Question 1

How is leadership at the staff nurse level exemplified?

Accepted Answer

A

Question 2

A family member of a patient files a complaint that her mother's dentures were lost when the patient was transferred from one unit to another. The risk management department interviews the patient and the staff nurses who cared for the patient. Which of the following problem-solving techniques was used?

Accepted Answer

The focus of leadership and management decision making is more closely related to the nurse's role as care coordinator and systems problem solver. Some decisions, such as those requiring disciplinary action, do require the manager's direct intervention.

Question 3

Which of the following problem definitions is matched with an accurate example?

Accepted Answer

Critical thinking involves analyzing and evaluating information to make a decision, as in counseling a woman with breast cancer about complex choices regarding her pregnancy and treatment.

Question 4

A disaster team is planning strategies to use in the event of multiple catastrophes. Various questions are posed such as, "If we lost all electricity in Kent County, what challenges would we face in providing care? If the Grand River flooded, which institutions would not be available for health care? What other facilities could be used as a backup system? Which roadways would be available in the event of a flood?" This is an example of which of the following decision-making strategies?

Accepted Answer

This is an example of worst case scenario planning, where the team considers the potential impact of a catastrophic event and plans accordingly. They consider the most extreme outcomes and plan for how to respond if they were to occur.

Question 5

A nationwide community health care nursing organization has formed a team to assist with disaster victim relocation and to plan for psychological, physical, and emotional needs that the victims may encounter. In which stage of decision making is this group?

Accepted Answer

The organization has formed a team to assist with disaster victim relocation and to plan for their needs, indicating that they are currently in the process of deliberation, or considering various options and solutions. They have not yet made a decision or selected a specific course of action, which would fall under the selection stage. Evaluation and judgment occur after a decision has been made and a course of action has been implemented.

Question 6

A team consisting of preoperative, operative, and postoperative health care professionals and ancillary staff is examining the turnaround time from the preoperative area to discharge for patients having tonsillectomies. The goal is to decrease waiting times for clients. Which of the following techniques would delineate processes that are delaying time for patients having tonsillectomies?

Accepted Answer

Shared decision making involves collaboration among healthcare professionals to identify and address inefficiencies in processes, such as those causing delays in patient turnaround times.

Question 7

A nurse manager has ordered equipment for a new unit. The company has sent two notices that the equipment is on back order. The nurse manager is debating whether to wait for the equipment on back order or to cancel the order and go with another company. She discusses this issue with another nurse manager. This is an example of:

Accepted Answer

The answer of A nurse manager has ordered equipment for...

Question 8

A multidisciplinary team makes a decision to develop a plan for the use of thrombolytics in the emergency medical service system. Questions are asked such as, "Is the client a candidate for thrombolytic therapy? Does the client have a history of gastrointestinal bleeding? Has the client ever had a stroke? Does the client have any bleeding disorders?" Which of the following decision-making strategies would work best in this situation?

Accepted Answer

A decision tree would work best in this situation as it allows for the consideration of multiple factors and their potential outcomes in a systematic and organized manner. The team can utilize the decision tree to develop a clear decision-making process based on the client's medical history and potential risks and benefits of thrombolytic therapy.

Question 9

A patient has arrived at the critical care unit with a head injury. On admission, the patient is talking and is a little drowsy but oriented. Two hours later, the nurse discovers that the patient is talking at a rapid pace and keeps repeating his words. Which of the following examples best depicts Benner's stages and appropriate critical-thinking processes in this situation?

Accepted Answer

This situation requires critical thinking to identify the potential cause of the patient's change in behavior. The nurse must consider the patient's head injury as a possible cause and assess for signs of cerebral edema, which can cause changes in speech and behavior. This level of reasoning is consistent with the competent stage of Benner's stages of clinical competence.

Question 10

The nursing education department is revising its orientation curriculum for nurse externs. A consultant has been hired to revise the program completely. When the curriculum is completed, most of the prior curriculum and activities are found to be the same. This is an example of which of the following decision-making distortions?

Accepted Answer

The Status quo trap occurs when decision-makers choose a familiar or existing option instead of considering new alternatives, even if the familiar option may not be the best choice. In this scenario, the nursing education department chose to keep most of the prior curriculum and activities, even though they hired a consultant to revise the program completely.

Question 11

What is the definition of the process of making choices that will provide maximum benefit?

Accepted Answer

Decision making is the process of making choices that will provide maximum benefits.

Question 12

A long-term care facility has been busy for several months with patients who have a very high acuity. Nurses have been working double shifts. The nurses have been given the task of determining whether they would like to implement an on-call program and determine guidelines for implementation, if most nurses believe that it is the best solution. This example depicts which type of decision-making style?

Accepted Answer

The answer of A long-term care facility has been busy...

Question 13

The marketing department of a major children's hospital is hosting a fund-raiser for the local Ronald McDonald House. In the past, fund-raisers were successful when scheduled in the spring. This year, the fund-raiser is scheduled in the fall, when the city and several local organizations have community festivals. The first fund-raiser was scheduled 10 years ago in the fall and raised $50,000, only one eighth of the goal. This depicts an example of which of the following decision-making distortions?

Accepted Answer

The situation describes an estimating and forecasting trap, where the decision-makers are relying on past data (the unsuccessful fall fundraiser) to predict future outcomes without considering changes in circumstances or new information.

Question 14

Nursing students are working on a long-term care unit at a new clinical site. The instructor is concerned because the clinical site is missing some needed components. In a discussion with the director of nursing, it is determined that the instructor should document the expected and actual outcomes of the experience and compare them. This type of decision making is made utilizing (the):

Accepted Answer

The answer of Nursing students are working on a long-term...

Question 15

Family members of a dying patient are arguing about terminating life support. The nurse educates the two opposing groups individually about terminating life support and discusses the dying process. This is an example of:

Accepted Answer

The nurse is using clinical judgment by educating the family members about terminating life support and discussing the dying process. The nurse is providing appropriate and relevant information to the family members to make an informed decision about the end-of-life care of the patient.

Question 16

A staff registered nurse (RN) has been struggling with the delivery system from central supply. He documents a delay of 1 to 3 hours from the time that the order is sent to central supply to the time that the requested equipment is sent to the floor. The RN asks, "Why does a central supply unit need to service the entire hospital? Why not consider a decentralized central supply established for each floor?" This is an example of what type of thinking?

Accepted Answer

The RN's questioning of the current system and suggestion for a new approach shows critical thinking. They are examining the current system and proposing a solution to improve it.

Question 17

A continuous quality improvement team has considered all aspects of a decision to purchase two new computed tomography scanners to meet the needs of the community. The team decides to go with the less expensive, larger machines with few additional capabilities because of current budget restraints, even though it will mean purchasing newer smaller models with more capabilities in the future when moving to a new hospital in 3 years. This decision is known as a(n) _____ decision.

Accepted Answer

The decision to go with the less expensive, larger machines with few additional capabilities because of current budget restraints, even though it will mean purchasing newer smaller models with more capabilities in the future when moving to a new hospital in 3 years is an example of a satisficing decision. Satisficing is the process of making a decision that is satisfactory or acceptable, even though it may not be the best or optimal decision. This decision meets the minimum criteria of being cost-effective while still meeting the needs of the community, despite the fact that a better option may be available in the future.

Question 18

An intravenous infusion center is considering switching intravenous pumps to another vendor. A team of nurses is gathered to examine the benefits and uses and to conduct a cost analysis of various intravenous pumps. After thoroughly reviewing the data and piloting several intravenous pumps, the team and the nurse leader vote to determine which pumps to use. This example depicts which of the following decision styles?

Accepted Answer

The decision-making process described involves collaboration and voting, which aligns with a facilitative style where the leader seeks input and consensus from the team.

Question 19

Nurses working on the intermediate care unit have had many hours of overtime in the last 6 months. Before forming a team, the nurse manager gathers data about patient condition severity, staffing ratios, educational levels of staff, and personality mixes on each shift. What level of decision making is this process?

Accepted Answer

The nurse manager is identifying a problem or situation, which is the first step in the decision-making process.

Question 20

A staff RN is leading a quality improvement team on the care of the total hip replacement patient. The issue is an increased length of stay from 1 year ago. The nurse asks team members to reframe the problem statement from their perspective. Twenty different problem statements were developed. The team is focusing on four of the problem statements. This is an example of which of the following techniques?

Accepted Answer

This is an example of problem-solving where a team is tasked with identifying and solving a problem related to patient care. The team is working to reframe the problem statement to identify the root cause of the increased length of stay following total hip replacement procedures.

Quiz 4: Critical Thinking and Decision-Making Skills

How is leadership at the staff nurse level exemplified?

Which of the following problem definitions is matched with an accurate example?

A nationwide community health care nursing organization has formed a team to assist with disaster victim relocation and to plan for psychological, physical, and emotional needs that the victims may encounter. In which stage of decision making is this group?

What is the definition of the process of making choices that will provide maximum benefit?

Family members of a dying patient are arguing about terminating life support. The nurse educates the two opposing groups individually about terminating life support and discusses the dying process. This is an example of: