Marquis Leadership 8e Ch 1: Decision Making, Problem Solving, and Critical Thinking:, Marquis Leadership 8e Ch 2: Introduction to Management, Marquis Leadership 8e Ch 3: Developing Leadership, Marquis Leadership 8e Ch 19 Organizational, interpersonal...

19. What is the most significant barrier to effective interpersonal communication? A) Incongruence between verbal and nonverbal messages B) Incongruence between telephone and written messages C) Incongruence between verbal and written messages D) Incongruence between telephone and nonverbal messages

Ans: A Feedback: The incongruence between verbal and nonverbal messages is the most significant barrier to effective interpersonal communication.

What does a decision grid allow the decision maker to do? A) Examine alternatives visually and compare each against the same criteria B) Quantify information C) Plot a decision over time D) Predict when events must take place to complete a project on time

Ans: A Feedback: A decision grid allows one to visually examine the alternatives and compare each against the same criteria. Although any criteria may be selected, the same criteria are used to analyze each alternative.

16. What is the definition of a standard? A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care C) Process of measuring products, practices, and services against those of best- performing organizations D) Identify not only what and how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Ans: A Feedback: A standard is a predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced. The remaining options all fail to accurately define a standard.

A transition has occurred in the twenty-first-century industrial age leadership to what type of leadership? A) Relationship age B) Quantum C) Authentic D) Thought

Ans: A Feedback: A transition has occurred in the twenty-first-century industrial age leadership to relationship age leadership. Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead, leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things.

Which represents the management functions that are incorporated into the management process? A) Planning, directing, organizing, staffing, and evaluating B) Planning, organizing, staffing, directing, and controlling C) Organizing, planning, staffing, directing, and evaluating D) Organizing, staffing, planning, implementing, and controlling

Ans: B Feedback: Management functions include planning, organizing, staffing, directing, and controlling. These are incorporated into what is known as the management process.

What type of management was emphasized in the human relations era of management? A) Participatory B) Authoritarian C) Democratic D) Laissez-faire

Ans: A Feedback: The human relations era of management science emphasized concepts of participatory and humanistic management. Three primary leadership styles have been identified: authoritarian, democratic, and laissez-faire.

What is a characteristic of a left-brain thinker? A) Creative B) Intuitive C) Analytical D) Holistic

Ans: C Feedback: Analytical, linear, left-brain thinkers process information differently from creative, intuitive, right-brain thinkers. Left-brain thinkers are typically better at processing language, logic, numbers, and sequential ordering, whereas right-brain thinkers excel at nonverbal ideation and holistic synthesizing.

4. What results from effective benchmarking? A) Two organizations become financially integrated under a capitated model B) Organizations compete for a best practices label from the National Committee for Quality Assurance (NCQA) C) An organization compares its performance with that of best-performing institutions D) Minimum practice guidelines are established for each health-care organization

Ans: C Feedback: In benchmarking, an organization compares its performance with that of best- performing institutions. Benchmarking is not associated with the other options.

Which statement is true regarding an economic man style manager? A) Lacks complete knowledge and generates few alternatives B) Makes decisions that may not be ideal but result in solutions that have an adequate outcome C) Makes most management decisions using the administrative man model of decision making D) These managers gather as much information as possible and generate many alternatives

Ans: D Feedback: Economic managers gather as much information as possible and generate many alternatives. Most management decisions are made by using the administrative man model of decision making. The administrative man never has complete knowledge and generates fewer alternatives.

What statement describes the concept of quantum leadership? A) Ability to use emotions effectively that is required by leader-managers in order to enhance their success B) In order to lead, leaders must be true to themselves and their values and act accordingly C) One individual convinces another to consider a new idea, product, or way of looking at things D) The environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity

Ans: D Feedback: Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead, leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things.

What type of manager is concerned with the day-to-day operations? A) Transactional B) Transformational C) Interactional D) Bureaucratic

Ans: A Feedback: The traditional manager, concerned with the day-to-day operations, is termed a transactional leader. This is not a characteristic of the other options.

21. How can the Internet be best used as a means of improving one's personal nursing practice? A) Accessing the latest research and best practice information B) Communicating with other health-care team members C) Minimizing the need for paper documentation D) Securing patient information for confidentially

Ans: A Feedback: As an information source, the Internet allows nurses to access the latest research and best practice information so that their care can be evidence based. The remaining options are not focused on personal nursing practice.

8. An RN is orienting a new graduate nurse to the unit and has found this individual's charting to be inadequate. What is the most appropriate statement to initiate a discussion with the new RN? A) ìTell me in your own words what you intend your charting to convey.î B) ìYour charting is non-descriptive.î C) ìDo you think a refresher course in charting would help you?î D) ìAre you having difficulty assessing your patient?î

Ans: A Feedback: Assertive communication is not rude or insensitive, nor is it passive aggressive.

21. What is the result of arriving at a consensus? A) All involved parties agree to support the way a conflict has been resolved B) A conflict is resolved by meeting the goals of all involved parties C) It resolves a conflict by an initial unanimous decision D) Conflict is resolved through the mediation process

Ans: A Feedback: Consensus means that negotiating parties reach an agreement that all parties can support, even if it does not represent everyone's first priorities. Consensus decision making does not provide complete satisfaction for everyone involved in the negotiation as an initially unanimous decision would, but it does indicate willingness by all parties to accept the agreed-upon conditions. Mediation is not a required factor in arriving at a consensus.

9. What is the most important criterion for success for health-care providers collaborate on patient care? A) Having mutual respect for one another's knowledge and expertise B) Having the skills to negotiate successfully C) Liking each other enough to want to collaborate D) Being willing to cooperate with each other

Ans: A Feedback: In collaboration, problem solving is a joint effort with no superior/subordinate relationships. Mutual respect is required for its success. While the other options identify factors that add to the collaborative process, its foundation is mutual respect.

25. Which intervention is associated with the nursing leadership role? A) Inspiring staff to establish and maintain high standards regarding patient care B) Being aware of the changes in quality control regulations C) Reviewing research results upon which to base changes D) Identifying outcomes that support quality nursing care

Ans: A Feedback: Inspiring subordinates to establish and achieve high standards of care is a leadership skill. The remaining options are management roles.

20. Considering dispute resolution, which statement is true regarding what occurs during mediation? A) It uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict B) It asks questions to clarify the issues C) It makes a final decision for the parties in conflict D) It involves presentation of evidence including that of expert witnesses

Ans: A Feedback: Mediation uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict. None of the other options accurately describes the process of mediation.

23. After a compromise has been made, what is the manager's initial action? A) Clearly restating the compromise's specific outcomes to all involved B) Thanking all involved for their cooperation on reaching the compromise C) Evaluating the compromise's outcomes for fairness to all involved parties D) Assuring all involved that the compromise will not cause a change in goals

Ans: A Feedback: Once a compromise has been reached, restate it so that everyone is clear about what has been agreed upon. A compromise by its natural requires a change in original goals. The evaluation for fairness needs to have been done prior to the compromise being agreed upon. Thanking all involved is appropriate but would not be the initial action.

17. What are the least common sources of organizational conflict? A) Communication problems B) Organizational structure C) Individual behavior within the organization D) Self-scheduling

Ans: A Feedback: Self-scheduling is not generally associated with common causes of organizational conflict. The most common sources of organizational conflict are communication problems, organizational structure, and individual behavior within the organization.

5. Which statement reflects the contemporary thinking about conflict? A) It can lead to new ideas B) It leads to decreased motivation C) It should be avoided whenever possible D) It is neither qualitative nor quantitative

Ans: A Feedback: Some level of conflict in an organization appears to be desirable since it appears to prevent organizational stagnation. None of the other options reflect contemporary thinking about conflict.

19. What are the four evidence-based standards identified by the Leapfrog Group to reduce medical errors? A) Computerized physician provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Practices scores B) Computerized physician provider order entry, evidence-based visiting nurse referral, ED physician staffing, and the use of Leapfrog Safe Practices scores C) Computerized primary care provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Medication scores D) Computerized nurse practitioner provider order entry, evidence-based outpatient referral, ED physician staffing, and the use of Leapfrog Safe Medication scores

Ans: A Feedback: The Leapfrog Group identified four evidence-based standards that they believe will provide the greatest impact on reducing medical errors: computerized physician provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Practices scores.

20. Which practice has the U.S. Food and Drug Administration suggested in order to decrease the risk of medication errors? A) Computerized order entry with a drug bar code system B) Medications automatically dispensed to patients at predetermined times C) Use of medication nurses to administer all ordered medications D) Have patients' medications kept at the bedside for self-administration

Ans: A Feedback: The U.S. Food and Drug Administration has suggested that a drug bar code system coupled with a computerized order entry system would greatly decrease the risk of medication errors.

18. What occurs when there is very little conflict in an organization? A) Stasis B) Increased productivity C) Decreased effectiveness D) Employee immobilization

Ans: A Feedback: Too little conflict results in organizational stasis and decreased productivity, whereas too much conflict reduces the organization's effectiveness and eventually immobilizes its employees.

3. Which task is a management function associated with quality control? A) Periodic evaluation of unit mission and philosophy B) Making out the daily patient care assignments C) Creating a yearly budget D) Distributing holiday staffing policies

Ans: A Feedback: Unit mission, philosophy, goals, and objectives are the blocks on which policies and standards rest. All these must be in place to measure whether quality is being achieved on the unit. The other options are not related to quality control.

16. The nurse-manager facilitates a conflict that involves the delineation of staff job descriptions. What is this an example of? A) Responsibility charting B) Smoothing conflict C) Alternate dispute resolution D) Mediation counseling

Ans: A Feedback: When a supervisor delineates job duties to persons in conflict, it is called responsibility charting. The other options are not related to job description conflict.

19. What is the name given to the first stage in the conflict process? A) Latent B) Perceived C) Felt D) Manifest

Ans: A Feedback: The first stage in the conflict process is called latent conflict, which implies the existence of antecedent conditions. Latent conflict may proceed to perceived conflict or to felt conflict. Manifest conflict may also ensue. The last stage in the process is conflict aftermath.

9. Who is involved in quality control measurement functions? Select all that apply. A) Facility staff B) Consumers C) All levels management D) Health-care professionals

Ans: A, B, C, D Feedback: Consumers, health professionals, staff, and all levels of management should be involved in quality control measurement. Community members become involved when they become health-care consumers.

15. Which statement is true regarding adverse drug events (ADEs)? A) They occur infrequently in accredited hospitals B) They are responsible for about 20% of hospitalized disabilities C) They usually involve either prescribing or pharmacy errors D) They occur because of individual recklessness

Ans: B Feedback: ADEs occur in all hospitals, are to blame for 20% of injury disabilities, and involve more than prescribing or pharmacy errors, but are rarely due to individual recklessness. They occur in both accredited and unaccredited facilities.

24. What results from the development of plan of correction associated with health-care delivery errors? A) Sentinel event B) Root cause analysis C) Quality assessment (QA) program D) Failure mode and effects analysis (FMEA)

Ans: B Feedback: Another Joint Commission priority is the development of root cause analysis with a plan of correction for the errors that do occur. A sentinel event is likely the trigger of the root cause analysis. FMEA examines all possible failures in a design including sequencing of events, actual and potential risk, points of vulnerability, and areas for improvement. QA is an ongoing process that focuses on continued delivery improvement.

17. What do clinical practice guidelines provide? A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care C) Process of measuring products, practices, and services against those of best- performing organizations D) Identify not only what and how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Ans: B Feedback: Clinical practice guidelines provide diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care and yet control resource utilization and costs. The remaining options all fail to accurately identify what a clinical practice guideline provides.

21. When working on clinical practice guidelines for a mental health unit, the nursing committee will implement which intervention initially? A) Assessing the medical psychiatric staff for practice suggestions B) Implementing a search of the literature for current related research results C) Reviewing patient satisfaction data to identify the unit's strengths and weaknesses D) In-servicing all unit nursing staff on the need to adhere to established guidelines

Ans: B Feedback: Clinical practice guidelines reflect evidence-based practice; that is, they should be based on cutting edge research and best practices. The other options may be helpful but should occur after the review of the research literature.

13. What is Consensus in negotiation referring to? A) One party wins at the expense of another B) The willingness by all parties to accept agreed-on conditions C) The most rapid conflict resolution strategies D) An unanimous decision has been reached

Ans: B Feedback: In a consensus, an agreement is found that all parties can support, or at least not oppose. The term is not used to describe any of the other options.

2. A charge nurse assists a group of personnel to resolve their conflict, with the outcome being that the two opposing goals were discarded and new goals were adopted. What is this an example of? A) Smoothing of conflict by the leader B) Facilitating collaboration among personnel C) A majority rule approach D) A good lesson in compromising

Ans: B Feedback: In collaboration, all parties set aside their original goals and work together to establish a common goal. None of the other options are examples of the described outcome.

25. Which personal characteristics will best help meet the psychological needs of conflict negotiation? A) Perseverance and assertiveness B) Calmness and self-assuredness C) Compassion and reflectiveness D) Organization and preparedness

Ans: B Feedback: Negotiation is psychological and verbal. The effective negotiator always appears calm and self-assured. The other options are not as impactful when considering the psychological aspects of the negotiation process.

24. A nurse-manager is engaged in a negotiation with staff representatives when the discussion becomes controlled by a particularly aggressive member. Which action will the nurse-manager take to assure that the process is successful? A) Asks that the aggressive individual recognize the rights of all the other members B) States, I need to have time to think over all that we have discussed. C) Halts any discussion until new representatives can be appointed D) Shares with the members that aggressiveness negatively impacts the negotiations

Ans: B Feedback: Some people win in negotiation simply by rapidly and aggressively taking over and controlling the negotiation before other members realize what is happening. If managers believe that this may be happening, they should call a halt to the negotiations before decisions are made. Saying simply, I need to have time to think this over is a good method of stopping an aggressive takeover. The other options are much less effective and may even lead to increased aggressiveness among team members.

12. What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)? A) Findings are not released to the public B) Only about half of managed care organizations have chosen to participate C) Performance indicators are process focused rather than outcome focused D) There are only 15 performance measures

Ans: B Feedback: The NCQA, a private nonprofit organization that accredits managed care organizations, has developed HEDIS. One of the most significant weaknesses of NCQA accreditation is that such accreditation is voluntary and only about half of managed care organizations currently undergo such review. The remaining options do not relate to the HEDIS

8. When is the competing approach to resolving conflict used? A) When fair play is important to all involved parties B) When one party wins at the expense of the others C) When managers need to control a volatile situation D) When an appropriate political strategy is necessary

Ans: B Feedback: The competing approach is used when one party pursues what it wants at the expense of the others. Because only one party typically wins, the competing party seeks to win regardless of the cost to others. Neither manager control nor political strategy is necessarily associated with the competing approach to resolving conflict.

4. What did the interactionist theorists of the 1970s believe about organizational conflict? A) It should be dealt with immediately B) It should be encouraged C) It was an indication of poor management D) It should be avoided

Ans: B Feedback: The interactionist movement encouraged organizations to promote conflict as a means of producing growth. The remaining options were not necessarily supported by the interactionist theorists.

6. Nursing students who scored in the top 5% on the examination studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided this type of data? A) Structure B) Process C) Outcome D) Concurrent

Ans: B Feedback: A process audit assumes that a relationship exists between the process used and the quality of the result. This is the only option that fulfills that function.

22. What is the function of an ombudsperson? A) Providing expert testimony in conflict cases B) Mediating disputes between an organization and its employees C) Educating individuals involved in a grievance situation of their rights D) Monitoring the implementation of the terms of a conflict's compromise

Ans: C Feedback: A function of an ombudsperson is to assure that those involved in a conflict understand their rights as well as the process that should be used to report and resolve the conflict. This role is not appropriately described by any of the other options.

11. Which statement best defines conflict? A) It involves an internal struggle resulting from value-related discord B) Its basis is the violation of personal rights or values C) It centers on either internal or external discord between individuals D) It is the outcome of a visible struggle between individuals

Ans: C Feedback: Conflict is generally defined as the internal or external discord that results from differences in ideas, values, or feelings between two or more people. The remaining options describe only limited aspects of conflict.

3. Which is a true statement about negotiation tactics? A) Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic B) Most managers successfully resist the illness/wellness tactic because of their nursing preparation. C) Negotiation tactics can be manipulative; thus, managers should know how to identify and counter destructive tactics D) The tactic of paternalism allows both parties in the negotiation to reach a consensus of opinion

Ans: C Feedback: Destructive negotiation tactics are never a part of a successful collaborative conflict resolution. A good manager will be alert for such tactics. None of the other options are true statements regarding negotiation tactics.

11. Which statement is true regarding criteria for assuring that a quality control program will be effective? A) The primary purpose of the program is to satisfy various federal and state standards B) Developed standards should reflect minimally acceptable levels so the organization will score well on self-assessment audits C) A belief in the importance of quality control must be integrated through all levels of the organizational hierarchy D) The process should be reactive; in other words, quality improvement efforts should be initiated after problems are identified

Ans: C Feedback: For any quality control program to be effective, a belief in the importance of quality control must be integrated through all levels of the organizational hierarchy. The remaining statements are false.

7. Which statement is true concerning perceived conflict? A) It develops during the first stage of the conflict process B) It is sometimes referred to as antecedent conflict C) It occurs if the conflict is intellectualized D) It occurs when the conflict is emotionalized

Ans: C Feedback: Perceived or substantive conflict is intellectualized and often involves issues and roles. The person recognizes it logically and impersonally as occurring. None of the other options are true statements concerning perceived conflict.

14. What is the best course of action to stimulate staff nurses' involvement in quality control research on a nursing unit? A) Hire a well-qualified researcher to help staff design studies B) Create a joint medical/nursing staff research committee C) Provide staff with paid release time for research activities D) Ensure that research designs are well grounded and scientific

Ans: C Feedback: Staff should be involved in determining criteria or standards, reviewing standards, and collecting data. To stimulate staff nurses' involvement in quality control research, the best course of action would be to provide staff with paid release time for research activities. The other options fail to actually stimulate the nurse's involvement in the process.

10. Which is a true statement regarding TQM? A) It is based on the premise that the organization knows what is best for the consumer B) Its guiding purpose is to save the organization money C) It is based on the premise that the customer is the focal element on which production and service depend D) It assumes that inspection and removal of errors lead to the delivery of quality services

Ans: C Feedback: TQM is based on the premise that the customer is the focal element on which production and service depend. The other options are false statements.

14. The nurse-manager is negotiating for the funds necessary to purchase several new isolettes for the facility's newborn nursery. The Chief Financial Officer (CFO) states, I've always been curious about that piece of equipment; how does it actually work?î What negotiation action has the CFO engaged in? A) Collaborating B) Smoothing C) A diversionary tactic D) Appropriate fact finding

Ans: C Feedback: The CFO was consciously or unconsciously using a diversionary tactic. The action described is not accurately associated with any of the other options.

8. What role has the Joint Commission assumed in ensuring quality at the organizational level? A) Establishing clinical practice guidelines B) Reducing diagnosis-related group reimbursement levels C) Standardizing clinical outcome data collection D) Assessing monetary fines for hospitals that fail to meet standards

Ans: C Feedback: The Joint Commission ensures quality at the organizational level by requiring participating organizations to choose from among 60 acceptable performance measurement systems. The Joint Commission is not actively involved in any of the other options.

1. What is the first step in quality control? A) To take corrective action when standards have not been met B) To collect data to determine whether standards have been met C) To determine criteria and standards D) To determine who will measure the standard

Ans: C Feedback: The first step in quality control is to determine criteria and standards. Measuring performance or making corrections is impossible if standards have not been clearly established.

7. What is the function of a nursing minimum data set? A) Compares the quality of nursing care and medical care B) Identifies minimal levels of quality necessary for nurses to maintain licensure C) Standardizes the collection of nursing data for use by multiple data users D) Identifies only nursing-sensitive patient outcome measures

Ans: C Feedback: The nursing minimum data set standardizes the collection of nursing data for use by multiple data users. None of the remaining options accurately describes the function of such a data set.

15. Several RNs on the unit want to address the possibility of initiating flextime on the unit. What is the manager's initial response? A) Assuring the RNs that their suggestion will be taking under consideration B) Asking the RNs to circulate a partition to be signed by employees who support the change C) Arranging for the RNs to air their views at the next staff meeting. D) Sharing with the RNs that they need to address the issue with upper management

Ans: C Feedback: This manager should plan to let employees air their views at the next staff meeting. Nursing managers can no longer afford to respond to conflict traditionally (to avoid or suppress conflict), because this is nonproductive. In an era of shrinking health-care dollars, it has become increasingly important for managers to confront and manage conflict appropriately. The ability to understand and deal with conflict appropriately is a critical leadership skill.

How many primary leadership styles have been identified? A) One B) Two C) Three D) Four

Ans: C Feedback: Three primary leadership styles have been identified: authoritarian, democratic, and laissez-faire.

5. Thirty-eight percent of the people who attended a smoking cessation clinic were not smoking 1 year after the clinic closed. What type of audit provided this type of data? A) Structure B) Process C) Outcome D) Concurrent

Ans: C Feedback: An outcome audit determines what outcomes resulted from specific nursing interventions for clients. That is the function of the remaining options.

23. What is the guiding principle when attempting to address errors made in the delivery of health care? A) Reporting of errors must be both mandatory and voluntary B) Errors are a result of faulty organizational processes C) People are the root cause of health delivery errors D) Errors are either unavoidable or result from reckless behavior

Ans: D Feedback: A just organizational culture emphasizes the finding of the middle ground between the two extremes of error cause (people or system). It seeks to separate unavoidable error from reckless behavior and unjustifiable risk. Reporting of errors can be both mandatory and voluntary but this factor has less importance than the organization attitude regarding the cause of errors.

12. What is a critical goal in negotiation? A) That gains for each party are different but equal B) That the hidden agendas of all parties be exposed C) That each party willingly reveals their negotiated limits D) That both parties perceive that they have won something they value

Ans: D Feedback: A successful negotiation leaves both parties feeling like they have gained something they want and/or value. None of the other options are considered a goal of negotiation.

18. What do the critics of prospective payment system argue? A) Diagnosis-related groups have not helped to contain rising health care costs B) The system has increased the length of hospital stay C) Services provided under this system have only slightly increased D) On the whole quality of care has declines since its implementation

Ans: D Feedback: Critics of the prospective payment system argue that although DRGs may have helped to contain rising health-care costs, the associated rapid declines in length of hospital stay and services provided have resulted in declines in the quality of care.

2. An RN is a supervisor in an organization that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. How does the RN practice TQM on the unit? A) Encouraging employees to think of a unit slogan B) Developing a quota system for number of patients cared for C) Explaining to the staff that if it's not broke, don't fix it D) Promoting teamwork rather than individual accomplishments

Ans: D Feedback: In TQM, team efforts are favored over individual accomplishments. Slogans, quota systems, and maintaining the status quo work against quality in this philosophy.

13. What is the best qualitative measurement in determining quality control for marketing? A) Morbidity and mortality rates B) Nursing care hours per patient day C) Average length of stay D) Patient surveys of general satisfaction

Ans: D Feedback: In determining quality control for marketing, the best qualitative measurement would be patient surveys. The other options are not necessarily qualitative measurements.

6. What term is used when two or more people have conflict about values or goals? A) Intergroup conflict B) Common control C) Intrapersonal conflict D) Interpersonal conflict

Ans: D Feedback: Interpersonal conflict happens between two or more people with differing values, goals, and beliefs. No other option is used to describe this situation.

10. A registered nurse reports to the nurse-manager that the team's nursing assistant regularly fails to complete assigned tasks. The nurse-manager responds that it is the nurse's responsibility to talk with the nursing assistant about this problem. The manager is engaged in what aspect of conflict? A) Conflict avoidance B) Conflict smoothing C) Encouraging competitive conflict D) Facilitating conflict resolution

Ans: D Feedback: Managers should not intervene in every conflict, but should urge subordinates to handle their own problems. This is an example of supporting conflict resolution. The action of the manager is not reflective of any of the other options.

22. Which statement is true regarding the factors that impact patient satisfaction with a hospitalization? A) The quality of care delivered is the primary factor related to B) The patient's understanding of his/her condition influences satisfaction C) The length of the hospital stay is the deciding influence on satisfaction D) The patient's satisfaction has little to do with actual health improvement

Ans: D Feedback: Patient satisfaction often has little to do with whether a patient's health improved during a hospital stay. It is important to remember that quality care, length of stay, and patient perception do not always equate with patient satisfaction.

What effect of organizational power on decision making is often reflected in the tendency of staff? A) Making decisions independent of organizational values B) Not trusting others to decide C) Desiring personal power D) Having private beliefs that are separate from corporate ones

Ans: D Feedback: The ability of the powerful to influence individual decision making in an organization often requires adopting a private personality and an organizational personality.

1. Which action is an accepted tactic when engaged in a negotiation? A) Being willing to win at any cost B) Communicating only when asked direct questions C) Compromising only as a last resort D) Beginning with a high but realistic expectation

Ans: D Feedback: The selected starting point in negotiations should be at the upper limits of the negotiator's expectations, within reason. However, negotiators must realize they may have to come down to a lesser goal. The other options are not reflective of accepted tactics used in successful negotiations.

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when analyzing data rationally before making decisions? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) Self-awareness

Ans: A Feedback: Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guide his/her behavior. Relational transparency refers to openly sharing feelings and information appropriate to a situation, and self-awareness alludes to a knowing of self so as to make sense of the world.

What does the Hawthorne effect implied about people? A) Human beings under investigation will respond to the fact that they are being studied B) Production will increase or decrease as light in a factory is increased or decreased C) Membership in small groups forms social control D) People are inherently good and will seek out work

Ans: A Feedback: Hawthorne effect indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. The other statements do not reflect implied beliefs about people.

10. Which statement describes the informal communication referred to as ìthe grapevine? A) Most personnel engaging in the unofficial exchange of information. B) Information exchange is initiated by subordinates and directed upward C) Information is conveyed unofficially by administration through department heads D) The exchange of information initiated by someone in a staff position to someone in a line position

Ans: A Feedback: Informal communication through the ìgrapevineî occurs when most personnel are involved in the unofficial exchange of information. This process is not accurately described by any of the other options.

Which leadership style maintains strong control over the work group and uses coercion to motivate others? A) Authoritarian B) Democratic C) Laissez-faire D) A contingency approach

Ans: A Feedback: Lewin identified three common leadership styles: authoritarian, democratic, and laissezfaire. Authoritarian leadership results in well-defined group actions that are usually predictable, reducing frustration in the work group and giving members a feeling of security. Productivity is usually high, but creativity, self-motivation, and autonomy are reduced. Authoritarian leadership is frequently found in very large bureaucracies such as the armed forces. Coercion to motivate is not associated with the other options.

What statement regarding management decision-making aides is true? A) They are subject to human error B) They ensure good decision making C) They eliminate uncertainty and risk D) They tend to save management time

Ans: A Feedback: Management decision-making aides are subject to human error. Some of these aides encourage analytical thinking, others are designed to increase intuitive reasoning, and a few encourage the use of both hemispheres of the brain. Despite the helpfulness of these tools, there is a strong tendency for managers to favor first impressions when making a decision, and a second tendency, called confirmation biases, often follows.

What is heuristics? A) Discrete, unconscious process to allow individuals to solve problems quickly B) Set of rules to encourage learners to discover solutions for themselves C) Formal process and structure in the decision-making process D) Trial-and-error method or rules-of-thumb approach

Ans: A Feedback: Most individuals rely on discrete, often unconscious processes known as heuristics, which allows them to solve problems more quickly and to build upon experiences they have gained in their lives. Thus, heuristics use trial-and-error methods or a rules-ofthumb approach, rather than set rules, and in doing so, encourages learners to discover solutions for themselves.

Goleman in his best seller Emotional Intelligence identifies self-awareness as one of the five components of emotional intelligence. What is self-awareness? A) The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others B) The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment C) A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment D) The ability to understand and accept the emotional makeup of other people

Ans: A Feedback: Self-awareness: The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people.

Which activity supports the principles of strengths-based leadership? A) Tuition reimbursement for LPN to RN transition programs B) Rehab services to staff diagnosed with abuse problems C) Mental health counseling for depression and anxiety D) Smoking cessation support classes

Ans: A Feedback: Strengths-based leadership, which grew out of the positive psychology movement (began in the late 1990s), focuses on the development or empowerment of workers' strengths as opposed to identifying problems, improving underperformance, and addressing weaknesses and obstacles.

What is the basic premise of the interactional theory? A) Leadership behavior is generally determined by the relationship between the leader's personality and the specific situation B) Manager behaviors are generally determined by the relationship between the manager's personality and the specific situation. C) Both managers and followers have the ability to raise each other to higher levels of motivation and morality. D) Both leaders and followers have the ability to raise each other to higher levels of motivation and morality.

Ans: A Feedback: The basic premise of interactional theory is that leadership behavior is generally determined by the relationship between the leader's personality and the specific situation. Transformational leadership is where both leaders and followers have the ability to raise each other to higher levels of motivation and morality.

Which statement by a subordinate demonstrates the greatest problem for the leader? A) ìYour plans for the changes will be difficult to implement.î B) ìI don't think you heard what the rest of us had to say.î C) ìDo you have an idea what direction we need to go?î D) ìCan you tell me why my suggestion will not work?î

Ans: A Feedback: The statement is a clear indication that the subordinate feels the leader is not listening and collaborating; this is a fatal flaw. The other statements are more open to explanation by and with the subordinate and leader.

What is the conclusion of interactional theories regarding successful leadership? A) Leaders, followers, and the situation were all variables that interacted B) The situation had the most profound effect on success in leadership C) The situation has a greater effect on outcomes than followers do D) Good results would occur if leaders led well

Ans: A Feedback: The successful leader will diagnose the situation before applying strategies from a large repertoire of skills that involve assessing the various variables presented by the leader, the followers and the situation. The remaining options are not related to interactional leadership theory.

What is a weakness of the traditional problem-solving model? A) Its need for implementation time B) Its lack of a step requiring evaluation of results C) Its failure to gather sufficient data D) Its failure to evaluate alternatives

Ans: A Feedback: The traditional problem-solving model is less effective when time constraints are a consideration. Decision making can occur without the full analysis required in problem solving. Because problem solving attempts to identify the root problem in situations, much time and energy are spent on identifying the real problem.

Which situation is characteristic of the weakness of the nursing process? A) The frequent absence of well-written patience-focused objectives B) The confusion created by the existence of numerous nursing diagnoses C) The ever-increasing need for effective assessment skills required of the nurse D) The amount of nursing staff required to implement the patients' plans of care

Ans: A Feedback: The weakness of the nursing process, like the traditional problem-solving model, is in not requiring clearly stated objectives. Goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured. While the remaining options relate to the nursing process, they are not directly a result of the process itself.

Which principle will help increase the likelihood that followers do not mislead their leader? A) Support the followers' right to disagree B) Rely only on facts and discount intuition C) Discourage acceptance until the facts are proved D) Identify who to rely upon and who not to listen to

Ans: A Feedback: There is no guarantee that followers will not mislead leaders, but adhering to certain principles, such as making sure that followers are allowed to disagree, will guard against this happening. The remaining options are flawed in the principles they support.

What concept is servant leadership based upon? A) Trusting and valuing employees B) Genuinely liking your colleagues C) A laissez-faire style of leadership D) A dynamic leadership charisma

Ans: A Feedback: These managers, termed servant leaders, put serving others, including employees, customers, and the community, as the number-one priority. In addition, servant leaders foster a service inclination in others that promotes collaboration, teamwork, and collective activism. The servant leader is not necessarily associated with the concepts identified in the other options.

What is a focus of thought leadership? A) Challenging the status quo B) Learning new technology C) Keeping up with current nursing knowledge D) Being a transformational leader

Ans: A Feedback: Thought leadership applies to a person who is recognized among his or her peers for innovative ideas and who demonstrates the confidence to promote those ideas. Thus, thought leadership refers to any situation in which one individual convinces another to consider a new idea, product, or way of looking at things. None of the other options is a focus of thought leadership.

2. When does communication have the greatest likelihood of being accurately interpreted? A) More than one mode is used B) Face-to-face communication is used C) Written communication is used D) The sender repeats the message using the same mode

Ans: A Feedback: Using various communication methods in combination increases the likelihood that everyone in the organization who needs to hear the message actually will hear it. The other options are single methods.

What is the best definition of decision making? A) The planning process of management B) The evaluation phase of the executive role C) One step in the problem-solving process D) Required to justify the need for scarce items

Ans: C Feedback: Decision making is a complex, cognitive process often defined as choosing a particular course of action. Decision making, one step in the problem-solving process, is an important task that relies heavily on critical thinking and clinical reasoning skills.

Which statement demonstrates a characteristic of a critical thinker? Select all that apply. A) ìSince that didn't work effectively, let's try something different.î B) ìThe solution has to be something the patient is willing to do.î C) ìI'll talk to the patient's primary care giver about the problem.î D) ìMaybe there is no new solution to this particular problem.î

Ans: A, B, C Feedback: A critical thinker displays persistence, empathy, and assertiveness. The remaining options reflect limited thinking and an inability to think outside the box.

What is the typical focus of managers? Select all that apply. A) Establishing a legitimate source of power B) Delegating responsibilities to staff members C) Formulate the budget to achieve the stated goals D) Direct attention to the management of unwilling subordinates

Ans: A, B, C Feedback: The manager is typically involved in the delegation of responsibilities through the power of the legitimate power associated with the position. To manipulate people, the environment, money, time, and other resources to achieve organizational goals is also a manager's focus. Attention to both willing and unwilling subordinates as well as established responsibilities is associated with the role of the manager.

The failure to engage in which activity is considered a fatal flaw of leadership? Select all that apply. A) Collaboration B) Communication C) Self-improvement D) Staff development

Ans: A, B, C, D Feedback: Leadership is flawed and likely ineffective when the leader does not collaborate and communicate effectively with others in the organization. The improvement and development of both others and oneself is vital to the effectiveness of a leader. Clear forward thinking is associated with good leadership.

Which activity is associated with a leadership role? Select all that apply. A) Mentoring two new managers B) Establishing goals for the coming year C) Advocating for employee regarding personal policies D) Providing a motivational speech at the new employee orientation

Ans: A, B, C, D Feedback: Leadership roles include mentoring, decision making, advocating, andenergizing. Risk taking is also considered a leadership role.

Which action is associated with relationship age leadership? Select all that apply. A) Communicates regularly with subordinates B) Encourages teamwork to achieve problem solving C) Includes committee representatives from all areas that will be affected by the change D) Recognizes staff members who have contributed plausible problem-solving solutions

Ans: A, B, C, D Feedback: People skills, cooperation, and valuing staff knowledge are all characteristics of the relationship age leader. Focus on fact gathering rather than finding the meaning of the data is characteristic of an industrial age leader.

A manager demonstrating an understanding of the principles of Human Capital theory will schedule which staff in-service? Select all that apply. A) Effective communication skills B) Financial planning for retirement C) Advanced cardiopulmonary resuscitation D) Meeting the needs of the patient's family

Ans: A, C, D Feedback: Human capital can refer to a group's collective knowledge, skills, and abilities. Human capital theory suggests that individuals and/or organizations will invest in education and professional development if they believe that such an investment will have a future payoff. Communication, meeting family needs, and cardiopulmonary resuscitation are all skills and abilities that will enhance the individual's professional development and ultimately the services of the facility. The other options are related to the personal interests of the staff.

Which characteristics are associated with Collin's Highly Capable Individual level of leadership? Select all that apply. A) Possesses useful knowledge B) Builds effective interdisciplinary teams C) Galvanizes members to achieve goals D) Demonstrates effective organization skills

Ans: A, D Feedback: Level 1: Highly capable individual makes high quality contributions with their work; possesses useful levels of knowledge; and has the talent and skills needed to do a good job. Team building is a Level 2 characteristic. Organizational skills are associated with Level 3 while galvanizing members to achieve goals is demonstrated by Level 4 leaders.

If decision making is triggered by a problem with what does it end? A) An alternative problem B) A chosen course of action C) An action that guarantees success D) A restatement of the solution

Ans: B Feedback: A decision is made when a course of action has been chosen. Problem solving is part of decision making and is a systematic process that focuses on analyzing a difficult situation. Problem solving always includes a decision-making step.

Which response is characteristic of a servant leader? A) ìI don't think you have the skills necessary to be effective.î B) ìLet me think about that request for 24 hours.î C) ìDo whatever it takes to get it done fast.î D) ìI'll personal handle this situation.î

Ans: B Feedback: A servant leader always thinks before reacting. This leader also chooses words carefully so as to not damage those being led, provides directions toward goal achievement, and finds asking for input more important than personally providing solutions.

What is the value of using a structured approach to problem solving for the novice nurse? A) Facilitates effective time management B) Supports the acquisition of clinical reasoning C) Supplements the orientation process D) Encourages professional autonomy

Ans: B Feedback: A structured approach to problem solving and decision making increases clinical reasoning and is the best way to learn how to make quality decisions because it eliminates trial and error and focuses the learning on a proven process. This is particularly helpful to the novice nurse with limited clinical experience and intuition. The other options are outcomes of the possession of critical thinking skills and clinical reasoning.

3. Which statement concerning nonverbal communication is true? A) It is consistent across cultures B) It is given more credence than verbal communication when the two are incongruent C) It should be minimized because it confuses the receiver regarding the true intent of the message D) It is a significant part of the communication exchange only when it is not congruent with the verbal exchange

Ans: B Feedback: Because nonverbal communication indicates the emotional component of the message, it is generally considered more reliable than verbal communication. None of the remaining options present true statements regarding nonverbal communication.

Which is a characteristic of Theory Z? A) Non-consensus decision making B) Fitting employees to their jobs C) Rapid career promotions D) Authoritative problem solving

Ans: B Feedback: Characteristics of Theory Z include fitting employees to their jobs, consensus decision making, job security, slower promotions, examining the long-term consequences of management decision making, quality circles, guarantee of lifetime employment, establishment of strong bonds of responsibility between superiors and subordinates, and a holistic concern for the workers.

What does traditional management science focuses upon? A) Meeting worker satisfaction B) Delineating barriers to productivity C) Using a laissez-faire approach D) Encouraging employee participation

Ans: B Feedback: Classical, or traditional, management science focuses on production in the workplace and on delineating organizational barriers to productivity. Little attention was given to worker job satisfaction, and workers were assumed to be motivated solely by economic rewards.

What is an example of a positive outcome of a leader's emotional intelligence? A) Emotions are held in check B) Emotions are used effectively C) Expression of one's emotions is expected D) Expression of one's emotions is encouraged

Ans: B Feedback: Emotional intelligence refers to the ability to use emotions effectively and is required by leader-managers in order to enhance their success. Holding one's emotions in check can be unhealthy. The remaining options do not address the usefulness of emotions.

What does knowledge about good decision making lead one to believe? A) Good decision makers are usually right-brain, intuitive thinkers B) Effective decision makers are sensitive to the situation and to others C) Good decisions are usually made by left-brain, logical thinkers D) Good decision making requires analytical rather than creative processes

Ans: B Feedback: Good decision makers seem to have antennae that make them particularly sensitive to other people and situations. Left-brain thinkers are typically better at processing language, logic, numbers, and sequential ordering, whereas right-brain thinkers excel at nonverbal ideation and holistic synthesizing.

6. Which behaviors would be associated with a group in the ìnormingî stage? A) Group members actively attempt to impress each other with their credentials B) Group members establish short- and long-term goals for the group to accomplish C) Group members achieve stated goals D) The group terminates and celebrates its accomplishments

Ans: B Feedback: In the norming stage, consensus evolves as group cohesion develops. This is the only option that describes a behavior associated with a group's norming stage.

Which statement regarding the characteristics of a good leader is true? A) They are totally trustworthy B) They may have character flaws C) They are by nature good intentioned D) Charisma is their strongest attribute

Ans: B Feedback: Leaders may be deceitful and trustworthy, greedy and generous, and cowardly and brave. To assume that all good leaders are good people is foolhardy and makes us blind to the human condition. It is only when we recognize and manage our failings that leaders achieve greatness.

How do administrative man managers make the majority of their decisions? A) After gathering all the facts B) In a manner good enough to solve the problem C) In a rational, logical manner D) After generating all the alternatives possible

Ans: B Feedback: Many managers make decisions that are just ìgood enoughî because of lack of time, energy, or creativity to generate a number of alternatives. This is also called ìsatisficing.î Most people make decisions too quickly and fail to systematically examine a problem or its alternatives for solution.

Which statement concerning the role of the powerful in organizational decision making is true? A) They exert little influence on decisions that are made B) They make decisions made that are in congruence with their own values C) They allow others to make the decisions however they wish D) They make all the important decisions with consideration to others

Ans: B Feedback: Not only does the preference of the powerful influence decisions of others in the organization, but the powerful are also able to inhibit the preferences of the less powerful. Powerful people in organizations are more likely to have decisions made that are congruent with their own preferences and values.

5. The hospital is facing low census and downsizing. However, the RNs have been assured that everyone on the unit will keep their jobs and downsizing will occur through normal attrition and voluntary absences without pay. Today, the evening charge nurse reported that last evening the staff was discussing various rumors about mass layoffs. What is the best approach to take? A) Tell an informal leader on the evening shift the truth and let the leader spread the news informally B) Hold a meeting for all staff members and tell them that the rumor is not true C) Ignore the rumor because it will soon pass D) Find out who started the rumor and correct the information

Ans: B Feedback: Nurse-leaders should intervene appropriately when communication problems (in this case, rumors) arise. The remaining options fail to fulfill that responsibility as effectively as the correct option does.

20. Which method best provides a structured orderly approach to communicating accurate, relevant information, in emergent patient situations as well as routine handoffs? A) GRRRR listening model B) SBAR tool C) Hospital information system D) Wireless, local area networking

Ans: B Feedback: SBAR provides a structured, orderly approach to provide accurate, relevant information, in emergent patient situations as well as routine handoffs. The other options are not as focused on providing information in all the described situations.

Which problem-solving learning strategy provides the learner with the most realistic, risk-free learning environment? A) Case studies B) Simulation C) Problem-based learning (PBL) D) Grand rounds

Ans: B Feedback: Simulation provides learners opportunities for problem solving that have little or no risk to patients or to organizational performance while providing models, either mechanical or live, to provide experiences for the learner. While the other options provide learning opportunities that include problem solving, simulation is the most realistic while also being low risk.

23. Which nursing action demonstrates compliance with the American Nurses Association (ANA) principles for social networking by nurses? A) Strictly avoiding the use of social networking in a professional setting B) Participating in the development of institutional policies governing online conduct C) Ignoring any information that appears to have the potential to harm a patient's welfare D) Realizing that social networking is not related to a nurse's professional boundaries

Ans: B Feedback: The ANA has developed principles for social networking that include participation in policy development, nurse patient boundaries, separating personal and professional online information, and reporting to authorities when patient welfare has been potentially harmed.

22. Which behavior by a team member is demonstrated through cynicism and a nonchalance attitude about the group's work? A) Blocker B) Playboy C) Dominator D) Recognition seeker

Ans: B Feedback: The playboy remains uninvolved and demonstrates cynicism, nonchalance, or horseplay. The blocker persists in expressing negative points of view and resurrecting dead issues. The dominator attempts to control and manipulate the group while the recognition seeker works to focus positive attention on himself.

What assumption about workers does Theory X hold? A) Workers will naturally put forth effort B) Workers need threats to be motivated C) Workers are diligent and responsible D) Workers are in tune with organizational needs

Ans: B Feedback: Theory X managers believe that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs.

What type of leader is the person who is committed, has a vision, and is able to empower others with this vision? A) Transactional B) Transformational C) Interactional D) Bureaucratic

Ans: B Feedback: Transformational leadership positively impacts the leader and the follower, who have a collective purpose. The traditional manager, concerned with the day-to-day operations, was termed a transactional leader. The remaining options are not associated with these characteristics.

Which of the following statements is true regarding decision making? A) Scientific methods provide identical decisions by different individuals for the same problems B) Decisions are greatly influenced by each person's value system C) Personal beliefs can be adjusted for when the scientific approach to problem solving is used D) Past experience has little to do with the quality of the decision

Ans: B Feedback: Values, life experience, individual preference, and individual ways of thinking will influence a person's decision making. No matter how objective the criteria will be, value judgments will always play a part in a person's decision making, either consciously or subconsciously.

Shirey suggests there are five distinguishing characteristics of authentic leaders. Which characteristic is occurring when authentic leaders link between purpose and passion by having congruence in beliefs and actions? A) Purpose B) Values C) Heart D) Relationships

Ans: B Feedback: Values: Authentic leaders link between purpose and passion by having congruence in beliefs and actions. Purpose: Authentic leaders understand their own purposes and passions as a result of ongoing self-reflection and self-awareness. Heart: Authentic leaders care for themselves and the people they lead, and their compassion is genuine. Relationships: Authentic leaders value building relationships and establishing connections with others, not to receive rewards but rather to strengthen the human connection.

Max Weber, a well-known German sociologist, began to study large-scale organizations to determine what made some more efficient than others. What was his conclusion? A) Workers had to have a say in management to work most effectively B) Consistent rules and regulations for workers increased efficiency C) Employees should feel appreciated and valued D) Workers need frequent rest periods to increase overall production

Ans: B Feedback: Weber saw the need for legalized, formal authority and consistent rules and regulations for personnel in different positions. He thus proposed bureaucracy as an organizational design. None of the other options reflect his conclusions.

16. What is the traditional form of communication in organizations that helps to coordinate activities in various levels of the hierarchy? A) Upward B) Downward C) Horizontal D) Diagonal

Ans: B Feedback: In downward communication, the manager relays information to subordinates. This is a traditional form of communication in organizations and helps to coordinate activities in various levels of the hierarchy. The other forms are not as effective as the various levels of an organization's hierarchy.

What is a distinguishing trait of integrated leader-managers? Select all that apply. A) Inward thinkers B) Long-term thinkers C) Concerned with employee motivation D) Possess influence beyond their own group

Ans: B, C, D Feedback: Gardner asserted that integrated leader-managers possess six distinguishing traits: They influence others beyond their own group; they emphasize vision, values, and motivation; they think longer term; they look outward, toward the larger organization they are politically astute; they think in terms of change and renewal.

Which statement depicts leadership? A) A leadership position is assigned B) A leadership position carries a legitimate source of power C) Members of a group will follow a person in a leadership position only by choice D) Leadership requires meeting organizational goals

Ans: C Feedback: A leader is the person who guides direction, opinion, and course of action without having an assigned position within the formal organization and so people choose to follow them. The other options are not accurate descriptions of leadership.

7. Which statement describes assertive communication? A) It makes you respect yourself and allows you to get what you want B) Although it is unfeminine, it is a necessary communication skill for female managers C) It involves rights and responsibilities for all parties in the communication D) Assertive communication will never offend anyone

Ans: C Feedback: Assertive communication allows people to express themselves in direct, honest, and appropriate ways that do not infringe on another's rights. The remaining statements do not correctly describe assertive communication.

9. The RN overhears the nurses' aide speaking in a harsh tone to Mrs. Smith, who has some early Alzheimer's memory loss. Which statement will the RN make to begin addressing this issue? A) ìYou must remember to watch your tone of voice with patients. Someone might overhear.î B) ìDo you think it would be a good idea to have an in-service on dealing with Alzheimer's patients?î C) ìI am concerned about your conversation with Mrs. Smith. It seemed short and impatient.î D) ìI have decided to reassign Mrs. Smith to another aide.î

Ans: C Feedback: Assertive communication effectively identifies and addresses an issue without being rude, insensitive, or passive aggressive. None of the remaining options actually identifies the communication problem.

15. What location of the SBAR charting tool states the patient's problem? A) Situation B) Background C) Assessment D) Recommendation

Ans: C Feedback: Assessment is where the nurse states the patient's problem. The problem is not documented in any of the other SBAR locations.

A manager has proposed to the hospital board that it hires someone to teach management and leadership classes and that head nurses are paid to attend the classes. What is this an example of? A) Using emotional intelligence B) Transformational leadership C) Building human capital D) Using quantum leadership

Ans: C Feedback: By providing classes in leadership, the manager is investing in the potential of the head nurse staff to become better leaders and managers. Human capital refers to the attributes of a person that are productive in some economic context, although it is normally measured and conceived of as a private return to the individual as well as a social return. None of the remaining options relate to the example provided.

Which statement is true concerning critical thinking? A) It is a simple approach to decision making B) It is narrower in scope than decision making C) It requires reasoning and creative analysis D) It is a synonym for the problem-solving process

Ans: C Feedback: Critical thinking has a broader scope than decision making and problem solving. It is sometimes referred to as reflective thinking. Critical thinking also involves reflecting upon the meaning of statements, examining the offered evidence and reasoning, and forming judgments about facts.

What statement is true regarding decision making? A) It is an analysis of a situation B) It is closely related to evaluation C) It involves choosing between courses of action D) It is dependent upon finding the cause of a problem

Ans: C Feedback: Decision making is a complex cognitive process often defined as choosing a particular course of action. Problem solving is part of decision making and is a systematic process that focuses on analyzing a difficult situation. Critical thinking, sometimes referred to as reflective thinking, is related to evaluation and has a broader scope than decision making and problem solving.

Managing conflict among staff members would occur in which part of the management process? A) Planning B) Organizing C) Directing D) Evaluating

Ans: C Feedback: Directing sometimes includes several staffing functions. However, this phase's functions usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals.

What concept does early leadership-theory development suggest? A) Leadership is a process of influencing others within an organizational culture B) The interactive relationship between the leader and the follower is significant C) Some are born to lead, whereas others are born to be led D) Vision and empowerment are two of the most critical leadership skills

Ans: C Feedback: Early leadership theorists focused on broad conceptualizations of leadership that assumed that people have certain characteristics or personality traits that make them better leaders than others. The remaining options do not describe a concept suggested by early leadership-theory development.

What type of brain dominance creates a management style that is highly organized and detail oriented? A) Upper left brain B) Upper right brain C) Lower left brain D) Lower right brain

Ans: C Feedback: Individuals with lower-left-brain dominance are highly organized and detail oriented and individuals with upper-left-brain dominance truly are analytical thinkers who like working with factual data and numbers. These individuals deal with problems in a logical and rational way. Individuals with upper-right-brain dominance are big picture thinkers who look for hidden possibilities and are futuristic in their thinking. Individuals with lower-right-brain dominance experience facts and problem solve in a more emotional way than the other three types.

14. What is important to remember about gender differences in communication? A) Men are more collaborative communicators B) It rarely impacts nursing care C) It affects the quality of organization communication D) Women are more competitive communicators

Ans: C Feedback: Men are usually more competitive and less collaborative than women in their communication patterns, and differences often impact the quality of organization communication.

What is the advantage of using a payoff table when applicable? A) It assures the correct decision when dealing with financial situations B) It is very helpful when quantitative information about the topic is available C) It assists in the visualization of the available historic and current data D) It is easy to construct even for the novice decision maker

Ans: C Feedback: Payoff tables do not guarantee that a correct decision will be made, but they assist in visualizing data. While it does lend itself to the use of quantitative data that are not its strength, the table may not be difficult to construct that is not its strength since it is dependent on the inclusion of accurate data and effective evaluation of that data.

To decrease overtime, the manager of a surgical unit offers nurses who get their work finished on time for an entire 2-month period an extra day off with pay at regular time. What is this an example of? A) Bribing nurses B) Quantum leadership C) Principal agent theory D) Servant leadership

Ans: C Feedback: Principal agent theory suggests that followers may have an informational (expertise or knowledge) advantage over the leader as well as their own preferences, which may deviate from that of the principal. This may lead to a misalignment of goals. To influence the agent, the principal offers an incentive that corrects excessive overtime. The remaining options do not represent the example offered.

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when one openly shares feelings and information appropriate to a situation? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) Self-awareness

Ans: C Feedback: Relational transparency refers to openly sharing feelings and information appropriate to a situation. Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guide his/her behavior, and self-awareness alludes to a knowing of self so as to make sense of the world.

17. What portion of GRRRR (greeting, respectful listening, review, recommend or request more information, and reward) is being used when the speaker summarizes the information conveyed to make sure the message was understood correctly? A) Greeting B) Respectful listening C) Review D) Recommend or request more information

Ans: C Feedback: Review occurs when the speaker summarizes the information he/she has conveyed to make sure the message was understood correctly. Once the speaker is finished conveying this summary and the other party has validated or clarified it, the listener has enough information to recommend or request more information. This does not occur in any of the other portions of the model.

How many characteristics such as servant leadership does Tabaka suggest is required of an agile organization today? A) 1 B) 5 C) 10 D) 15

Ans: C Feedback: Tabaka suggests that servant leadership is one of the top 10 characteristics of an agile organization today.

1. What is the best combination that characterizes the communication process? A) Sender receiver message B) Receiver message sender C) Sender message receiver D) Message sender receiver

Ans: C Feedback: The combination that best characterizes the communication process is sender message receiver. The other options would result in the likelihood of miscommunication.

12. Regarding group building, what is the responsibility of the gatekeeper? A) Mediating, harmonizing, and resolving conflict B) Accepting and praising the contributions and viewpoints of group members C) Facilitating and promoting open communication of all group members D) Recording the group's process and providing feedback to the group

Ans: C Feedback: The gatekeeper makes sure all voices in the group are heard in order to facilitate and promote open communication. The role of gatekeeper is not accurately described by any of the other options.

What influences the quality of a decision most often? A) The decision maker's immediate superior B) The type of decision that needs to be made C) Questions asked and alternatives generated D) The time of day the decision is made

Ans: C Feedback: The greater the number of alternatives that can be generated by the decision maker, the better the final decision will be. The alternatives generated and the final choices are limited by each person's value system.

4. An RN is a team leader for a small module of patients. While listening to a tape- recorded report on Mr. Smith, one of your team members remarks, ìMy mother lives near him and she says his wife is a terrible housekeeper.î As the leader of the team, what will the RN do? A) Ask the informant to be quiet B) Include the information in report for the next shift C) Ask the team member what the purpose was in sharing the information D) Ignore the comment

Ans: C Feedback: The role of the leader is to encourage communication that is appropriate and discourage communication that is inappropriate among staff. The other options fail to convey that responsibility.

What is the critical leadership skill when attempting to build a cooperative and effective team? A) Showing their true feelings B) Empathizing with followers C) Identifying existing emotions in themselves and others D) Manipulating the emotions of all involved to achieve stated goals

Ans: C Feedback: Theorists studying emotional intelligence posit that the ability to identify emotions in themselves and in others is a critical ingredient of leaders, enabling them to build a cooperative and effective team. While the other options may have value, they do not represent the critical skill related to team building.

It is the idea that context is an important mediator of transformational leadership, that led to the creation of full range leadership theory early in the 21st century. This theory originally developed by Antonakis, Avolio, and Sivasubramaniam suggests how many transformational factors impacting leadership style and its impact on followers? A) One B) Three C) Five D) Nine

Ans: C Feedback: There are nine factors impacting leadership style and its impact on followers; five are transformational, three are transactional, and one is a nonleadership or laissez-faire leadership factor.

Gardner states that integrated leaders-managers distinguish themselves from more traditional managers in six ways. Which is a distinguishing trait of a traditional manager rather than an integrated leader-manager? A) They are politically astute B) They look outward, toward the larger organization C) They extend influence only to their own group D) They emphasize vision, values, and motivation

Ans: C Feedback: Traditional managers influence those in their own groups while integrated leaders influence others beyond their own group. The remaining options represent traits that may be shared by both types.

24. Which vocal delivery suggests that a person is asking a question rather than making a statement? A) Loudness B) Slurred words C) Tentativeness D) Rapid delivery

Ans: C Feedback: Vocal clues such as tone, volume, and inflection add to the message being transmitted. Tentative statements sound more like questions than statements, leading listeners to think that you are unsure of yourself, and speaking quickly may be interpreted as being nervous. Loud and slurred speech can be barriers to communication.

18. What communication mode is considered most reliable in conveying the emotional component of the message? A) Written B) Verbal C) Nonverbal D) Telephone

Ans: C Feedback: Nonverbal communication is considered more reliable because it conveys the emotional part of the message. The other modes are not as effective with conveying emotion.

There are current and future paradigm shifts in health care that affect the leadership skills needed by nurses in the twenty-first century. What issue at the organizational and unit levels are nurse-leaders being directed to address? A) Active involvement in greatly needed health-care reform B) Persistent and growing international nursing shortage C) Shortage of qualified first-level nursing managers D) High turnover rates by staff nurses

Ans: D Feedback: At the organizational and unit levels, nurse-leaders are being directed to address high turnover rates by staff, an emerging shortage of qualified top-level nursing administrators, growing trends toward unionization, and intensified efforts to legislate minimum staffing ratios and eliminate mandatory overtime, while maintaining cohesive and productive work environments. At the national level, nurse-leaders and nursemanagers are actively involved in greatly needed health-care reform and in addressing a persistent, and likely growing, international nursing shortage. The other options, while describing noteworthy issues, do not include the issue that affects needed skills.

13. What statement about the maintenance of confidentiality is true? A) It must never be breached B) It is made easier with electronic technology C) It is primarily the duty of the medical records staff D) It can be breached when necessary for legitimate professional need

Ans: D Feedback: Confidentiality of patients must be upheld, unless there is a legitimate professional need to know, such as when a provider must share information about a patient with another provider so that the other provider can assume care. None of the other options is an accurate statement regarding confidentiality.

Which function of the management process involves the performance evaluation of staff? A) Planning B) Organizing C) Staffing D) Controlling

Ans: D Feedback: Controlling is the function that includes performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control.

Which statement concerning nursing leadership functioning at its potential is true? A) The leadership role is most important in nursing today B) Leadership is most important in managing health-care costs C) The most important nursing leadership role is being charismatic D) There is a need to integrate nursing management and nursing leadership

Ans: D Feedback: For managers and leaders to function at their greatest potential, the two roles must be integrated. The other statements are not true.

What is the idea that workers should be hired, trained, and promoted based on their competence and abilities related to? A) Part of the management functions identified by Fayol B) The result of the human relations studies C) The outcome of studies done by Mayo at the Hawthorne Works D) One of the four overriding principles of scientific management

Ans: D Feedback: Frederick Taylor, the ìfather of scientific management,î had the idea that workers should be hired, trained, and promoted based on their competence and abilities. This concept is not associated with any of the other options.

11. Which statement regarding a memo is true? A) A memo makes it main point at least twice B) A memo is written using an authoritative format C) Headings are not used in a memo to avoid confusing the reader D) Only essential information is included in a memo

Ans: D Feedback: Only essential information is included in a memo since extraneous information will detract from the message. None of the other options presents correct information concerning a memo.

An organization has hired six RNs who have recently immigrated to the United States. The manager has noticed they interact very little with other staff, often speaking in their own language during their breaks, although they speak English while on duty. Which intervention would be the most helpful action for the manager to help these new RNs better assimilate? A) Explain to the new nurses the problem that their isolating is causing. B) Arrange to send them to an English language course at the local adult school. C) Ask the established RNs to make an effort to include the new nurses in after-work activities. D) Begin a short sharing session before client report, so all RNs can share information about their cultures and differences in client care.

Ans: D Feedback: Providing an opportunity for both groups of nurses to share their cultural heritage and differences in nursing care is an opportunity to promote acceptance among all members of the staff. It has been established that speaking the language is not a problem since they do so while on duty. Including them in after-work activities may demonstrate willingness on the staff's part but will not address work-related isolation. Merely presenting the problem to the new nurses does not show managing initiative.

Goleman in his best seller Emotional Intelligence built upon work in his identification of five components of emotional intelligence. Which component of emotional intelligence is occurring when a person is proficiently handling relationships and building networks? A) Self-regulation B) Motivation C) Empathy D) Social skills

Ans: D Feedback: Social skills: Proficiency in handling relationships and building networks; an ability to find common ground. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people.

What needs to be considered in evaluating the quality of one's decisions? A) Is evaluation necessary when using a good decision-making model? B) Can evaluation be eliminated if the problem is resolved? C) Will the effectiveness of the decision maker be supported? D) Will the evaluation be helpful in increasing one's decision-making skills?

Ans: D Feedback: The evaluation phase is necessary to find out more about one's ability as a decision maker and to find out where the decision making was faulty.

Which statement about situational or contingency leadership theory is correct? A) High relationship behavior is much more essential to a good manager than high task behavior B) This leadership model is effective in bureaucratic organizations because it is task focused C) Management should be consistent in different situations so workers understand what is expected of them D) The leadership style chosen by a manager should reflect the task/relationship behavior of those being managed

Ans: D Feedback: The idea that leadership style should vary according to the situation or the individuals involved was first suggested almost 100 years ago by Mary Parker Follett, one of the earliest management consultants and among the first to view an organization as a social system of contingencies. The other options present statements that are incorrect.

25. A nurse sits at the foot of a patient's bed during an admission interview. This positioning supports the proxemics concept of which psychological comfort zone? A) Intimate relationships B) Personal interactions C) Social exchange D) Public distance

Ans: D Feedback: The study of how space and territory affect communication is called proxemics. In the United States, between 0 and 18 inches of space is typically considered appropriate only for intimate relationships; between 18 inches and 4 feet is appropriate for personal interactions; between 4 and 12 feet is common for social exchanges; and more than 12 feet is a public distance (Loo). Most Americans claim a territorial personal space of about 4 feet.

One of the nurses on the unit said, ìMale patients have a low threshold for pain.î This is an example of what type of illogical thinking? A) Affirming the consequences B) Arguing from analogy C) Deductive reasoning D) Overgeneralizing

Ans: D Feedback: This type of ìcrookedî thinking occurs when one believes that because A has a particular characteristic, every other A also has the same characteristic. This kind of thinking is exemplified when stereotypical statements are used to justify arguments and decisions.

Why do our values often cause personal conflict in decision making? A) Some values are not realistic or healthy B) Not all values are of equal worth C) Our values remain unchanged over time D) Our values often collide with one another

Ans: D Feedback: Values, life experience, individual preference, and individual ways of thinking will influence a person's decision making. No matter how objective the criteria will be, value judgments will always play a part in a person's decision making, either consciously or subconsciously.