. Answer: C. Rightmost box
The leftmost box is occupied by the highest authority while the lowest level worker occupies the rightmost box.
16. Answer: D. Promotes better interpersonal relationship
Decentralized structures allow the staff to solve decisions by themselves, involve them in decision making; hence they are always given opportunities to interact with one another.
17. Answer: B. Provides care to a group of patients together with a group of nurses
This function is done in team nursing where the nurse is a member of a team that provides care for a group of patients.
18. Answer: B. Modular nursing
Modular nursing is a variant of team nursing. The difference lies in the fact that the members in modular nursing are paraprofessional workers.
19. Answer: B. Identify the values of the department
Identify the values of the department will set the guiding principles within which the department will operate its activities
20. Answer: B. Rotation of duty will be done every four weeks for all patient care personnel.
Structure standards include management system, facilities, equipment, materials needed to deliver care to patients. Rotation of duty is a management system.
21. Answer: A. Process
Process standards include care plans, nursing procedure to be done to address the needs of the patients.
22. Answer: D. Identify possible courses of action
This is a step in a quality control process and not a basic step in the control process.
23. Answer: B. Characteristics used to measure the level of nursing care
Criteria are specific characteristics used to measure the standard of care.
24. Answer: A. Instructing the members of the standards committee to prepare policies
Instructing the members involves a directing function.
25. Answer: C. Patients’ reports 95% satisfaction rate prior to discharge from the hospital.
This refers to an outcome standard, which is a result of the care that is rendered to the patient.
26. Answer: A. The things that were planned are done
Controlling is defined as seeing to it that what is planned is done.
27. Answer: A. Span of control
Span of control refers to the number of workers who report directly to a manager.
28. Answer: B. Initiate a group interaction
Initiate a group interaction will be an opportunity to discuss the problem in the open.
29. Answer: C. Age of patients
An extraneous variable is not the primary concern of the researcher but has an effect on the results of the study. Adult patients may be young, middle or late adult.
30. Answer: B. Sr. Callista Roy
Sr. Callista Roy developed the Adaptation Model which involves the physiologic mode, self-concept mode, role function mode and dependence mode
31. Answer: C. Most accurate and valid method of data gathering
The most serious disadvantage of this method is accuracy and validity of information gathered
32. Answer: B. “Turnaround Time in Emergency Rooms”
The article is for pediatric patients and may not be relevant for adult patients.
33. Answer: C. Salary of nurses
Salary of staff nurses is not an indicator of patient satisfaction, hence need not be included as a variable in the study.
34. Answer: A. degree of agreement and disagreement
Likert scale is a 5-point summated scale used to determine the degree of agreement or disagreement of the respondents to a statement in a study.
35. Answer: B. Reliability
Reliability is repeatability of the instrument; it can elicit the same responses even with varied administration of the instrument
36. Answer: A. Sensitivity
Sensitivity is an attribute of the instrument that allow the respondents to distinguish differences of the options where to choose from
37. Answer: A. Validity
Validity is ensuring that the instrument contains appropriate questions about the research topic
38. Answer: A. Random
Random sampling gives equal chance for all the elements in the population to be picked as part of the sample.
39. Answer: B. Ethnography
Ethnography is focused on patterns of behavior of selected people within a culture
40. Answer: B. Madeleine Leininger
Madeleine Leininger developed the theory on transcultural theory based on her observations on the behavior of selected people within a culture.
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