Fourth Year Examination
)‫)الئحة جديدة‬Nursing Administration
Date: -22/1/2011
Time: - 3 hours
Total degree:-80
I.
Multiple choice questions:
( 13 marks)
1)
Leadership is the ability to:
a.
Guide and influence others without having the authority to direct their behavior.
b.
Guide and influence others having the authority to direct their behavior.
c.
Influence others through authority to direct their behavior
d.
All of the above.
2)
The report given by the head nurse of one shift to all members of incoming
shift is:a.
Shift report
b.
Report of complaint
c.
Census report
d.
Incident report
3)
The form used to document evaluation of patient care is:
a.
kardex record.
b.
Assessment form.
c.
nursing progress notes.
d.
Non of the above.
4)
Diagonal flow of communication is:
a.
Passes from subordinates to superior.
b.
Occurs with persons at different levels who have no direct reporting relationship.
c.
Takes place directly people on the same or similar organizational level.
d.
flows from people at higher level to those at lower level.
5)
Shift report includes information about the following except: a.
Special procedures
b.
Critically ill patients
c.
Patient with operation
d.
Normal vital signs
6)
The following records are used in the nursing unit except:
a.
Assignment record
b.
Census record
c.
Medication record
d.
Attendance record.
7)
All the following are types of managerial decisions except:
a.
Programmed decisions.
b.
Structured decisions
c.
Nonprogrammed decisions.
d.
Crises decision.
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7) The traditional leadership styles are the following except:
a.
Autocratic leadership style.
b.
Democratic leadership style.
c.
Transformational leadership style
d.
Laissez- faire leadership style.
9) All the following are types of positional power except:
a.
Reward power.
b.
Coercive power.
c.
Rational persuasion power
d.
Legitimate power.
10)
The lowest difficult and shortest time to make a change occurs with
aBehavior
bKnowledge
cGroup behavior
dAttitude individual
11)
The actual change occurs in the
aRefreezing stage
bUnfreezing stage
cMoving stage
dStabilization and self renewal
12)
The nurse is responsible for her patient from admission to discharge in
aPrimary method
bTeam method
cFunction method
dModular method
13)
Comparison of care given as shown on the record with the established
standard defined as:
aQuality assurance
bStandard
cQuality
dNursing audit
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II.
True or false
( 12 marks)
Read the following statements carefully and circle the letter (T) if the statement is true
and the letter (F) if the statement is false.
Statement
T
F
Patient classification is used to determine the degree of patients
T
F
T
F
T
F
T
F
T
F
No
1
dependency
2
In factor system nursing tasks are assigned time to reflect the amount
of time needed to perform the nursing task.
3
Mangers are people who do things right and leaders are people who do
the right thing.
4
It is easier to control non- verbal message than words and speech
message we send.
5
continuing education is a planned learning experience within and
outside the agency
6
New changes are integrated and stabilized in the unfreezing stage
T
F
7
In Decision making the manager must focus on symptoms instead of
T
F
T
F
T
F
T
F
T
F
T
F
causes
8
Face to face
meetings and written reports are means of upward
communication
9
Decision making and problem solving are interrelated and
interchangeable
10
Power is a personal quality while authority is mostly vested in the
position
11
discretionary time or especially time involve those activities which are
accomplished alone
12
preparing the agenda for meeting is an example of managerial time
3
III.
Match from Column (B) the appropriate word for the
appropriate definition in Column (A)
(4 marks)
A
b
1-
Describe the organization purpose and essence
3 - a-Policy
2-
Provide consistent basis for practice
4 -b-Procrastination
3-
Outline responsibilities and appropriate actions
for specific circumstances
4-
1- c-Mission
2- d-Standard
Postponing of activities
e-Clinical indicator
IV.
Situation
(4 marks)
Surgical department , its capacity is 40 bed ; the occupied beds are 25 bed . 10 of
them are preoperative patients with no restriction of activity; and 10 of them are
two days postoperative patients while the other 5 patients are immediate
postoperative patients and the number of available nurses are 8 nurses with
different experience .
1abcd2abcd3abcd-
The two days postoperative patients are
Modified intensive care requiring from 7-8hrs/ day / patient
minimal care requiring from 3-4 hrs/ day / patient .
intensive care requiring from 10-14 hrs/ day / patient.
None of the above
The immediate postoperative patients are
Modified intensive care requiring from 7-8hrs/ day / patient
self care requiring from 1-2 hrs/ day / patient .
intensive care requiring from 10-14 hrs/ day / patient
None of the above.
the best method of delivery system do you prefer to assign patients is :
Case method
Function method
Case and function method
Function and team method
4
4Nurses with different experience is important in which method of delivery
system :aPrimary method
bTeam method
cCase and function method
dFunction and team method
V.
Define the following :
( 5 Marks)
1Problem solving:
Is part of decision making, it is a systematic process that focuses on analyzing a difficult
situation.
2Quality assurance :
Is a formal systematic program to identify problems in health care delivery , design and
implement activities to solve these problems
3Planned change:
-is defined as a process of intentional intervention.
-In general, it is a process by which an invention of new ideas is created and developed,
diffused through communication , and result in consequents of adoption or rejection.
-Planned change is a decision making involves careful though and action , problem solving
,decision making and interpersonal competence.
4leadership style:
was defined as the manner in which the leader influences the group member's behaviors in
various situations .
5Unit manager:
a unit manager is responsible for all management activities to be carried out on the nursing
unit
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VI.
Differentiate
( 16 Marks)
Differentiate between the following:1- Up word and down word communication.
Up word communication
Communication
is
an
Down word communication
interactive
Communication
is
an
interactive
process that occurs when a person (the
process that occurs when a person (the
sender) sends a verbal or nonverbal
sender) sends a verbal or nonverbal
massage to another person (the receiver)
massage to another person (the receiver)
and receives feedback
and receives feedback
 *it passes from subordinates to superior, i.e. “
*It flows from people at higher level to those
continues Up the organizational hierarchy”
at lower level, i.e. from a superior to
* upward communication provides a means
subordinate or from manager to assistant
for motivating and satisfying personnel by
manager in the organizational hierarchy.
allowing employee input.
*It includes instructions speeches , meetings ,
Common means of upward communication
use of telephone, letters , handbooks pamphlets
include
, policy statements and procedures .
• Face to face meetings.
• Open door policies.
• Performance appraisal
• written reports.
• Staff meetings.
• Counseling.
• Suggestion boxes.
• Democratic management.
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2- Structure and process standard and give example for each.
Structure standard
Structure
standard
Process standard
regulate
the Process standards focus on whether the activities
environment to ensure quality (human within an organization are being appropriately
resources,
physical
resources conducted. Legal parameters of process
&environmental characteristics.
standards are: Procedures, practice guidelines,
Legal parameters of structure standards plans &documentation.
are: mission, philosophy ,goals, policies Example :
&job description.
Patient's history should be taken one hour of the
Example:
pt. admission.
There should be philosophy &objectives.
3-
Transformational and transactional leadership.
Transformational leadership
Transactional leadership
Leadership
Leadership
• As a process, leadership is the use of
* As a process, leadership is the use of
noncoercive influence to direct and coordinate
noncoercive
the activities of group members to meet a goal.
coordinate the activities of group members
• is the process of interpersonal influence in
to meet a goal.
which one individual " the leader " directs and
influence
to
direct
and
* is the process of interpersonal influence in
stimulates positive response in a group
which one individual " the leader " directs
member ( s ) " follower ( s ) " to achieve a
and stimulates positive response in a group
desired objective .
member ( s ) " follower ( s ) " to achieve a
desired objective
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•In this style, the leader:
In this style the leader:
•Be a charismatic leader, i.e. highly respected *
Emphasizes mutual agreement on goals.
* Provides rewards that match the
by the followers.
•Sets high standards and challenges his staff to
employee's achievement .
* Uses management by exception i.e.
go beyond their usual level of effort.
•Shares a vision with the staff that appeals to
reacts when problems occurs .
* Tends to use negative feedback more
both their emotions and ideas .
•Stimulate followers to question the status quo,
to think critically about what they doing and
than positive one , and is relatively
punitive rather than facilitative in
approaching his /her staff .
why.
•Takes a faculty approach . The uniqueness of
each employee is recognized and assignments
are based on ability and needs.
4-Tradetional and progressive organization pattern in the role of head nurse
Traditional organization
Progressive organization
Coordinates activities of many individuals who Coordinating the patient
perform tasks on the patient unit
services.
Managing the unit activities.
Makes sure that reports are made, records are
kept
Makes sure that supplies and equipment are
provided.
Coordinates unit and hospital administration
with patient care.
care
Maintaining the supplies and
equipment.
permits the head nurse to be free
from
increased
management
functions
It increases the volume of management Permits the head nurse to carry out
functions performed by the H.N in the unit .
the coordination of patient care
management .
It decreases, the H.N time spent inpatient care
management.
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VII.
Short Answers
( 14 marks )
1-
List common mistakes that may occur at the first step of decision making.
•Mistake 1:Is defining the problem too broadly or too narrowly.
•Mistake 2:Is focusing on symptoms instead of causes.
•Mistake 3:Is choosing the wrong problem to deal with. Managers should set priorities
and deal with the most important ones first.
2-
Identify (3) principles of documentation in kardex:
1- Write neatly and legibly.
2Write in pencil .
3Use the correct spelling and grammar.
4Use standard abbreviations.
5Write clear concise sentences.
6Say what you mean.
7Chart promptly.
8Note the time.
9Chart on chronological order.
10- Document accurately, completely and objectively.
11- Sign and date each entry.
312345-
List (4) goals of communication.
To Change behavior
To get action
To get and give information
To ensure understanding
To persuade
4identify two reasons of resistance to change
1- the nature of the change
2- misconceptions and in accurate information about what the change might mean.
5-
•
•
Enumerate (4) of leader traits.
Sense of Responsibility
Self-confidence
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• High Energy Level
• Empathy
• Internal Locus of Control
• Sense of Humor
• Highly Flexible
• Broad Range of Skills
• Articulate
• Energetic
• Empowering
• Inspire a collaborative approach
•Tap into the endless source of: Ideas
Innovation,
knowledge
know-how &
6-
state of internal time wasters
1- poor planning.
2- ineffective communication.
3- failure to set goals & objectives.
4- inability to delegate.
5- inability to say no.
6- management by crisis.
7-haste.
8- indecisiveness.
9- open door policy.
10- procrastination.
7123456-
Enumerate administrative guidelines for conference
adequately prepare herself for all conferences
proper announcement of the time, place, purpose and duration of conference.
relieve the worker from responsibilities
try to make every one comfortable.
start the conference on time.
seating the group in a circle
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81234-
list steps of quality assurance process
Establishing standard &criteria.
collecting data.
Compare & make judgment.
corrective action &follow up
VIII. Discuss the following:
1-
( 12 marks )
Give short account on the staff development components
Staff development " is a planned learning experience within and outside the agency in order to help
employee to perform more effectively as a person and as a worker " .
Staff development programs in nursing " are ongoing training programs provided by the
employing authority to assist individual nurse to attain the new knowledge , skills , attitudes to
grow personally and professionally
through orientation, continuing education, job related
counseling& in service training.
Needs for staff development :
1. The rapidity of change of customers' needs , fosters recognition of staff development .
2. The impact of new technology and the increase of sophistication of nursing science emphasized
the need for continued learning .
3. The complexity of human relationships in a society with changing values style requires
development of leader ship styles such as transformational one who ha an advanced educational
and training capabilities .
4. Introduction of new concepts in the nursing field as quality improvement , cost containment ,
changing methods of delivering nursing care has brought about a needs for frequent interaction
with staff development .
5. Complexity of management functions in relation to the new concepts give motive to the need for
continuous development .
Components of staff development ( Scope of Program Areas ) :
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Staff development programs in nursing are usually built around four areas of personnel needs .
These needs are designed as :
1. Orientation .
2. Skill training .
3. Leadership and management development .
4. Continuing education .
1. Orientation program :
After the appointment of personnel to vacant positions in nursing department , the new
employees should be ready for work through attending orientation program .
Orientation : is the process of providing the new worker with work basic requirements so that he /
she can relate quickly and effectively adapted , familiar to new surroundings .
Content :
Orientation for new employees consists of two parts :
A. Induction training : instructions given to an employee to be acquainted by the agency's overall
purpose and function .
B. Job orientation : instructions concerning specific job tasks that the employee must perform .
A. Induction :
Should be standardized to all agency new employees and is provided during the employee's first
2 to 3 days in the agency . It provides the following information :
1. Employment policies , purpose , structure .
2. Holidays , vacations , allowance .
3. Sick time benefits and employees health services .
4. Position classifications and promotion opportunities .
5. Labor contracts and grievance procedure .
6. Pay dates .
7. Parking , eating facilities .
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8. In – service education .
B. Job orientation :
After induction training is completed , an employee should be oriented by the requirements of
the position for which he / she was hired .
In many agencies , 2- week orientation is given to nurse who are assigned to general ward ,
while 3 - or 4 – month orientation is given to nurse in OR or ICU to help new employee overcome
reality shock when they transform from student to employee status .
2. Skill Training program :
It is a form of continuation of the orientation program , but it should not be limited to new
employees only . When new techniques and procedures are to be introduced , the need for
extensive skills training program is obvious for new and older employees as well .
This program is directed towards providing employees with basic skills and attitudes required
for the job or for revision .
3. Leadership and Management Development Program :
This program is directed towards equipping a selected group of employees for management and
leadership , growing responsibilities and new positions in nursing .
4. Continuing Education :
It is a formal education , which can be offered in the form of workshops seminars , conferences
or courses.
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2-
You are working as a head nurse in pediatric unit at Benha University Hospital,
your nursing staff have a problem with their abilities. According to your role
discuses how can utilize nurses’ efforts in appropriate manner ?
Staff utilization:
1. Assigns the tasks to staff member with proper authority.
2. Ensure that every staff member knows :
- To whom she is responsible?
- For whom she is responsible?
- To whom she may go for counseling?
3. Plans time schedule for staff in advance taking into account personnel request (morale).
4. Maintain effective working condition e.g. preventing interruption, beginning day on time
and putting thing in order.
5. Maintains effective means of communication with staff through planned conference,
written reports, nursing notes, discussions and informal teaching.
6. Ensuring that each staff nurse is competent in utilizing the nursing process.
7. Provides opportunities for staff nurses to learn and through practice, gain skills in the
application of the nursing process.
8. Holds staff nurses accountable for implementing the nursing process.
9. Develops routine for frequently performed activities e.g. ordering supplies, carrying out
doctor's orders, and assignments of new patients.
Staff development:
1. Setting and utilizing high standards for nursing staff performance which leads to their
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growth.
2. Encouraging nursing staff:
a-
to participate in planning of the improvement of nursing care .
b-
to apply findings of nursing researches into practice .
3. Providing their opportunities to seek clinical advancements and conducting advanced
studies.
4. Sharing in planning for , conducting , and participating in training programs .
GOOD LUCK
STAFF OF NURSING ADMINISTRATION DEPARMENT
Dr.sawla Brahmin Mhmoud
Lecturer of nursing administration
Dr. Hoda abdalla saleh
Lecturer of nursing administration
Dr. Latifa Tawfik Abd El-Aziz
Lecturer of nursing administration
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