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Cherry & Jacob Contemporary Nursing Issues, Trends, and Management, 7th Edition CHAPTER 15-28

Chapter 15: Information Technology in the Clinical Setting
Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th
1. Consumers are concerned with security issues related to their confidential health information
being placed in an electronic health record (EHR). However, when the security of the EHR is
compared with that of paper-and-pencil records, the EHR is:
a. more secure.
b. less secure.
c. equivalent.
d. not comparable with the paper-and-pencil record.
Computer-based patient record systems, such as EHRs, provide better protection than
paper-based systems. The EHR allows only authorized users to view data, and access to
records can be audited for inappropriate use.
DIF: Comprehension REF: p. 271
2. During a search for the term informatics, when the nurse finds the domain ―.edu,‖ the site is
affiliated with a(n):
a. government agency.
b. commercial site.
c. educational institution
d. Internet service provider.
The domain of an educational institution is .edu.
DIF: Knowledge REF: p. 276
3. When paper-and-pencil medical records are compared with computer-based records:
a. paper-and-pencil records provide controls to determine who has viewed the health
b. information contained in a paper-and-pencil record has the capability of being
more in-depth than that found in computer-based records.
c. patients have the right to know that the confidentiality of their records is strictly
maintained, regardless of the type of medical record used.
d. patients must sign for each item of information released on the computer record.
Regardless of the type of record used, the Health Insurance Portability and Accountability Act
(HIPAA) protects the confidentiality of the patient‘s medical information and imposes legal
consequences for those who breech confidentiality.
DIF: Comprehension REF: p. 271
4. A nurse is preparing a scholarly publication on the prevalence of hepatitis A worldwide. The
most efficient and effective means of conducting an Internet search to gather information for
this publication is to use:
a. a search engine such as Google or Yahoo.
b. a consumer health website.
c. a decision support system.
d. MEDLINE database.
MEDLINE is one of the scientific and research scholarly databases, and it would be the most
appropriate for use in gathering information for a scholarly publication.
DIF: Comprehension REF: p. 276
5. A consumer is learning about electronic health records at a local health fair and states, ―I am
worried that someone can read my health information and I really don‘t understand the
difference between privacy and confidentiality.‖ The nurse explains that an example of
confidentiality would be:
a. a pledge that states, ―I will hold matters pertaining to my patients in strict
b. a patient who does not tell the physician that he has been treated for a sexually
transmitted disease.
c. a teenager who sustains a broken arm and in the emergency department and
withholds information about her use of recreational drugs.
d. locking medical records in cabinets to prevent unauthorized users from accessing
patient information.
Confidentiality is keeping private the personal information that was given to a health care
provider, unless others have a legitimate need to know.
DIF: Application REF: p. 271
6. A physician has installed a computer-based patient records system. An outside care provider
who requests medical information must obtain the patient‘s signed consent and then is
assigned a password to gain access to the medical information. A monthly audit is conducted
to determine for whom and for what purpose patient records have been accessed. This
protection is referred to as:
a. privacy.
b. confidentiality.
c. security.
d. data capture.
Security is the limitation of access to health care information through passwords and other
DIF: Comprehension REF: p. 271
7. A nurse walks up to a computer in the hallway and presses the index finger to the sensor,
thereby gaining access to patient data. A few moments later another nurse performs the same
steps and is granted access. A visitor who is watching from a room walks over and places the
index finger on the sensor, only to receive an ―error and access denied‖ message. Security is
being maintained by:
a. robot technology.
b. biometric technology.
c. telehealth.
d. ubiquitous computing.
Biometric fingerprint identification uses personal characteristics to allow access to health
DIF: Comprehension REF: p. 277
8. A nurse who is teaching a class to introduce telehealth to the staff would include which
a. A robot performs menial housekeeping chores for an invalid patient.
b. A computer software program alerts the nurse or physician who is reviewing
orders that an order for a new drug can cause synergy of the theophylline inhaler.
c. A physician speaks into a computer, and the admission history is recorded and
saved in the patient file.
d. While a patient in Wyoming performs peritoneal dialysis, a nurse watches
remotely from California to ensure that all steps are being followed correctly.
Telehealth is the delivery of care to a patient who is at a distance from the health care
DIF: Application REF: p. 273
9. An advanced practice nurse inputs into a computer software program the following clinical
manifestations: open wound with tibia exposed, petechial hemorrhage, and temporary loss of
consciousness. The computer diagnosis of fat emboli is generated by a system known as:
a. decision support.
b. telehealth.
c. robotic technology.
d. biometric technology.
Decision support systems are computer-based information systems that include
knowledge-based systems designed to support clinical decision making.
DIF: Comprehension REF: pp. 268-269
10. A nurse is preparing a presentation using different websites to collect information. The nurse
is concerned that contact information and the author‘s credentials are not listed for one of the
websites reviewed. Which criterion required to establish a reputable website is missing?
a. Authority
b. Objectivity
c. Usability
d. Currency
Authority is the criterion that is related to the credentials and background that have prepared
an author to publish on the subject.
DIF: Comprehension REF: p. 276
11. A nurse is interested in locating reliable information concerning noninvasive blood glucose
monitoring. Information is located, and the author is a scientist who conducted studies within
the last year on the effectiveness of a particular noninvasive blood glucose monitor. The
scientist received funding from a pharmaceutical company to support the studies. The URL
indicates the pharmaceutical company site.com. The nurse is concerned about this
a. authority.
b. objectivity.
c. accuracy.
d. currency.
Sites sponsored by organizations such as pharmaceutical companies may influence the
DIF: Comprehension REF: p. 276
12. A nurse providing care at the bedside receives an ―alert‖ that a patient‘s stat potassium level is
2.5 and digoxin (Lanoxin) is scheduled. The nurse holds the medication and prevents a
possible complication. This feature of the Electronic Health Record is available through which
core function of EHR?
a. Order entry/order management
b. Decision support
c. Patient support
d. Administrative support
Decision support provides reminders about preventive practices, such as immunizations, drug
alerts for dosing and interactions, and clinical decision making.
DIF: Comprehension REF: pp. 268-269
13. A nurse works on a unit where electronic health records (EHR) are being initiated and asks,
―What is meant by ‗meaningful use‘ standards that are in our education packet?‖ The best
answer is that ―meaningful use‖:
a. identifies a set of EHR proficiencies and benchmarks that EHR systems must meet
to be certain that they are functioning to their maximum capacity and meeting this
standard allows companies/organizations to qualify for funds to defray cost of the
EHR from Medicare.
b. refers to training competencies that all users must achieve to be able to access and
transfer patient data/information.
c. refers to a requirement that at least 50% plus one of all patients have data entered
into the EHR.
d. the requirement that rigorous confidentiality security is in place to protect all
patient information from sources which have no right to the data.
Meaningful use is ―A defined set of EHR capabilities and standards that EHR systems must
meet to ensure their full capacity is realized and for the users (hospitals and physician
practices) to qualify for financial incentives from Medicare.‖
DIF: Application REF: p. 271
14. A nurse is caring for a patient who is to receive an antibiotic drug that causes severe skin
damage when infiltrated. The order reads, ―infuse over 1 hour by portacath.‖ The nurse
accesses the Personal Digital Assistant for software that lists the steps to access a portacath.
The nurse is using:
a. electronic health records.
b. point-of-care technology.
c. data management.
d. telehealth.
Using a Personal Digital Assist device to access information at the bedside is considered
point-of-care technology. The nurse was able to retrieve the steps for accessing a portacath
electronically while remaining at the bedside.
DIF: Comprehension REF: p. 273
15. The Institute of Medicine (IOM) (2003) recommends that EHR systems offer eight
functionalities. A patient has a severe allergy to eggs and penicillin. Which of the eight
functions of the EHR would address sharing this information?
a. Health information and data capture
b. Results/data management
c. Provider order entry management
d. Clinical decision support
The health information and data capture function includes information such as medical
history, laboratory tests, allergies, current medications, and consent forms.
DIF: Comprehension REF: p. 269, Table 15-1
1. A new nurse asks, ―Since Electronic Medical Records can improve quality care by having
seamless data available for a patient, why doesn‘t everyone just replace paper and pencil
charts‖? Barriers to a universal health information infrastructure include the fact that: (select
all that apply)
a. competition from individual companies to build EMR prevent a universal
b. cost is prohibitive even with federal funding for larger health care systems.
c. preventive health reminders for immunizations and yearly screenings such as
mammograms are used in clinical decision making.
d. insurance companies have halted sharing of some patient data due to fear of law
e. the full capacity of EHRs has not been realized with only Stage 1 of 3 nearing
It has been recommended that only a federal-based EMR would provide an infrastructure that
allows access to comprehensive patient information. The first stage, years 2011 and 2012,
forms the foundation for electronic data capture and information sharing.
DIF: Comprehension REF: p. 271
2. A nurse interested in quality improvement tools performed a search for cause and effect
diagrams using www.ishikawa.com. A page opened that provided images and templates for
performing fishbone diagrams. Which type of search did the nurse conduct?
a. Quick and dirty
b. Advanced
c. Brute force
d. Link searching
Brute force is a method of searching where you type in what you think might logically be a
web address and see what happens.
DIF: Comprehension REF: p. 275
1. Software programs that process data to produce or recommend valid choices are known as
decision support systems
Decision support systems use software programs that process data to produce or recommend
decisions by linking with an electronic knowledge base.
DIF: Knowledge REF: p. 269
Chapter 16: Emergency Preparedness and Response for Today’s World
Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th
1. Nurses and community officials are working together to ensure that churches and schools
have needed supplies to provide shelter for large numbers of individuals in the event of a
natural or manmade disaster. These activities represent which phase of a disaster continuum?
a. Preparedness
b. Relief response
c. Recovery
d. Crisis intervention
Every disaster response begins as a local event known as the preparedness phase, which
consists of planning, preparedness, prevention, and warning.
DIF: Comprehension REF: p. 285
2. A nurse at a school notices that several students have ―blisters‖ on their bodies. Further
investigation reveals that a terrorist incident has occurred, causing smallpox. If the chemical,
biologic, radiologic, nuclear, and explosive (CBRNE) agent categories are used, this incident
would be classified as:
a. chemical.
b. biologic.
c. radiologic.
d. nuclear.
The biologic category refers to diseases such as plague or smallpox.
DIF: Comprehension REF: p. 284, Table 16-1
3. The Metropolitan Medical Response System (MMRS):
a. is totally financed by the federal government national disaster fund.
b. consists of responders who have obtained specialized training and equipment to
deal with mass casualty events.
c. has a storehouse of medications and antidotes to be used during response in times
of national emergencies.
d. arranges for patient admissions to federal hospitals.
The MMRS responds to disaster with trained individuals who have expertise in this type of
situation and who have the equipment required to be effective.
DIF: Comprehension REF: p. 286
4. A community in the New Madrid fault zone experiences an earthquake resulting in injuries
from propelled objects and abrasions for many victims. The local supply of antibiotics is
quickly exhausted. Local authorities would contact the:
a. Commissioned Corps Readiness Force.
b. Strategic National Stockpile.
c. Department of Homeland Security.
d. local Young Men‘s Christian Association (YMCA).
The Strategic National Stockpile provides antibiotics, antidotes, and medical and surgical
items when local and state supplies have been exhausted.
DIF: Comprehension REF: p. 287
5. During the relief response phase of a disaster resulting from a ―dirty bomb‖:
a. treatment for burns and poisoning is provided for victims.
b. emergency plans are coordinated between agencies.
c. reconstruction of destroyed facilities and homes begins.
d. food stores are collected for potential victims.
During the relief response phase of a disaster, emergency responders provide assistance to
victims and stabilize the scene; with a dirty bomb, radioactive material causes burns and
DIF: Analysis REF: p. 288
6. A nurse learns of a mass casualty disaster following a known terrorist attack. On arriving at
the scene, the nurse knows that:
a. the response of local hospitals will be dictated by the federal government.
b. the same ground rules practiced in other settings and during smaller crises will be
c. the least experienced nurses will be assigned to triage low-risk victims and victims
who have no chance of survival.
d. multiple incident commanders ensure a quick, effective response.
The fundamentals of nursing applied to other settings and situations can be used in a disaster.
DIF: Comprehension REF: p. 283
7. Nurses caring for the victims of a mass casualty incident:
a. determine the common terminology to be used by hospitals and participating
b. take charge of communicating with the news media.
c. determine whether there is a credible threat of a terrorist attack.
d. give priority for care to those with the greatest chance of survival rather than those
most critically ill.
Care is shifted from categorizing patients at low, intermediate, and critical risk to using
resources to serve those with the greatest likelihood of survival.
DIF: Comprehension REF: p. 283
8. During a community health fair the disaster medical assistance team (DMAT) informs
participants that every community must be ready to provide disaster care. A participant asks,
―In a disaster, the local community cannot possibly be effective, so why not have a plan to call
federal agencies immediately to provide relief?‖ The correct response by the DMAT is:
a. ―Unless known terrorist activities involving mass destruction occur, the federal
government does not become involved.‖
b. ―The community is essentially the ‗first responder‘ to any disaster.‖
c. ―The preparedness phase of a disaster is the responsibility of the community, the
relief response phase is assigned to state agencies, and the recovery phase is the
responsibility of federal agencies.‖
d. ―Unless local health care facilities are incapacitated, state and federal agencies will
withhold assistance.‖
Each disaster begins locally, and each community responds first and receives assistance from
state and federal agencies when local resources are not adequate for the situation.
DIF: Comprehension REF: p. 285
9. A nurse who is conducting a staff in-service on the phases of a disaster continuum teaches
participants that, during the impact/response stage, activities focus on:
a. community awareness in anticipation of a terrorist attack or natural disaster.
b. determining the effectiveness of the disaster medical assistance team (DMAT).
c. the use of an all-hazards approach.
d. initiating response activities.
Response activities during the relief response phase consist of immediate actions to save lives
and meet basic human needs.
DIF: Comprehension REF: p. 288
10. Following a terrorist attack, victims are exhibiting posttraumatic stress syndrome, and care
providers are exhibiting compassion fatigue. Which federal response system should be
a. Strategic National Stockpile
b. Metropolitan Medical Response System (MMRS)
c. Commissioned Corps Readiness Force
d. National Disaster Medical System
The MMRS is concerned with deploying trained responders who are able to provide mental
health care for victims and health care providers.
DIF: Comprehension REF: p. 286
11. The crisis communication officer may first inform the public or health care facility of a
disaster or an act of terrorism. This representative has the responsibility to:
a. contain the facts to within the administration group.
b. incite the public to quickly take cover and obtain emergency supplies.
c. provide understandable and straightforward facts about the event within the facility
and possibly to the news media.
d. inform the public that no information can be released until it has been confirmed
by state and federal agencies.
The crisis communication officer is the first contact for patients, families, and employees
within the facility or news media, so they may better understand the situation and know how
to react and protect themselves.
DIF: Comprehension REF: p. 289
12. The disaster medical assistance team works quickly to contain contaminants from a chemical
plant explosion. Afterward, personnel undergo a special process to remove harmful chemicals
from equipment and supplies. This removal process is known as:
a. containment.
b. decontamination.
c. triage.
d. scene assessment.
Decontamination is the physical process of removing harmful substances from personnel,
equipment, and supplies.
DIF: Knowledge REF: p. 280
13. A group of local volunteers respond to a tornado. Volunteers have completed an emergency
response course and are able to assist with triage of injured citizens. They also participate in
local health fairs to teach residents how to react during tornadoes. The responders are
members of the:
a. Medical Reserve Corps (MRC).
b. Metropolitan Medical Response System (MMRS).
c. National Disaster Medical System (NDMS).
d. Commissioned Corps Readiness Force (CCRF).
The MRC are local volunteers trained to respond to local emergencies.
DIF: Comprehension REF: p. 285
14. Troops from the United States participating in a peace mission in a foreign country were the
victims of suicide bombers and many soldiers were evacuated back home to receive
specialized medical care. The nation‘s medical responses will be augmented by:
a. the federally coordinated National Disaster Medical System.
b. local homeland communities where troops receive care.
c. the Medical Reserve Corps, which organizes and utilizes public health, nursing,
medical, and other volunteers.
d. the National Incident Management System, which guides government,
nongovernmental organizations, and the private sector to work seamlessly during
disaster situations.
The National Disaster Medical System supplements care for casualties evacuated back to the
United States from overseas and federally declared disasters including national disasters,
major transportation accidents, technologic disasters, and acts of terrorism.
DIF: Comprehension REF: pp. 286-287
15. A nurse is informed that the Federal Bureau of Investigation has determined that a bomb has
been detected and is in the possession of a known terrorist group. The government buildings
in the local community are the target. This situation is termed a(n):
a. all-hazards approach.
b. biologic event.
c. credible threat.
d. natural disaster.
A credible threat is a situation in which the Federal Bureau of Investigation (FBI) determines
that a terrorist threat is probable and verifies the involvement of a weapon of mass destruction
in the developing terrorist incident.
DIF: Comprehension REF: p. 280
16. The emergency response team responded to a terrorist attack where hundreds of people died
following symptoms of chest tightness, palpations, seizures, and finally paralysis. A colorless
odorless liquid known as Sarin (GB) was the agent, which is primarily inhaled with limited
exposure through the skin. The concentration of Sarin has not been measured. What level is
the minimum level of personal protection and safety equipment (PPE) that would be needed?
a. A
b. B
c. C
d. D
Level B requires a high level of respiratory protection, but less skin protection, providing a
chemical splash–resistant suit with hood and self-contained breathing apparatus (SCBA). It
provides maximum respiratory protection but less skin protection than level A equipment.
DIF: Analysis REF: p. 289
17. A state is devastated by a tornado killing many people, destroying communication systems,
utility services, homes, and medical facilities. The state requests immediate assistance from
the U.S. Congress and from surrounding states. The affected state should first contact the:
a. Emergency Management Assistance Compact (EMAC).
b. Institute of Medicine (IOM).
c. Red Cross.
d. Strategic National Stockpile.
The EMAC is an organization authorized by the U.S. Congress through which a state
impacted by a disaster can request and receive assistance from other member states quickly
and efficiently.
DIF: Comprehension REF: p. 280
18. A nurse is interested in learning the phases of the disaster continuum and realizes it has many
similarities to the nursing process. To better understand the phases of a disaster, which is true
when comparing the phases of the disaster continuum to the nursing process?
a. The preparedness phase of the disaster continuum is consistent with the assessment
and planning steps of the nursing process.
b. The recovery phase of the disaster continuum is consistent with the planning step
of the nursing process.
c. The recovery phase of the disaster continuum is consistent with the
implementation step of the nursing process.
d. The response relief phase of the disaster continuum is consistent with the
evaluation step of the nursing process.
The preparedness phase requires assessing possible needs of the community and planning
appropriate interventions and is consistent with the assessment and planning steps of the
nursing process.
DIF: Comprehension REF: p. 285
19. In the preparedness phase for disasters, the community plans for a possible terrorist attack
using anthrax as the weapon of destruction. What treatments and/or preparations would be
a. Vaccines and Level B Personal Protection Equipment (PPE)
b. Treatment for burns, decontamination, and Level A PPE
c. Social distance determination, decontamination for radioactive fallout
d. Identify and detect incendiary devices, treatment for burns and propellants
Anthrax is a biologic weapon and requires Level B protection since it is a known agent and
can be carried in wind or surfaces. Timing of treatment is critical and vaccines are available.
DIF: Analysis REF: pp. 282-284, Table 16-1
1. Health care professionals have been activated to respond to a disaster, and the registered nurse
who is coordinating the effort realizes that: (select all that apply)
a. in the event of a mass casualty incident, care is prioritized to those who have the
greatest chance of surviving.
b. communities should use their own resources first to attempt to stabilize and
organize the response.
c. state assistance occurs any time a disaster occurs, regardless of the community‘s
d. the emergency operating plan developed by one central agency rather than
individual facilities should be put into operation.
e. strict protocols regarding the use of resources must be followed.
Care is shifted to doing the most good for the most people. Efforts begin at the local level.
DIF: Comprehension REF: pp. 283-284
2. When teaching community preparedness for a community group, the nurse explains that
components of the National Disaster Medical System (NDMS) provide for: (select all that
a. a nationwide bomb disposal squad team for the rapid removal of explosive devices.
b. teams of health care providers who are experts and have specialized supplies and
c. structures for patient evacuation from the disaster area to an unaffected area.
d. arrangements for hospitalization in federal and volunteer nonfederal acute care
e. providing mental health care for the community, for victims, and for health care
ANS: B, C, D
The NDMS provides specially trained teams of people along with equipment designed for
disaster relief. The NDMS is responsible for removing patients from unsafe to safe areas. The
NDMS coordinates efforts to evacuate victims to federal or nonfederal volunteer hospitals that
can care for disaster victims.
DIF: Comprehension REF: p. 286
1. The emergency preparedness term that is used to describe the process of limiting the
emergency situation within a well-defined area is .
Containment is correct because the focus is to prevent the agent that caused the disaster from
DIF: Knowledge REF: p. 280
2. The term used during a pandemic disaster that refers to the attempt to contain germs by
limiting socialization and personal interactions is .
social distancing
The term social distancing refers to the attempt to keep people as far apart as possible so as to
limit the possibility of spreading germs.
DIF: Knowledge REF: p. 291
Chapter 17: Nursing Leadership and Management
Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th
1. In an attempt to persuade employees to bargain for another type of health insurance, a handout
is circulated that describes the present employees‘ health care insurance as being insensitive,
limiting choices of care providers, and providing inferior care. This reflects which aspect of
Lewin‘s planned change?
a. Unfreeze
b. Move
c. Refreeze
d. Acceptance
Unfreeze is correct because the change agent promotes problem identification and encourages
awareness of the need for change. In alignment with Lewin‘s stages of change (unfreezing,
moving, and refreezing), education and involvement are keys to successful change. People
must believe that improvement is possible before they will be willing to consider change.
DIF: Comprehension REF: p. 311
2. One difference between a leader and a manager is that a:
a. leader has legitimate authority.
b. manager motivates and inspires others.
c. manager focuses on coordinating resources.
d. leader focuses on accomplishing goals of the organization.
The terms leadership and management are often used interchangeably, and it is difficult to
discuss one without discussing the other. However, these roles have specific traits unique to
themselves. The manager is the coordinator of resources (time, people, and supplies) needed
to achieve outcomes.
DIF: Comprehension REF: p. 296
3. The first step in the nursing process and in the problem-solving process is to:
a. identify the problem.
b. gather information.
c. consider the consequences.
d. implement interventions.
The nursing process, which is familiar to nurses who address patient care needs, can be
applied to all management activities that require decision making and problem-solving. As in
the nursing process and the problem-solving process, one must first gather information about
the problem or situation.
DIF: Comprehension REF: pp. 309-310
4. An explosion just occurred at the local factory, and hundreds of employees have sustained
varying degrees of injury. Which type of nursing leadership is most effective in this situation?
a. Autocratic
b. Democratic
c. Laissez-faire
d. Referent
The dynamics of the situation demand that the leader take control and direct employees to
specific actions in response to the emergency.
DIF: Comprehension REF: p. 300, Box 17-3
5. An RN with excellent assessment and psychomotor skills would derive power on the basis of
which source?
a. Rewards
b. Coercion
c. Expert
d. Legitimate
Seven primary sources of power are known. Expert power is based on knowledge, skills, and
DIF: Comprehension REF: p. 297
6. Managers who exhibit an authoritative behavioral style are most likely to use which source of
a. Informal
b. Expert
c. Coercive
d. Reward
Seven primary sources of power are known. Coercive power is based on fear of punishment or
failure to comply. Coercive power fits well into the authoritative behavioral style because
authoritative managers dictate the work with much control, usually ignore the ideas or
suggestions of subordinates, and provide little feedback or recognition for work accomplished.
DIF: Application REF: p. 300, Box 17-3
7. Florence Nightingale is attributed with being intelligent (she developed statistical methods to
evaluate health care), dependable (she often worked long hours to care for the injured), and
ambitious (she fought against society‘s perception of nursing). Those who depict her as a
leader on the basis of these qualities are practicing which leadership theory?
a. Trait
b. Chaos
c. Bureaucracy
d. Organizational
Leadership trait theory describes intrinsic traits of leaders and is based on the assumption that
leaders were born with particular leadership characteristics. Other traits found to be associated
with this leadership theory include intelligence, alertness, dependability, energy, drive,
enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery.
DIF: Comprehension REF: p. 298
8. A nurse manager is concerned with restocking the emergency cart, creating the staff schedule,
requesting floor stock from pharmacy, and checking the orders on patient charts. Which type
of leader accurately describes this nurse?
a. Transactional
b. Situational
c. Transformational
d. Contemporary
The transactional leader is concerned with the day-to-day operations of the facility.
DIF: Comprehension REF: p. 298, Box 17-1
9. According to the unit‘s policy for call-ins, a nurse is suspended for 3 days because of
excessive call-ins that occur within 15 minutes of shift change. The nurse states, ―You are
unfair to me.‖ Which theory would disprove the nurse‘s statement?
a. Authoritative
b. Closed systems
c. Open systems
d. Trait
Autocratic/authoritative management style revolves around the assumption that authority
confers the right to issue commands within an organization on the basis of impersonal rules
and rights, by virtue of the management position rather than any trait ascribed to the person
who occupies that position. Other characteristics include the following: Impersonal rules
govern the actions of superiors over subordinates, all personnel are chosen for their
competence and are subject to strict rules that are applied impersonally and uniformly, and a
system of procedures for dealing with work situations is in place.
Represents the systems theory of the organization.
DIF: Application REF: p. 300, Box 17-3
10. A nurse is reading about positive reinforcement with the goal of increasing staff motivation.
Which action would demonstrate positive reinforcement?
a. Every morning at shift change, thank each employee for an excellent job.
b. Rotate a monthly ―employee recognition award‖ among all employees on the unit.
c. Wait until the annual performance review to recognize accomplishments.
d. Give spur-of-the-moment recognition to an employee who has accomplished a
To be effective, positive reinforcement should (1) be specific, with praise given for a
particular task done well or a goal accomplished; (2) occur as close as possible to the time of
the achievement; (3) be spontaneous and unpredictable (praise given routinely tends to lose
value); and (4) be given for a genuine accomplishment.
DIF: Application REF: p. 306
11. Which action represents the key management function of strategic planning?
a. Determining that all nurses on the unit understand the current organizational
b. Evaluating the communication process between the pharmacy and the nursing
c. Monitoring data from the quality management initiative related to the last three
orientation programs
d. Developing a 5-year plan that will incorporate the clinical nurse leader as a part of
all nursing units
A strategic plan is a written document that details organizational goals, allocates resources,
assigns responsibilities, and determines time frames. The strategic plan generally looks 3 to 5
years into the future.
DIF: Application REF: pp. 301-302
12. A hospital‘s policy requires that all nurse managers must have a minimum of a bachelor‘s
degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager
for the oncology unit. An RN who has worked on this unit for many years is unable to be
promoted to a nurse manager position because of his educational status and has been
commenting to physicians and staff, ―The new nurse manager has book sense but no
leadership abilities.‖ What is the best approach that can be used by the new nurse manager
who is attempting to gain the trust and respect of the nursing staff on the unit?
a. Send memos to all staff except the upset nurse to invite them to a luncheon.
b. Ask management to transfer the upset nurse to another unit.
c. Assign the upset nurse to committees that do not directly affect that nursing unit.
d. Acknowledge the clinical expertise of the upset nurse and clearly explain the
expectations for teamwork and open, honest communication.
The best way for the new nurse manager to communicate with this employee, who may be an
informal leader, is to show respect for the individual‘s clinical expertise and experience
through clear and direct communication. The new nurse manager should attempt to identify
the staff nurse‘s power as an informal leader, should involve him and other staff members in
decision-making and change-implementation processes, and should clearly communicate
goals and work expectations to all staff members.
DIF: Application REF: pp. 297-298
13. A clinical nurse leader (CNL) enters the workforce and hopes to use her interdisciplinary
skills to participate on a quality improvement committee. The coordinator of the quality group
invites the CNL to join the group. Which type of power is demonstrated by the coordinator of
the group?
a. Coercive
b. Transformational
c. Laissez-fair
d. Legitimate
The coordinator of the committee has an official position within the organizational committee.
DIF: Comprehension REF: p. 297
14. A director of nursing (DON) asks the staff to list how their nursing unit can help the
organization meet its goal to ―provide quality patient care with attention to compassion and
excellence.‖ An ad hoc committee is formed to develop a timeline of identified actions. The
DON coaches the committee to reach desired outcomes. This DON is demonstrating which
other role of leadership and management?
a. Transactional
b. Clinical consultant
c. Corporate supporter
d. Autocratic
The manager is embracing the mission of the organization by supporting achievement of goals
noted in the mission statement.
DIF: Comprehension REF: p. 311
15. A staff nurse provides care based on intuition and always seems to be in control of her
personal and professional life—serving on the board of the state nurses association, serving as
the nursing unit‘s representative on the ethics committee, and coaching her daughter‘s soft
ball team. Many of the staff observes how she manages time and provides care. This nurse‘s
power comes from which type of power?
a. Referent
b. Legitimate
c. Information
d. Connection
Referent power comes from the followers‘ identification with the leader. Referent leaders are
admired and respected and able to influence other nurses because of their desire to emulate
DIF: Comprehension REF: p. 297
16. A staff nurse states, ―I really enjoyed having dinner with the Chief of Medical Staff and the
President of the hospital. We hope to meet again soon.‖ Which source of power does this
nurse possess?
a. Expert
b. Legitimate
c. Connection
d. Reward
Connection power results from knowing or associating with power people such as the upper
DIF: Comprehension REF: pp. 297-298
17. A nurse manager wants his nursing unit to be a place where all nurses want to work, where
patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged
to chair taskforces to improve quality of care and he counsels staff in areas of measuring
patient outcomes. Other managers want to mimic this manager‘s approach to improve their
own units. This nurse is which type of leader?
a. Transformational
b. Transactional
c. Laissez-faire
d. Authoritative
Transformational leaders mentor followers through a vision and are admired and emulated.
DIF: Comprehension REF: p. 298
18. A hospital recently learned that their scorecard did not meet the national benchmark for
patient satisfaction and brought in a professional change agent to determine what their issues
were and how they could improve their score. The agent collected data and recommended that
nurses participate in interdisciplinary walking rounds and allow the patient and family to be
participants. Nurses now round every shift and perform ―huddles to update the team‖ as
needed throughout the shift as part of best practices. Random visits are made to nursing units
to ensure all nurses are participating and patients are interviewed for their involvement. This
stage of Lewin‘s change is:
a. unfreeze.
b. moving.
c. refreeze.
d. resistance.
In the refreezing stage, change becomes status quo and the agent reinforces until the change is
part of the daily process as in the above situation.
DIF: Comprehension REF: p. 311
19. A manager just finished the last annual performance review of the staff, reviews the
unexpected expenditures for the month due to use of agency nurses, and shares the latest
quality indicators with the staff nurses. This manager is performing which management
a. Directing
b. Planning
c. Organizing
d. Controlling
Controlling is the final management function. It includes performance evaluations, financial
activities, and tracking outcomes of care to ensure quality.
DIF: Comprehension REF: p. 307
1. Registered nurses who are entering the workforce will have expanded leadership
responsibilities that include: (select all that apply)
a. serving on interdisciplinary care teams.
b. being competent to work in several areas independently when dictated by patient
c. attending a meeting to plan advanced training for unlicensed assistive personnel.
d. evaluating outcomes of care that are reported to a standing committee.
e. managing units with higher acuity, shorter length of stay, and more diverse
patients and staff.
ANS: A, C, D, E
The new nurses will be placed in many situations that require leadership and management
skills: for example, managing a group of assigned patients, serving on a task force or
committee, acting as team leaders or charge nurses, and supervising unlicensed assistive
personnel and licensed vocational/practical nurses. Diverse patients have comorbidities and
require complex interventions delivered during shorter stays with an ever-increasing diverse
staff. The new nurses will be placed in many situations that require leadership and
management skills, for example, managing a group of assigned patients, serving on a task
force or committee, acting as team leaders or charge nurses, and supervising unlicensed
assistive personnel and licensed vocational/practical nurses. The new nurses will be placed in
many situations that require leadership and management skills, for example, managing a
group of assigned patients, serving on a task force or committee, acting as team leaders or
charge nurses, and supervising unlicensed assistive personnel and licensed
vocational/practical nurses. The new nurses will be placed in many situations that require
leadership and management skills, for example, managing a group of assigned patients,
serving on a task force or committee, acting as team leaders or charge nurses, and supervising
unlicensed assistive personnel and licensed vocational/practical nurses.
DIF: Application REF: pp. 296-297
2. A nurse asks, ―What is meant by ‗internal‘ customers?‖ The correct response is: (select all that
a. insurance companies
b. accreditors such as The Joint Commission
c. X-ray technicians
d. clinical pharmacist
e. chief financial officer
ANS: C, D, E
Internal customers are employees of an organization at all levels. An x-ray technician is an
example of an internal customer. Internal customers are employees of an organization at all
levels. A clinical pharmacist is an example of an internal customer. Internal customers are
employees of an organization at all levels. A chief financial officer is an example of an
internal customer.
DIF: Comprehension REF: p. 308
Chapter 18: Budgeting Basics for Nurses
Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th
1. A nurse manager plans the fiscal budget to include salaries for two RNs for two 12-hour shifts
with a patient census of 6 in the short-stay observation room. The nurse manager reviews the
budget report 3 months later and notes that the salary expenses are higher than was budgeted
because of higher-than-planned RN staff salaries. This additional RN staff is necessary to
meet patient care needs because the census has remained constant at 10 patients rather than
the 6 projected when the budget was developed. The difference between the planned budget
and the actual cost is known as:
a. revenue.
b. variance.
c. monitoring.
d. capital expenditures.
Variance is the difference between the planned budget and actual results; it can be a positive
or a negative discrepancy.
DIF: Comprehension REF: p. 316
2. A nursing unit‘s census consists primarily of long-term residents with a high risk for falls. To
meet new safety regulations, the nurse manager must plan to replace all 50 patient beds with
new beds equipped with Fall Watch electronic sensors that will detect when patients get out of
bed. The manager will be involved in which type of budgeting to replace the beds?
a. Fiscal
b. Labor
c. Operational
d. Capital
Capital budgets are concerned with major purchases such as equipment paid for over several
DIF: Comprehension REF: pp. 320-321
3. A nurse manager is preparing a budget that does not base annual budgets on the revenue and
expenditures of the prior year and has the advantage that outdated information is not
integrated into the budget. The manager is using which budget method?
a. Zero-based
b. Incremental
c. Labor
d. Operational
The zero-based method is based on the assumption of no volume and no resources assigned; it
essentially starts each new budget period at zero rather than building from past budgets.
DIF: Comprehension REF: p. 321
4. A nurse on the unit is heard saying, ―I am not going to document that I used four catheters to
start that IV; it doesn‘t matter anyway.‖ What action can help the staff nurse understand the
financial budget goals of the unit?
a. Have the nurse work in payroll for a week.
b. Enroll the staff in continuing education units (CEU) for personal finance.
c. Ask the nurse to represent the unit on the budget planning committee.
d. Make the nurse responsible for monitoring all disposable equipment and supplies.
Participating on the committee will give the nurse ownership of the unit‘s budget and will
provide insight into the unit‘s budgetary goals.
DIF: Analysis REF: p. 326
5. In a large health care facility, the executive administrative leaders set the budget goals to
decrease full-time equivalents by 3%, eliminate the cost of agency nurses, reduce lost revenue
from lost supplies by 1%, and provide a 0.5% hourly salary incentive for working on a float
unit when the assigned unit has a low census. Nurse managers meet with nursing
administrators to design their unit budgets to meet these established goals. The budget
approach that is being used is the approach.
a. top-down
b. participatory
c. iterative
d. incremental
Budget goals are established by administrators; unit managers do not contribute to goal
setting, which is the primary principle of the top-down approach.
DIF: Comprehension REF: pp. 321-322
6. Which component of budgeting might normally be addressed in the annual performance
evaluation for a nurse manager?
a. Including in the labor budget costs for overtime and benefits
b. Managing variances in nursing overtime costs and supply usage
c. Accurately predicting revenues on the basis of unit-of-service
d. Providing qualitative analysis for variances in the capital budget
Nurse managers are often evaluated according to their success in managing nursing overtime
costs and supply usage as reflected in the unit‘s budget.
DIF: Application REF: p. 319
7. A primary function of the budgeting process is to provide managers with an opportunity to:
a. insist that salary increases for all nurses are included in the annual budget.
b. discuss concerns about resource allocation with leaders of the organization who are
capable of resolving issues.
c. develop a mechanism for changing from zero-based budgeting to incremental
d. develop for all staff an educational program related to supply usage.
Coordination and communication are very important functions of budgeting that require many
different groups within an organization to come together with organizational leaders to
discuss the resources necessary to accomplish the goals of a business unit.
DIF: Application REF: p. 318
8. Organizations measure the effectiveness of their budgets by examining actual revenues and
expenditures versus:
a. planned variances.
b. incremental budgets.
c. productivity metrics.
d. expected performance.
Variance analysis is the process by which deviations from budgeted amounts are examined by
comparing actual performance results against expected, or budgeted, performance.
DIF: Comprehension REF: p. 323
9. When the nurse manager conducts a qualitative analysis of budget variances, he or she is:
a. determining the percentage increase of supply usage from the last quarter to the
current quarter.
b. identifying the overall increase in the dollar amount of salaries paid for overtime.
c. comparing productivity metrics across all nursing units in the facility.
d. reconciling with current conditions the underlying assumptions on which the
budget was based.
Qualitative analysis of the budget explains why current conditions are different than they were
when the budget was developed; new conditions might include greater patient acuity or
additional physicians with increased admissions.
DIF: Application REF: p. 323
10. A nurse manager is working with the financial officer to develop the budget of the nursing
unit for the next fiscal year. The nurse manager tells the financial officer that which of the
following pieces of information will affect budget assumptions?
a. The capital budget request for new emergency department equipment has been
turned in for consideration by the hospital‘s administrative team.
b. The patient census likely will increase during the next fiscal year because two
large physician groups have transferred their admission privileges to this hospital.
c. The participatory budgeting approach instituted last year has been helpful in
controlling supply costs.
d. Zero-based budgeting will help the managers to be more efficient in establishing
next year‘s budget.
Budget assumptions are future predictors of performance and include the stability of the price
of supplies, the salary range needed to recruit and retain quality employees, new services
offered by competitors, and the variability of the patient census.
DIF: Application REF: p. 322
11. The nurse manager meets with upper management to share strategic goals agreed upon by her
staff for their individual nursing unit as the first step to begin budget negotiations. One
strategic goal is that staff will have access to technology that will allow them to incorporate
point-of-care devices for all RNs. The second goal is to improve RNs‘ ability to recognize
critical indicators that a patient‘s health status is deteriorating through advanced health
assessment skills. During the meeting the manager discusses the strategy options and selecting
the one that works for the unit. Which type of budget development is used?
a. Iterative
b. Top-down
c. Participatory
d. Zero-based
In the participatory approach, the people responsible for achieving the budget goals are
included in goal setting.
DIF: Comprehension REF: p. 322
12. The nursing executive team met to review last year‘s productivity metric to strategize for the
upcoming year‘s metric. The team wants to be certain the productivity metric shows
productivity was:
a. high.
b. low.
c. balanced.
d. iterative.
A balanced productivity is desired because it encourages quality and safety while providing
financial efficiency.
DIF: Comprehension REF: p. 320
13. The nurse manager meets with upper administration and learns that the strategic plan for
nursing is to have 80% BSN staff within the next 3 years. The nurse manager then built her
budget to meet the organization‘s strategic goal by providing tuition reimbursement and
flexible work hours, which required some agency staffing. Which approach to budgeting is
a. Iterative
b. Top-down
c. Participatory
d. Zero-based
The iterative approach is a combination of the top-down and the participatory approach, with
upper management defining strategic goals and then unit leaders developing their operating
budgets to incorporate their individual goals in conjunction with the organization‘s strategic
DIF: Comprehension REF: pp. 321-322
The nurse managers of an organization are meeting with administration to plan the budget.
The above graph shows last year‘s 2011 expenditures, and the team will trend the upcoming
budget knowing that, with the slowdown in the economy, patient census will be lower. Which
budget approach is being used?
a. Incremental
b. Zero-based
c. Productivity metrics
d. Capital
The incremental approach is simply a forward trend of current or recent performance with
adjustments for future growth or decline in revenues or expenses.
DIF: Comprehension REF: p. 321
15. Nurses on a unit met with the nurse manager as part of participatory budgeting. They ask,
―What exactly is the difference between fixed and variable costs? Understanding this will help
us better understand the budgeting process.‖ The manager provides a definition and asks the
staff to list types of direct and indirect cost. Which example would indicate a need for further
a. Fixed costs would include accreditation fees.
b. Fixed cost would include the cost for the automated medication-dispensing system.
c. Variable cost would include the nurse manager‘s salary.
d. Variable cost would include the salary expense for registered nurses.
Variable costs would include the salary expense for registered nurses because their number
can change.
DIF: Analysis REF: p. 326
1. A nurse manager has calculated that providing 75 hours of direct nursing care per day requires
that 120 hours must actually be worked by nursing staff. The manager is involved in: (select
all that apply)
a. developing the capital budget.
b. applying productivity metric.
c. monitoring the labor budget.
d. incremental budgeting processes.
e. addressing budget assumptions.
The nurse manager is determining the amount of work produced by calculating the actual
number of nursing hours worked, which is productivity metric. Budgets use productivity
DIF: Application REF: p. 320
2. A nurse has recently been appointed to the position of nurse manager. To become successful
in managing the unit‘s budget, the new nurse manager should: (select all that apply)
a. read the financial policy manual to learn more about the organization‘s budgeting
b. allow the nursing administration office to manage the unit‘s budget until he or she
is able to complete an online financial management course.
c. communicate regularly with a person in the hospital‘s finance office about
interpreting budget reports.
d. pay attention to only the bottom-line numbers in budget reports rather than trying
to understand each line in these reports.
e. discuss the process of developing budgets with other members of the management
ANS: A, C, E
Knowing the organization‘s financial policies is an important step toward understanding the
organization‘s budget process. Building a relationship with the finance office is fundamental
to learning about the budgeting. As one participates more in the budget process, one‘s
understanding of the process and related responsibilities is enhanced.
DIF: Application REF: p. 323, Box 18-3
1. The financial plan required for the distribution of resources and expenses is a .
A budget is an organization‘s financial plan that expresses expected expenses (such as
personnel and supplies) and anticipated revenues for products and services over a defined
period, usually 12 months.
DIF: Comprehension REF: p. 316
Chapter 19: Effective Communication and Conflict Resolution
Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th
1. A nurse is listening to a patient‘s apical heart rate. The patient asks, ―Is everything okay?‖
The nurse says nothing and shrugs her shoulders. The nurse is demonstrating:
a. open communication.
b. filtration.
c. blocking.
d. false assurance.
Blocking occurs when the nurse responds with noncommittal or generalized answers.
DIF: Comprehension REF: p. 335
2. A teenage patient is using earphones to listen to hard rock music and is making gestures in
rhythm to the music. The nurse assesses the amount of urine output in the Foley catheter and
leaves the room. What communication technique is demonstrated in both of these situations?
a. Blocking
b. Filtration
c. Empathy
d. False assurance
Filtration is the unconscious exclusion of extraneous stimuli in communication.
DIF: Comprehension REF: p. 331
3. In today‘s world of fast, effective communication, what is the most commonly used means of
societal communication?
a. Facial expression
b. Spoken word
c. Written messages
d. Electronic messaging
Verbal communication, which involves talking and listening, is the most common form of
interpersonal communication. An important clue to verbal communication is the tone or
inflection with which words are spoken and the general attitude used when speaking.
DIF: Knowledge REF: p. 331
4. Which statement accurately describes communication?
a. The components of communication are mutually exclusive.
b. Communication is linear.
c. Communication involves only the sender and the receiver; everything else is
d. When the receiver becomes the sender, the subcomponent of communication that
is in use is feedback.
Communication is a process that requires certain components, including a sender, a receiver,
and a message. Effective communication is a dynamic process: With a response (feedback),
the sender becomes the receiver, the receiver becomes the sender, and the message changes.
DIF: Comprehension REF: p. 330, Figure 19-1
5. A licensed practical nurse (LPN) has been practicing for 25 years on a unit where a newly
graduated RN with a bachelor‘s degree is hired. Before the RN arrives on the unit, the LPN is
heard saying, ―She‘ll try to tell everyone what to do because she makes more money. She‘ll
sit at the desk and let us do all the work.‖ This is an example of a(n):
a. interpretation.
b. context.
c. precipitating event.
d. preconceived idea.
Preconceived ideas are conceptions, opinions, or thoughts that the receiver has developed
before having an encounter. Such ideas can dramatically affect the receiver‘s acceptance and
understanding of the message.
DIF: Application REF: p. 330
6. A new mother is experiencing pain after delivering an infant with Down syndrome. The staff
nurse states, ―I don‘t think she is really hurting. Let the next shift give the pain medication.‖
The team leader notices the staff nurse looks agitated and anxious and asks about any
concerns in providing care to this new mom. The staff nurse admits having a stillborn infant
with Down syndrome. This is an example of which component of communication?
a. Personal perception
b. Past experiences
c. Filtration
d. Preconceived idea
With past experiences that include a variety of positive, neutral, and negative events, the
influence that these experiences can and will have on communication may be positive, neutral,
or negative. The importance of recognizing that any reaction from the receiver may be biased
by previous experience cannot be overstated.
DIF: Application REF: p. 331
7. A nurse gives Dilantin intravenously with lactated Ringer‘s solution containing multivitamins.
The drug precipitates and obstructs the only existing line. When the team leader informs the
nurse that these drugs cannot be mixed, the nurse states, ―Everyone just pushes the medicine
slowly. No one checks for compatibility. There isn‘t even a compatibility chart on the unit.‖
Which type of logical fallacy has influenced the nurse?
a. Ad hominem abusive
b. Appeal to common practice
c. Appeal to emotion
d. Appeal to tradition
An appeal to common practice occurs when the argument is made that something is okay
because most people do it.
DIF: Application REF: p. 336
8. An RN is consistently late to work, causing reassignment of patient care and the need for
repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, ―My
husband left me, I have no car, no family close by, and the bus is always late, which makes
me late. The nurse manager doesn‘t care how hard I try to get here, and I am raising a child by
myself.‖ The nurse is using which type of logical fallacy?
a. Appeal to emotion
b. Appeal to tradition
c. Hasty generalization
d. Confusing cause and effect
An appeal to emotion is an attempt to manipulate other people‘s emotions for the purpose of
avoiding the real issue.
DIF: Application REF: p. 336
9. The new director of nurses has instituted ―walking rounds‖ on all nursing units, rather than the
usual taped shift reports. A veteran nurse exclaims, ―She doesn‘t know how we do things
here!‖ The nurse is demonstrating:
a. appeal to emotion.
b. appeal to tradition.
c. red herring.
d. straw man.
An appeal to tradition is the argument that doing things a particular way is best because
they‘ve always been done that way.
DIF: Application REF: p. 336
10. A male nurse hired to work in the emergency department is observed throwing a contaminated
needle into the trash can. The team leader reprimands the nurse for not appropriately
disposing of sharps. The nurse states, ―You don‘t care that I threw the needle in the trash. You
just want an all-female staff,‖ putting the team leader in a defensive position. This
communication technique is known as:
a. straw man.
b. red herring.
c. slippery slope.
d. confusing cause and effect.
A red herring is the introduction of an irrelevant topic for the purpose of diverting attention
away from the real issue.
DIF: Application REF: pp. 336-337
11. A nurse who was recently certified in chemotherapy administration fails to check
compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D5W
leading to occlusion of the line. Which statement by the nurse demonstrates a red herring?
a. The nurse is upset and states, ―I am sure I have injected this before without a
problem‖ and the supervisor interprets this to mean the nurse often take shortcuts.
b. The nurse states, ―You are just upset because I am certified in chemotherapy
administration and you are not.‖
c. ―The nurse who started the IV didn‘t get a blood return but determined the IV was
the patient‘s—that is the problem.‖
d. ―This drug always occludes the line because it is so viscous.‖
The nurse diverts attention away from the issue of not checking compatibility to introduce an
irrelevant topic of chemotherapy administration certification which is not related to this
DIF: Application REF: pp. 336-337
12. During a health history interview, the nurse listens to a patient relating the precipitating events
that led to the onset of chest pain. She focuses her attention on the patient, makes eye contact,
and acknowledges what the patient has to say. The nurse is exhibiting:
a. assertive communication.
b. active listening.
c. empathy.
d. passive communication.
In active listening a number of techniques can be used by the receiver to enhance the ability to
listen; these include (1) providing undivided attention, (2) giving feedback (rephrasing), (3)
making eye contact, (4) noting nonverbal messages (body language), and (5) finishing
listening before one begins to speak.
DIF: Comprehension REF: p. 337
13. The nurse is demonstrating active listening when:
a. while assessing the patient‘s vital signs, the nurse records the data and states, ―You
are improving, your vital signs are normal.‖
b. eye contact is maintained while focusing on the patient as the patient describes the
current pain level and location.
c. he or she states,

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