Nurse Executive Test Nurse Executive Advanced 3 — Questions and Answers
Question 1: A nurse executive is addressing a culture of low psychological safety on a surgical unit. Which intervention has the strongest evidence for building psychological safety?
- Mandatory reporting of all near-miss events
- Leader-modeled vulnerability and active solicitation of dissenting opinions (Correct answer)
- Anonymous suggestion boxes placed on each unit
- Monthly staff satisfaction surveys
Correct answer: Leader-modeled vulnerability and active solicitation of dissenting opinions
Research by Amy Edmondson shows that leaders who openly acknowledge uncertainty and welcome challenge are the strongest drivers of psychological safety.
Question 2: Which staffing model gives nurse managers the MOST flexibility to respond to fluctuating census while controlling labor costs?
- Fixed staffing with permanent full-time employees only
- A core-plus-flex model combining a fixed core staff with a float pool (Correct answer)
- Agency-only staffing during high-census periods
- Mandatory overtime for all existing staff during surges
Correct answer: A core-plus-flex model combining a fixed core staff with a float pool
A core-plus-flex model maintains quality and institutional knowledge through permanent core staff while using float pools to scale with census changes cost-effectively.
Question 3: In the SBAR communication framework, what information belongs in the 'Background' section when a nurse calls about a deteriorating patient?
- The nurse's recommended course of action
- The patient's admitting diagnosis and relevant medical history (Correct answer)
- Current vital signs and presenting symptoms
- The specific request being made of the provider
Correct answer: The patient's admitting diagnosis and relevant medical history
Background provides clinical context including admitting diagnosis, relevant history, and treatment course to help the provider understand the situation.
Question 4: A nurse executive is tasked with reducing hospital-acquired infections. Which of Porter's Five Forces framework elements is MOST relevant when evaluating technology vendors for infection prevention?
- Threat of new entrants to the healthcare market
- Bargaining power of suppliers in the medical technology space (Correct answer)
- Rivalry among existing hospital competitors
- Threat of substitute products from pharmaceutical companies
Correct answer: Bargaining power of suppliers in the medical technology space
Supplier bargaining power determines how much leverage vendors have on pricing and contract terms, directly affecting the cost-effectiveness of infection prevention investments.
Question 5: A magnet-designated hospital is conducting its re-designation review. The chief nursing officer must demonstrate evidence of which primary structural element?
- Nurse-patient ratios equal to California mandated levels
- Transformational leadership throughout the nursing organization (Correct answer)
- 100% BSN preparation among registered nurses
- Zero patient adverse events in the preceding year
Correct answer: Transformational leadership throughout the nursing organization
The ANCC Magnet Model's five components begin with Transformational Leadership as the foundational structural element evaluated during redesignation.
Question 6: Which type of budget variance requires IMMEDIATE action by the nurse executive?
- Favorable supply variance due to lower utilization
- Unfavorable labor variance caused by unexpected high census
- Unfavorable supply variance due to a unit-specific stockpiling practice (Correct answer)
- Favorable labor variance from reduced orientation costs
Correct answer: Unfavorable supply variance due to a unit-specific stockpiling practice
Unfavorable variances caused by controllable behavioral practices like stockpiling represent wasteful spending that can be corrected immediately through management intervention.
Question 7: A nurse executive receives a complaint that a charge nurse is consistently assigning the most difficult patients to nurses she dislikes. This represents which type of workplace issue?
- Scope of practice violation
- Horizontal workplace violence and abuse of positional power (Correct answer)
- Patient safety event requiring RCA
- Negligent supervision by the unit manager
Correct answer: Horizontal workplace violence and abuse of positional power
Using assignment authority to punish or disadvantage colleagues is a form of horizontal workplace violence that must be addressed through formal corrective processes.
Nurse Executive Test Nurse Executive Advanced 3
A nurse executive is addressing a culture of low psychological safety on a surgical unit.
Which intervention has the strongest evidence for building psychological safety?