Exam 1

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

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

Which area of questioning is considered an illegal interview inquiry? A) Questions about the applicants marital status B) The languages the applicant speaks or writes C) Inquiries about educational experiences D) Place of residence

Ans: A Feedback: Asking applicants about their marital status or whether they have children is unlawful. None of the other options are considered illegal areas of questioning.

Which factor is considered the greatest obstacle to solving the projected nursing shortage? A) Lack of nursing faculty B) Expense of nursing education C) Lack of interest in nursing as a career D) Poor social respect of the nursing profession

Ans: A Feedback: The nursing faculty shortage will likely be the greatest obstacle to solving the projected nursing shortage. None of the other options have the impact on the nursing shortage that the lack of nursing faculty has on the projected nursing shortage.

What determines the size of the authority-power gap between a manager and an employee? A) The organizational philosophy B) The degree of rigidity in the corporate chart C) How credible the manager is perceived to be D) How much informal power the manager possesses

Ans: C

What Positions should never be offered until information on the application has been verified and references have been checked. A) Physical examination B) Preemployment testing C) Reference check D) Personal interview

Ans: C Feedback: Positions should never be offered until information on the application has been verified and references have been checked.

What is the name of the gap that sometimes exist between a position of authority and subordinate response? A)Leadership-subordinate B)Manger-subordinate C)Administrator-power D)Authority-power

Ans: D

What are necessary components of leadership and management? A) Power and authority B) Power and Empowerment C) Authority and Authority-power gap 4) Empowerment and authority-power gap

Ans: A

What are the reasons for losing this power? A) Being politically naive, Failure to use appropriate political strategies B) Being politically naive, The lack of a dynamic and powerful persona C) Failure to use appropriate political strategies, Association with others who desire similar power D) The lack of a dynamic and powerful persona, Association with others who desire similar power

Ans: A

What does proactive political strategy include? A) Assuming authority to do something if it is not expressly prohibited B) Using competitive approaches to the decision-making process C) Attempting to appear as a victim so future gains can be made D) Verbalizing discontent with the politics of an organization

Ans: A

What is the foundation of reference of power? A) Association with others B) Ability to grand favor C) Personality D) Fear

Ans: A

What is the primary influence that shapes a person's response to authority? A) Power figures in the family unit B) Work experiences in each job held C) Administrative figures in the workplace D) Experiences in the spiritual dimension of life

Ans: A

Which factors are associated with the empowerment of staff? A) Allow, Develop, Enable B) Allow, Develop, Lead C) Allow, Enable, Lead D) Develop, Enable, Lead

Ans: A

Which is the positive outcome for a manger perceived to possess manager power? A) Staff have trust in the manager B) Unit staffing tends to remain stable C) The manager will be a leader as well D) Administration supports the manager's decision

Ans: A

Which strategy is most effective in empowering staff? A) Serving as a role model of an empowered nurse B) Following a rigid but consistent rule enforcement policy C) Providing all employees with an annual cost-of-living raise D) Encouraging staff to establish a strong unit culture with turf boundaries

Ans: A

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

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

Which statement about the proper placement of employees within the organization is correction? A) It occurs when an attempt is made to place employees in units where they have the greatest chance of success B) It is overrated as a retention strategy because most employees readily adapt to whatever unit on which they are placed C) It refers to placing employees on units that have the greatest need for new staff D) It occurs when employees are able to modify their own personal values and beliefs to coincide with that of the unit on which they are placed

Ans: A Feedback: If employees are placed where they have the greatest chance of success, employee morale and retention will be positively affected. None of the other options are accurate statements.

Which is an appropriate strategy for planning, conducting, and controlling the interview? A) When an applicant clearly does not have the proper qualifications for a position, the interviewer should be tactful, but advise the applicant as soon as possible that there is a lack of appropriate qualifications for the job B) Personal questions should be asked early during the interview process so a rapport can be established between the interviewer and the applicant C) The interviewer should develop questions that can be answered with a yes or no answer D) The interviewer should assess an applicants perceptive skills by sending nonverbal cues to the applicant during his or her responses

Ans: A Feedback: In situations in which the interviewee is not qualified for the position, the interviewer must inform the interviewee of this early and tactfully. After the interview is completed, the interviewer should take notes for the file of the exact reason for rejection in case of later discrimination charges. None of the other options identify an appropriate strategy.

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

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

12. Which assessment must the RN do initially when assigning tasks to non-licensed personnel (NAP)? A) Evaluating the NAPs skills and knowledge level B) Assessing which tasks the NAP is interested in assuming C) Evaluating how patients rate the NAPs 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.

An RN is orienting a new graduate nurse to the unit and has found this individuals charting to be inadequate. What is the most appropriate statement to initiate a discussion with the new RN? A) Tell me in your own words what you intend your charting to convey. B) Your charting is non-descriptive.i C) Do you think a refresher course in charting would help you? D) Are you having difficulty assessing your patient?

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

From an economic perspective, what is driving the current nursing shortage? A) Supply side of the supply/demand equation B) Demand side of the supply/demand equation C) Both the supply and demand sides of the supply/demand equation D) Short-term rise in demand in nursing services

Ans: A Feedback: From an economic perspective, the current nursing shortage is being driven more by the supply side of the supply/demand equation than the demand side. None of the other options identify that connection.

Which statement describes the induction phase of employee indoctrination? A) It occurs after hiring but before performing the role B) It includes the activities performed by the personnel department C) It relates to the information included in the employees handbook D) It is the responsibility of the staff development department

Ans: A Feedback: Induction, the first phase of indoctrination, includes all activities that educate the new employee about the organization and personnel policies and procedures before actually assuming nursing responsibilities. None of the other options identify that phase accurately.

What is the advantage of staff turnover? A) Fresh ideas B) Younger staff C) Cost containment D) Increased groupthink

Ans: A Feedback: Some turnover is normal and, in fact, desirable. Turnover infuses the organization with fresh ideas. It also reduces the probability of groupthink, in which everyone shares similar thought processes, values, and goals. However, excessive or unnecessary turnover reduces the ability of the organization to produce its end product and is expensive.

What is the most significant barrier to effective interpersonal communication? A) In-congruence between verbal and nonverbal messages B) In-congruence between telephone and written messages C) In-congruence between verbal and written messages D) In-congruence between telephone and nonverbal messages

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

23. Which action on the part of a manager demonstrates the mark of a great leader? A) Acknowledging the accomplishment of staff members at the units staff meeting B) Providing onsite in-services on new equipment for the staff C) Including funds in the units 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.

18. What occurs when a manager has the false assumption that delegation may be interpreted as a lack of ability on the subordinates 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.

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

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

In checking the background of a potential candidate for hire, which is the least frequently checked source? A) Academic credentials B) References of former employers C) References of recent teachers D) Verification of work history

Ans: A Feedback: Academic credentials are the least frequently checked background information. All of the other options are frequently checked.

16. 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 inurses aidesi (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.

When do nursing shortages historically occur? A) When the economy is beginning an upswing B) When the economy is receding C) When nursing salaries decline D) When patient acuity increases

Ans: A, B Feedback: Historically, nursing shortages occur when the economy is on the upswing and decline when the economy recedes. Historically, salaries were not a factor in existing nursing shortages. Currently, as the nursing pool ages, there is a nursing shortage projected.

Health disparities in the patient care population are most likely to occur when the health-care workforce lacks diversity in which area? Select all that apply. A) Age B) Gender C) Ethnicity D) Education

Ans: A, B, C Feedback: The workforce should also reflect the gender, culture, ethnicity, age, and language diversity of the communities that the organization serves. The lack of ethnic, gender, and generational diversity in the workforce has been linked to health disparities in the populations served. The importance of this goal cannot be overstated. The remaining options do not have the impact that the correct options have on this situation.

Which power-building strategy would be the appropriate for a new employee? Select all that apply. A) Maintaining a sense of humor B) Gaining additional nursing certifications C) Learning the institution's organizational culture D) Attending a training seminar on a new piece of unit equipment

Ans: A, B, C, D

Which statement regarding the view of power held by some women is true? Select all that apply. A) Power is inherently possessed by men B) Power is associated with personal attributes C) Power is viewed as dominance versus submission D) Power is associated with personal qualities not accomplishment

Ans: A, B, C, D

Which statement supports the manager's commitment to staff empowerment? Select all that apply. A) Unit goals include hiring an additional 2 nursing assistants B) A staff committee will be formed to address that unit issue C) We can arrange for you to spend 2 months working on another unit D) I've got funding to support staff who are interested in earning certifications

Ans: A, B, C, D

Which factor affects the accurate prediction of staffing needs? Select all that apply. A) When staff resignations historically occur B) How long new hires usually stay employed C) Education of current nursing staff members D) Third-party insurer reimbursement levels

Ans: A, B, C, D Feedback: Accurately predicting staffing needs is a crucial management skill because it enables the manager to avoid staffing crises. Managers should know the usual length of employment of newly hired staff and peak staff resignation periods. In addition, managers must consider the education and knowledge level of needed staff and have a fairly sophisticated understanding of third-party insurer reimbursement since this has a significant impact on staffing in contemporary health-care organizations.

What does empowerment encourage? A) Delegation of responsibility B) Sharing authority with others C) Relinquishing informal power D) Successful authoritarian leadership

Ans: B

What is coercive power based on? A) The ability to grand rewards to others B) The power of fear and of punishment C) The power inherent in one's position D) The gaining of knowledge and skills

Ans: B

What type of power does a professional nursing certificate provide? A) Legitimate B) Expert C) Charismatic D) Organizational

Ans: B

Which statement concerning women's view of power is true? A) Women view power as a male right B) Women view power differently than men do C) Gender views regarding power differ only slightly D) Gender view regarding power are rapidly changing

Ans: B

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

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

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

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

What is the relationship between the national and local economy and an organizations ability to maintain an adequate workforce? A) When the economy is on an upswing, many unemployed nurses return to work and recruitment becomes easier B) When a recession occurs it causes many part-time nurses to return to full-time employment and others to delay their retirement C) Although the economy tends to affect the size of the blue-collar workforce, professions such as nursing remain fairly stable regardless of economic changes D) When there is an economic downturn, many nurses reduce their work hours from full time to part time

Ans: B Feedback: Nursing shortages occur when the economy is on the upswing and decline when the economy recedes, because many unemployed nurses return to the workforce and part- time employees return to full-time employment. None of the other options identify that relationship.

What should managers do to maintain adequate staff in their organization? A) Proactively plan to hire two RNs for each unit each year B) Use knowledge of turnover rates on their units for planning and hiring C) Look at staff-to-patient ratios at other health-care organizations in the area D) Hire consultants to study national turnover rates to determine recruitment needs

Ans: B Feedback: Staffing needs are unique to each institution and should be determined by looking at patient census, patient health-care needs, the type of patient care management used, and budget. None of the remaining options are accurate statements concerning adequate staffing.

22. 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.

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

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

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

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

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

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

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

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

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

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

A nursing administrator believes that the organization supports an inadequate distribution of power. What is the administrator's initial action to combat this situation A) To form a coalition to extend administrative networking. B) To pose a plan for organizational restructuring. C) To gain entry into an informal power group. D) To improve one's personal power base

Ans: C

A staff member ask the manager for particular day off on the next schedule. Which response demonstrates the concept of under-promising and help the manager retain the staff's trust? A) I will do my best to give you the time off. B) Be sure to get the written request in early C) If staffing stays the same, I will arrange for your request D) If you don't take any sick time before then, I'll give it to you

Ans: C

Two of the organizational goals are to increase physician satisfaction and reduce costs. A unit goal is to increase professional RN staffing. Which statement best supports all the stated goals? A) Increasing the RN staff will cut down on nursing errors, prevent burn out, and decrease the cost associated with staff turnover B) Increasing the RN staff will result in increased patient safety and quality care, and thus improve physician satisfaction C) Increasing the RN staff will free more nurses to be available to answer doctors' concerns during their rounds and will reduce our costly use of overtime D) Increasing the RN staff will lead to improved patient education and a reduction in costly patient stays

Ans: C

Which statement concerning the queen bee syndrome is true? A) It occurs more often with women than with men B) It encourages the empowerment of subordinates C) It prevents the sharing of power D) It is an informal leadership role

Ans: C

Which statement about the role of unit managers in recruitment and selection is accurate? A) The more centralized nursing management is and the more complex the personnel department, the greater the involvement of the unit manager B) Unit managers should always leave such decisions to a centralized personnel department so consistency can be maintained C) Regardless of the extent of their involvement, all managers must be aware of recruitment and selection constraints within their organization D) Unit managers should assume total responsibility for recruitment and selection of personnel on their units

Ans: C Feedback: Although some institutions have personnel departments and nurse recruiters to carry out most of the hiring responsibilities, the nurse-manager must understand how recruitment and selection are accomplished within the organization. None of the remaining options are accurate statements concerning recruiting.

7. 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.

6. 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 should selectors do when processing the employment application? A) Accept the resume as an honest and objective source of data regarding the applicant B) Require a physical examination before making a hiring decision C) Always follow up on references and verify employment history D) Use unsolicited personal information about an applicant as a valid reason for job disqualification

Ans: C Feedback: Some managers prefer to verify credentials and references before the interview; others do it after the interview. Either way, doing a comprehensive check of credentials and references is of absolute importance. None of the other options identify the selectors processing role.

What is a common cause of a manger 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.

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

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

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

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

What location of the SBAR charting tool states the patients problem? A) Situation B) Background C) Assessment D) Recommendation

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

4. 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.

24. Which statement by the nurse-manager demonstrates an understanding of the need to provide effective guidance to those a project has been delegated? A) iDont be afraid to let me know if you feel the project is overwhelming you.i B) iWhat do you suggest we do to address the problems that exist with the project?i C) iI can give you a few solutions for the issues you have been having with the project.i D) iDo you want more time to complete the project?i

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.

25. 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.

13. 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 agencys 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.

What must managers delegate to another RN in order to assure completion of a task? A. Time & space B. Leadership & creativity C. Authority & responsibility D. Personnel & 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.

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

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

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

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

8. 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.

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

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

1. What is an inappropriate reason for delegation? A) To empower subordinates by istretchingi 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.

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

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

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

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

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

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

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

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

21. 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, nursenpatient ratios, and hospitalization stays does not have as great an impact as does the correct option.

What factor contributed significantly to the beginning of the acute RN shortage that originated in the late 1990s? A) Closing of nursing programs B) Lack of interest in nursing C) Hospital downsizing D) Poor nursing salaries

Ans: C Feedback: Hospital downsizing and shortsightedness regarding recruitment and retention contributed to the beginning of an acute shortage of RNs in many health-care settings by the late 1990s. None of the other options were significant contributors to the nursing shortage that began in the late 1990s.

20. Which restraining force occurs when a subordinate itests the wateri 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 itest the wateri and determine what the consequences are of not completing delegated tasks. The remaining options do not represent the behaviors described.

Which statement about power is correct? A) It is a finite quality and, once gained, is very difficult to lose B) It is destructively manipulative but is necessary for effect management C) Woman generally view power more positively than do men D) Having power generally results in the gain of additional power

Ans: D

Which statement describes both self-power and feminist power? A) The militant expression of power by assertive women B) The power gained from knowing other powerful people C) The narrowing of the authority gap between nurses and physicians D) Personally awareness that is demonstrated by having power over one's life

Ans: D

Which statement represents a powerful image of a team leader? A) I'm in charge here, and so all requests need to come to me B) I'm too tired to deal with Dr. Jones today. When he gets here, tell him I've gone to lunch C) Is it okay with the rest of you if I do all the charting and you do the direct patient care? D) We have a great deal to accomplish today, but I am confident that, by working together, we can do it and do it well

Ans: D

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

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

Which question asked during an interview is acceptable? A) Are you married? B) Have you ever been arrested? C) What is your religious preference? D) What professional organizations do you belong to?

Ans: D Feedback: It is lawful for an interviewer to ask about professional organizations, but the interviewer cannot ask the interviewee to produce a list of all memberships. None of the other options identify an acceptable question.

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

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

14. 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.

11. 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.

19. 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.

What should the interviewer do to increase the reliability and validity of an interview? A) Conduct single, rather than multiple, interviews B) Trust his or her first impressions of an applicant C) Avoid taking notes during the interview D) Develop a structured interview format

Ans: D Feedback: The same structured interview should be used for all employees applying for the same job classification. None of the other options identify an appropriate technique.

9. 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 istretchingi opportunities for employees

Ans: D Feedback: iStretchingi 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.

17. Who bears the ultimate responsibility for ensuring that the nursing care provided by team members meets or exceeds minimum safety standards? A) The patients primary healthcare provider B) The facilitys Director of Nursing C) The units nursing manager D) The teams RN

Ans: D Feedback: The teams 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.