Exam 1

A The traditional manager, concerned with the day-to-day operations, is termed a transactional leader. Transformational leadership prioritizes long-term vision and empowerment. Bureaucratic leadership emphasizes rules and regulations, whereas interactional leadership focuses on the link between personality and situations.

The manager of a busy emergency department is primarily concerned with the practical, day-to-day operations of the department. This manager is most clearly demonstrating what type of leadership? a. Transactional b. Transformational c. Interactional d. Bureaucratic

C Traditional managers influence those in their own groups, whereas integrated leaders influence others beyond their own group. Political astuteness, an outward view, and an emphasis on vision and values are all characteristics of an integrated leader-manager.

What characteristic of a nurse-manager suggests that they are acting in the role of a traditional manager rather than an integrated leader-manager? a. The manager is conscious of the important role of politics and is politically astute. b. The manager has an outward view, extending to the larger organization. c. The manager's influence is limited to their own group. d. The manager emphasizes the importance of vision and values.

C Managers must delegate the authority and the responsibility necessary to complete a task. Qualities like leadership, knowledge, and creativity are not transferable. The remaining option choices are resources that are provided rather than delegated.

What must managers delegate to another RN in order to assure completion of a task? a. Time and space b. Leadership and creativity c. Authority and responsibility d. Personnel and knowledge

B In general, increasing delegation to NAPs increases the scope of liability for the RN. There is no reason why this change in staffing would create a risk for underdelegating or make culture a more salient concern. The RNs' scope of practice is enacted in the jurisdiction's nurse practice act and is not affected by this change.

A health care organization has laid off several RNs and hired numerous NAPs in their place. What effect is this change most likely to have on the remaining RNs? a. There will be a risk of the RNs underdelegating. b. The RNs' level of liability will increase. c. Cultural variables will become a larger consideration. d. The RNs' scope of practice will become expanded.

B EI 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; EI does not demand this. EI does not require that emotions dominate decision making or that the expression of emotion is the marker of success.

A leader is applying the principles of emotional intelligence (EI). What outcome indicates successful application of these principles? a. Emotions are held in check. b. Emotions are used effectively. c. Emotions dominate decision making. d. Expression of emotion indicates success.

A 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 from happening. The manager can often not avoid making unpopular decisions. Enacting punitive measures (consequences) has not been shown to encourage honesty. The use of "informants" is likely to cultivate mistrust and is likely to increase dishonesty.

A leader-manager provides oversight on a busy medical-surgical unit. There has recently been an incident where two nurses were not honest about neglecting a controversial new protocol and misled the leader. How can the leader-manager best prevent similar episodes? a. Support employees' right to disagree with proposed changes. b. Ensure that employees know the consequences of misleading the manager. c. Avoid making decisions that displease large numbers of employees. d. Identify allies who can be trusted to report employees who may mislead the manager.

D Frederick W. Taylor, the "father of scientific management," had the idea that workers should be hired, trained, and promoted based on their competence and abilities. Scientific management does not emphasize relationships between managers and employees, lifelong learning, or high levels of independence for workers.

A manager demonstrates one of the four principles of scientific management when he or she: a. shows an interest in employees' personal lives and emotional health. b. engages in lifelong learning and expects employees to do the same. c. allows employees to do their jobs independently, with minimal oversight. d. hires and promotes employees on the basis of their competence and skills.

C 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. There is no mention of the role of emotions or emotional intelligence. Quantum leadership focuses on the dynamic and multifactorial nature of leadership, but this is not evident in the scenario. Transformational leadership focuses on influencing and promoting vision; these are not evident in the scenario.

A manager has proposed to the hospital board that it hire 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

B Managers should ask the individuals to whom they are delegating if they are capable of completing the delegated task. If the person lacks the appropriate qualifications, the fact that they have experience is irrelevant. The manager should not base delegation decisions primarily on whose turn it is or on cost.

A manager needs to delegate some tasks. What consideration should the manager prioritize when identifying the appropriate person to whom to delegate a specific task? a. Whose turn it is to take on a delegated task b. The qualifications of the person regarding the task c. The fiscal cost of delegating the task d. Whether the person has experience with similar tasks

B A manager should be available to the employee to help identify solutions to problems encountered with a delegated task and should encourage the employee to persevere. Taking back a task that was originally delegated is an absolute last resort. Reassigning and coassigning the task are options that should not be initially considered, but which may be necessary later.

A manager's subordinate is having difficulty carrying out a delegated task. What is the manager's best initial action? a. Release the subordinate from the task so they will not become demoralized. b. Be available to the employee as a role model and resource for the task. c. Assign another more experienced employee to help with the task. d. Reassign the employee a different, less complex task.

D The manager should help the overwhelmed employee reprioritize the workload with the goal of making it manageable for that employee. This strategy should be tried before assigning work to another team member or having the employee abandon some of the tasks. In most cases, it is ineffective if the RN takes on the tasks that the employee was supposed to complete.

A member of the team has been delegated some tasks and reports, "I've been given too much to do and I'm not going to be able to complete the work on time." What is the RN's best initial action? a. Assign the work to another team member. b. Take on the responsibility of the tasks. c. Have the team member perform only the most necessary tasks. d. Examine the workload and assist the individual in reprioritizing

A Strengths-based leadership posits that effective leaders surround themselves with people who have different strengths than they do. The leader should focus on addressing areas where they are weaker, not relying solely on existing strengths. This model does not rank people on a two-dimensional scale because there are diverse ways of being strong.

A new leader-manager is planning to implement the principles of strengths-based leadership after being hired for a new position. What action will best facilitate this plan? a. Creating a team with diverse abilities and talents b. Identifying the leader's personal strengths and utilizing them c. Appraising team members on a scale that runs from "weaker" to "stronger" d. Organizing the flow of work to match the leader's strengths

C Frequent mistakes made in delegating include underdelegating, overdelegating, and improper delegating. That the manager is not intellectually challenged by a task is not a valid reason for delegating that task to another person. The other options are all appropriate reasons to delegate tasks to qualified staff.

A new nurse-manager is evaluating recent tasks that had been delegated to other staff for effectiveness. What is an inappropriate reason for delegation? a. To empower subordinates by "stretching" them in their work assignment b. To allow the manager to address more complex unit needs c. To free the manager of a task that is not intellectually challenging d. To give the task to someone who is better qualified

A 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. Assessment and diagnosis often cannot be performed at the same time. Ethics should always be considered, of course, but this variable is not identified as enhancing the overall effectiveness of the nursing process. Evaluation is recommended as an ongoing, iterative process that is not reserved for when all outcomes have been met. Indeed, it is impossible to determine whether outcomes have been met without performing evaluation.

A novice nurse has been trying to apply the nursing process to each client interaction. What should the nurse do to enhance the effectiveness of this process for making decisions and solving problems? a. Ensure that specific goals are identified during the planning process. b. Conduct assessment and diagnosis simultaneously whenever possible. c. Prioritize ethics during each phase of the nursing process. . d. Avoid evaluating the process until every outcome has been met.

A If an employee does not complete delegated tasks, the manager should assess the reasons for this before taking action. Addressing the problem before knowing the circumstances or the cause would be premature.

A nurse delegated some tasks to a nurse several hours ago. The manager has now learned that the nurse did not complete any of the delegated tasks. What is the manager's best initial action? a. Determine exactly why the nurse did not complete the delegated tasks. b. Assertively state the expectation that delegated tasks will be completed on time. c. Document the nurse's insubordination and arrange a private meeting. d. Take action to reestablish the authority power gap.

D The ability of the powerful to influence individual decision making in an organization often requires adopting a private personality and an organizational personality. The nurse will often have to accept decisions that solely reflect the values of more powerful individuals. This may lead to a feeling of powerlessness but not necessarily mistrust and lack of communication. Delegation of decision making is likely to be rare, not common, because it is concentrated with those in power.

A nurse has accepted a job in a workplace where organizational power has a pronounced effect. This characteristic may have what effect on the nurse and the workplace? a. Many decisions will be delegated to the nurse by supervisors. b. There will be high levels of mistrust and suspicion at the workplace. c. Communication will be compromised at the workplace. d. The nurse may have to accept decisions contrary to their own values.

C Values clarification is an imperative first step when preparing for a role that requires decision making and problem solving. This form of internal examination must precede strategic interactions with others or an analysis of where power lies in the organization. Internal examination should come before external examination.

A nurse has accepted a management position in a busy ambulatory clinic and recognizes that the day-to-day operations of the clinic will require many decisions. What is the nurse's best initial action when preparing for this new role? a. Identify staff who are likely to be allies. b. Determine where organizational power exists in the clinic. c. Clarify and reflect on their own values. d. Collaborate with the previous manager of the clinic.

D For managers and leaders to function at their greatest potential, the two roles must be integrated. This helps ensure positive outcomes for all. Authoritative leadership is generally not preferred in the 21st century because it has poorer results than more contemporary models. Charisma can be beneficial in a leadership position, but it is not among the major traits of successful leadership and management. A focus on finances with all employees is not normally necessary and is not linked to high-level outcomes.

A nurse has been hired to oversee a day surgery clinic. What action will best ensure good outcomes for this nurse, the clients, and the employees of the clinic? a. Implement the principles of authoritative leadership. b. Teach all employees about the financial considerations at the clinic. c. Consciously develop the ability to be charismatic. d. Integrate nursing management and nursing leadership roles and practices.

B Success and high achievement are best promoted when leadership and management functions are integrated by individuals. Promoting certain management skills among employees can be beneficial, but this cannot replace the importance of the leader-manager's own skill set. Followership cannot be mandated; it must be earned. The presence of multiple leaders can make it more difficult to effect change because of diverse visions.

A nurse has been hired to oversee the operations of a series of ambulatory clinics. The nurse can best promote the success of the organization by: a. promoting management skills among all employees. b. integrating leadership skills and management skills. c. clearly communicating to employees that they will be required to follow organizational leadership. d. advocating for the organization to hire a leader for each site.

C It is important to reward employees for accomplishment. This must precede "stretching" the nurse with even more difficult assignments or asking the nurse to act as a role model.

A nurse has successfully completed a difficult and complex task that the manager delegated. What is the manager's best action? a. Document the fact that the nurse completed the task. b. Assign a slightly more difficult task the next time. c. Acknowledge the nurse's significant accomplishment. d. Ask the nurse to act as a role model for other staff members.

C 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. It is not always realistic for the nurse to solve each of the problems contributing to a larger challenge, especially at the beginning of the decision-making process. The nurse often lacks the time, information, or resources to analyze the root causes of a situation. Many times, the nurse makes a decision that benefits the largest number of people, but this is not always feasible or desirable.

A nurse is applying a decision-making process to a clinical challenge. When applying this process, the nurse must: a. analyze the root causes of a situation. b. begin by solving the underlying problem. c. choose between different courses of action. d. prioritize the maximum good for the maximum number of people.

A The traditional problem-solving model attempts to identify the root problem in situations, a task that requires much time and energy. Efficiency is desirable, but trying to implement a solution as quickly as possible can result in a hasty and incorrect solution. Outside input may or may not be necessary; this varies with each individual problem. Reflective thinking is always beneficial, but this is not a specific component of the traditional problem-solving model.

A nurse is applying the traditional problem-solving model when mediating a conflict between two colleagues. When applying this model, the nurse should prioritize what task? a. Identifying the root cause of the conflict b. Implementing a solution as quickly as possible c. Eliciting input from other nurses d. Encouraging each nurse to reflect on their actions

A An individual's comfort level with risk has a major bearing on that person's ability and willingness to make difficult decisions. It also affects the outcomes of decisions. The nursing process can have application in the decision-making process, but it is not among the most common decision-making models in management situations. A focus on pleasing other people may make it difficult to arrive at a decision when there are no ideal options available. Quick thinking can be beneficial when making some decisions, but people who are more methodical thinkers are not necessarily at a disadvantage, as quick thinking does not always lead to wise decisions.

A nurse is considering applying for a management job that will require the nurse to make many difficult decisions. What question should the nurse ask when considering his or her ability to make difficult decisions? a. "How comfortable am I with taking risks?" b. "Am I able to apply the nursing processes in varied circumstances?" c. "Am I usually able to please my coworkers?" d. "How quickly do I think?"

B Simulation provides learners opportunities for problem solving that have little or no risk to clients or to organizational performance, while also providing models, either mechanical or live, to provide experiences for the learner. Simulation is generally considered to be more realistic (and conducive to learning) than a case study. A decision-making or problem-solving model is not normally implemented when learning new skills or procedures.

A nurse is working with a group of students who are learning a high-risk procedure. How should the nurse best ensure learning while protecting the safety of clients? a. Create an unfolding case study featuring the procedure. b. Use simulation for the students to learn and practice the skill. c. Help the students use a decision-making model to choose the safest technique. d. Teach the students about the traditional problem-solving process before they practice the procedure.

B, C, D, E 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; and they think in terms of change and renewal.

A nurse oversees the care of a hospital unit in the role of an integrated leader-manager. What characteristics should this nurse exhibit? Select all that apply. a. The nurse describes herself as an "inward thinker." b. The nurse's thinking includes long-term issues. c. The nurse consciously attempts to motivate the employees. d. The nurse has influence that goes beyond her own group. e. The nurse is always conscious of political realities.

C Laissez-faire leadership is generally understood to be a "hands-off" approach. The manager using this approach would likely allow the two nurses to self-manage this event and reach a solution independently. Requiring a meeting would be a more authoritarian or autocratic approach. Punishing the nurse and requiring an apology would be a strong autocratic approach.

A nurse was 20 minutes late returning from a scheduled lunch break and a colleague's break was consequently cut short. What response by the manager best demonstrates a laissez-faire leadership approach? a. Ask each of the nurses to speak with the manager separately to discuss the implications of this event. b. Ask the nurses to attend a short meeting together in the manager's office. c. Allow the two nurses to dialogue about this event and observe for evidence of a satisfactory resolution. d. Impose a meaningful consequence on the first nurse and have the nurse apologize to the colleague.

C Transformational leadership is characterized by empowering others and instilling them with vision. Transactional leadership is more management oriented and includes functions around rewarding performance and allocating resources. Transactional and transformational leadership can both result in loyalty and respect.

A nurse-leader has set a goal of becoming a more transformational leader. What outcome will best indicate progress toward achieving this goal? a. The nurse maximizes efficiency when allocating scarce resources. b. The nurse's subordinates demonstrate respect and loyalty. c. The nurse empowers others to reach their full potential. d. The nurse provides praise for good work performance.

C If an employee has the skills necessary to complete a task, that employee should be able to carry out the task with autonomy and be provided with the authority and resources necessary. There should be no need for the manager to give excessively detailed instructions. Depending on the complexity of the project, the manager should meet with the employee for updates. The manager must always confirm employees' qualifications.

A nurse-manager delegates many tasks in the course of a day. Which practice should the manager reconsider or discontinue? a. The manager grants temporary authority to support completion of a delegated task. b. The manager confirms that the person to whom a task is delegated is adequately qualified. c. The manager provides employees with exact instructions for each step of completing the task. d. The manager asks for regular updates from the employee when tasks take a long time.

A Most individuals rely on discrete, often unconscious processes known as heuristics, which allows them to solve problems more quickly and to build on experiences they have gained in their lives. This manager's prompt decision making exemplifies this rapid approach. This does not necessarily lead to worse outcomes than a slower, more methodical approach. Heuristics can be based on experience and knowledge and are not simply expressions of emotion. Heuristics and rapid decision making are not synonymous with an autocratic leadership style that downplays input from others.

A nurse-manager had to intervene in a conflict between a client and a staff member. The manager chose to make a decision "in the moment" rather than applying a methodical or deliberate decision-making tool. How should this manager's actions be best interpreted? a. The manager applied heuristics to a problem that required a quick solution. b. The manager should have used a decision-making tool before responding. c. The manager's decision was likely made on the basis of emotion. d. The manager demonstrated an autocratic leadership style.

C If the worker is having difficulty carrying out the delegated task, the leader-manager should be available as a role model and resource in identifying alternative solutions. Leaders should encourage employees, however, to attempt to solve problems themselves first, although they should always be willing to answer questions about the task or to clarify desired outcomes as necessary. Suggesting solutions or removing the person from the task prematurely does not demonstrate an understanding of effective guidance. The NAP has already expressed feeling overwhelmed, so there is no need to give permission to do so.

A nurse-manager has asked a NAP for an update on delegated tasks, and the NAP has said, "I'm swamped right now." What is the manager's best response? a. "Don't be afraid to let me know if you feel the project is overwhelming you." b. "Time management is key to keeping on schedule with your tasks." c. "I can give you a few solutions to help manage this heavy workload." d. "Do you want more time to complete your work?"

B, C, E Safe and effective delegation involves evaluating the skills and education of staff, identifying goals clearly, and evaluating performance after completion. Tasks should not be selected for delegation on the sole basis of being time-consuming for the manager. Monitoring is appropriate and necessary and is not reserved just for problems or emergencies.

A nurse-manager has begun a new role in a community health center and will need to delegate tasks often to subordinates. What actions should the manager perform when delegating tasks? Select all that apply. a. Choose the most time-consuming tasks to delegate to subordinates. b. Evaluate the skills and education of subordinates before delegating. c. Ensure that subordinates know the goal of any delegated task. d. Avoid monitoring the subordinate unless there is evidence of a problem. e. Evaluate subordinates' performance after they have completed a task.

B, E In delegation, the individual transfers the authority to perform a specific activity from their own practice to an individual qualified to perform that task, but retains accountability for the delegated task. Delegation does not involve going beyond the nurse's scope of practice, and there is still a need for oversight. The nurse does not perform on someone else's license when completing delegated tasks.

A nurse-manager has delegated some administrative tasks to an experienced RN. Which of the following is true about this act of delegation? Select all that apply. a. The nurse's task will be beyond their scope of practice. b. The manager transfers the authority for the task to the nurse. c. The nurse is practicing on the manager's license. d. The manager is released of the need to oversee the nurse. e. The manager remains accountable for the task.

D 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. This step cannot be eliminated from the decision-making process because it provides the means for determining whether a good decision was made. Happiness is not the criterion by which decisions are usually evaluated. Rather, evaluation is done by comparing actual outcomes to desired outcomes.

A nurse-manager has made a decision and is now preparing to evaluate that decision. What question should best guide the nurse's evaluation process? a. Is evaluation necessary when using a good decision-making model? b. Can evaluation be eliminated if the problem is resolved? c. Is every party happy with the outcomes of the decision? d. Did the outcomes align with the original objectives?

B Confirmation bias refers to our tendency to search for and favor information that confirms our beliefs while simultaneously ignoring or devaluing information that contradicts our beliefs. Self-awareness and reflection can reduce this tendency. Delegating the data-gathering process may be beneficial in some situations, but every person is prone to confirmation bias, although in differing ways. Considering the implications of a decision is an important part of decision making but does not address the issue of confirmation bias. Minimizing data collection may reduce confirmation bias but could compromise the quality of a decision.

A nurse-manager has realized that the data gathering process before a recent decision may have been influenced by confirmation bias. How can the manager best prevent this in the future? a. Delegate data gathering to a trusted colleague who has different values. b. Make sure not to prioritize information that supports their own beliefs. c. Consider all of the implications of an alternative before making a decision. d. Collect only the minimum quantity of data before making a decision.

B The characteristics of Theory Z include consensus decision making. Autocratic decision making, formal analysis of pros and cons, and maximizing the number of alternatives are not major characteristics of this leadership theory.

A nurse-manager has recently been accused of assigning work unequally. The manager has recognized the need to revise the process for assigning work to nurses. How can the manager best apply the principles of Theory Z? a. Making a decision independently and imposing it on the nurses b. Gathering input from employees in order to reach a consensus c. Making a decision based on the pros and cons of each option d. Identifying as many different alternatives as possible

D Regardless of what decision-making or problem-solving tool a manager is going to use, the process must necessarily begin with clear identification of the objectives. Once these are determined, subsequent steps like engaging stakeholders, creating alternatives, and considering previous approaches can be performed.

A nurse-manager has to make some difficult decisions around the allocation of vacation time during the holiday season. When making a decision, what should the manager do first? a. Elicit ideas from as many staff members as possible. b. Consider how the issues have been addressed in the past. . c. Think of as many alternatives as possible. d. Clearly identify each of the desired objectives in the situation.

C The PICO format is used in evidence-based practice to guide the search for the current best evidence to address a problem. Client and family preferences and cost are included in evidence-based practice but are not explicit components of the PICO format. Intuition is a component of decision making but is not specifically included in the PICO format.

A nurse-manager is applying an evidence-based approach to a clinical question around client mobilization. When using a PICO (patient or population, intervention, comparison, and outcome) format to search for evidence, the nurse should identify what? a. The role of intuition in the decision-making process b. The preferences of clients and their families c. The clients for whom the intervention would be relevant d. Costs associated with a potential change in practice

B A decision is made when a course of action has been chosen. A decision may not always be pleasing to everyone involved in the situation, and success can never be fully guaranteed. The manager should seek to fully understand the problem, but this is a phase in decision making, not the result of the process.

A nurse-manager is applying the decision-making process when addressing a nurse's high rate of absenteeism. This process should result in: a. an outcome that is desired by all. b. a chosen course of action. c. an action that guarantees success. d. a new understanding of the problem.

D Every person has a value system, and this cannot simply be "set aside." Awareness and reflection are necessary to make good decisions in the context of one's own values. Intuition and values are not counterpoints, and prioritizing intuition does not negate the importance of values. Values influence every decision to varying degrees, and it is impractical to defer every value-laden decision to someone else.

A nurse-manager is faced with a difficult decision in a situation that involves the manager's values. What is the manager's best action? a. Try to base a decision on intuition rather than values. b. Set aside their own values and make a rationale decision. c. Defer the decision to a colleague with different values. d. Identify and reflect on their own values.

A Underdelegating occurs when a manager has a false assumption that delegation may be interpreted as a lack of ability on his or her part to do the job correctly or completely. This insecurity may make the manager highly reluctant to delegate.

A nurse-manager is new to the unit and is worried about being perceived as incompetent or underqualified by subordinates. The manager should recognize that this creates a risk for what problem? a. Underdelegating b. Overdelegating c. Improper delegating d. Inappropriate delegating

A, B, D, E There are six cultural phenomena that must be considered when working with staff from a culturally diverse background: communication, space, social organization, time, environmental control, and biologic variations. Intelligence is not a cultural phenomenon.

A nurse-manager is overseeing a culturally diverse group of staff. The manager should consider what variables when planning delegation? Select all that apply. a. Communication style b. Concepts of time c. Intelligence d. Biologic variations e. Social organization

A Management decision-making aids are subject to human error and do not remove the effects of individual values, which always affect decision making. There is no particular reason that a tool would have to be applied by another person. Making the correct decision can take time; moving too quickly can compromise the quality of the process.

A nurse-manager is planning to apply a decision-making model to a clinical challenge. When using a decision-making tool, what should the manager do? a. Be aware that the tool cannot eliminate the risk of human error. b. Have an impartial colleague apply the tool, if possible. c. Apply the tool as quickly as possible. d. Recognize that the tool will negate the effect of the manager's values.

C PERT is a popular tool to determine the timing of decisions; it is essentially a flowchart that predicts when events and activities must take place if a final event is to occur. This tool does not explicitly address some of the other relevant considerations when making decisions, including values and ethics, and it does not focus on consequences.

A nurse-manager is preparing to use the program evaluation and review technique (PERT) tool when making a staffing decision. This tool will primarily address what component of the decision-making process? a. Values b. Consequences c. Timing d. Ethics

C Theorists studying emotional intelligence posit that the ability to regulate the emotions of self and others is key to effective leadership. Emotional intelligence does not involve removing emotion from decision making; conversely, it does not claim that emotion should trump reason. Management of emotions is not the same as manipulating the emotions of others, which is unethical.

A nurse-manager who seeks to exemplify emotional intelligence should: a. attempt to remove emotion from decision making. b. prioritize emotion over reason when making decisions. c. regulate their own emotions and those of others. d. effectively manipulate the emotions of others to achieve goals.

C A manager with a need for perfectionism and control may believe that another person will not complete a task. Trust in subordinates and a democratic leadership style would support effective delegation. Delegating should not be based on the issue of time exclusively.

A performance appraisal states that the manager often underdelegates. What is potential cause of this delegation error? a. A high degree of trust in subordinates b. A democratic leadership style c. A need for perfectionism d. Sufficient time to accomplish unit goals alone

D The team's RN always bears the ultimate responsibility for ensuring that the nursing care provided by their team members meets or exceeds minimum safety standards. This is not the ultimate role of any of the other positions mentioned

A registered nurse (RN) was working with a nursing assistive personnel (NAP) and delegated some tasks to the NAP. The NAP exceeded their scope of practice and caused injury to a client. Ultimate responsibility for this adverse event lies with whom? a. The NAP b. The facility's director of nursing c. The unit's nursing manager d. The RN

B Delegation to an LPN is different from delegation to an NAP. The parameters vary from state to state, and the RN should review the scope of practice. The LPN's comfort level is secondary to their knowledge, skills, and scope of practice. A decision tree for delegation to unlicensed assistive personnel would guide delegation to NAPs, not LPNs.

A registered nurse has been leading teams of NAP for several years and will soon be leading licensed practical nurses (LPNs) for the first time. In preparation for delegating to these nurses, the RN should: a. delegate the same tasks to the LPNs that the RN normally delegated to NAPs. b. review the LPN scope of practice in the jurisdiction in which they are working. c. ask each LPN what tasks they are comfortable performing. d. consult a decision tree for delegation to unlicensed assistive personnel.

D Affirming the consequences is a logical fallacy where a person decides that if B (i.e., the new brief) is good and someone is using A (i.e., the old brief), then A must not be good. The fact that the new brief is good does not mean the old brief is bad. Arguing from analogy is an illogical thinking that applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects. Overgeneralizing involves extending characteristics of an individual to a group.

A sales representative is describing the benefits of a new brand of incontinence brief to a manager. The representative states, "These are a superior product. With what you're currently using, you're actually causing harm to your clients." How should the manager best interpret this statement? a. The representative is arguing from analogy. b. The representative is overgeneralizing about the new briefs. c. The representative is overgeneralizing about the briefs the unit currently uses. d. The representative is affirming the consequences.

B Empowering the subordinate who lacks self-confidence is an appropriate initial action. If this is not possible, then reassigning the task may be necessary. Teaching about the need for self-confidence rarely instills self-confidence in those who lack it. Restating the importance of the task does not address the nurse's confidence level.

A subordinate is reluctant to accept a task that the nurse-manager wants to delegate. The manager suspects that the subordinate's reluctance is due to a lack of self-confidence. What is the manager's best initial action? a. Teach the subordinate about the value of self-confidence. b. Try to empower the subordinate. c. Offer a reward to the subordinate in order to motivate. d. Restate the importance of the task to the subordinate.

A, D Payoff tables can be used to make decisions involving cost, profit, and volume. To make a decision, the team would need to know how much it costs to introduce a mattress and how much it costs to treat a pressure ulcer. Other variables such as client expectations, timing, and prognosis would be considered when making a decision, but these variables would not be quantified into a payoff table.

A team of nurse-managers is considering the purchase of pressure-reducing mattresses to reduce the incidence of pressure ulcers among long-term care residents. In order to use a payoff table to assist with the decision making, what must the managers know? Select all that apply. a. The cost for each new mattress b. Clients' expectations for how a mattress should feel c. The prognosis for recovery from a pressure ulcer d. The cost of treating pressure ulcers e. The amount of time between ordering the mattresses and their delivery

A A decision grid allows one to visually examine the alternatives and compare each against the same criteria. This assists with the decision-making process, but it cannot guarantee that the decision will be completely objective. A decision grid is not a tool for tracking the outcomes of a decision. Decision grids are not synonymous with project planning tables.

A unit manager has created a decision grid in order to assist with a difficult staffing decision that will affect many nurses. The decision grid will allow the manager to: a. examine alternatives visually and compare each against the same criteria. b. ensure that the decision is made objectively rather than subjectively. c. plot the outcomes of a decision over time and evaluate the decision-making process. d. predict when events must take place to complete a project on time.

C With the increased use of NAP in client care, the need for nurses to have highly developed delegation skills has never been greater. The impact of insurance, nurse-client ratios, and hospitalization stays does not have as great an impact on delegation as does the correct option. Hospital stays are shorter, not longer, than in the past.

An experienced RN has seen a significant increase in the need for delegation skills over the past several years. This change is most likely attributable to: a. increased numbers of uninsured clients. b. increased lengths of stay. c. increases in the use of NAP. d. decreases in nurse-client ratios.

B Right-brained thinkers have traditionally been characterized as creative and intuitive, and thinking outside of normal standards to find a solution. Linear analysis, such as the ability to generate solutions based on data sets, is more closely aligned with left-brained thinking. Transparency, such as getting all those involved, and efficiency, which focuses on the process to reach a goal, are desirable qualities that are not particularly aligned with either of these two paradigms.

An experienced nurse-manager has been described as being a "right-brained thinker." Which is an example of this manager's decision-making process? a. Uses data sets to generate solutions b. Uses thinking that is outside the normal standards to find a solution c. Has the ability to ask all those involved in the decision making d. Focuses on the intended process to reach a solution or goal

D 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 and is central to contingency (situational) leadership. This model of leadership does not emphasize workers' autonomy in decision making rigid rules and norms or the avoidance of

How can a manager best implement the principles of situational or contingency leadership theory? a. By establishing rules and norms that can be applied in all conditions in the organization b. By avoiding punitive consequences when addressing workers' lack of performance c. By deferring to employees for day-to-day management decisions d. By adapting their leadership style to a particular circumstance

A The human relations era of management science emphasized concepts of participatory and humanistic management in which participative management was espoused. A manager with a human relations approach includes workers in decision making. This leadership style is more democratic but is not characterized as laissez-faire. The focus is on "the human element" and not just the processes. Punitive actions are not central to human relations management.

In an introductory meeting, the new nurse-manager indicates that her management style is based on the human relations approach. The staff identify this to incorporate which of the following? a. Engaging workers in decision making b. Applying laissez-faire leadership c. Focusing primarily on processes d. Withdrawing raises from workers who are unproductive

A, B, C, D 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. Variables related to pay scales are more suggestive of a management role; this particular activity is not identified as a fatal flaw of leadership.

It is considered a fatal flaw in leadership to fail to engage in which of the following activities? Select all that apply. a. Collaboration with colleagues b. Communication with employees c. Self-improvement d. Staff development e. Determining salary scales for employees

D This type of flawed thinking occurs when one believes that because one person has a particular characteristic, every other person in the same category also has the same characteristic. It is an overgeneralization to assign one meaning for an action to every person from dozens of countries. This kind of oversimplified deduction is exemplified when stereotypical statements are used to justify arguments and decisions. When affirming the consequences, the nurse thinks that if B is good, but someone is doing A, then A must not be good. When arguing from analogy, the nurse applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects.

One of the nurses on the unit said, "My Vietnamese client won't look me in the eye, but I know that Asian clients avoid making eye contact as a way of showing respect." This nurse is demonstrating what type of illogical thinking? a. Affirming the consequences b. Arguing from analogy c. Deductive reasoning d. Overgeneralizing

C This manager provided the team with the autonomy to complete the work and was available should any need arise. This describes effective delegation. This action does not constitute micromanagement, provided it is not excessive. This promotes client safety but is not synonymous with it. This practice is not a form of skills evaluation.

Periodically during the day, an RN checks with the team members to determine whether they are having difficulty completing their assigned tasks. This describes which manager role? a. Skills evaluation b. Client safety c. Effective delegation d. Micromanagement

A Although the Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of "nurse's aides" (minimum of 75 hours of theory and practice and successful completion of an examination in both areas), no federal or community standards have been established for training the more broadly defined NAP. LPNs and ward clerks are not addressed by this act.

The Omnibus Budget Reconciliation Act of 1987 established regulations for the education and training of which category of health care worker? a. Certified nurse aide (CNA) b. Registered nurse (RN) c. Licensed practical nurse (LPN) d. Ward clerk

C Directing entails 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 client care delivery, and grouping activities to meet unit goals. Evaluation is not one of the five specific functions in the management process.

The manager at a long-term care facility has intervened in a conflict between two staff members about the timing and length of lunch and coffee breaks. What management function is this manager demonstrating? a. Planning b. Organizing c. Directing d. Evaluating

B Classical, or traditional, management science focuses on production in the workplace and on delineating organizational barriers to productivity and efficiency. Little attention is given to workers' job satisfaction, and they are assumed to be motivated solely by economic rewards. This management style tends to be more authoritarian than empowering. Rewards are more likely to be conferred on workers who increase efficiency rather than those who exemplify psychosocial concepts, such as caring.

The manager of a care facility advocates traditional management science. What is this manager most likely to prioritize? a. Ensuring that workers are satisfied in their roles b. Identifying and addressing barriers to efficiency c. Empowering workers to make decisions independently d. Providing rewards for exceptional caring

B Transformational leadership is characterized by the presence of a vision. Transformational leaders impart this to others, creating a collective purpose. The traditional manager, concerned with the day-to-day operations, is termed a transactional leader. Transactional leaders are not typically known as being visionaries. Bureaucratic leaders are focused on functions and processes, not vision. 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; vision is not a central focus.

The nurse who manages an ambulatory clinic is well known as being a visionary leader who is skilled at empowering others with this vision. What type of leader is this nurse? a. Transactional b. Transformational c. Interactional d. Bureaucratic

A Democratic leadership involves the use of awards and feedback. Accusations of favoritism are unlikely, provided the manager's commendation is evidence based. The Great Man theory posits that leadership is an inherent trait, not a learned trait; the manager's actions do not point to this. There is no reason to believe that a commendation may discourage the nurse's peers.

The nurse-manager has been approached by three different families in recent weeks, all of whom have described a particular nurse as giving exceptional care. The manager has relayed this feedback to the nurse and nominated the nurse for an organization-wide award. How should the manager's actions be best interpreted? a. The manager is giving an example of democratic leadership. b. The manager's actions are likely to cause accusations of favoritism. c. The manager is following the Great Man theory of leadership. d. The manager's actions may inadvertently discourage the other nurses.

D Legal and ethical issues, such as violations of confidentiality, are categorized within the controlling function. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of client care delivery, and grouping activities to meet unit goals. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff. Directing entails human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration.

The nurse-manager is addressing a nurse's suspected breach of client confidentiality in a social media posting. What function of the management process is this nurse-manager demonstrating? a. Organizing b. Staffing c. Directing d. Controlling

A, E 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. The nurse would not ignore other variables, such as finances, employee motivation, and the risks for failure, but these are not the central considerations in the model of interactional leadership.

The nurse-manager of a community clinic is applying the principles of interactional leadership when addressing a challenging situation. What variables should the nurse prioritize when applying this model of leadership? Select all that apply. a. The characteristics of the nurse-manager's personality b. The financial resources available to the nurse c. The consequences of failure d. The factors that motivate the employees of the clinic e. The specifics of the clinical challenge that the nurse is addressing

C The greater the number of alternatives that can be generated by the decision maker, the better the final decision will be. Generating multiple alternatives may require involving more people in the decision-making process, but the process can easily become unwieldy if too many people are involved. The manager should always consider the status quo as a possible option, but this is not always considered to be the default option. Innovation is often a desirable characteristic, but it would be inappropriate to choose an option solely because it is innovative; many other values must be considered.

The nurse-manager of a short-staffed unit needs to make a decision about a nurse's request for an unpaid leave of absence. In order to increase the chance of making a good decision, the manager should: a. involve as many people in the decision-making process as possible. b. begin the decision-making process by presuming the status quo to be the best option. c. generate as many different alternatives as possible. d. prioritize the option that is most innovative.

A, D, E The FRLM integrates the principles of laissez-faire, transactional, and transformational leadership. This model does not emphasize practices associated with autocratic leadership. Scientific management is an antiquated model of management that was influential in the early 20th century, not in contemporary models of leadership such as FRLM.

The nurse-manager of the perioperative department is attempting to apply the full-range leadership model (FRLM) when overseeing the department. The nurse should attempt to integrate what types of leadership? Select all that apply. a. Laissez-faire b. Scientific c. Autocratic d. Transactional e. Transformational

B The implementation of EBP usually follows a linear approach that begins with formulating a specific question that can be used to guide a literature search. This should be done before starting a literature review or consulting experts in the field.

The nurses on a medical unit are using several different techniques for performing wound care and the manager recognizes a need to implement evidence-based practice (EBP). What should the manager do first when applying the principles of EBP? a. Identify the main peer-reviewed journals in the field of wound care. b. Formulate a specific, searchable clinical question about wound care. c. Perform a review of the literature about wound care. d. Identify how expert nurses typically perform wound care.

C 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. This action is performance-based, so it would be difficult to characterize it as favoritism. Servant leadership prioritizes the interests of others; creating incentives to address the misalignment of goals is not central to servant leadership. Quantum leadership is a holistic theory of leadership that does not mainly focus on the alignment of disparate goals.

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. The nurse is enacting what model of leadership? a. Favoritism b. Quantum leadership c. Principal agent theory d. Servant leadership

A Managers who are servant leaders put serving others, including employees, customers, and the community, as the number one priority. This attitude is not dependent, however, on having a personal relationship with every subordinate. Customer service is valued, but the servant leader also emphasizes the needs of employees and the community. Vision has a place in servant leadership, but this is not a specific characteristic of this type of leadership.

What action by a nurse-manager best demonstrates servant leadership? a. Prioritizing the interests of others over the manager's own interests b. Cultivating a personal relationship with each subordinate c. Making decisions on the basis of customer service d. Communicating a clear vision for the future and asking subordinates to share it

D Transformational leadership often involves the communication of a vision and empowering employees to share in it. Functions involving performance review, scheduling, and licensure are more consistent with a transactional role. Taking responsibility is a trait of effective transformational and transactional leadership.

What action by the nurse-manager in a health organization best demonstrates transformational leadership? a. The manager readily takes responsibility after making a scheduling error. b. The manager's employees are reminded that they must submit evidence of renewing their license. c. The manager informs each employee about the new criteria that will be the basis of the performance reviews. d. The manager holds a workshop to outline a new vision for client-centered care.

D "Stretching" provides growth opportunities for employees, builds employee self-esteem, and helps prevent boredom and demotivation. Client safety is prioritized over professional development. The manager should avoid excessive reassurance and threats of reassignment. The nurse should not presume that the task will need to be redone before the subordinate has attempted it.

What action should a nurse-manager perform when supporting the delegation of a task to a subordinate? a. Holding the subordinate's professional development as the highest priority b. Frequently reassuring the employee that if they are incapable of completing a delegated task, it will be reassigned c. Drafting a preliminary plan of how the task will be redone if the outcome does not meet stated expectations d. Occasionally providing learning or "stretching" opportunities for employees

B Weber saw the need for legalized, formal authority and consistent rules and regulations for personnel in different positions. Clear expectations around authority and processes reflect Weber's beliefs. Weber did not emphasize collaborative decision making, using awards to incentivize work, or autonomy in workers' decision making.

What aspect of the way that work is organized on a nursing unit best reflects the management theories of Max Weber? a. A committee that includes employees and managers has been established to plan the work on the unit. b. The hierarchy of authority and the policies and procedures on the unit are clearly posted. c. Quarterly awards are granted to employees who have demonstrated exceptional service. d. Employees are allowed to self-schedule their vacation time and must work out any conflicts on their own.

C Left-brained thinkers process information in a linear, analytical way, which is different from the creative and intuitive approach of right-brained thinkers. Placing a value on relationships and being open to feedback are not specifically associated with one or the other side of the brain.

What characteristic of a nurse-manager best demonstrates left-brained thinking? a. The manager highly values innovation and intuition when making decisions. b. The manager's relationships with peers are prioritized when evaluating decisions. c. The manager applies a linear, analytical model when making a decision. d. The manager is open to feedback from staff when making a decision.

B 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.

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

C No federal or community standards have been established for the training of the NAP. The hiring policies of institutions vary regarding the employment qualifications of the NAP, and many institutions do not have distinct job descriptions for NAP that define their scope of practice. NAPs do not have a license that they can lose.

What principle should guide the nurse's delegation of tasks to unlicensed nursing assistive personnel (NAP)? a. It is safe to assume that the NAP has at least a high school diploma as a minimum hiring criterion. b. Like all members of the care team, NAP stands to lose their licensure in case of negligent practice. c. No federal or community standards have been established for training the broad classification of NAP. d. The nurse is protected from liability when allowing the NAP to perform only those tasks the employer includes in their job description.

C The Great Man theory purports that some people are born to lead and some are born to follow. This early theory of leadership does not emphasize the role of relationships or earning the respect of others. This theory does not state that leadership and management are a synonymous skill set.

What statement by a leader most clearly demonstrates the Great Man theory of leadership? a. "Leadership is grounded in close, supportive relationships." b. "Leadership and management are two different manifestations of one skill set." c. "Some people are born to lead, and some are born to be led." d. "Leadership can't exist without earning people's respect."

A Interactional leadership emphasizes the fact that people's motives are very important and that these are constantly changing. Interactional leadership does not prioritize pressure as a form of incentive or motivation, and it does not deny a role for authority or for the integration of leadership and management principles.

What statement by a manager best reflects the principles of interactional leadership? a. "People's motives are important, and motives change over time." . b. "People perform to their fullest potential and then they're under pressure." c. "A person can't simultaneously act as a manager and a leader." d. "Organizations run best when there is no formal, centralized authority."

C Factors such as communication, space, social organization, timing, environmental control, and biologic variations affect delegation to a culturally diverse staff and should be modeled as a leadership role. The other choices are all management functions.

Which action is considered a leadership role associated with delegation? a. Creating job descriptions for all personnel b. Providing formal recognition or reward for completion of delegated tasks c. Demonstrating sensitivity to how cultural phenomena affect transcultural delegation d. Reprimanding employees who demonstrate overt resistance to the tasks they are delegated

A The mark of a great leader is when they can recognize the excellent performance of someone else and allow others to shine for their accomplishments. Although the other options are appropriate, they are not identified as being the mark of a great leader but rather an efficient manager.

Which action on the part of a unit's nurse-manager demonstrates the mark of a great leader? a. Acknowledging the accomplishments of staff members at the unit meeting b. Providing onsite inservices on new equipment for the staff c. Including funds in the unit's budget of staff development d. Stressing the importance of client safety to all new employees

A, B, C, D Leadership roles include mentoring, decision making, advocating, and energizing. Risk taking is also considered a leadership role. Day-to-day functions such as staff scheduling are more closely associated with a management role.

Which activities are associated with a leadership role? Select all that apply. a. Mentoring two new managers b. Establishing goals for the coming year c. Advocating for nurses to receive more professional development opportunities d. Providing a motivational speech at the new employee orientation e. Finding a nurse to cover another nurse's shift

A The nurse or manager must be knowledgeable about the skills and knowledge of all members of the health care team. These variables are more important than the NAP's motivation, ability to following instructions, or personal attributes because they are more closely associated with client safety and the avoidance of liability.

Which assessment should an RN prioritize when assigning tasks to nursing assistive personnel (NAP)? a. Determining the NAP's skills and knowledge level b. Assessing which tasks the NAP is motivated to perform c. Evaluating the NAP's ability to follow instructions d. Asking colleagues to appraise the NAP's strengths and weaknesses

D Controlling is the function that includes performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control. 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 client care delivery, and grouping activities to meet unit goals. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff.

Which function of the management process involves the performance evaluation of employees? a. Planning b. Organizing c. Staffing d. Controlling

B Management functions include planning, organizing, staffing, directing, and controlling. These are incorporated into what is known as the management process. Inspiring, empowering, and transforming are more often associated with a leadership role.

Which list represents the management functions that are incorporated into the management process? a. Planning, directing, organizing, staffing, and transforming b. Planning, organizing, staffing, directing, and controlling c. Inspiring, planning, staffing, directing, and evaluating d. Organizing, staffing, planning, empowering, and controlling

C Those individuals who choose to follow a leader do so by choice, not because they have to; "followership" cannot be coerced. Leadership is a much broader concept than management, which implies a more specific and finite role. Leadership is not necessarily dependent on meeting organizational goals.

Which statement best depicts leadership? a. Strong leaders can coerce people into following them. b. A leadership position has a narrower scope than a management position. c. People will follow a person in a leadership position by choice. d. Leadership requires meeting organizational goals.

A The statement is a clear indication that the subordinate feels the leader is not listening and collaborating; this is a fatal flaw. The subordinate is not making a statement that leads to dialogue and solutions. The other statements express openness to explanation by and with the subordinate and leader.

Which statement by a subordinate demonstrates the greatest challenge for the leader a. "Your plans for the change can't realistically be implemented." b. "I don't think you heard what the rest of us had to say." c. "Do you have an idea what direction we need to go?" d. "Can you tell me why my suggestion will not work?"

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

Which statement concerning critical thinking is true? 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.

B Not only does the preference of the powerful influence decisions of others in an 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. Powerful people tend to make decisions on their own rather than delegating them. Often, the effect on others is not prioritized as highly as it should be.

Which statement concerning the role of the most powerful individuals in organizational decision making is true? a. They exert less influence on decisions than was previously thought. b. They often make decisions that are in congruence with their own values. c. They tend to delegate decision making rather than making decisions themselves. d. They usually make important decisions with consideration of the effect on others.

D Managers with an "economic man" style gather as much information as possible and generate many alternatives. However, most management decisions are made by using the "administrative man" model of decision making, in which the manager never has complete knowledge and generates fewer alternatives. The "administrative man" carries out decisions that are "satisficing," a term used to describe decisions that may not be ideal but result in solutions that have adequate outcomes. The term "economic man" does not suggest that the manager is motivated by personal financial gain.

Which statement is true regarding an "economic man" style manager? a. The manager may lack complete knowledge and generate few alternatives. b. The manager makes decisions that may not be ideal but result in solutions that have an adequate outcome. c. The manager is primarily motivated by their own financial gain. d. The manager gathers as much information as possible and produces many alternatives.

B 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. It is not possible for a nurse to fully "set aside" personal beliefs when making a decision, even if the nurse applies the principles of self-reflection.

Which statement 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.

B 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 failings that leaders can achieve greatness. No one can be brave in each and every situation. Many good leaders have strong charisma, but this is not always the case.

Which statement regarding the characteristics of a good leader is true? a. They are brave in all situations. b. They may have character flaws. c. They are by nature good intentioned. d. Charisma is their strongest attribute.

A, B, C, E A critical thinker displays persistence, empathy, and assertiveness. Trying a new approach shows persistence. Considering the client's participation shows empathy. Speaking to the care provider on the client's behalf shows assertiveness. Stating "It's important that we do not give up; our clients deserve it" shows persistence and empathy. Concluding that there is no solution to a problem reflects an inability to think outside the box.

Which statements demonstrate a characteristic of a critical thinker? Select all that apply. a. "Since that didn't work effectively, let's try something different." b. "The solution has to be something the client is willing to do." c. "I'll talk to the client's primary care giver about the problem." d. "Maybe there is no new solution to this particular problem." e. "It's important that we do not give up; our clients deserve it."

C Management responsibilities associated with budgeting would not normally be delegated to another RN on the staff because this is a role that is not the responsibility of an RN. The other options could be appropriately delegated to another RN in most circumstances.

Which task would the director of a home health agency not delegate to another staff RN? a. Assigning home health aides to specific client care b. Serving on a diabetic study committee of community resources c. Meeting with the agency's administration regarding budget cuts d. Reviewing the care assignment for the following shift

A, B, D, E Assessment is beyond the scope of NAP. However, NAP can appropriately feed, reposition, transport, and weigh clients.

An RN is leading a care team on a busy hospital unit. What tasks is the RN justified in delegating to NAP? Select all that apply. a. Feeding a client who has unilateral weakness b. Repositioning an immobile client every 2 hours c. Assessing a client's surgical wound d. Weighing a client who has chronic heart failure e. Transporting a client to a diagnostic test

D State boards of nursing are responsible for clarifying the delegation parameters for RNs. None of the other options are involved in this process.

An RN needs to confirm the specific delegation parameters for RNs. The RN should refer to guidelines from what organization? a. The Joint Commission b. U.S. Department of Health and Human Services c. National League for Nursing (NLN) d. The state board of nursing

A The Hawthorne effect means that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. Avoiding scrutiny and blame shifting do not demonstrate this effect of performance improvement, nor does adopting a leadership role on a temporary basis, which may or may not be seen as beneficial.

Accreditors are scheduled to visit a hospital site, and staff members have been made aware of what they will be assessing. What staff behavior would most clearly suggest the presence of the Hawthorne effect? a. The nurses consciously improve their performance because they know it is being scrutinized. b. The nurses avoid contact with the accreditors because they fear criticism. c. The manager blames individual nurses for deficits identified in the accreditation report. d. The manager temporarily adopts a leadership role.

B Theory X managers believe that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs. Close scrutiny of nurses' performance would suggest this perspective. Being inaccessible during a crisis is an undesirable trait in a manager, but this does not directly suggest a Theory X perspective. Collaboration and the distribution of rewards would be more closely associated with a Theory Y approach, which is more optimistic.

Caregivers at a public health center believe that their manager adheres to Theory X. What action by the manager best confirms this suspicion? a. The manager collaborates with senior staff to set quarterly goals for the center. b. The manager insists on accompanying nurses to community events and observes them closely. c. The manager is difficult to access when there is a problem or crisis in the center. d. The manager allocates rewards based on the outcomes of nurses' work.

A Authoritarianism is associated with strong control and decision making that does not involve others. Democratic leadership emphasizes broad participation in decision making, and a laissez-faire approach is highly permissive with low control. A contingency approach emphasizes the need for flexibility in leadership, not high control and centralized decision making.

The clinic leader tends to make decisions independently and closely supervises and controls the practice of the nurses at the clinic. What type of leadership is being exemplified? a. Authoritarian b. Democratic c. Laissez-faire d. Contingency

C Proper delegation practices that include assessment and evaluation help protect the RN from liability. In general, accountability is shared and does not lie solely with the subordinate. Delegation to licensed personnel does not completely release a nurse from liability.

Which statement is true regarding the general delegation liability of a registered nurse (RN)? a. It is minimal because subordinates alone are held accountable for practicing within the accepted scope of practice for their job classification. b. It is high because the RN is automatically held liable for the tasks delegated to all recognized subordinates. c. It is reduced when the RN delegates appropriately and supervises the completion of the tasks. d. It is avoided entirely as long as the nurse delegates only other licensed personnel.