chapter 20 Delegation

What occurs when a manager has the false assumption that delegation may be interpreted as a lack of ability on the subordinate's part to do the job correctly or completely? A) Underdelegating B) Overdelegating C) Improper delegating D) Inappropriate delegating

Ans: A Feedback: 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.

Which task would the director of a home health agency not delegate another staff RN? A) Assigning home health aides to specific patient care B) Serving on a diabetic study committee of community resources C) Meeting with the agency's administration regarding budget cuts D) Reviewing staff time cards for completion and accuracy

Ans: C Feedback: Management responsibilities associated with budgeting would not be delegated to another RN on the staff. The other options could be appropriately delegated to another RN.

Which action on the part of a manager demonstrates the mark of a great leader? A) Acknowledging the accomplishment of staff members at the unit's staff meeting B) Providing onsite in-services on new equipment for the staff C) Including funds in the unit's budget of staff development D) Stressing the importance of patient safety to all new employees

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

The Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of which health-care worker? A) Nurse aide (NA) B) NAP C) Licensed practical nurse (LPN) D) RN

Ans: A Feedback: Although the Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of ìnurse's aidesî (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 RNs are not addressed by this act.

Which assessment must the RN do initially when assigning tasks to non-licensed personnel (NAP)? A) Evaluating the NAP's skills and knowledge level B) Assessing which tasks the NAP is interested in assuming C) Evaluating how patients rate the NAP's performance D) Assessing how team members like working with the NAP

Ans: A Feedback: The manager must be knowledgeable about the skills and knowledge of all members of the health-care team. While the other options are factors regarding general NAP utilization, initially skills and knowledge levels take priority.

What is the first step the manager takes when a subordinate is having difficulty carrying out a delegated task? A) Take over the task so the employee 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) Re-assign the employee a different, less complex task

Ans: B Feedback: 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 co-assigning the task are options that are not initially considered.

What is the most important consideration for the manager when identifying the appropriate person to whom to delegate a specific task? A) Whose turn it is to delegate a 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

Ans: B Feedback: Managers should ask the individuals to whom they are delegating if they are capable of completing the delegated task.

Which characteristic is most important when the nurse-manager is considering staff for a delegated role? A) Years of experience B) Willingness to grow professionally C) Aversion to risk taking D) Pervious experience with similar tasks

Ans: B Feedback: Identify which individuals can complete the job in terms of capability and time to do so. Remember that it is a leadership role to stretch new and capable employees who want opportunities to learn and grow. Also look for employees who are innovative and willing to take risks. It is also important that the person to whom the task is being delegated considers the task to be important. Years of experience and exposure to similar tasks are not as important as interest in professional growth.

What is a common cause of a manager to underdelegation? 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

Ans: C Feedback: 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.

What statement concerning the delegating of tasks by the nurse to unlicensed assistive personnel (NAP) is true? A) One can safely assume that the NAP has at least a high school diploma as a minimum hiring criterion B) All unlicensed assistive personnel have achieved at least minimum standardized training pursuant to the Omnibus Budget Reconciliation Act of 1987 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 employee includes in the job description

Ans: C Feedback: No federal or community standards have been established for the training of the NAP. The Omnibus Budget Reconciliation Act relates to certified nursing assistants only. 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.

What is an inappropriate reason for delegation? A) To empower subordinates by "stretching" them in their work assignment B) To free the manager to address more complex, higher-level unit needs C) When the task is not a challenge for the manager D) Because someone else is better qualified to do the task that needs to be done

Ans: C Feedback: That the manager is not challenged by a task is not a valid reason for delegating that task to another. The other options are all appropriate reasons to delegate tasks to qualified staff.

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

Ans: C Feedback: 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 situation presents an example of inappropriate delegation? A) Temporary authority is given to support completion of a delegated task B) The person to whom a task is delegated considers it a challenge C) The employee is given exact instructions on completing the task D) Regular updates on the task are exchanged with the manager and the employee

Ans: C Feedback: 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. Depending on the complexity of the project, the manager should meet with the employee for updates. One of the goals of delegation is to challenge employees into learning new skills.

Which statement by the nurse-manager demonstrates an understanding of the need to provide effective guidance to those a project has been delegated? A) ìDon't be afraid to let me know if you feel the project is overwhelming you.î B) ìWhat do you suggest we do to address the problems that exist with the project?î C) ìI can give you a few solutions for the issues you have been having with the project.î D) ìDo you want more time to complete the project?î

Ans: C Feedback: 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.

When a manager appropriately recognizes the successful completion of a delegated team task, what is the primary reward for the manager? A) Less involvement in uncomplicated tasks B) A staff that is familiar with team-related delegated tasks C) Professional recognition as a leader D) Staff that is growing as professional caregivers

Ans: C Feedback: Leaders are often measured by the successes of those on their teams. Therefore, the more recognition team members receive, the more recognition will be given to their leader. Spending less time on uncomplicated tasks is not the primary gain for the nurse- manager. It is the staff that benefit from the exposure to team work and professional growth.

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

Ans: C Feedback: Managers must delegate the authority and the responsibility necessary to complete the task. Nothing is more frustrating to a creative and productive employee than not having the resources or authority to carry out a well-developed plan. Qualities like leadership, knowledge, and creativity are not transferable. The remaining option choices are resources that are provided rather than delegated.

Which restraining force occurs when a subordinate ìtests the waterî to determine what the consequences are of not completing a delegated task? A) Failure of delegator to see subordinate perspective B) Subordinate incapable of completing the task C) Subordinate inherent resistance to authority D) Overdelegation of specificity of the task

Ans: C Feedback: One cause of subordinate resistance to delegation is an inherent resistance to authority. Some subordinates simply need to ìtest the waterî and determine what the consequences are of not completing delegated tasks. The remaining options do not represent the behaviors described.

Which statement is true regarding the general delegation liability of the 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 great because the RN is automatically held liable for the tasks delegated to all recognized subordinates C) It is reduced when the RN appropriately assesses what and to whom delegation is appropriate and supervises the completion of the tasks D) It is avoided entirely by delegating tasks to only other licensed personnel

Ans: C Feedback: Proper delegation practices that include assessment and evaluation help protect the RN from liability. The other statements are not true.

Periodically during the day the RN checked with the team members to determine whether they are having difficulty completing their assigned tasks. This describes which manager role? A) Skills evaluation B) Patient safety C) Effective delegation D) Micromanagement

Ans: C Feedback: 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 is not related to any of the other options.

Which factor has the greatest impact on the need for nurses to possess excellent delegation skills? A) Increase in patient acuity levels B) Decrease in patient hospitalization time C) Increase in the use of NAP D) Decrease in nurse-to-patient ratios

Ans: C Feedback: With the increased use of NAP in patient care, the need for nurses to have highly developed delegation skills has never been greater. The impact of acuity levels, nurseñpatient ratios, and hospitalization stays does not have as great an impact as does the correct option.

Which organization is actively engaged in clarifying the delegation parameters for RNs? A) American Hospital Association (AMA) B) The federal government C) National League for Nursing (NLN) D) State Boards of Nursing Licensure

Ans: D Feedback: State Boards of Nursing Licensure is responsible for clarifying the delegation parameters for RNs. None of the other options are involved in this process.

A member of the team reports that they have been given too much to do and are not going to be able to complete the work on time. What action will the RN take to effectively manage this situation? A) Assign the work to another team member B) Take on the responsibility of the tasks C) Have the team member perform only the necessary tasks D) Examine the workload and assist the individual in reprioritizing

Ans: D Feedback: The manager should help the overwhelmed employee reprioritize the workload with the goal of making it manageable for that employee. None of the other options realistically assist the team member in managing time and prioritizing effectively.

What cultural phenomena must be considered for the biopsychosocial differences between racial and ethnic groups that have susceptibility to disease and physiologic differences? A) Space B) Social organization C) Environmental control D) Biologic variations

Ans: D Feedback: The phenomenon Biologic variations refers to the biopsychosocial differences between racial and ethnic groups, such as susceptibility to disease and physiologic differences. None of the other options are associated with managing these differences.

Who bears the ultimate responsibility for ensuring that the nursing care provided by team members meets or exceeds minimum safety standards? A) The patient's primary healthcare provider B) The facility's Director of Nursing C) The unit's nursing manager D) The team's RN

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

What managerial action is important when supporting the delegation of a task to a subordinate? A) Always requiring a maximizing quality outcome 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 ìstretchingî opportunities for employees

Ans: D Feedback: ìStretchingî provides growth opportunities for employees, builds employee self-esteem, and helps prevent boredom and de-motivation. The other options are not actions that are supportive of the staff and the delegation process