Concept 50: Health Care Organizations My Nursing Test Banks

Concept 50: Health Care Organizations

Test Bank

MULTIPLE CHOICE

1. A nurse is interviewing at an agency owned by a national religious organization that serves homeless and uninsured patients. A large poster display shows a proposed addition that would add 16 beds to the facility that will be funded from profits of the previous 3 years of operation. The nurse recognizes that the agency is most likely what type of agency?

a.

For-profit

b.

Not-for-profit

c.

Publicly-owned

d.

Investor-owned

ANS: B

Many religious organizations are privately owned and administer not-for-profit health facilities, where profits are returned into the facility for improvements or equipment. For-profit agencies distribute profits to shareholders. Publicly-owned facilities are government supported and not linked to religious organizations. Investor-owned agencies would be for-profit agencies with profits distributed to investors.

REF: 500 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

2. A nurse is reported for taking prescribed patient medications for their personal use. Who has direct authority over deciding if the nurse may keep their professional license to continue practicing as a nurse?

a.

The hospital where the nurse is currently employed

b.

The American Nurses Association

c.

The National League for Nursing

d.

The State Board of Nursing who issued the license

ANS: D

Decisions related to practice are the responsibility of the licensing body, or State Board of Nursing, who is charged with protecting the public. The hospital does not determine who is eligible for a professional license. The National League for Nursing is active in nursing education standards. The American Nurses Association helps develop standards of care and is politically active, but it does not enforce standards for individuals.

REF: 502 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

3. The annual report for a hospital shows that external environment factors are affecting the amount of new staff hired. What is a likely factor contributing to this outcome?

a.

The recent implementation of becoming a not-for-profit institution

b.

The implementation of a hospital electronic medical record system

c.

A national recession that has been occurring for 3 years

d.

The closure of a hospital-based school of nursing due to lack of funding

ANS: C

External environmental factors that affect organizations are conditions or events that occur outside the control of the agency, such as new health laws, governmental regulations, or economic trends. Internal environmental factors occur within the organizational structure and include such factors as technology issues, changes in personnel roles, or the implementation of new policies.

REF: 502 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

4. A nurse manager recognizes that systems theory identifies that there is a social component within an organization that affects the overall functioning of the system. What indicator would demonstrate to the nurse manager that the social needs of an organization are being met?

a.

Most employees from the organization attend an annual holiday celebration.

b.

Separate eating areas for each discipline are set up in the cafeteria.

c.

Nurse managers are planning to move to a centralized area away from the care units.

d.

The summer softball teams are canceled due to lack of interest.

ANS: A

Systems theory focuses on the needs and desires of people who work in the organization. Good attendance at a work-sponsored function indicates that staff enjoy interacting and are meeting social and relationship roles. Separating disciplines does not foster a sense of team. Moving administration away from staff limits interaction and informal conversations that build trust. Lack of participation in sponsored events such as a softball team indicates that staff relationships are not strong, and a social component is not being achieved within the work environment.

REF: 503 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

5. A hospital organization is working to improve a feeling of being valued and respected among all staff members. Which action by administration would reinforce the feeling of being valued?

a.

Create professional pathways that require advanced education for any advancement of staff.

b.

Seek staff input when planning a remodeling project of patient rooms.

c.

Form committees that consist of upper management to plan organizational goals.

d.

Consistently schedule required staff meetings at the same time each month.

ANS: B

Including staff at all levels of an organization in planning and projects demonstrates respect for the intelligence and creativity of the individual. Requiring advanced education for any advancement limits those with barriers to attending additional schooling; advancement should be available in a variety of ways to show the value of the individual. Committees that only consist of upper management cause a feeling of disconnect between staff and administration. Scheduling meetings at the same time does not consider those who work shifts and either have to come in on their day off or must disrupt sleep to attend.

REF: 505 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

6. A quality improvement committee is reviewing discharge surveys. Results show that patients and their families have difficulty finding departments and areas of the hospital. What action by the committee would best address this concern for the organization?

a.

Continue to review future surveys to monitor the situation.

b.

Give additional training to the receptionists and switchboard personnel to give better directions.

c.

Form a multidisciplinary committee to identify options to help travel through the hospital.

d.

Send a work order to the maintenance department requesting that brighter lights be installed.

ANS: C

Successful organizations respect the input of all disciplines when searching for solutions for problems. Continuing to gather data delays solving a problem. There is no indication that verbal directions will solve the problem; additional measures may be required. Merely providing additional light may not solve the problemmulti-language signs or even remodeling may be identified by the committee as being needed.

REF: 504-506 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

7. A nurse manager finds an unsigned note reporting that patient care standards are not consistently being followed. Within the organizational structure, what is the best action for the manager?

a.

Schedule a staff meeting to ask staff who left the note.

b.

Send an email reminder that all staff need to review the policy and procedure book.

c.

Wait for a staff member to come forward who is willing to be identified.

d.

Form a small group to explore why staff are not comfortable reporting errors.

ANS: D

There are significant problems in an organization where staff are not willing to openly discuss problems, especially problems that affect patient care. A focus group can help identify what is preventing a sense of comfort to reveal problems. Scheduling a meeting is unlikely to have the person admit to complaining about care provided by coworkers in front of coworkers. A request to review policies and procedures is so broad the staff will not be able to identify a specific problem that needs to be corrected. Unless organizational changes are made, it is unlikely that staff will decide to come forward when they would not do so in the first place.

REF: 502 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

8. A hospital is experiencing a drop in patient admissions, resulting in the implementation of a hiring freeze. What is a potential critical consequence of this internal organizational decision?

a.

A decrease in the availability of future nurses to hire

b.

A savings of salaries and benefits

c.

Increased scholarships to nursing students from the local high school

d.

Increased cross-training of current staff

ANS: A

In an economic climate where hospitals are not hiring, nursing schools may limit enrollment which will limit the availability of future nurses available to be hired when the current nurses retire or reduce their hours. Salary savings is minimal as the number of patients, staffing, and revenue are closely aligned. Scholarships will decrease as hiring commitments to scholarship holders will no longer be in effect. Cross-training may occur, but it is not a critical consequence of a hiring freeze.

REF: 504 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

MULTIPLE RESPONSE

1. A hospital organization is applying for Magnet status to show excellence in nursing practice. What components would indicate that the hospital is meeting Magnet principles? (Select all that apply.)

a.

The education budget for nursing has been cut to provide for new laboratory equipment.

b.

On average, 40% of new nurses are leaving within 1 year of hire.

c.

Nurses are active participants on all major hospital committees.

d.

Quality improvement projects are planned and evaluated by nurses.

e.

Patient care outcome data are reported in the annual executive board meeting.

ANS: C, D

To gain Magnet status, an organization must show that nurses are active participants in the organization administrative structure, fully involved in quality improvement projects, and are recognized as a valuable resource.

REF: 506 OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment

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