Leadership exam 2 ch. 9, 11,12,14

15. Time management can be reduced to cyclic steps. What are the steps?

1. Allow time for planning and establishing priorities 3. Complete the highest priority task, and whenever possible, finish one task before beginning another. 4. Reprioritize based on remaining tasks and new information that may have been received. C) 1, 3, 4 Ans: C Feedback: Time management can be reduced to three cyclic steps: (a) allow time for planning and establish priorities; (b) complete the highest priority task, and whenever possible, finish one task before beginning another; and (c) reprioritize based on remaining tasks and new information that may have been received.

20. In prioritizing all the "do now" items, the manager may find preparing a written list helpful. What is important to remember about the written list?

1. It is a plan 3. It is a planning tool B) 1, 3 Ans: B Feedback: In prioritizing all the "do now" items, the manager may find preparing a written list helpful. The list is a planning tool. Remember, however, that a list is a plan, not a product, and that the creation of the list is not the final goal.

13. How can subordinates be discouraged from taking up a nursing manager's time unproductively?

3. Have limited office seating available 4. Refocus conversations as needed D) 3, 4 Ans: D Feedback: Do not make yourself overly accessible. Make it easy for people to ignore you. Try not to "work" at the nursing station, if this is possible. Interrupt. When someone is rambling on without getting to the point, break in and say gently, "Excuse me. Somehow I'm not getting your message. What exactly are you saying?" Avoid promoting socialization. Having several comfortable chairs in your office, a full candy dish, and posters on your walls that invite comments encourage socializing in your office. Be brief. Watch your own long-winded comments, and stand up when you are finished.

23. Which statement demonstrates adherence to habits that supports good time management skills? Select all that apply.

A) "It's important to me to be professional." B) "I can depend on the members of my team." C) "I've learned that I'm most energetic in the morning." D) "I'll adjust my sleep schedule now that I'm on night shift." Ans: A, B, C, D Feedback: Habit 1: Strive to be authentic. Be honest with yourself about what you want and why you do what you do. Habit 2: Favor trusting relationships. Build relationships with people you can trust and count on, and make sure those same people can trust and count on you. Habit 3: Maintain a lifestyle that will give you maximum energy. Exercise, eat well, and get enough sleep. Habit 4: Listen to your biorhythms and organize your day accordingly. Pay attention to regular fluctuations in your physical and mental energy levels throughout the day and schedule tasks accordingly. Habit 5: Set very few priorities and stick to them. Select a maximum of two things that are your highest priority, and work on them.

19. What do the "do now" requests reflect?

A) A unit's day-to-day operational needs Ans: A Feedback: The "do now" requests most commonly reflect a unit's day-to-day operational needs. These "do now" requests are not necessarily related to short-term goals or time-consuming. Nor are they also non-delegatable.

12. Which activity is associated with a leadership role in time management?

A) Assisting followers in working cooperatively to maximize time use Ans: A Feedback: A leadership role is to assist followers in working cooperatively to maximize time use. Management functions include the following: Appropriately prioritizes day-to-day planning to meet short-term and long-term unit goals; builds time for planning into the work schedule; utilizes technology to facilitate timely communication and documentation.

24. What is the primary reason for documenting nursing interventions as soon as possible after an activity is completed?

A) Decreasing the risk of inaccurate documentation Ans: A Feedback: Document your nursing interventions as soon as possible after an activity is completed. Waiting until the end of the workday to complete necessary documentation increases the risk of inaccuracies and incomplete documentation. The remaining options are accurate but lack the primary focus of patient safety.

11. Which is the foundational principle of nursing time management?

A) Short-term planning Ans: A Feedback: The foundational principle of time management is short-term planning. Strategic planning is a long-term activity while the other options lack the flexibility needed by time management.

2. What is the reason that first- and middle-level managers experience more interruptions than higher-level managers?

A) They generally interact directly with a greater number of subordinates in daily planning Ans: A Feedback: Frequent interruptions are common for first- and middle-level managers, who have a larger number of direct reports than do higher-level managers. The other options are not generally true statements.

14. What is the best response for a nurse-manager to handle someone who has a pattern of lengthy chatter?

B) "I can't speak with you now, but I'm going to have free time at 11 am." Ans: B Feedback: If someone has a pattern of lengthy chatter and manages to corner you on rounds or at the nurse's station, say, "I can't speak with you now, but I'm going to have some free time at 11 AM. Why don't you see me then?" Unless the meeting is important, the person who just wishes to chat will not bother to make a formal appointment. If you would like to chat and have the time to do so, use coffee breaks and lunch hours for socializing.

21. Which statement identifies a common mistake made related to daily planning?

B) "I have always handled my patients' needs as they arise." Ans: B Feedback: Two mistakes common in planning are underestimating the importance of a daily plan and not allowing adequate time for planning. The remaining options reflect an understanding of the importance of planning.

1. Which is the first step in the time management process?

B) Allowing enough time for sufficient daily planning Ans: B Feedback: Daily planning is essential if the manager is to manage by efficiency rather than by crisis. The remaining options are steps that occur after planning.

16. When is the best time of day for the manager to spend appropriate time on planning?

B) Beginning of the day Ans: B Feedback: Setting aside time at the beginning of each day to plan the day allows the manager to spend appropriate time on high-priority tasks.

18. What category of prioritizing will an item that will take care of itself be placed?

B) Don't do Ans: B Feedback: One simple means of prioritizing what needs to be accomplished is to divide all requests into three categories: "don't do," "do later," and "do now." The "don't do" items probably reflect problems that will take care of themselves, are already outdated, or are better accomplished by someone else.

4. What does the good manager have to remember about creating a daily list?

B) It is a planning tool, and thus must have flexibility in its implementation Ans: B Feedback: The daily list should be flexible, changeable, leave some time for the unexpected, and include appropriate short-term goals.

7. Which statement about time management is true?

B) Nurses who are self-aware and have clearly identified personal goals and priorities have greater control over how they spend their time Ans: B Feedback: Nurses who are self-aware and have clearly identified personal goals and priorities have greater control over how they spend their time. The other options are not true statements regarding time management.

8. Which task should the team leader initially engage in when planning care for a group of patients?

B) Prioritize the amount and type of nursing care each patient requires Ans: B Feedback: Prioritizing the care each patient will require is the initial step in care planning. The other options are considered but implementation will happen after the prioritizing.

10. Which technique will help the manager prioritize?

B) Putting some items in the "don't do" category Ans: B Feedback: The "don't do" list contains items that will take care of themselves, are already outdated, or are best accomplished by someone else. In the case of items that are best done by someone else, the manager should pass these along in a timely fashion. None of the remaining options address prioritization.

5. Which policy implemented by a manager will minimize unproductive socialization?

B) Scheduled appointments Ans: B Feedback: Appointments will discourage unproductive socialization since time will be allotted and a schedule maintained. Open-door policies and impromptu meetings encourage socialization while strict professional boundaries may actually interfere with communications.

6. Which plan is an effective way of handling a large task?

C) Break the task into smaller, less intimidating units Ans: C Feedback: Breaking down a task, or chunking, prevents the person from becoming overwhelmed by the size of the task. It may not be possible or advisable to finish the task without breaks or delegating it to staff.

9. What will the nurse-manager do to best reduce paper clutter in the workspace?

C) Deal with paper correspondence as soon as possible after it arrives. Ans: C Feedback: Whenever possible, incoming correspondence should be handled the day it arrives. It should either be thrown away or filed according to the date to be completed. The other options do not have the same amount of impact on controlling clutter.

22. How does the effective nurse manager most effectively deal with the ever-changing nature of the nursing work environment?

C) Frequently reassessing personally established priorities Ans: C Feedback: Setting new priorities or adjusting priorities to reflect ever-changing work situations is an ongoing reality for the unit manager. While the other options are appropriate, they are not directed to the management role in dealing with the ever-changing nature of the environment of nursing.

17. What is the most critical skill in good time management?

C) Priority setting Ans: C Feedback: Priority setting is perhaps the most critical skill in time management because all actions taken are some type of relative importance.

25. What is the suggested perception of a nurse manager who is consistently late for appointments?

C) The manager does not value other people's time Ans: C Feedback: A lack of punctuality suggests that one does not value other people's time. The other options may be true but the perception is the more emotional perception.

3. Which time waster does the manager have least control over?

D) Paperwork overload Ans: D Feedback: Excessive paperwork is an external time waster; the others are time wasters created by the manager (internal).

13. A nurse has asked a colleague for assistance with a complex wound dressing change. What response suggests that the colleague is at a novice level of nursing experience? b. "I'm really busy right now. Can we do it sometime this afternoon?" c. "I can do it for you later, if that helps." d. "Definitely. I'll go and get the supplies and meet you at the bedside." ANS: A Feedback: A novice typically requires clear directions and is oriented on following instructions and is less focused on thinking innovatively or independently. Deferring the other nurse's request or taking initiative would be less typical of a novice nurse.

a. "Sure. Can you give me directions and then I'll do what you say?"

13. A nurse has asked a colleague for assistance with a complex wound dressing change. What response suggests that the colleague is at a novice level of nursing experience?

a. "Sure. Can you give me directions and then I'll do what you say?" ANS: A Feedback: A novice typically requires clear directions and is oriented on following instructions and is less focused on thinking innovatively or independently. Deferring the other nurse's request or taking initiative would be less typical of a novice nurse.

22. The leadership of a large health-care organization has arranged a series of meetings with stakeholders. What individuals or groups would be included in this category? Select all that apply.

a. A community group that advocates for the rights of people addicted to drugs b. Representatives from the labor union that represents many staff members, an external organization, or individual c. A community group that promotes client safety in health care e. The surgeons and anesthetists who work in the operating room ANS: A, B, C, E Feedback: Stakeholders are those entities in an organization's environment that play a role in the organization's health and performance or that are affected by the organization. Stakeholders may be both internal and external, they may include groups. As a result, groups that focus on client safety or a particular vulnerable population would be considered stakeholders. As well, staff members or the organizations representing their interests would be considered stakeholders. The media would not normally play a role in the organization's health and performance or be affected by the organization.

7. A health-care organization utilizes decentralized decision making. What will most likely happen when there is need for decisions to be made in the organization?

a. A decision can be made at the lowest practical managerial level. ANS: A Feedback: Decentralized organizational structure allows decision making to be made at the level at which problems occur. Decision making by top managers is more likely when decision making is centralized. Decentralized decision making does not necessarily lead to rash decisions or unclear accountability.

16. A nurse is considering certification in an area of specialty. What potential benefits of certification should the nurse consider? Select all that apply.

a. A personal sense of accomplishment c. Increased career options d. Increased potential for advancement and promotions e. Higher salaries ANS: A, C, D, E Feedback: The certified nurse often finds many personal benefits related to the attainment of such status, including more rapid promotions on career ladders, advancement opportunities, and feelings of accomplishment. In addition, they often earn more than their noncertified counterparts. All nurses must complete continuing education requirements, regardless of certification.

2. Max Weber, as part of the scientific management era, contributed immensely to the development of organizational theory. Which statements are representative of his beliefs? Select all that apply.

a. Bureaucracy could provide a rational basis for administrative decisions. c. Organization charts could depict the hierarchy of authority. d. Impersonality of relationships should exist in organizations. ANS: A, C, D Feedback: Weber emphasized the impersonality of work relationships, the ability of bureaucracy to provide rational decisions, and the role of organizational charts. Max Weber's theories did not address worker satisfaction. Weber advocated promotions based on competence, not relationships.

3. A nurse manager is arguing for the establishment of a formal career development program in the healthcare facility. What potential benefits should the manager describe? Select all that apply.

a. Employee attrition can be reduced. b. Personnel can be used more effectively. e. New skills are brought into the organization. Feedback: Organizational justification for career development programs includes attrition reduction, improved productivity, and general improved quality of life. Career development programs cause a steady influx of new skills into an organization. Although employees may earn more money and additional benefits as a result of career development, they are not the reason that organizations undertake career development programs.

22. A nurse-manager is appraising employees' competency levels during performance reviews. What goal should the manager set when performing competency assessments?

a. Helping nurses identify ways to exceed minimal licensing requirements ANS: A Feedback: Competency assessment and goal setting in career planning should help the employee identify how to exceed the minimum levels of competency required by federal, state, or organizational standards. Consequently, goals should go beyond just meeting minimum requirements or fulfilling regulations.

10. The nurse-manager of a clinic has launched a career development program for nurses. The manager should anticipate what benefits? Select all that apply.

a. Increased retention of staff b. Decreased staff turnover c. Increased skill level of nurses d. Enhanced quality of work life for nurses ANS: A, B, C, D Feedback: Research has shown that career development programs increase retention, decrease attrition, increase nursing skill level, and improve the quality of work life for nurses. Career development is less likely to have a direct effect on interdisciplinary collaboration because this is not a direct result of career planning.

14. A nurse is applying for a job and is now writing a cover letter. The nurse should integrate what characteristics of a cover letter? Select all that apply.

a. Introduce the applicant. b. Briefly highlight key points of the resume. d. Make a positive first impression. e. Always used when submitting a resume. ANS: A, B, D, E Feedback: Cover letters should always be used when submitting a resumé. Their purpose is to introduce the applicant, briefly highlight key points of the resume, and make a positive first impression. The specific contact information for the nurse's references is not normally included in the cover letter.

25. Which statements are true concerning a bureaucratic organization? Select all that apply.

a. It is commonly referred to as a line organization. b. It is typically found in large health-care organizations. d. They resemble Weber's original design of organization. e. Its authority is represented by its staff organizational chart. ANS: A, B, D, E Feedback: Bureaucratic organizational designs are commonly called line structures or line organizations. Their structure is illustrated by an organizational chart. These designs are common in large health-care organizations and are based on Weber's original conceptualization. Policies and rules govern the organization rather than individual personalities.

1. After starting a new job, a nurse-manager has been surprised at the amount of grapevine communication that happens. The manager should recognize what characteristic of this type of communication?

a. It is difficult to control or stop. ANS: A Feedback: "Grapevine" communication is informal and is difficult to control or stop. Consequently, policies that aim to ban it are unrealistic. This type of communication can involve all types of content, not just negative messages. The spread of easy, instant electronic communication means that it is not always verbal.

16. A nurse-manager is chairing a workplace committee. What should the manager prioritize in this role?

a. Keeping members on task and promoting productivity ANS: A Feedback: Although all the items may be something the chairperson does, the primary responsibility is to keep members on task so that committee work gets completed. This is prioritized because it best reflects the main purpose of a committee, which is to collectively address specific tasks and challenges in the workplace.

12. A nurse-manager is working with a committee that is showing evidence of groupthink. What characteristic of the committee would show evidence of this phenomenon?

a. Members of the committee are unwilling to take risks with new ideas. ANS: A Feedback: Groupthink occurs when group members fail to take adequate risks by disagreeing, being challenged, or assessing discussion carefully. A preference for a rotating meeting chair does not necessarily indicate groupthink, nor does a preference for working by consensus. Unstable membership is not a desirable characteristic of a committee, but this does not directly indicate groupthink.

13. The nurse is working on a unit whose culture has become firmly entrenched? What solution should the nurses on the unit best propose?

a. New leadership Feedback: It is extremely difficult to change a unit culture without new leadership. A change in administrative support or even a reduction in workload will not necessarily challenge the established culture. Collaboration with a unit that is not entrenched may be beneficial, but new leadership is likely the most effective solution.

11. A nurse-manager is launching career coaching program in the workplace. What is the manager's best initial action?

a. Observe employees to see who would most benefit from coaching. ANS: A Feedback: The first step in career coaching is to observe employees and gather data. This should be performed before selecting participants or meeting with interested employees. It would be manipulative and counterproductive to link participation in a coaching program with an employee's performance appraisal. Coaching that is based on coercion is unlikely to be beneficial.

29. A nurse will soon be creating a plan for continuing competence. What activity should the nurse prioritize when making this plan?

a. Reflecting on his or her own practice Feedback: Reflection is a critical step in the development of a continued competence plan, and it must precede the development of goals. Eliciting input from others can be beneficial, but it is not a substitute for self-reflection.

24. The nurse-manager is designing a transition program for new nursing graduates. When planning this program, the manager should aim to address what issues? Select all that apply.

a. Supporting practice autonomy b. Strengthening new clinical skills c. Introducing time management skills d. Socializing nurses to the clinical environment ANS: A, B, C, D Feedback: A well-designed transition-to-practice program strengthens new graduates' skills and competencies and prepares the new nurse for the demands of caring for clients. As well, it socializes nurses to the professional role. These programs are designed to empower new graduates, not enforce policies and procedures.

26. A nursing supervisor has been given the responsibility for increasing the frequency and thoroughness of nursing assessments on a hospital unit. However, the supervisor does not have the authority to enforce new guidelines for assessment or assign consequences for noncompliance. What is the most likely outcome of this scenario?

a. The desired outcome will not be achieved. ANS: A Feedback: Responsibility without authority often causes role confusion and makes it difficult for a manager to enforce a necessary change. This is likely to cause the failure of the initiative. Without binding incentives and disincentives, it is unlikely that change will occur. Spontaneous collaboration is possible, but role confusion is more likely. The use of unauthorized enforcement could be problematic for the manager and would be most likely avoided due to the associated risk.

21. Which components are considered a part of an organizational structure? Select all that apply.

a. The individuals included in the group b. Lines of communication c. Decision-making process d. Channels of legitimate authority ANS: A, B, C, D Feedback: Organizational structure refers to the way in which a group is formed (membership), its lines of communication, and its means for channeling authority and making decisions. Organizational culture is an important aspect of every organization but this is not conveyed in the organizational structure.

28. A nurse-manager is reviewing the organizational chart of a health-care facility before accepting a job offer. When reviewing the organizational chart, the nurse should:

a. be aware that the informal structure of the organization cannot be discerned from the chart. ANS: A Feedback: Organizational charts convey the formal structure of an organization, but they do not include informal structures. It is impractical and unnecessary to review every individual's qualifications. Unless there are reasons to doubt the accuracy of the chart, it is unnecessary to confirm with the human resources department. Unless the manager is applying for a top-level position, it is often unnecessary and impossible to meet with the people at the top of the chart.

15. How can a nursing professional best demonstrate advanced achievement of competencies?

b. Achieving a new specialty certification ANS: B Feedback: Professional specialty certification is one way that an employee can demonstrate advanced achievement of competencies. The transfer, when used appropriately, may be an effective way to provide career. Career planning and ethical practice are minimum indicators of nursing practice, not indicators of advanced achievement. Requesting a transfer does not necessarily indicate that the nurse possesses advanced achievement.

17. The manager of a clinic is creating a system for career development for all employees. What should be included in this program? Select all that apply.

b. Appropriate use of transfers between work locations c. Policies and processes for handling promotions d. Long-term coaching ANS: B, C, D Feedback: The manager should have a well-developed, planned system for career development for all employees; this system should include the appropriate use of transfers, how promotions are to be handled, and long-term coaching. These policies should be fair and communicated effectively to all employees. Performance reviews are a necessity, but performing these quarterly is excessive and onerous. Specialty certifications are beneficial, but these are not normally required for all staff members. They are usually pursued by nurses who choose to pursue them rather than being a mandatory requirement for employment.

15. A manager is participating in introducing a shared governance model to a health-care organization. What is the manager's best action?

b. Form joint practice committees. ANS: B Feedback: In shared governance, the organization's governance is shared among board members, nurses, physicians, and management. Joint practice committees are developed to assume the power and accountability for decision making, and professional communication is egalitarian rather than hierarchical. Shared governance does not require a complete removal of lines of authority or the elimination of performance appraisals. Shared governance would not require more first-level managers.

1. A nurse is currently in the "promise" phase of career development. What goal should the nurse prioritize during this stage?

b. Gaining exposure to a variety of experiences Feedback: Promise is the earliest of the career phases and typically reflects the first 10 years of nursing employment. Milestones to be attained include socialization to the nursing role (becoming an insider); building knowledge, skills, abilities, credentials, and an education base; and gaining exposure to a variety of experiences. This stage begins after graduation, not before. Role modeling becomes more of a priority in the subsequent stages of the nurse's career. Obsolescence (or the perception of it) becomes an increasing concern during the harvest stage.

23. A nurse had made a renewed commitment to career planning. What activities should the nurse perform in order to meet this goal? Select all that apply.

b. Introducing evidence-based practice changes regarding wound dressings c. Discussing the health needs of the homeless with local politicians d. Earning a bachelor's degree in nursing e. Working with a seasoned mentor ANS: B, C, D, E Feedback: Career planning should include, at minimum, a commitment to the use of evidence-based practice, learning new skills or bettering practice through the use of role models and mentors, staying aware of and being involved in professional issues, and furthering one's education. Working more hours in the form of overtime will not necessarily advance the nurse's career plan.

23. A nurse had made a renewed commitment to career planning. What activities should the nurse perform in order to meet this goal? Select all that apply. a. Accepting more overtime shifts

b. Introducing evidence-based practice changes regarding wound dressings c. Discussing the health needs of the homeless with local politicians d. Earning a bachelor's degree in nursing e. Working with a seasoned mentor ANS: B, C, D, E Feedback: Career planning should include, at minimum, a commitment to the use of evidence-based practice, learning new skills or bettering practice through the use of role models and mentors, staying aware of and being involved in professional issues, and furthering one's education. Working more hours in the form of overtime will not necessarily advance the nurse's career plan.

20. A nurse is described by peers and colleagues as having expert knowledge, skills, abilities, credentials, and education base. What career stage is this nurse most likely in?

b. Momentum ANS: B Feedback: Momentum is the middle career phase and typically reflects the nurse with 11 to 29 years of experience. Nurses in this phase are experienced clinicians with expert knowledge, skills, abilities, credentials, and education base. "Promise" precedes this stage, and "harvest" follows it. Nurses in the harvest stage are often described as legacy clinicians.

25. A recent nursing graduate has begun working full-time and is committed to career planning. What action will be most likely to advance the nurse's career? a. Changing jobs every 12 to 18 months

b. Obtaining professional certification Feedback: Advanced certifications have many benefits for a new nurse's career plan. Changing jobs too often may create the impression that the nurse is unreliable. Ethical practice is an imperative part of nursing but is not considered a career planning activity. Similarly, active participation in career planning will not necessarily advance the nurse's career.

25. A recent nursing graduate has begun working full-time and is committed to career planning. What action will be most likely to advance the nurse's career?

b. Obtaining professional certification Feedback: Advanced certifications have many benefits for a new nurse's career plan. Changing jobs too often may create the impression that the nurse is unreliable. Ethical practice is an imperative part of nursing but is not considered a career planning activity. Similarly, active participation in career planning will not necessarily advance the nurse's career.

20. The nurse-manager works in a health-care facility that has applied for Magnet status. What characteristics of the organization will support the application? Select all that apply.

b. Open, participatory management c. Improved patient outcomes d. High staff nurse satisfaction ANS: B, C, D Feedback: Magnet designation is conferred by the ANCC to health-care organizations exemplifying well-qualified nurse executives in a decentralized environment, with organizational structures that emphasize open, participatory management. Magnet-designated organizations demonstrate improved patient outcomes and higher staff nurse satisfaction than organizations that do not have Magnet status. Magnet status is not dependent of registered nurses performing roles that are otherwise performed by practical nurses.

30. The top-level managers of a hospital have chosen to apply for magnet designation. The decision to grant this designation will be largely based on what factor?

b. The findings from an onsite visit by assessors ANS: B Feedback: A detailed onsite visit is a major component of the magnet accreditation process. Nurse educators from outside the organization would not normally be consulted, and a public opinion survey is not normally taken. Accreditors would review the organizational chart, but this is a lesser piece of data compared with the results of a site visit.

11. A manager has accepted a new position and there are more than 20 people who directly report to the manager. What description of this manager's role is most accurate?

b. The manager has a large span of control. ANS: B Feedback: The number of people directly reporting to any one manager represents that manager's span of control and determines the number of interactions expected of him or her. Without knowing more about the manager's role, there is no way of knowing if the workload is unrealistic or if this is a top-level position. This manager's large span of control is not necessarily a marker of a poorly designed organization.

14. Which characteristic of an organization would suggest that flattening is occurring?

b. There is reduction in the administration levels. ANS: B Feedback: Reducing the numbers of administration levels is called flattening the organization. A collective spirit, shared work goals, and adequate structures for conflict resolution are not related to organizational flattening.

8. A nurse who has transferred to a new workplace setting self-identifies as "competent" on Benner's continuum from novice to expert. What characteristic does this nurse most likely possess?

b. Two to 3 years of clinical experience ANS: B Feedback: Nurses who are at the "competent" stage of their career typically have around 2 or 3 years of experience. The possession of a degree is not a necessary characteristic. Similarly, it is unlikely that the nurse has firsthand experience at management. The nurse may or may not have a career plan; the absence of a career plan does not necessarily prevent ascension in nursing experience.

17. A nurse-manager has been commissioned to create a new workplace committee that will focus on client safety issues. When forming this committee, the manager should:

b. aim for diversity of genders and cultures among the membership ANS: B Feedback: When assigning members to committees, cultural and gender diversity should always be a goal. The manager should make efforts to accommodate members' schedules, but giving members' permission to attend as rarely as they wish will compromise the group's cohesion and effectiveness. Momentum must be created after the committee is formed, but this does not necessarily require twice-weekly meetings. It is unnecessary and unrealistic to split the membership between the manager's subordinates and superiors.

10. The nurse-manager is chairing a committee, most of whose members are subordinates. When communicating with the members during meetings, the manager should:

b. avoid overt demonstrations of power or authority. ANS: B Feedback: During committee work, encouraging interaction that is free of status and power is important. Recording for performance appraisal purposes is likely to be intimidating for committee members. There is no reason for all communication to be formal in a committee setting.

2. An experienced nurse manager describes a recently hired nurse as "very promising." The manager can best promote this nurse's career development by:

b. providing the nurse with increasingly challenging work assignments. Feedback: Providing challenging assignments is one way that the nurse's skills and knowledge can be enhanced, benefiting career development. Identifying the recent hire as a role model may place undue stress on the nurse and may create resentment from other nurses who have more experience. Giving the nurse positive feedback may validate the nurse's performance but will not necessarily promote career development. Removing the nurse from client care would be premature at this early stage.

27. What activity is most likely to promote a nurse's continued competence? a. Working in a variety of clinical settings b. Meeting minimal standards for relicensing

c. Acquiring new knowledge and skills on a regular basis Feedback: Continued competence requires a conscious plan for the nurse to increase his or her knowledge and skills on an ongoing basis. This goes beyond meeting the minimum requirements for licensure. Regular performance reviews will not necessarily cause a nurse to promote continued competence. Similarly, a variety of clinical settings will not expose the nurse to new experiences but may not be accompanied by an increase in knowledge and skills.

27. What activity is most likely to promote a nurse's continued competence?

c. Acquiring new knowledge and skills on a regular basis Feedback: Continued competence requires a conscious plan for the nurse to increase his or her knowledge and skills on an ongoing basis. This goes beyond meeting the minimum requirements for licensure. Regular performance reviews will not necessarily cause a nurse to promote continued competence. Similarly, a variety of clinical settings will not expose the nurse to new experiences but may not be accompanied by an increase in knowledge and skills.

27. An organization has proposed a policy stating that no more than five people should report to any single manager in the organization. What is the most likely outcome of this change in organizational structure?

c. Efficiency will decrease in the organization. ANS: C Feedback: Having too few people report to a manager creates an inefficient and top-heavy organization. Decision-making is likely to become similarly inefficient, although it may not become more unpredictable. This change in structure will not necessarily increase the autonomy or satisfaction of employees who may be under closer scrutiny.

23. A health-care organization has undergone an organizational restructure that increases nurses' autonomy and empowerment. What effect is most likely?

c. Increased effectiveness of client care ANS: C Feedback: Current research suggests that changing an organization's structure in a manner that increases autonomy and work empowerment for nurses will lead to more effective client care. There is no evidence that increasing the autonomy of nurses causes enhanced communication or collaboration, or that it has an effect on client autonomy.

4. A recent graduate's mentor is explaining the importance of career planning. What should the mentor teach the recent graduate about career planning?

c. It requires development and implementation of a long-term plan. Feedback: Effective career planning requires long-term planning; it is the responsibility of the individual and requires constant attention to function properly. Career planning should begin as soon as possible in the nurse's career; there is no need to delay it until accruing 12 months of experience.

19. During a strategic planning committee meeting to develop technology goals, several unit managers spend a considerable amount of time discussing current staffing problems. What is the primary action of the chairperson of this committee?

c. Request that committee members return to discussing items on the agenda. ANS: C Feedback: Committee time is wasted when agendas are not adhered to. The chairperson should avoid facilitating discussion of peripheral issues. It is unrealistic to put the committee's work "on hold" pending resolution of this problem. Dismissing the members who are discussing irrelevant issues is a heavy-handed approach that is unnecessary and which would be disruptive.

9. An experienced nurse-manager is organizing management development classes for some of the nurses in the organization. What principle should the manager follow when planning the classes?

c. The classes should include social learning activities. ANS: C Feedback: The inclusion of social learning activities in management development increases the possibility for employee retention. Management classes are not normally offered to every employee, but they should also not be limited to just employees with university degrees. There is no reason why they must be offered in an online format, and doing so may make it more difficult to apply social learning principles.

8. A middle-manager who oversees the operations of several nursing units has a high degree of organizational centrality. What is most likely true about this manager?

c. The manager receives much communication from varied directions. ANS: C Feedback: Centrality is a position on an organizational chart where it is possible to have many different types of communication (upward, downward, lateral, and diagonal). This does not suggest that there are more middle-level managers than lower level managers or that this manager is isolated from his or her superiors.

5. There is one vertical, solid line connecting a middle manager and a top-level manager on a clinic's organizational chart. What should a nurse conclude from this aspect of the organizational chart?

c. The middle manager has only one boss. ANS: C Feedback: Unity of command means one immediate boss per employee and is denoted by a single vertical line. This does not suggest equal authority among the two managers or that the top-level manager was promoted from the position below him or her. This portion of the chart does not indicate that the middle manager's position is permanent.

21. A nurse has applied for a new position and has presented a nursing portfolio to the human resources department. This portfolio will allow the nurse to:

c. give examples of professional growth. ANS: C Feedback: All nurses should maintain a professional portfolio to reflect their professional growth over their career. Normally, a professional portfolio is not used for presenting career goals, academic credentials, or justifying a desired salary.

24. The organization of work in a large health-care facility reflects Weber's theories around bureaucracies. What characteristic is most likely to exist in this facility?

d. A clear division of labor among employees ANS: D Feedback: Weber emphasized the need for a clear division of labor. Advancement was to be based on competence, not relationships. A high degree of accountability was to exist rather than absolute autonomy. The flow of work is more structured than flexible.

19. A nurse is currently in the "momentum" career phase. What activity is most appropriate during this stage of the nurse's career?

d. Being a role model to other nurses ANS: D Feedback: During the momentum stage, the individual often achieves a high enough level of expertise to be a role model to others. Adjusting from a student role and beginning to participate in continuing education are characteristic of the promise phase. During the harvest stage, the nurse must avoid obsolescence.

6. A nurse has recently graduated from nursing school and is transitioning into a nursing career. Which activity is the nurse's personal responsibility for career management?

d. Developing career goals ANS: D Feedback: Only the development of a career plan is the responsibility of the individual. The development of career ladders and career paths and the provision of challenging assignments are management responsibilities.

9. A nurse-manager has established a new committee and will be chairing the committee. The committee consists of six representatives from various departments, at various levels within the organization. What goal should the committee members set?

d. Implementing shared decision making ANS: D Feedback: A shared decision making is a desirable goal in most committees. This maximizes productivity and input. Communication does not necessarily need to be formal and a committee does not necessarily have to consist of 10 to 12 members. It would unusual for a committee to be charged with creating an entirely new organizational chart.

7. A nurse is interviewing for a position in a health-care facility. The interviewer identifies a long-term coaching program for career development as one of the benefits in the organization. The nurse should identify what characteristic of this program? a. It occurs annually at performance appraisal reviews. b. It focuses on employee performance deficits. c. It requires the same intensity as a mentoring relationship. Feedback: Long-term coaching should occur over the entire employment of the employee. Ideally, it is not something that happens solely at performance reviews, and it is generally not as interpersonally intense as a mentoring relationship. Coaching focuses on enabling strengths, not identifying deficits. Process

d. It occurs over the entire employment tenure of an employee. ANS: D

7. A nurse is interviewing for a position in a health-care facility. The interviewer identifies a long-term coaching program for career development as one of the benefits in the organization. The nurse should identify what characteristic of this program?

d. It occurs over the entire employment tenure of an employee. ANS: D Feedback: Long-term coaching should occur over the entire employment of the employee. Ideally, it is not something that happens solely at performance reviews, and it is generally not as interpersonally intense as a mentoring relationship. Coaching focuses on enabling strengths, not identifying deficits.

4. A clinical nurse specialist (CNS) is included on a hospital department's organizational chart. However, there are no solid lines leading to or from the nurse's position on the chart. What does this imply?

d. The CNS does not have formal authority over other staff members. ANS: D Feedback: The absence of a "line position" denotes an absence of formal decision-making authority. This is often the case for an advisory (staff) position such as CNS. However, this does not suggest that every other staff member holds authority over the CNS or that the CNS is not accountable for his or her safe practice and adherence to standards. Line positions do not represent personal relationships.

6. Which employee of a health-care organization would likely be considered a middle-level manager?

d. The hospital's nursing supervisor ANS: D Feedback: Nursing supervisors are middle-level managers. All the other listed nurses are first-level managers.

18. What characteristic of a nurse best indicates the attainment of an "expert" level of nursing experience?

d. The nurse possesses an intuitive grasp of complex clinical situations. ANS: D Feedback: Benner identifies the fact that the expert nurse has an intuitive grasp of complex situations. This normally requires more than 3 years of experience. Learning from experience and setting goals are characteristics of the earlier stages in Benner's continuum.

18. What should the leader remember when forming committees?

d. There should be sufficient expertise among committee members to accomplish the assigned task. ANS: D Feedback: The most important criterion for committee selection is overall adequate expertise to accomplish the agenda. Effort is an important criterion for membership, but this quality is not productive unless it is accompanied by expertise. There is no absolute minimum of 10 members. Written agendas provide structure and focus for committee meetings and the manager should provide these.

28. The manager of a busy medical-surgical wants to establish a transition-to-practice program. The manager should cite what benefit of the proposed program to the hospital's administrators?

d. Turnover of new staff will likely be reduced. ANS: D Feedback: Transition-to-practice programs reduce staff turnover and attrition. Their existence is less likely to be an issue for more experienced nurses. These programs can be expensive and may not cause a reduction in overall staffing costs. This program is unlikely to affect overall motivation on the unit.

28. The manager of a busy medical-surgical wants to establish a transition-to-practice program. The manager should cite what benefit of the proposed program to the hospital's administrators? a. More experienced nurses will be likely to apply for jobs. b. Nurses on the unit will be more motivated. c. Staffing costs will be reduced.

d. Turnover of new staff will likely be reduced. ANS: D Feedback: Transition-to-practice programs reduce staff turnover and attrition. Their existence is less likely to be an issue for more experienced nurses. These programs can be expensive and may not cause a reduction in overall staffing costs. This program is unlikely to affect overall motivation on the unit.

29. A rural hospital is considering a sharp reduction in the range and availability of the services it provides. Before making this change, the hospital's leadership should:

d. consult with local stakeholders. ANS: D Feedback: The stakeholders are all the internal and external individuals and groups that have an interest in an organization's operations. In a rural community where few options for health care exist, it would be prudent to consult with local stakeholders before a major change in service. There is no obvious need for this organization to decentralize, implement shared governance, or review its organizational chart.

30. A nurse has more than four decades of experience. In order to ensure that the nurse is not seen as obsolete by peers and colleagues, the nurse should:

d. continually seek new knowledge and experience. ANS: D

30. A nurse has more than four decades of experience. In order to ensure that the nurse is not seen as obsolete by peers and colleagues, the nurse should: a. seek a leadership position. b. offer to mentor newly graduated nurses. c. change jobs as frequently as possible.

d. continually seek new knowledge and experience. ANS: D

12. A nurse is selecting areas to focus on for continuing education and personal growth over the next year. During this process, the nurse should: a. prioritize learning that can take place in a college or university setting. b. ask the manager to perform this task, if possible. c. prioritize areas of study that are new to the nurse. ANS: D Feedback: Reflective practice has been suggested as a strategy for promoting personal growth and continued competence in nursing. This does not always point to a need for learning in a college or university setting, and it is unrealistic to delegate this task to a manager. Reflection may indicate a need to enhance knowledge and skills in areas that are familiar, not always new areas.

d. engage in reflective practice.

12. A nurse is selecting areas to focus on for continuing education and personal growth over the next year. During this process, the nurse should:

d. engage in reflective practice. ANS: D Feedback: Reflective practice has been suggested as a strategy for promoting personal growth and continued competence in nursing. This does not always point to a need for learning in a college or university setting, and it is unrealistic to delegate this task to a manager. Reflection may indicate a need to enhance knowledge and skills in areas that are familiar, not always new areas.

5. A nurse is constructing a resumé before beginning to search for a new job. When creating a resumé, the nurse should:

d. ensure that the document is concise and easy to read. ANS: D Feedback: The content of a resumé should be able to be grasped quickly by the individual doing the hiring, so conciseness and readability are of key importance. Weaknesses are not emphasized, and one to two pages is an ideal length

26. A manager is conducting career coaching for an employee who is new to the organization. When coaching this employee, the manager should: a. conduct the coaching in a group of no more than six to eight nurses. b. encourage the nurse to share his or her plans with the other nurses in the organization. c. help the nurse establish goals and make the attainment of the goals a condition of employment.

d. make sure not to intimidate the employee during questioning. ANS: D Feedback: In order to make coaching a productive activity, it is important that the manager not intimidate the nurse. Coaching is usually performed one-on-one, not in a group setting. In most cases, the nurse is not obliged or expected to describe these private and personal communications to the other nurses. Coaching should not normally become a precursor to binding expectations for performance.

26. A manager is conducting career coaching for an employee who is new to the organization. When coaching this employee, the manager should:.

d. make sure not to intimidate the employee during questioning. ANS: D Feedback: In order to make coaching a productive activity, it is important that the manager not intimidate the nurse. Coaching is usually performed one-on-one, not in a group setting. In most cases, the nurse is not obliged or expected to describe these private and personal communications to the other nurses. Coaching should not normally become a precursor to binding expectations for performance.

3. A nurse has begun working in a new health-care facility and is beginning to understand the organizational culture. When seeking to understand the organizational culture, the nurse should:

d. try to perceive the dominant values, traditions, and beliefs in the organization. ANS: D Feedback: Organizational culture is the symbols and beliefs, values, history, and communication patterns of the organization. It differs from organizational climate, which is how the employees perceive the organization. Employees may not be able to articulate the organizational culture due to their proximity to it. Culture does not determine the potential for advancement and is not solely a reflection of demographics.