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Quiz Session - Attempts With Random Questions

ANCC NE-BC Exam Questions

Page 5 of 20

81.

A nurse executive is reviewing the hospital's current approach to managing patient complaints. Which strategy is most likely to improve the hospital's response to and resolution of patient complaints?

  • Training staff in conflict resolution and effective communication techniques.

  • Centralizing the complaint management process under a single department to ensure consistency.

  • Implementing an automated system for patients to log complaints without direct interaction with staff.

  • Increasing the time frame for responding to patient complaints to ensure thorough investigation.

Correct answer: Training staff in conflict resolution and effective communication techniques.

Training staff in conflict resolution and communication directly improves how complaints are handled, likely leading to better outcomes and higher patient satisfaction.

While centralization might improve consistency, it doesn't directly address the quality of interaction between staff and patients during the complaint resolution process. It also may not facilitate resolutions that meet patient expectations as a sole intervention. An automated system may streamline the logging process but it lacks the personal touch necessary for effective resolution and may not improve patient satisfaction. Extending the response time could negatively impact patient satisfaction, as patients generally expect timely resolutions to their concerns.

82.

In evaluating the care delivery in the Emergency Department (ED), which nurse-sensitive indicator should be prioritized to improve patient outcomes?

  • Length of ED stay.

  • Patient-to-nurse ratio.

  • Rate of patient falls.

  • Rate of Central Line-Associated Bloodstream Infections (CLABSIs).

Correct answer: Length of ED stay.

The length of ED stay is critical for evaluating care delivery in the emergency department, as shorter stays can indicate more efficient and effective care, directly impacting patient outcomes and throughput.

While the patient-to-nurse ratio is important for determining adequate staffing, it is not a specific indicator of care quality in the emergency department context. The rate of patient falls is an important nurse-sensitive indicator but it is more relevant to inpatient care settings than the emergency department. Additionally, decreasing the length of ED stay is likely to result in a decreased rate of patient falls. The rate of Central Line-Associated Bloodstream Infections (CLABSIs) is critical for evaluating infection control practices but it is less directly related to emergency care delivery compared to the length of ED stay. Decreasing the length of ED stay will also decrease the rate of CLABSIs, as it facilitates central line placement in a more controlled environment instead of in the ED.

83.

If a nurse is performing their duties in a way that will benefit others, to what ethical concept is the nurse adhering?

  • Beneficence

  • Autonomy

  • Justice

  • Nonmaleficence

Correct answer: Beneficence

Beneficence is an ethical concept that means one is acting in a manner that will promote good or benefit others. This principle is basic to medicine and is one of the primary ethical principles that guides healthcare delivery.

Autonomy is an ethical principle that means a patient is using their ideas or beliefs to make medical decisions. Justice means fairness with respect to treatment. Nonmaleficence means to do no harm nor impose on the beliefs of the patient.

84.

During a department meeting, a nurse executive emphasizes the importance of Health Insurance Portability and Accountability Act (HIPAA) compliance. Which example best demonstrates adherence to HIPAA rules?

  • Encrypting all electronic patient records and requiring secure login credentials for access, even if inconvenient.

  • Leaving patient charts closed on the nurse's station counter for easy access while continuing to maintain privacy.

  • Encouraging the use of patients’ full names at all times to ensure correct patient identification.

  • Sending patient information via email to another department without encryption to facilitate access and continuity of care.

Correct answer: Encrypting all electronic patient records and requiring secure login credentials for access, even if inconvenient.

Encrypting electronic records and securing access with login credentials are essential practices for protecting patient information and complying with HIPAA standards.

Leaving patient charts in an unsecured area risks unauthorized access to private information. Encouraging the use of patients’ full names at all times can increase the risk of unauthorized disclosure of private details in public areas. Sending unencrypted patient information via email risks unauthorized access and breaches HIPAA regulations.

85.

A nurse manager is reviewing staff requests for leave. Which of the following situations would qualify for leave under the Family and Medical Leave Act (FMLA)?

  • A staff nurse requests leave to care for her healthy newborn.

  • A staff nurse requests time off to go on a vacation with her family.

  • A staff nurse requests time off for personal rest and relaxation.

  • A staff nurse requests leave to provide care to her step-cousin who has end-stage colon cancer.

Correct answer: A staff nurse requests leave to care for her healthy newborn.

FMLA provides eligible employees with unpaid, job-protected leave for the birth and care of a newborn child.

FMLA leave is intended for specific family and medical reasons, and does not include allowing unpaid leave for vacations. Personal rest and relaxation alone do not qualify for FMLA leave. While FMLA leave does provide an allowance for providing care for an immediate family member, a step-cousin is a distant enough family member that FMLA is not likely to apply.

86.

A nurse executive notices that the evening shift team in the ICU consistently outperforms the day shift team in terms of efficiency and patient satisfaction. What is the first step the nurse executive should take to understand and possibly replicate the success across all shifts?

  • Observe the evening shift team to identify effective practices.

  • Schedule additional training sessions for the day shift team.

  • Increase staffing levels on the day shift to match the evening shift.

  • Implement a reward system for the day shift based on performance metrics, using the night shift team’s performance as the standard to meet.

Correct answer: Observe the evening shift team to identify effective practices.

Observing the evening shift team and focusing on direct observation of team dynamics and effective practices is a proactive approach to understanding what makes this team successful.

Scheduling additional training assumes a knowledge or skill gap without having evidence to support the assumption. Increasing staffing levels may help but it doesn’t address underlying practices or behaviors contributing to success. Implementing this intervention without data regarding the difference in performance between the two teams is likely to be ineffective. Implementing a reward system might motivate the day shift but doesn’t directly facilitate learning from the evening shift’s effective practices. This intervention could also be seen as unfair by the night shift team that is already performing well.

87.

During a period of organizational change, a nurse leader emphasizes transparent communication and regular feedback sessions with staff. This strategy is best based on an understanding of which of the following?

  • Clear and open communication during change can mitigate uncertainty and foster engagement.

  • Transparency in leadership is expected and necessary to be seen as an effective leader.

  • Regular feedback sessions are a formality that has little impact on staff engagement.

  • Organizational change requires carefully managing information to promote staff buy-in while still avoiding information that could lead to resistance.

Correct answer: Clear and open communication during change can mitigate uncertainty and foster engagement.

Clear and open communication recognizes the importance of communication in managing change, helping to reduce uncertainty and maintain engagement by involving staff in the process.

Transparency in leadership should be to build trust and decrease anxiety by clarifying changes and expectations, not solely because it is expected or to influence how one is seen as a leader. Feedback sessions are crucial for engagement, providing a platform for voicing concerns and suggestions, not mere formalities. Limiting information tends to increase resistance and anxiety, not decrease it, making change management more difficult. Full transparency avoids the impression that information is being kept back, an impression that often develops when information is carefully managed.

88.

In a large healthcare facility undergoing a critical system-wide transition to a new Electronic Health Record (EHR) system, a nursing leader decides to use an authoritarian leadership style. Which action best exemplifies this decision?

  • The nurse leader establishes strict guidelines for EHR transition, mandates training sessions for all nursing staff, and sets non-negotiable deadlines for competency attainment.

  • The nurse leader forms a task force of experienced nurses and IT staff to lead the transition while encouraging open dialogue and shared decision-making.

  • The nurse leader delegates the responsibility of the EHR transition to department heads, trusting their discretion in method and timeline.

  • The nurse leader organizes a series of workshops where nursing staff can express concerns and suggest improvements to the EHR system transition plan.

Correct answer: The nurse leader establishes strict guidelines for EHR transition, mandates training sessions for all nursing staff, and sets non-negotiable deadlines for competency attainment.

Authoritarian leadership is characterized by clear, directive, and centralized decision-making. By setting strict guidelines and deadlines, the nurse leader is demonstrating this leadership style.

Forming a task force and encouraging open dialogue represents a more democratic or participative leadership style rather than authoritarian. Delegating responsibility and trusting department heads to decide on methods and timelines aligns more with a laissez-faire leadership style. Organizing workshops for staff input suggests a participative approach, which contrasts with the top-down decision-making typical of authoritarian leadership.

89.

A nurse executive initiates a PDSA cycle to improve the timeliness of post-operative pain assessment. Which of the following indicates the project is in the "Study" phase?

  • Comparing post-implementation pain assessment compliance rates to pre-implementation rates.

  • Creating a new policy that mandates pain assessment every two hours for post-operative patients.

  • Training post-operative nursing staff on the importance of timely pain assessments.

  • Soliciting feedback from patients on their satisfaction with pain management.

Correct answer: Comparing post-implementation pain assessment compliance rates to pre-implementation rates.

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. Comparing compliance rates before and after intervention is a key activity in the "Study" phase to assess impact.

Creating new policies is part of the "Plan" phase. Training is an action in the "Do" phase. While patient feedback is valuable, the direct measurement of compliance rates is a more specific indicator for the "Study" phase in this context.

90.

In aiming to improve hand hygiene compliance, a nurse executive formulates several research questions. Which of the following questions is most likely to lead to actionable evidence-based changes?

  • “Does implementing a visual reminder system improve hand hygiene compliance among healthcare workers?”

  • “How do healthcare workers describe their experiences with hand hygiene practices?”

  • “What factors influence hand hygiene compliance among healthcare workers?”

  • “What is the rate of hand hygiene compliance in our facility?”

Correct answer: “Does implementing a visual reminder system improve hand hygiene compliance among healthcare workers?”

The question, “Does implementing a visual reminder system improve hand hygiene compliance among healthcare workers?” directly tests an intervention's impact, providing a clear pathway to evidence-based improvement.

Descriptive experiences offer insight but do not necessarily lead to actionable interventions. Identifying factors influencing compliance is a step toward intervention but does not directly test an intervention's effectiveness. Knowing the rate of compliance is important for benchmarking but does not in itself test an intervention.

91.

A nurse executive wants to improve innovation in patient care through team diversity. Which of the following actions should they prioritize?

  • Creating a mentorship program pairing experienced nurses with new graduates from diverse backgrounds.

  • Developing a policy that requires each new hire to have a diverse cultural background.

  • Enforcing an increase in the diversity of patient populations served.

  • Encouraging staff to use their own diverse cultural practices in the delivery of patient care.

Correct answer: Creating a mentorship program pairing experienced nurses with new graduates from diverse backgrounds.

Creating a mentorship program pairing experienced nurses with new graduates from diverse backgrounds facilitates knowledge sharing, fosters innovation, and utilizes the strengths of diverse backgrounds to improve patient care.

Developing a policy that requires each new hire to have a diverse cultural background is not legal and results in staff being hired based on their cultural background instead of their skills. Focusing on an increased diversity of patient populations does not necessarily leverage team diversity. Encouraging staff to use their own diverse cultural practices in the delivery of patient care does not necessarily foster innovation in the team as a whole and may conflict with the standard of care in some situations.

92.

A healthcare provider is educating a new patient about the privacy of their health information. Which statement accurately reflects HIPAA regulations?

  • "Your health information can be shared with public health authorities without consent to report that you have a communicable disease."

  • "You cannot access your own medical records without signing a confidentiality agreement according to HIPAA."

  • "HIPAA allows us to share your information with specific family members, insurance providers, or clinicians involved in your care without your consent."

  • "HIPAA permits the sale of your health information for marketing purposes as long as your name is not used."

Correct answer: "Your health information can be shared with public health authorities without consent to report that you have a communicable disease."

Health Insurance Portability and Accountability Act (HIPAA) permits the sharing of health information without consent only in specific situations required by law, such as reporting communicable diseases.

Patients typically have the right to access their own medical records under HIPAA without specific conditions. HIPAA does not allow healthcare providers to share information with patient family members without consent, except under specific legal circumstances. HIPAA does not permit the sale of health information for marketing purposes without patient consent, ensuring the protection of patient privacy.

93.

When introducing a predictive analytics system to forecast Emergency Department (ED) volume, what is the most critical data source for accurate predictions?

  • Historical ED visit patterns.

  • Forecasted disaster and mass casualty event incidence.

  • Department of Health data on flu outbreaks.

  • Current and forecasted hospital occupancy rates.

Correct answer: Historical ED visit patterns.

Historical ED visit patterns provide the most direct and relevant data for forecasting future ED volumes, enabling more accurate and reliable predictions.

Forecasted disaster and mass casualty event incidence can influence ED visits, however, these events are uncommon and difficult to forecast, making them far less reliable as a primary data source for volume prediction. Department of Health data on flu outbreaks may indicate trends, but these trends are too indirect and unreliable for precise volume forecasting. Also, trends beyond solely flu trends should be taken into consideration. Current and forecasted hospital occupancy rates impact capacity but do not directly predict ED visit volumes.

94.

Of the four elements that must be present for medical malpractice to occur, which is best characterized by the following question: How would a reasonable and judicious healthcare provider act under the same circumstances?

  • Duty

  • Breach of duty

  • Causation

  • Injury

Correct answer: Duty

Four elements must exist (and be proven) for a medical malpractice case to occur:

  1.  Duty: the clinician is said to owe a duty of reasonable professional care to the patient.
  2.  Breach of duty: was the standard of care breached in this particular scenario?
  3.  Causation: was the unreasonable behavior by the clinician a direct cause of the injury in question?
  4. Injury: to prove this element (injury), the injured plaintiff must show a direct relationship between the alleged misconduct and a subsequent injury.

If any one of these four elements cannot be absolutely proven, then the malpractice suit may be dismissed.

95.

The management of a healthcare facility conducts a series of mandatory meetings for nurses to attend during their shifts. The meetings focus on the perceived negative impacts of unionization on the facility and the quality of patient care. According to the National Labor Relations Act (NLRA), which of the following is correct regarding this practice?

  • Illegal, but only if the meetings are designed to intimidate or coerce employees against unionization.

  • Legal, but only as long as attendance is mandatory and conducted during paid working hours.

  • Legal, provided that no explicit threats are made during the meetings.

  • Illegal, unless employees are given the opportunity to rebut the management's arguments.

Correct answer: Illegal, but only if the meetings are designed to intimidate or coerce employees against unionization.

While conducting a meeting to make management’s position known is not necessarily prohibited, conducting meetings that are designed to intimidate or coerce employees against unionization can be considered an unfair labor practice under the NLRA.

The legality does not depend solely on the meetings being mandatory and during paid hours but on the content and intent of the meetings. The absence of explicit threats does not automatically make such meetings legal if the intent or effect is to intimidate or coerce employees regarding their union activities. The legality is not contingent upon giving employees a chance to rebut; it is about whether the meetings are conducted in a manner that violates the NLRA by intimidating or coercing employees.

96.

In response to a recent survey finding low compliance with continuing education requirements, what should the nurse executive do first to address this issue?

  • Surveying staff to identify barriers to completing continuing education.

  • Mandating overtime for staff to complete their continuing education.

  • Reducing the number of required continuing education hours.

  • Dismissing staff who have not met their continuing education requirements.

Correct answer: Surveying staff to identify barriers to completing continuing education.

Understanding the barriers faced by staff in completing continuing education allows for targeted solutions that address the root causes.

Mandating overtime does not address the underlying reasons for non-compliance and could lead to burnout. Reducing requirements may compromise the quality of care and does not solve the problem of why staff are not completing their education. Dismissing staff is an extreme measure that does not contribute to a constructive solution or understanding of the issue.

97.

A nurse executive is evaluating the effectiveness of a new skill mix strategy in the Emergency Department (ED). Which outcome most indicates a successful implementation?

  • A decrease in patient wait times.

  • An increase in RN overtime hours.

  • An increase in the use of LPNs.

  • A decrease in administrative tasks for RNs.

Correct answer: A decrease in patient wait times.

A decrease in patient wait times suggests that the skill mix is allowing for more efficient and effective patient triage and care.

An increase in RN overtime hours may indicate inadequate staffing or improper skill mix utilization. Simply increasing the use of LPNs without considering the impact on patient care and RN workload is not beneficial. Decreasing administrative tasks for RNs is not as good a measure of successful implementation of a new skill mix strategy as a decrease in patient wait times.

98.

A nurse executive wants to improve engagement by involving staff in decision-making. Which approach is most effective?

  • Forming a committee of staff members from various levels to address unit issues.

  • Sending out annual surveys to collect feedback.

  • Implementing changes based on management's perceptions of needs identified by staff.

  • Holding monthly organization-wide meetings to communicate engagement initiatives being run by nursing leadership.

Correct answer: Forming a committee of staff members from various levels to address unit issues.

Forming a committee of staff members from various levels actively involves staff in problem-solving and decision-making, enhancing their engagement and sense of ownership.

Annual surveys may not provide timely feedback or involve staff in the decision-making process. Implementing changes based solely on management perceptions may not accurately reflect needs identified by staff or involve them in the implementation process. Monthly organization-wide meetings to communicate engagement initiatives result in increased awareness of these initiatives but do not necessarily improve engagement.

99.

A nursing executive is evaluating the implementation of a new Electronic Health Record (EHR) system. Which of the following criteria is most important to ensure successful integration and adoption by the nursing staff?

  • Ease of use and intuitive navigation.

  • Customization options for different departments.

  • The ability to use clinical prompts to guide care.

  • The number of clicks required to enter data.

Correct answer: Ease of use and intuitive navigation.

Ease of use and intuitive navigation are essential for ensuring staff can effectively use the system, thereby improving adoption rates.

While customization is important, it is not as critical a factor for successful integration and adoption by staff as ease of use and intuitive navigation. The ability to use clinical prompts to guide care is helpful for improving adoption and utility, however, it does not impact the successful integration and adoption of the EHR system as much as the ability to use the system. Although minimizing the number of clicks can enhance efficiency, ease of use and intuitive design are more critical for overall adoption and integration success. Minimizing the number of clicks is a component of ease of use, but is more narrow than the overall ease of use of the system.

100.

In a bundled payment reimbursement model, how are payments typically made?

  • A single payment is made for all services related to a specific treatment or condition.

  • Payments are made for each service provided to patients.

  • Payments are adjusted based on the quality outcomes of the services provided.

  • A fixed monthly payment is made for each patient without regard to services rendered.

Correct answer: A single payment is made for all services related to a specific treatment or condition.

Bundled payments involve a single payment for all services provided during an episode of care for a specific condition or treatment, encouraging efficiency and coordination among providers.

Payments made for each service provided to patients describes a fee-for-service model, not bundled payment. Quality outcomes may influence payment but are not the primary mechanism of bundled payments. A fixed monthly payment made for each patient without regard to services rendered describes capitation, not bundled payment.

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