No products in the cart.
ANCC NE-BC Exam Questions
Page 4 of 20
61.
A group of nurses at a hospital are discussing their wages and working conditions in the hospital's cafeteria during their break. The hospital administration wants to prohibit such discussions to maintain professionalism. According to the National Labor Relations Act (NLRA), which action is most appropriate?
-
Allow nurses to discuss wages and working conditions during their breaks.
-
Prohibit any discussions of wages and working conditions within hospital premises.
-
Only permit discussions of wages and working conditions off hospital premises.
-
Don’t take any action, as discussions of wages and working conditions are always permitted.
Correct answer: Allow nurses to discuss wages and working conditions during their breaks.
Under the NLRA, employees have the right to engage in "protected concerted activities," which include discussing wages and working conditions for mutual aid and protection. An employer can require that these conversations do not take place during working hours, but cannot prohibit them during breaks.
The NLRA protects employees' rights to discuss wages and working conditions among themselves, regardless of the employer's policy. The NLRA does not restrict discussions to off-premises locations and employees are protected to have these conversations at work during non-working times. While employers cannot unduly restrict the rights of employees to discuss wages and working conditions as protected by the NLRA, they may set reasonable workplace rules during times when employees are performing work.
62.
A nursing team is facing low morale and high turnover. For a nurse executive who wants to employ a democratic leadership style, which strategy would be most appropriate to address these issues?
-
Organizing focus groups with nursing staff from various shifts to discuss their concerns and suggestions for improvements.
-
Implementing an action plan developed by a majority vote of the executive team.
-
Conducting an anonymous survey among the nursing staff to identify the causes of low morale and high turnover.
-
Announcing a series of incentives for staff retention and then assessing the response of the nursing staff.
Correct answer: Organizing focus groups with nursing staff from various shifts to discuss their concerns and suggestions for improvements.
Focus groups offer a direct way to involve staff in the discussion, allowing for the exchange of ideas and collaborative problem-solving. This intervention best exemplifies the democratic leadership style.
The top-down approach of having the executive team develop and implement a plan does not reflect the collaborative nature of democratic leadership, which seeks to involve the input of all members affected by the change. While surveys are a tool for gathering information, they do not provide a platform for interactive discussion and shared decision-making, which are both characteristics of democratic leadership. Implementing incentives without staff input prior to implementation misses the opportunity for engagement and participation that a democratic leadership style seeks to foster.
63.
A nurse executive wants to apply the ADKAR Model to enhance nursing staff competency in using a new patient monitoring technology. Which action best aligns with the stage represented by “K”?
-
Providing detailed training sessions on the new technology.
-
Assessing the staff's current level of competency with existing technology.
-
Surveying staff to understand their attitudes toward the new technology.
-
Monitoring the improvement in patient outcomes after the new technology is implemented.
Correct answer: Providing detailed training sessions on the new technology.
The ADKAR Model is a change management framework that outlines five essential steps for successful change: Awareness, Desire, Knowledge, Ability, and Reinforcement. The "Knowledge" stage involves educating the staff on how to make the change, in this case, how to use the new technology effectively.
Assessing current competency levels would be part of the "Awareness" stage, where the need for change is identified. Surveying staff attitudes may help in the "Desire" stage, to motivate them for the change. Monitoring patient outcomes relates to the "Reinforcement" stage, ensuring the change is sustained.
64.
Under the Family and Medical Leave Act (FMLA), an eligible employee is entitled to how many weeks of unpaid, job-protected leave during a 12-month period?
-
12 weeks
-
24 weeks
-
18 weeks
-
Varies based on the reason for requesting leave
Correct answer: 12 weeks
FMLA allows eligible employees up to 12 weeks of unpaid leave.
While eligibility for FMLA leave is dependent on the reason for requesting leave, the duration is not.
65.
During the "Do" phase of the PDSA cycle to reduce patient falls, a nurse executive implements a new fall prevention protocol. What is the most critical next step?
-
Monitor and record the number of patient falls.
-
Review the effects of the protocol with all staff members.
-
Compare the fall rates after implementation of the new protocol to baseline data.
-
Make the fall prevention protocol a permanent practice.
Correct answer: Monitor and record the number of patient falls.
The Plan-Do-Study-Act (PDSA) cycle is a systematic series of steps for gaining valuable learning and knowledge for the continual improvement of a process or product, involving planning the test or change, implementing it, observing and studying the results, and acting on what is learned to make further improvements. After implementing a new fall prevention protocol, part of the "Do" phase, the most critical next step is to monitor and record outcomes, such as the number of patient falls. This activity aligns with the "Study" phase, where the impact of the changes is evaluated.
Reviewing the effects of the protocol is part of analyzing the data collected during the "Study" phase and often leads into the "Act" phase. It is not the immediate next critical step. Comparing the fall rates after the implementation of the new protocol to the baseline data is a key component of the "Study" phase but follows the initial monitoring and recording step. Making the fall prevention protocol a permanent practice would be part of the "Act" phase, contingent upon positive results from the "Study" phase.
66.
When introducing a new model of patient care that requires changes in roles and responsibilities, which action best aligns with the initial step of the PDCA Cycle?
-
Deciding how role changes will be communicated and implemented.
-
Training staff on their new roles.
-
Monitoring the outcomes of the change.
-
Making adjustments based on feedback from staff.
Correct answer: Deciding how role changes will be communicated and implemented.
The Plan-Do-Check-Act (PDCA) Cycle is a framework for planning and implementing change. Deciding how role changes will be communicated and implemented corresponds with the "Plan" phase, which is the initial step of the PDCA Cycle.
Training staff on their new roles is an essential action but aligns more closely with the "Do" phase, where the plan is executed. Monitoring the outcomes of the change falls under the "Check" phase of the PDCA Cycle, where the outcomes of the change are monitored and analyzed to determine whether the change is achieving the desired effect. Making adjustments based on feedback from staff corresponds to the "Act" phase, where adjustments are made based on the outcomes and feedback to ensure the change is effectively integrated and optimized.
67.
A nurse executive is reviewing the quarterly nurse-sensitive indicators report. Which indicator would be most critical for assessing the quality of nursing care and patient safety in the surgical unit?
-
Rate of post-operative infections.
-
Patient satisfaction scores.
-
Staffing levels.
-
Number of educational sessions attended by staff.
Correct answer: Rate of post-operative infections.
The rate of post-operative infections is a direct nurse-sensitive indicator of the quality and safety of care in a surgical unit. It reflects the effectiveness of nursing interventions in infection control.
While patient satisfaction is important, it does not directly measure the quality of nursing care and patient safety related to surgical interventions. Staffing levels are a factor in patient care but do not directly measure the quality and safety of nursing care in the context of surgical outcomes. The number of educational sessions attended by staff is an indirect measure of staff development and does not directly assess the quality and safety of patient care.
68.
In an effort to improve patient experience, a nurse executive considers changes to the physical environment of patient rooms. Which of the following modifications is most likely to contribute to a positive patient experience?
-
Ensuring all rooms have natural lighting and are equipped with comfortable furniture.
-
Adding more beds to each room to increase capacity.
-
Installing larger televisions with more entertainment options in each room.
-
Increasing the size of the nursing stations.
Correct answer: Ensuring all rooms have natural lighting and are equipped with comfortable furniture.
Natural lighting and comfortable furniture can significantly improve a patient's mood and comfort, directly enhancing the patient experience.
Adding more beds could lead to overcrowding and decreased privacy, negatively impacting patient experience. While improved entertainment options may be beneficial, they do not fundamentally improve the patient's environment as well as improving the overall environment with natural lighting and comfortable furniture. The size of nursing stations, while important for staff, does not directly impact the patient's physical comfort or experience.
69.
Which of the following best represents the "Do" phase in a PDSA cycle for improving patient handoff communications?
-
Training nursing staff on the use of the new handoff checklist.
-
Developing a new standardized handoff checklist based on best practices.
-
Collecting data on handoff errors before implementing the new checklist.
-
Analyzing feedback from staff about the checklist's usability and effectiveness.
Correct answer: Training nursing staff on the use of the new handoff checklist.
The Plan-Do-Study-Act (PDSA) cycle is a systematic series of steps for gaining valuable learning and knowledge for the continual improvement of a process or product, involving planning the test or change, implementing it, observing and studying the results, and acting on what is learned to make further improvements. Training nursing staff on the use of the new handoff checklist is part of the implementation or "Do" step.
Developing a new standardized handoff checklist is part of the "Plan" phase. Collecting baseline data is also part of the "Plan" phase. Analyzing feedback from staff is part of the "Study" phase.
70.
A nurse executive is assessing the impact of a newly implemented Electronic Health Record (EHR) system on care coordination across departments. Which indicator would best reflect an improvement in care coordination?
-
Decrease in duplicate diagnostic testing.
-
Increase in EHR system logins by staff.
-
Improved patient satisfaction.
-
Use of the EHR by a wider variety of disciplines than the previous EHR.
Correct answer: Decrease in duplicate diagnostic testing.
Reducing duplicate testing directly indicates better information sharing and coordination between departments, a key goal of EHR implementation.
More logins indicate increased use but not necessarily improved care coordination. An increase in patient satisfaction could indicate improved care coordination, but it could also be due to other factors. Use of the EHR by a wider variety of disciplines than the previous EHR is not as good an indicator of improvement in care coordination as a decrease in duplicate diagnostic testing.
71.
During a quality improvement meeting, a nurse executive discusses strategies to reduce the risk of falls in the hospital. Which strategy aligns with a proactive risk management approach?
-
Conducting regular safety drills that simulate patient falls.
-
Reviewing and analyzing fall incidents after they occur to identify trends.
-
Focusing on complete adherence to existing fall prevention interventions before developing new approaches.
-
Getting detailed reports from nurses after a fall incident.
Correct answer: Conducting regular safety drills that simulate patient falls.
Conducting safety drills is a proactive measure that prepares staff to prevent falls and respond effectively if they occur.
Reviewing and analyzing fall incidents after they occur is a reactive approach, not a proactive one. New interventions should not be delayed because of incomplete adherence to existing interventions. Rather, adding new interventions and improving existing interventions should occur in tandem. Increasing paperwork does not address the prevention of falls and is a reactive approach, not a proactive one.
72.
A nurse executive is planning to implement a new scheduling system that accommodates staff preferences while ensuring adequate coverage. Which scheduling strategy best achieves this goal?
-
Self-scheduling
-
Fixed scheduling
-
Rotating shifts
-
Mandatory overtime
Correct answer: Self-scheduling
Self-scheduling empowers staff to choose their shifts, improving satisfaction and potentially coverage, as they commit to filling in needed slots on their own accord.
Fixed scheduling does not accommodate individual staff preferences as it does not allow for flexibility. Rotating shifts can lead to dissatisfaction and burnout, not taking into account individual preferences and disrupting work-life balance. Mandatory overtime can lead to burnout and dissatisfaction, and does not consider staff preferences.
73.
A nurse executive is developing a policy to increase the integration of Evidence-Based Practice (EBP) into nursing operations. Which element is most essential to include according to the ANA Nursing Administration Scope and Standards of Practice?
-
Mechanisms for staff to incorporate EBP into daily practice.
-
Routine reviews of nursing literature by all staff.
-
Decreased barriers for staff to request additional EBP training.
-
Incentives for staff who publish research findings.
Correct answer: Mechanisms for staff to incorporate EBP into daily practice.
Establishing mechanisms for daily practice integration is the most practical way to facilitate the adoption of EBP into nursing practice. This approach aligns with the ANA's emphasis on continuous improvement of care quality through EBP, making it the most essential element.
While a literature review is important, encouraging it does not ensure the integration of EBP into practice. Facilitating training requests is supportive but this approach is passive, not active. This intervention is not as important as having a system in place for daily EBP application. Incentives for publishing research can encourage EBP but do not directly facilitate its routine use in patient care.
74.
A nurse executive is concerned about the high turnover rate among nursing staff. Which research question would be most effective for addressing this issue?
-
“What strategies can reduce nursing staff turnover in healthcare settings?”
-
“Why do nurses leave their jobs?”
-
“How does staff turnover affect patient care quality?”
-
“What are the common characteristics of hospitals with low staff turnover?”
Correct answer: “What strategies can reduce nursing staff turnover in healthcare settings?”
The question, “What strategies can reduce nursing staff turnover in healthcare settings?” is actionable and directly aimed at identifying and evaluating strategies to address the problem.
Understanding reasons nurses leave their jobs is useful but does not directly lead to testing specific interventions. While it's important to understand the impact of turnover, this question does not address how to reduce it. Identifying characteristics provides insights but does not directly test interventions aimed at reducing turnover.
75.
In the process of integrating a new clinical decision support system, what is the most important step to ensure its effectiveness and acceptance by the nursing staff?
-
Involving nursing staff in the selection and implementation process.
-
Ensuring the system provides real-time data analysis.
-
Choosing a system with the most advanced AI capabilities.
-
Ensuring the system does not lead to excessive alarm fatigue.
Correct answer: Involving nursing staff in the selection and implementation process.
Staff involvement ensures the system meets their needs and increases their commitment to using it effectively.
Real-time data analysis is a valuable feature, but staff involvement is key to acceptance and effective use. Staff involvement in the selection process can also provide better insight into the value real-time data analysis provides. Advanced AI capabilities can be beneficial, but user acceptance and practical utility are more important. Alarm fatigue can be an important consideration, however, having nursing staff involvement in the selection and implementation process can address a wider variety of concerns that will include alarm fatigue.
76.
A nurse executive wants to leverage value-based purchasing to enhance care delivery. Which of the following strategies would be most effective in aligning with value-based purchasing goals?
-
Enhancing interdisciplinary communication to improve care coordination.
-
Focusing exclusively on reducing the length of hospital stays.
-
Increasing the ratio of nurses to patients across all units.
-
Negotiating lower prices for medical supplies.
Correct answer: Enhancing interdisciplinary communication to improve care coordination.
Improved care coordination through enhanced communication among healthcare professionals directly contributes to better patient outcomes, a key goal of value-based purchasing.
Reducing hospital stays is important but focusing solely on this may not address the comprehensive quality and outcome measures valued in value-based purchasing. While important, simply increasing nurse-to-patient ratios does not directly address the specific metrics of care coordination, patient satisfaction, and outcome improvement targeted by value-based purchasing. This intervention may impact these metrics, but not to the same extent that improving care coordination would. Lowering the cost of supplies can reduce expenses and increase margins, but it does not impact the quality of patient care metrics that value-based purchasing programs measure.
77.
In evaluating research studies for evidence-based practice, which of the following best ensures the reliability and validity of the findings for application in a clinical setting?
-
The study findings have been replicated in other studies.
-
The study is published in a peer-reviewed journal.
-
The sample size is large and diverse.
-
The research is funded by a reputable organization.
Correct answer: The study findings have been replicated in other studies.
Replication of study findings in other studies is a strong indicator of the reliability and validity of the findings, confirming that the results are consistent and not due to chance.
While publication in a peer-reviewed journal is important for ensuring that the study has undergone rigorous review, it does not alone ensure reliability and validity. A large and diverse sample size enhances the generalizability of the study, but not necessarily its reliability and validity. Funding by a reputable organization supports the credibility of the research but does not directly ensure the reliability and validity of its findings.
78.
A nurse executive is involved in a case where a patient refuses a life-saving treatment due to personal beliefs. According to the ANA Code of Ethics, the executive's approach should ultimately be to do which of the following?
-
Respect the patient's decision and ensure their comfort and dignity are maintained.
-
Persuade the patient to accept treatment by explaining the consequences of refusal.
-
Override the patient's decision in the interest of saving their life by having the patient declared suicidal if possible.
-
Consult the hospital's legal team to force treatment.
Correct answer: Respect the patient's decision and ensure their comfort and dignity are maintained.
Respecting the patient's decision and ensuring their comfort and dignity are maintained respects the patient's autonomy and right to make informed decisions about their care. This action is most in line with the ANA Code of Ethics.
While education is important, ultimately respecting the patient's autonomy and decision, even when it conflicts with medical advice, is a fundamental ethical principle. Persuading the patient to accept treatment is a correct initial approach, but cannot be the ultimate decision if the patient continues to refuse. Overriding the patient's decision without their consent is unethical and violates the principles of autonomy and respect outlined in the ANA Code of Ethics. Seeking to force treatment through legal means disregards the patient's autonomy and the ethical principle of respect for persons.
79.
To address the challenge of medication non-adherence in a community clinic, a nurse executive considers several strategies. Which strategy would most likely improve adherence rates among patients?
-
Developing personalized medication management plans.
-
Implementing an automated call system to remind patients to take their medication.
-
Providing medication at no cost to the patient.
-
Restricting the number of medication refills to encourage patients to visit the clinic more frequently and facilitate timely recognition of non-adherence.
Correct answer: Developing personalized medication management plans.
Personalized plans with education and follow-up can address a range of factors affecting adherence, from understanding the medication's purpose to managing side effects.
While reminders can be helpful, they do not address underlying reasons for non-adherence such as confusion or fear of side effects. Providing medication for free may remove financial barriers but doesn't ensure patients understand how and why to take their medication. Restricting refills could discourage patients and potentially worsen adherence by creating additional barriers to accessing medication.
80.
In an effort to improve staff engagement, a nurse executive implements shared governance in the nursing department. This decision is primarily based on which of the following principles?
-
Autonomy and shared decision-making enhance job satisfaction.
-
Increased pay scales for nurses lead to better patient outcomes.
-
Strict management control improves efficiency and effectiveness.
-
External motivation is more effective than internal motivation.
Correct answer: Autonomy and shared decision-making enhance job satisfaction.
Shared governance models empower nurses by involving them in decision-making processes, thereby increasing their sense of autonomy and job satisfaction.
While fair compensation is important, it does not directly relate to the principle of shared governance. Strict management control might improve certain efficiencies but can diminish staff engagement and job satisfaction. Shared governance models focus on staff empowerment, not strict management control. Shared governance models are more likely to increase internal motivation, such as a sense of accomplishment and autonomy. Internal motivation is generally more sustainable for engagement than external rewards.