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14. What is the disadvantage of democratic leadership in group functioning? a. Requires more time and effort to make decisions and accomplish goals b. Discourages participation from quieter members of the group c. Increases the possibility of "scapegoating" or argumentative behavior d. Is difficult to control the outcomes and decisions of the group

ANS: A Because of the encouragement of participation in decision making and the democratic leadership's emphasis on group function, decision making becomes more involved with consensus and is less timely. DIF: Cognitive Level: Comprehension REF: pp. 195-196 OBJ: Discuss theories of management and leadership. TOP: Nursing management MSC: NCLEX®: Not applicable

11. The nurse manager on a surgical unit receives notification that multiple victims of a plane crash will arrive at the hospital momentarily. What is the most appropriate leadership style to adopt in this situation? a. Authoritarian b. Democratic c. Laissez-faire d. Eclectic

ANS: A The authoritarian style of management has its emphasis on the tasks. The autocratic manager may be most effective in a crisis situation. DIF: Cognitive Level: Analysis REF: p. 194 OBJ: Differentiate between power and authority. TOP: Nursing management MSC: NCLEX®: Not applicable

19. The nurse understands that having a stand-up meeting versus the traditional (sitting at a conference table) meeting because it takes less time to come to a decision is based on which of the following ideas? a. Contingency-style leadership b. Evidence-based management protocols and interventions c. Autocratic management style d. Presence of a clinical nurse leader (CNL)

ANS: B Nurses are expected to practice using evidence-based protocols and interventions for clinical decision making, and managers are expected to use those management practices that are not simply based on conventional wisdom but on demonstrated outcomes. Evidence indicates that stand-up meetings took 34% less time to make decisions (Pfeffer & Sutton, 2006). Using this model could save an organization many hours a year that can be put to another productive use or could be eliminated from the payroll. However, very few organizations use this model for meetings even in the face of the clear evidence of the impact it would have on the organization. The CNL is a highly prepared individual in the clinical setting whose role is to positively impact patient safety issues by identifying and managing risk while meeting standards of quality clinical care. Autocratic management style is authoritative. Contingency leadership style is a style of leading that is flexible to adapt to the situation. DIF: Cognitive Level: Analysis REF: pp. 207-208 OBJ: Discuss the value of using evidence-based management actions. TOP: Nursing management MSC: NCLEX®: Not applicable

18. What types of changes in management can be anticipated with the introduction of Generations X and Y to the nursing work force? a. More flexible work time and increased personal responsibility for work outcomes b. Increased loyalty to the institution and the need for a well-defined work environment c. Increased interest in the goals and needs of the institution d. Increased structure within the nursing environment to more effectively predict outcomes

ANS: A Members of Generations X and Y are more independent and place higher values on personal time. They are not characteristically team players, but they are very creative and want to be responsible for their work outcomes. DIF: Cognitive Level: Analysis REF: p. 201 OBJ: Identify distinguishing generational characteristics of today's work force. TOP: Generations X and Y MSC: NCLEX®: Not applicable

4. The nursing staff on a busy unit enjoys autonomy and needs minimal direction for patient care. Which leadership style would be most effective on this unit? a. Democratic b. Authoritarian c. Laissez-faire d. Bureaucratic

ANS: A The democratic manager is people-oriented and emphasizes effective group functioning. The environment is open, communication is both ways, and staff members are encouraged to participate in decision making. The manager is also willing to take responsibility to make decisions when staff participation is not necessary. DIF: Cognitive Level: Analysis REF: pp. 194-196 OBJ: Describe various types of management. TOP: Nursing management MSC: NCLEX®: Safe, effective care environment—management of care

6. The nurse identifies which step as the most important part of problem solving? a. Define the problem. b. Gather information. c. Analyze the information. d. Consider the alternatives.

ANS: A The good manager will guide the process of identifying the problem by asking the what, when, and where of the problem. Importance is placed on management's ability to differentiate between facts and opinions and to attempt to break down the information to its simplest terms. DIF: Cognitive Level: Knowledge REF: pp. 206-207 OBJ: Apply problem-solving strategies to clinical management situations. TOP: Nursing management MSC: NCLEX®: Not applicable

3. What do the responsibilities of the nurse manager include? a. Planning and organizing how nursing care can most effectively be delivered on the nursing unit b. Establishing the nursing care standards to be implemented on the unit c. Developing educational programs to assist staff to meet licensure requirements d. Assisting staff to adhere to organizational policies and procedures

ANS: A Managers must be attentive to both dimensions of their job: the mission and goals of the organization and planning with the staff to meet the nursing care goals of the unit within the overall goals of the institution. Both levels must be addressed—the organization as well as the needs of the individuals. Other options are not as comprehensive and could be included within the first option. DIF: Cognitive Level: Application REF: p. 192 OBJ: List characteristics of an effective manager and an influential leader. TOP: Nursing management MSC: NCLEX®: Safe, effective care environment—management of care

5. Which statement best describes effective leadership by the nurse manager? a. Directs a staff nurse to modify his or her communication skills b. Fosters behavior changes in one staff member that have positive effects on the nurse manager and his or her peers c. Encourages behavior changes through the annual evaluation process d. Uses the group process to determine what behavior is distressing to staff

ANS: B Leadership in groups is democratic; the members feel positive about their participation and the outcomes of the group process. DIF: Cognitive Level: Analysis REF: p. 210 OBJ: List characteristics of an effective manager and an influential leader. TOP: Nursing management MSC: NCLEX®: Not applicable

13. Which of the following best describes a nurse manager? a. Is given information and power through an official position b. Coordinates group activities toward a common goal c. Is responsible for developing goals to be accomplished d. Selects and assumes a role among a group of peers

ANS: B Management requires different levels of functioning. This may include planning and coordinating care with other nursing personnel so that patient needs will be met. DIF: Cognitive Level: Comprehension REF: p. 191 OBJ: List characteristics of an effective manager and an influential leader. TOP: Nursing management MSC: NCLEX®: Not applicable

1. What is the most consistent concern of the nurse as manager? a. To develop long-range career goals b. To coordinate patient care while meeting the agency goals c. To maintain harmony within the agency d. To organize the subordinates to meet agency goals

ANS: B The role of the nurse as manager has evolved into a complex one that includes organizing patient care, directing personnel to achieve agency goals, and allocating resources. DIF: Cognitive Level: Analysis REF: p. 192 OBJ: List characteristics of an effective manager and an influential leader. TOP: Nursing definition MSC: NCLEX®: Safe, effective care environment—management of care

9. Which type of power is possible for any nurse to obtain and use for advancement in nursing? a. Reward b. Coercive c. Expert d. Legitimate

ANS: C An expert refers to someone who is knowledgeable, experienced, and respected in his or her area of nursing. This type of power would assist the nurse to advance to higher positions in nursing. DIF: Cognitive Level: Knowledge REF: p. 205 OBJ: Differentiate between power and authority. TOP: Nursing management MSC: NCLEX®: Not applicable

12. The nurse manager tells the patient that he must eat his breakfast before getting out of bed. What type of power is she using? a. Legitimate power b. Expert power c. Coercive power d. Referent power

ANS: C Coercive power is power derived from fear of consequences. DIF: Cognitive Level: Analysis REF: p. 205 OBJ: Differentiate between power and authority. TOP: Nursing management MSC: NCLEX®: Not applicable

7. What is the first step in the decision-making process? a. Evaluate the outcome. b. Identify and evaluate options. c. Set the objective. d. Implement the options.

ANS: C Decision making requires the definition of a clear objective to guide the process. DIF: Cognitive Level: Knowledge REF: p. 209 OBJ: Use the decision-making process in clinical situations. TOP: Nursing management MSC: NCLEX®: Not applicable

2. What is the first step for a nurse toward becoming an effective manager? a. Learn how to effect and direct the change process. b. Assess individuals' sources of power. c. Develop communication and interpersonal skills. d. Implement effective nursing care plans.

ANS: C Effective managers are a balanced mix of management skills and leadership qualities. DIF: Cognitive Level: Knowledge REF: p. 206 OBJ: List characteristics of an effective manager and an influential leader. TOP: Nursing management MSC: NCLEX®: Safe, effective care environment—management of care

16. To implement any change in the work environment, what is the most important thing for a staff nurse to do? a. Ask for suggestions from peers working in other institutions. b. Explain to coworkers how a different plan would work better. c. Seek input from coworkers from the beginning. d. Incorporate all suggestions into the plan before implementing.

ANS: C In the unfreezing phase, all of the factors that may cause resistance to change are considered. Others who may be affected by the change are sought out to determine whether they recognize that a change is needed. DIF: Cognitive Level: Comprehension REF: pp. 212-213 OBJ: Discuss the change process. TOP: Nursing management MSC: NCLEX®: Not applicable

15. Janis is unhappy about the way medications are being administered on her unit. What does she need to do first to facilitate a change in the process? a. Initiate a new method starting with her assigned patients. b. Discuss her concerns with fellow nurses. c. Develop a better method to administer the medications. d. Inform the charge nurse of how it can be done better.

ANS: C The nurse needs to shift into the moving phase, which incorporates taking the lead by being responsible and willing to implement change by sorting out what must be done and by facilitating an appropriate and effective approach. Whenever one is not happy with a situation or procedure, it is important that providing suggestions for change be incorporated into the process. DIF: Cognitive Level: Application REF: p. 213 OBJ: Discuss the change process. TOP: Nursing management MSC: NCLEX®: Not applicable

10. A nurse is respected by his peers for his clinical skills and effective interpersonal relationships. He has studied diabetic-patient educational needs and consults with several units. What type of power does this nurse possess? a. Informational b. Legitimate c. Reward d. Expert

ANS: D Expert power is based on specialized knowledge, skills, or abilities that are recognized and respected by others. DIF: Cognitive Level: Analysis REF: p. 205 OBJ: Differentiate between power and authority. TOP: Nursing management MSC: NCLEX®: Not applicable

17. If many complaints arise about a newly developed procedure, what is the best way to handle them? a. Discontinue the change because it is not working. b. Persuade a few friends to talk positively about it. c. Consider the complaints as indications that change is being resisted. d. Analyze the complaints and alter the plan as needed.

ANS: D In handling complaints about a new procedure, consideration should be given to bringing in a person with expert power and returning to the moving phase for analysis and adjustment of the procedure if needed. DIF: Cognitive Level: Application REF: p. 213 OBJ: Discuss the change process. TOP: Nursing management MSC: NCLEX®: Not applicable

8. What is the primary advantage in using the group process in decision making? a. Increases the time spent discussing alternatives b. Eliminates opposition to decisions by administrators c. Allows additional time for the planning process d. Promotes acceptance of the decision by the group

ANS: D When the group has input in the decision-making process, there is more acceptance of the group's decision. Groups can be beneficial to the decision-making process. Groups generally offer the benefits of a broader knowledge base for defining objectives and more creativity in identifying alternatives. The effectiveness of the group decision-making process is dependent on the dynamics of the group. DIF: Cognitive Level: Comprehension REF: p. 210 OBJ: Identify characteristics of effective work groups. TOP: Nursing management MSC: NCLEX®: Not applicable