EXAM 1 EVERYTHING (leadership)

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2. During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating? 1. Democratic 2. Autocratic 3. Laissez-faire 4. Bureaucratic

ANS: 1 Chapter: Chapter 9, Intervention in Groups Objective: Identify various leadership styles in groups. Page: 187 Heading: Leadership Styles: Democratic Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 The nurse who encourages clients to present problems and discuss solutions is demonstrating a democratic leadership style. Democratic leaders share information with group members and promote decision-making by the members of the group. The leader provides guidance and expertise as needed. 2 The autocratic leader is in charge of the group and others must persuade the leaders. 3 The laissez-faire leader is easily swayed and gives little to no direction. 4 Bureaucratic is not a leadership style.

11. A nursing instructor is teaching students about self-help groups like AA. Which student statement indicates that learning has occurred? 1. "There is little research to support AA's effectiveness." 2. "Self-help groups used to be the treatment of choice, but their popularity is waning." 3. "These groups have no external regulation, so clients need to be cautious." 4. "Members themselves run the group, with leadership usually rotating among the members."

ANS: 4 Chapter: Chapter 9, Intervention in Groups Objective: Identify various types of groups Page: 184 Heading: Types of Groups > Self-help Groups Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 These groups allow members to talk about feelings and reduce feelings of isolation, while receiving support from others undergoing similar experiences. 2 Self-help groups are very popular and very effective. 3 The groups are run by members, with leadership rotating. 4 The student indicates an understanding of self-help groups when stating, "Members themselves run the group, with leadership usually rotating among the members." Nurses may or may not be involved in self-help groups.

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.

8. During an inpatient educational group, a client shouts out, "This information is worthless. Nothing you have said can help me." These statements indicate to a nurse leader that the client is assuming which group role? 1. The group role of aggressor 2. The group role of initiator 3. The group role of gatekeeper 4. The group role of blocker

ANS: 1 Chapter: Chapter 9, Intervention in Groups Objective: Identify various roles that members assume within a group. Page: 188 Heading: Table 9.2: Member Roles Within Groups Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 The nurse should identify that the client is assuming the group role of the aggressor. The aggressor expresses negativism and hostility toward others in the group or to the group leader and may use sarcasm in an effort to degrade the status of others. 2 The initiator outlines tasks at hands and proposes methods for solution. 3 The gatekeeper encourages acceptance of and participation by all members. 4 The blocker resists group efforts.

9. During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development? 1. "It's hard for me to tell my story when I'm not sure about the reactions of others." 2. "I think Joe's Antabuse suggestion is a good one and might work for me." 3. "My situation is very complex, and I need professional, not peer, advice." 4. "I am really upset that you expect me to solve my own problems."

ANS: 2 Chapter: Chapter 9, Intervention in Groups Objective: Describe the phases of group development. Page: 186 Heading: Phases of Group Development > Phase II: Middle or Working Phase Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Stating, "It's hard for me to tell my story when I'm not sure about the reactions of others," does not demonstrate that the group has progressed to the working phase. 2 The nurse should recognize that group members have progressed to the working phase of group development when members begin to look to each other instead of to the leader for guidance. Group members in the working phase begin to accept criticism from each other and use it constructively to create change. 3 Stating, "My situation is very complex, and I need professional, not peer, advice," does not demonstrate that the group has progressed to the working phase. 4 Stating, "I am really upset that you expect me to solve my own problems," does not demonstrate that the group has progressed to the working phase.

16. A nursing instructor is teaching about psychodrama, a specialized type of therapeutic group. Which student statement indicates that further teaching is necessary? 1. "Psychodrama provides a safe setting in which to discuss painful issues." 2. "In psychodrama, the client is the antagonist." 3. "In psychodrama, the client observes actor interactions from the audience." 4. "Psychodrama facilitates resolution of interpersonal conflicts."

ANS: 2 Chapter: Chapter 9, Intervention in Groups Objective: Discuss psychodrama as a specialized form of group therapy. Page: 189 Heading: Psychodrama Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 This statement does not indicate a need for further teaching. 2 The nurse should educate the student that in psychodrama the client plays the role of him or herself in a life situation scenario and is called the protagonist. 3 This statement is accurate about psychodrama. 4 This statement indicates that teaching has been effective.

15. An experienced psychiatric registered nurse has taken a new position leading groups in a day treatment program. Which group is this nurse most qualified to lead? 1. A psychodrama group 2. A psychotherapy group 3. A parenting group 4. A family therapy group

ANS: 3 Chapter: Chapter 9, Intervention in Groups Objective: Describe the role of the nurse in group therapy. Page: 189 Heading: The Role of the Nurse in Therapeutic Groups Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Psychodrama is a form of group therapy and must be lead by qualified leaders who generally have advanced degrees in psychology, social work, nursing, or medicine. 2 Psychotherapy is a form of group therapy and must be lead by qualified leaders who generally have advanced degrees in psychology, social work, nursing, or medicine. 3 A psychiatric registered nurse is qualified to lead a parenting group. A parenting group can be classified as either a teaching group or therapeutic group. 4 Family therapy is a form of group therapy and must be lead by qualified leaders who generally have advanced degrees in psychology, social work, nursing, or medicine.

10. Which group leader activity should a nurse identify as being most effective in the final, or termination, phase of group development? 1. The group leader establishes the rules that will govern the group after discharge. 2. The group leader encourages members to rely on each other for problem solving. 3. The group leader presents and discusses the concept of group termination. 4. The group leader helps the members to process feelings of loss.

ANS: 4 Chapter: Chapter 9, Intervention in Groups Objective: Describe the phases of group development. Page: 186 Heading: Phases of Group Development > Phase III: Final or Termination Phase Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 This option is not appropriate after the group has ended. 2 Group members should have gained independence while in the group. 3 This option does not have the group members move through the termination phase. 4 The most effective intervention in the final, or termination, phase of group development would be for the group leader to help the members to process feelings of loss as they are losing the support of their group as it disbands. The leader should encourage members to review goals and discuss outcomes, reminisce about what has occurred, and encourage members to provide feedback to each other about progress.

What type of management was emphasized in the human relations era of management? A) Participatory B) Authoritarian C) Democratic D) Laissez-faire

Ans: A Feedback: The human relations era of management science emphasized concepts of participatory and humanistic management. Three primary leadership styles have been identified: authoritarian, democratic, and laissez-faire.

12. 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.

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 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.

What is the typical focus of managers? Select all that apply. A) Establishing a legitimate source of power B) Delegating responsibilities to staff members C) Formulate the budget to achieve the stated goals D) Direct attention to the management of unwilling subordinates

Ans: A, B, C Feedback: The manager is typically involved in the delegation of responsibilities through the power of the legitimate power associated with the position. To manipulate people, the environment, money, time, and other resources to achieve organizational goals is also a manager's focus. Attention to both willing and unwilling subordinates as well as established responsibilities is associated with the role of the manager.

Which statement depicts leadership? A) A leadership position is assigned B) A leadership position carries a legitimate source of power C) Members of a group will follow a person in a leadership position only by choice D) Leadership requires meeting organizational goals

Ans: C Feedback: A leader is the person who guides direction, opinion, and course of action without having an assigned position within the formal organization and so people choose to follow them. The other options are not accurate descriptions of leadership.

A manager has proposed to the hospital board that it hires someone to teach management and leadership classes and that head nurses are paid to attend the classes. What is this an example of? A) Using emotional intelligence B) Transformational leadership C) Building human capital D) Using quantum leadership

Ans: C Feedback: By providing classes in leadership, the manager is investing in the potential of the head nurse staff to become better leaders and managers. Human capital refers to the attributes of a person that are productive in some economic context, although it is normally measured and conceived of as a private return to the individual as well as a social return. None of the remaining options relate to the example provided.

What statement is true regarding decision making? A) It is an analysis of a situation B) It is closely related to evaluation C) It involves choosing between courses of action D) It is dependent upon finding the cause of a problem

Ans: C Feedback: Decision making is a complex cognitive process often defined as choosing a particular course of action. Problem solving is part of decision making and is a systematic process that focuses on analyzing a difficult situation. Critical thinking, sometimes referred to as reflective thinking, is related to evaluation and has a broader scope than decision making and problem solving.

What is the best definition of decision making? A) The planning process of management B) The evaluation phase of the executive role C) One step in the problem-solving process D) Required to justify the need for scarce items

Ans: C Feedback: Decision making is a complex, cognitive process often defined as choosing a particular course of action. Decision making, one step in the problem-solving process, is an important task that relies heavily on critical thinking and clinical reasoning skills.

What concept does early leadership-theory development suggest? A) Leadership is a process of influencing others within an organizational culture B) The interactive relationship between the leader and the follower is significant C) Some are born to lead, whereas others are born to be led D) Vision and empowerment are two of the most critical leadership skills

Ans: C Feedback: Early leadership theorists focused on broad conceptualizations of leadership that assumed that people have certain characteristics or personality traits that make them better leaders than others. The remaining options do not describe a concept suggested by early leadership-theory development.

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) Don't be afraid to let me know if you feel the project is overwhelming you. B) What do you suggest we do to address the problems that exist with the project? C) I can give you a few solutions for the issues you have been having with the project. D) Do you want more time to complete the project?

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.

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 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.

To decrease overtime, the manager of a surgical unit offers nurses who get their work finished on time for an entire 2-month period an extra day off with pay at regular time. What is this an example of? A) Bribing nurses B) Quantum leadership C) Principal agent theory D) Servant leadership

Ans: C Feedback: Principal agent theory suggests that followers may have an informational (expertise or knowledge) advantage over the leader as well as their own preferences, which may deviate from that of the principal. This may lead to a misalignment of goals. To influence the agent, the principal offers an incentive that corrects excessive overtime. The remaining options do not represent the example offered.

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.

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when one openly shares feelings and information appropriate to a situation? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) Self-awareness

Ans: C Feedback: Relational transparency refers to openly sharing feelings and information appropriate to a situation. Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guide his/her behavior, and self-awareness alludes to a knowing of self so as to make sense of the world.

1. 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.

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.

How many primary leadership styles have been identified? A) One B) Two C) Three D) Four

Ans: C Feedback: Three primary leadership styles have been identified: authoritarian, democratic, and laissez-faire.

Gardner states that integrated leaders-managers distinguish themselves from more traditional managers in six ways. Which is a distinguishing trait of a traditional manager rather than an integrated leader-manager? A) They are politically astute B) They look outward, toward the larger organization C) They extend influence only to their own group D) They emphasize vision, values, and motivation

Ans: C Feedback: Traditional managers influence those in their own groups while integrated leaders influence others beyond their own group. The remaining options represent traits that may be shared by both types.

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

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 stretching opportunities for employees

Ans: D Feedback: Stretching 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.

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.

1. During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style? 1. The nurse mandates that all group members reveal an embarrassing personal situation. 2. The nurse asks for a show of hands to determine group topic preference. 3. The nurse sits silently as the group members stray from the assigned topic. 4. The nurse shuffles through papers to determine the facility policy on length of group.

. ANS: 3 Chapter: Chapter 9, Intervention in Groups Objective: Identify various leadership styles in groups. Page: 187 Heading: Leadership Styles >Laissez-faire Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Mandating that all group members reveal an embarrassing personal situation is not an example of a laissez-faire leadership style. 2 Asking for a show of hands to determine group topic preference is not an example of a laissez-faire leadership style. 3 The nurse leader who sits silently and allows group members to stray from the assigned topic is demonstrating a laissez-faire leadership style. This style allows group members to do as they please with no direction from the leader. Group members often become frustrated and confused in reaction to a laissez-faire leadership style. 4 Shuffling through papers to determine the facility policy on length of group is not an example of a laissez-faire leadership style.

17. Which of the following behavioral skills should a nurse implement when leading a group that is functioning in the orientation phase of group development? (Select all that apply.) 1. Encourage members to provide feedback to each other about individual progress. 2. Ensure that group rules do not interfere with goal fulfillment. 3. Work with group members to establish rules that will govern the group. 4. Emphasize the need for and importance of confidentiality within the group. 5. Help the leader to resolve conflicts and foster cohesiveness within the group.

17. ANS: 2, 3, 4 Chapter: Chapter 9, Intervention in Groups Objective: Describe the phases of group development. Page: 186 Heading: Phases of Group Development > Phase I: Initial or Orientation Phase Integrated Processes: Planning Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1. Individuals should not be providing feedback to each other on progress. 2. The leader should ensure that group rules do not interfere with goal fulfillment. 3. During the orientation phase of group development, the nurse leader should work together with members to establish rules that will govern the group. 4. The leader should establish the need for and importance of confidentiality within the group. Members need to establish trust and cohesion in order to move into the working phase. 5. During the orientation phase it would not be appropriate to implement feedback or resolve conflict.

18. Order the following leadership expectations that occur in the three phases of the group development process. ___The leader encourages members to provide feedback to each other about individual progress and to review goals and discuss outcomes. ___The leader promotes an environment of trust and ensures that rules established by the group do not interfere with fulfillment of the goals. ___The leader helps to resolve conflict and fosters cohesiveness, while ensuring that members do not deviate from the intended task.

ANS: The correct order is 3, 1, 2. Chapter: Chapter 9, Intervention in Groups Objective: Phases of Group Development: Leadership Expectations. Page: 184 Heading: Physical Conditions That Influence Group Dynamics > Seating Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Analysis [Analyzing] Concept: Cognition Difficulty: Moderate Feedback: In the Initial, or Orientation, phase, the leader is expected to orient members to specific group processes, encourage members to participate without disclosing too much too soon, promote an environment of trust, and ensure that rules established by the group do not interfere with fulfillment of the goals. In the Middle, or Working, phase, the role of leader diminishes and becomes more one of facilitator. Some leadership functions are shared by certain members of the group as they progress toward resolution. The leader helps to resolve conflicts and continues to foster cohesiveness among the members, while ensuring that they do not deviate from the intended task or purpose for which the group was organized. In the Final, or Termination, phase, the leader encourages the group members to reminisce about what has occurred within the group, to review the goals and discuss the actual outcomes, and to encourage members to provide feedback to each other about individual progress within the group. The leader encourages members to discuss feelings of loss associated with termination.

19. A ______________________ is a collection of individuals whose association is founded on shared commonalities of interest, values, norms, or purpose.

ANS: group Chapter: Chapter 9, Intervention in Groups Objective: Define a group. Page: 183 Heading: Functions of a Group Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application[Applying] Concept: Cognition Difficulty: Moderate Feedback: A group is a collection of individuals whose association is founded on shared commonalities of interest, values, norms, or purpose. Membership in a group is generally by chance (born into the group), by choice (voluntary affiliation), or by circumstance (the result of life-cycle events over which an individual may or may not have control).

14. A 10-week, prenuptial counseling group composed of five couples is terminating. At the last group meeting, a nurse notices that the two most faithful and participative couples are absent. When considering concepts of group development, what might explain this behavior? 1. They are experiencing problems with termination, leading to feelings of abandonment. 2. They did not think any new material would be covered at the last session. 3. They were angry with the leader for not extending the length of the group. 4. They were bored with the material covered in the group.

ANS: 1 Chapter: Chapter 9, Intervention in Groups Objective: Describe physical conditions that influence groups. Page: 186 Heading: Phases of Group Development > Phase III: Final or Termination Phase Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 The nurse should determine that the clients' absence from the final group meeting may indicate that they are experiencing problems with termination. The termination phase of group development may elicit feelings of abandonment and anger. Successful termination may help members develop skills to cope with future unrelated losses. 2 This statement is unlikely for members who have attended every meeting previously. 3 They are likely experiencing sadness, not anger. 4 It is unlikely that they were bored.

6. During a group discussion, members freely interact with each other. Which member statement is an example of Yalom's curative group factor of imparting information? 1. "I found a Web site explaining the different types of brain tumors and their treatment." 2. "My brother also had a brain tumor and now is completely cured." 3. "I understand your fear and will be by your side during this time." 4. "My mother was also diagnosed with cancer of the brain."

ANS: 1 Chapter: Chapter 9, Intervention in Groups Objective: Discuss "curative factors" that occur in groups. Page: 185 Heading: Curative Factors Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Yalom's curative group factor of imparting information involves group members sharing knowledge gained through formal instruction, as well as advice and suggestions. 2 Stating, "My brother also had a brain tumor and now is completely cured," is not an example of imparting information. 3 Stating, "I understand your fear and will be by your side during this time," is not an example of imparting information. 4 Stating, "My mother was also diagnosed with cancer of the brain," is not an example of imparting information.

5. A client diagnosed with alcohol use disorder experiences a first relapse. During an Alcoholics Anonymous (AA) meeting, another group member states, "I relapsed three times, but now have been sober for 15 years." Which of Yalom's curative group factors does this illustrate? 1. Imparting of information 2. Instillation of hope 3. Catharsis 4. Universality

ANS: 2 Chapter: Chapter 9, Intervention in Groups Objective: Discuss "curative factors" that occur in groups. Page: 185 Heading: Curative Factors Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Analysis [Analyzing] Concept: Cognition Difficulty: Moderate Feedback 1 Imparting of information consists of giving and receiving information through formal instruction. 2 This scenario is an example of the curative group factor of instillation of hope. This occurs when members observe the progress of others in the group with similar problems and begin to believe that their personal problems can also be resolved. 3 Catharsis is the expression of both positive and negative feelings in the group setting. 4 Universality occurs when individuals realize that they are not alone in the problems, thoughts, and feelings they are experiencing.

3. Which situation should a nurse identify as an example of an autocratic leadership style? 1. The president of Sigma Theta Tau assigns members to committees to research problems. 2. Without faculty input, the dean mandates that all course content be delivered via the Internet. 3. During a community meeting, a nurse listens as clients generate solutions. 4. The student nurses' association advertises for candidates for president.

ANS: 2 Chapter: Chapter 9, Intervention in Groups Objective: Identify various leadership styles in groups. Page: 187 Heading: Leadership Styles: Autocratic Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Assigning members to committees to research problems is not an example of an autocratic leadership style. 2 The nurse should identify that mandating decisions without consulting the group is considered an autocratic leadership style. Autocratic leadership increases productivity but often reduces morale and motivation owing to lack of member input and creativity. 3 Listening as clients generate solutions is not an example of an autocratic leadership style. 4 Advertising for candidates for president is not an example of an autocratic leadership style.

12. When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group? 1. Open-ended membership; circle of chairs; group size of 5 to 10 members 2. Open-ended membership; chairs around a table; group size of 10 to 15 members 3. Closed membership; circle of chairs; group size of 5 to 10 members 4. Closed membership; chairs around a table; group size of 10 to 15 members

ANS: 3 Chapter: Chapter 9, Intervention in Groups Objective: Describe physical conditions that influence groups. Page: 184 Heading: Physical Conditions That Influence Group Dynamics > Seating Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Membership should be closed and focused on relations within the group. 2 Closed membership helps keeps the focus on members within the group. 3 The nurse should identify that the most optimal conditions for a therapeutic group is one in which the membership is closed and the group size is between 5 and 10 members, who are arranged in a circle of chairs. These criteria create a more favorable working environment for clients, as they are able to become more comfortable with each other. The focus of therapeutic groups is directed to relations within the group and the interactions among group members. 4 This configuration is not the most optimal.

7. Prayer group members at a local Baptist church are meeting with a poor, homeless family whom they are supporting. Which member statement is an example of Yalom's curative group factor of altruism? 1. "Social services might be able to help you find a job." 2. "The last time we helped a family, they got back on their feet and prospered." 3. "I can give you all of my baby clothes for your little one." 4. "I can appreciate your situation. I had to declare bankruptcy last year."

ANS: 3 Chapter: Chapter 9, Intervention in Groups Objective: Discuss "curative factors" that occur in groups. Page: 185 Heading: Curative Factors Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 The statement, "Social services might be able to help you find a job," is not an example of the curative group factor of altruism. 2 The statement, "The last time we helped a family, they got back on their feet and prospered," is not an example of the curative group factor of altruism. 3 Yalom's curative group factor of altruism occurs when group members provide assistance and support to each other that creates a positive self-image and promotes self-growth. Individuals gain self-esteem through mutual caring and concern. 4 The statement, "I can appreciate your situation. I had to declare bankruptcy last year," is not an example of the curative group factor of altruism.

4. A single, pregnant teenager in a parenting class discloses her ambivalence toward the pregnancy and the subsequent guilt that these thoughts generate. A mother of three admits to having felt that way herself. Which of Yalom's curative group factors does this illustrate? 1. Imparting of information 2. Instillation of hope 3. Altruism 4. Universality

ANS: 4 Chapter: Chapter 9, Intervention in Groups Objective: Discuss "curative factors" that occur in groups. Page: 185 Heading: Curative Factors > Universality Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Analysis [Analyzing] Concept: Cognition Difficulty: Moderate Feedback 1 Imparting of information consists of giving and receiving information through formal instruction. 2 Installation of hope gives members hope that their problems can be resolved. 3 Altruism is assimilated through mutual sharing and concern. 4 The scenario is an example of the curative group factor of universality. Universality occurs when individuals realize that they are not alone in the problems, thoughts, and feelings they are experiencing. This realization reduces anxiety by the support and understanding of others.

13. During the sixth week of a 10-week parenting skills group, a nurse observes as several members get into a heated dispute about spanking. As a group, they decide to create a pros-and-cons poster on the use of physical discipline. At this time, what is the role of the group leader? 1. The leader should referee the debate. 2. The leader should adamantly oppose physical disciplining measures. 3. The leader should redirect the group to a less controversial topic. 4. The leader should positively reinforce the behavior of collective problem solving.

ANS: 4 Chapter: Chapter 9, Intervention in Groups Objective: Identify various roles that members assume within a group. Page: 186 Heading: Phases of Group Development > Phase II. Middle or Working Phase > Leader Expectations Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Cognition Difficulty: Moderate Feedback 1 Members are encouraged to solve issues that relate to the group cooperatively. 2 The leader should not take sides in the debate. 3 A democratic leadership style supports members in their participation and problem-solving. 4 The role of the group leader is to encourage the group to solve the problem collectively.

A transition has occurred in the twenty-first-century industrial age leadership to what type of leadership? A) Relationship age B) Quantum C) Authentic D) Thought

Ans: A Feedback: A transition has occurred in the twenty-first-century industrial age leadership to relationship age leadership. Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead, leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things.

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when analyzing data rationally before making decisions? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) Self-awareness

Ans: A Feedback: Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guide his/her behavior. Relational transparency refers to openly sharing feelings and information appropriate to a situation, and self-awareness alludes to a knowing of self so as to make sense of the world.

What does the Hawthorne effect implied about people? A) Human beings under investigation will respond to the fact that they are being studied B) Production will increase or decrease as light in a factory is increased or decreased C) Membership in small groups forms social control D) People are inherently good and will seek out work

Ans: A Feedback: Hawthorne effect indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. The other statements do not reflect implied beliefs about people.

Which leadership style maintains strong control over the work group and uses coercion to motivate others? A) Authoritarian B) Democratic C) Laissez-faire D) A contingency approach

Ans: A Feedback: Lewin identified three common leadership styles: authoritarian, democratic, and laissezfaire. Authoritarian leadership results in well-defined group actions that are usually predictable, reducing frustration in the work group and giving members a feeling of security. Productivity is usually high, but creativity, self-motivation, and autonomy are reduced. Authoritarian leadership is frequently found in very large bureaucracies such as the armed forces. Coercion to motivate is not associated with the other options.

Goleman in his best seller Emotional Intelligence identifies self-awareness as one of the five components of emotional intelligence. What is self-awareness? A) The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others B) The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment C) A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment D) The ability to understand and accept the emotional makeup of other people

Ans: A Feedback: Self-awareness: The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people.

Which activity supports the principles of strengths-based leadership? A) Tuition reimbursement for LPN to RN transition programs B) Rehab services to staff diagnosed with abuse problems C) Mental health counseling for depression and anxiety D) Smoking cessation support classes

Ans: A Feedback: Strengths-based leadership, which grew out of the positive psychology movement (began in the late 1990s), focuses on the development or empowerment of workers' strengths as opposed to identifying problems, improving underperformance, and addressing weaknesses and obstacles.

What is the basic premise of the interactional theory? A) Leadership behavior is generally determined by the relationship between the leader's personality and the specific situation B) Manager behaviors are generally determined by the relationship between the manager's personality and the specific situation. C) Both managers and followers have the ability to raise each other to higher levels of motivation and morality. D) Both leaders and followers have the ability to raise each other to higher levels of motivation and morality.

Ans: A Feedback: The basic premise of interactional theory is that leadership behavior is generally determined by the relationship between the leader's personality and the specific situation. Transformational leadership is where both leaders and followers have the ability to raise each other to higher levels of motivation and morality.

Which statement by a subordinate demonstrates the greatest problem for the leader? A) ìYour plans for the changes will be difficult to implement.î B) ìI don't think you heard what the rest of us had to say.î C) ìDo you have an idea what direction we need to go?î D) ìCan you tell me why my suggestion will not work?î

Ans: A Feedback: The statement is a clear indication that the subordinate feels the leader is not listening and collaborating; this is a fatal flaw. The other statements are more open to explanation by and with the subordinate and leader.

What is the conclusion of interactional theories regarding successful leadership? A) Leaders, followers, and the situation were all variables that interacted B) The situation had the most profound effect on success in leadership C) The situation has a greater effect on outcomes than followers do D) Good results would occur if leaders led well

Ans: A Feedback: The successful leader will diagnose the situation before applying strategies from a large repertoire of skills that involve assessing the various variables presented by the leader, the followers and the situation. The remaining options are not related to interactional leadership theory.

What type of manager is concerned with the day-to-day operations? A) Transactional B) Transformational C) Interactional D) Bureaucratic

Ans: A Feedback: The traditional manager, concerned with the day-to-day operations, is termed a transactional leader. This is not a characteristic of the other options.

What is a weakness of the traditional problem-solving model? A) Its need for implementation time B) Its lack of a step requiring evaluation of results C) Its failure to gather sufficient data D) Its failure to evaluate alternatives

Ans: A Feedback: The traditional problem-solving model is less effective when time constraints are a consideration. Decision making can occur without the full analysis required in problem solving. Because problem solving attempts to identify the root problem in situations, much time and energy are spent on identifying the real problem.

Which principle will help increase the likelihood that followers do not mislead their leader? A) Support the followers' right to disagree B) Rely only on facts and discount intuition C) Discourage acceptance until the facts are proved D) Identify who to rely upon and who not to listen to

Ans: A Feedback: There is no guarantee that followers will not mislead leaders, but adhering to certain principles, such as making sure that followers are allowed to disagree, will guard against this happening. The remaining options are flawed in the principles they support.

What concept is servant leadership based upon? A) Trusting and valuing employees B) Genuinely liking your colleagues C) A laissez-faire style of leadership D) A dynamic leadership charisma

Ans: A Feedback: These managers, termed servant leaders, put serving others, including employees, customers, and the community, as the number-one priority. In addition, servant leaders foster a service inclination in others that promotes collaboration, teamwork, and collective activism. The servant leader is not necessarily associated with the concepts identified in the other options.

What is a focus of thought leadership? A) Challenging the status quo B) Learning new technology C) Keeping up with current nursing knowledge D) Being a transformational leader

Ans: A Feedback: Thought leadership applies to a person who is recognized among his or her peers for innovative ideas and who demonstrates the confidence to promote those ideas. Thus, thought leadership refers to any situation in which one individual convinces another to consider a new idea, product, or way of looking at things. None of the other options is a focus of thought leadership.

18. 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.

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 nurse's aides (minimum of 75 hours of theory and practice and successful completion of an examination in both areas), no federal or community standards have been established for training the more broadly defined NAP. LPNs and RNs are not addressed by this act.

The failure to engage in which activity is considered a fatal flaw of leadership? Select all that apply. A) Collaboration B) Communication C) Self-improvement D) Staff development

Ans: A, B, C, D Feedback: Leadership is flawed and likely ineffective when the leader does not collaborate and communicate effectively with others in the organization. The improvement and development of both others and oneself is vital to the effectiveness of a leader. Clear forward thinking is associated with good leadership.

Which activity is associated with a leadership role? Select all that apply. A) Mentoring two new managers B) Establishing goals for the coming year C) Advocating for employee regarding personal policies D) Providing a motivational speech at the new employee orientation

Ans: A, B, C, D Feedback: Leadership roles include mentoring, decision making, advocating, andenergizing. Risk taking is also considered a leadership role.

Which action is associated with relationship age leadership? Select all that apply. A) Communicates regularly with subordinates B) Encourages teamwork to achieve problem solving C) Includes committee representatives from all areas that will be affected by the change D) Recognizes staff members who have contributed plausible problem-solving solutions

Ans: A, B, C, D Feedback: People skills, cooperation, and valuing staff knowledge are all characteristics of the relationship age leader. Focus on fact gathering rather than finding the meaning of the data is characteristic of an industrial age leader.

A manager demonstrating an understanding of the principles of Human Capital theory will schedule which staff in-service? Select all that apply. A) Effective communication skills B) Financial planning for retirement C) Advanced cardiopulmonary resuscitation D) Meeting the needs of the patient's family

Ans: A, C, D Feedback: Human capital can refer to a group's collective knowledge, skills, and abilities. Human capital theory suggests that individuals and/or organizations will invest in education and professional development if they believe that such an investment will have a future payoff. Communication, meeting family needs, and cardiopulmonary resuscitation are all skills and abilities that will enhance the individual's professional development and ultimately the services of the facility. The other options are related to the personal interests of the staff.

Which characteristics are associated with Collin's Highly Capable Individual level of leadership? Select all that apply. A) Possesses useful knowledge B) Builds effective interdisciplinary teams C) Galvanizes members to achieve goals D) Demonstrates effective organization skills

Ans: A, D Feedback: Level 1: Highly capable individual makes high quality contributions with their work; possesses useful levels of knowledge; and has the talent and skills needed to do a good job. Team building is a Level 2 characteristic. Organizational skills are associated with Level 3 while galvanizing members to achieve goals is demonstrated by Level 4 leaders.

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.

Which response is characteristic of a servant leader? A) ìI don't think you have the skills necessary to be effective.î B) ìLet me think about that request for 24 hours.î C) ìDo whatever it takes to get it done fast.î D) ìI'll personal handle this situation.î

Ans: B Feedback: A servant leader always thinks before reacting. This leader also chooses words carefully so as to not damage those being led, provides directions toward goal achievement, and finds asking for input more important than personally providing solutions.

Which is a characteristic of Theory Z? A) Non-consensus decision making B) Fitting employees to their jobs C) Rapid career promotions D) Authoritative problem solving

Ans: B Feedback: Characteristics of Theory Z include fitting employees to their jobs, consensus decision making, job security, slower promotions, examining the long-term consequences of management decision making, quality circles, guarantee of lifetime employment, establishment of strong bonds of responsibility between superiors and subordinates, and a holistic concern for the workers.

What does traditional management science focuses upon? A) Meeting worker satisfaction B) Delineating barriers to productivity C) Using a laissez-faire approach D) Encouraging employee participation

Ans: B Feedback: Classical, or traditional, management science focuses on production in the workplace and on delineating organizational barriers to productivity. Little attention was given to worker job satisfaction, and workers were assumed to be motivated solely by economic rewards.

What is an example of a positive outcome of a leader's emotional intelligence? A) Emotions are held in check B) Emotions are used effectively C) Expression of one's emotions is expected D) Expression of one's emotions is encouraged

Ans: B Feedback: Emotional intelligence refers to the ability to use emotions effectively and is required by leader-managers in order to enhance their success. Holding one's emotions in check can be unhealthy. The remaining options do not address the usefulness of emotions.

What does knowledge about good decision making lead one to believe? A) Good decision makers are usually right-brain, intuitive thinkers B) Effective decision makers are sensitive to the situation and to others C) Good decisions are usually made by left-brain, logical thinkers D) Good decision making requires analytical rather than creative processes

Ans: B Feedback: Good decision makers seem to have antennae that make them particularly sensitive to other people and situations. Left-brain thinkers are typically better at processing language, logic, numbers, and sequential ordering, whereas right-brain thinkers excel at nonverbal ideation and holistic synthesizing.

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 statement regarding the characteristics of a good leader is true? A) They are totally trustworthy B) They may have character flaws C) They are by nature good intentioned D) Charisma is their strongest attribute

Ans: B Feedback: Leaders may be deceitful and trustworthy, greedy and generous, and cowardly and brave. To assume that all good leaders are good people is foolhardy and makes us blind to the human condition. It is only when we recognize and manage our failings that leaders achieve greatness.

Which represents the management functions that are incorporated into the management process? A) Planning, directing, organizing, staffing, and evaluating B) Planning, organizing, staffing, directing, and controlling C) Organizing, planning, staffing, directing, and evaluating D) Organizing, staffing, planning, implementing, and controlling

Ans: B Feedback: Management functions include planning, organizing, staffing, directing, and controlling. These are incorporated into what is known as the management process.

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.

What assumption about workers does Theory X hold? A) Workers will naturally put forth effort B) Workers need threats to be motivated C) Workers are diligent and responsible D) Workers are in tune with organizational needs

Ans: B Feedback: Theory X managers believe that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs.

What type of leader is the person who is committed, has a vision, and is able to empower others with this vision? A) Transactional B) Transformational C) Interactional D) Bureaucratic

Ans: B Feedback: Transformational leadership positively impacts the leader and the follower, who have a collective purpose. The traditional manager, concerned with the day-to-day operations, was termed a transactional leader. The remaining options are not associated with these characteristics.

Which of the following statements is true regarding decision making? A) Scientific methods provide identical decisions by different individuals for the same problems B) Decisions are greatly influenced by each person's value system C) Personal beliefs can be adjusted for when the scientific approach to problem solving is used D) Past experience has little to do with the quality of the decision

Ans: B Feedback: Values, life experience, individual preference, and individual ways of thinking will influence a person's decision making. No matter how objective the criteria will be, value judgments will always play a part in a person's decision making, either consciously or subconsciously.

Shirey suggests there are five distinguishing characteristics of authentic leaders. Which characteristic is occurring when authentic leaders link between purpose and passion by having congruence in beliefs and actions? A) Purpose B) Values C) Heart D) Relationships

Ans: B Feedback: Values: Authentic leaders link between purpose and passion by having congruence in beliefs and actions. Purpose: Authentic leaders understand their own purposes and passions as a result of ongoing self-reflection and self-awareness. Heart: Authentic leaders care for themselves and the people they lead, and their compassion is genuine. Relationships: Authentic leaders value building relationships and establishing connections with others, not to receive rewards but rather to strengthen the human connection.

Max Weber, a well-known German sociologist, began to study large-scale organizations to determine what made some more efficient than others. What was his conclusion? A) Workers had to have a say in management to work most effectively B) Consistent rules and regulations for workers increased efficiency C) Employees should feel appreciated and valued D) Workers need frequent rest periods to increase overall production

Ans: B Feedback: Weber saw the need for legalized, formal authority and consistent rules and regulations for personnel in different positions. He thus proposed bureaucracy as an organizational design. None of the other options reflect his conclusions.

What is a distinguishing trait of integrated leader-managers? Select all that apply. A) Inward thinkers B) Long-term thinkers C) Concerned with employee motivation D) Possess influence beyond their own group

Ans: B, C, D Feedback: Gardner asserted that integrated leader-managers possess six distinguishing traits: They influence others beyond their own group; they emphasize vision, values, and motivation; they think longer term; they look outward, toward the larger organization they are politically astute; they think in terms of change and renewal.

2. 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.

Managing conflict among staff members would occur in which part of the management process? A) Planning B) Organizing C) Directing D) Evaluating

Ans: C Feedback: Directing sometimes includes several staffing functions. However, this phase's functions usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals.

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.

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.

15. 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.

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.

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

How many characteristics such as servant leadership does Tabaka suggest is required of an agile organization today? A) 1 B) 5 C) 10 D) 15

Ans: C Feedback: Tabaka suggests that servant leadership is one of the top 10 characteristics of an agile organization today.

What influences the quality of a decision most often? A) The decision maker's immediate superior B) The type of decision that needs to be made C) Questions asked and alternatives generated D) The time of day the decision is made

Ans: C Feedback: The greater the number of alternatives that can be generated by the decision maker, the better the final decision will be. The alternatives generated and the final choices are limited by each person's value system.

What is the critical leadership skill when attempting to build a cooperative and effective team? A) Showing their true feelings B) Empathizing with followers C) Identifying existing emotions in themselves and others D) Manipulating the emotions of all involved to achieve stated goals

Ans: C Feedback: Theorists studying emotional intelligence posit that the ability to identify emotions in themselves and in others is a critical ingredient of leaders, enabling them to build a cooperative and effective team. While the other options may have value, they do not represent the critical skill related to team building.

It is the idea that context is an important mediator of transformational leadership, that led to the creation of full range leadership theory early in the 21st century. This theory originally developed by Antonakis, Avolio, and Sivasubramaniam suggests how many transformational factors impacting leadership style and its impact on followers? A) One B) Three C) Five D) Nine

Ans: C Feedback: There are nine factors impacting leadership style and its impact on followers; five are transformational, three are transactional, and one is a nonleadership or laissez-faire leadership factor.

There are current and future paradigm shifts in health care that affect the leadership skills needed by nurses in the twenty-first century. What issue at the organizational and unit levels are nurse-leaders being directed to address? A) Active involvement in greatly needed health-care reform B) Persistent and growing international nursing shortage C) Shortage of qualified first-level nursing managers D) High turnover rates by staff nurses

Ans: D Feedback: At the organizational and unit levels, nurse-leaders are being directed to address high turnover rates by staff, an emerging shortage of qualified top-level nursing administrators, growing trends toward unionization, and intensified efforts to legislate minimum staffing ratios and eliminate mandatory overtime, while maintaining cohesive and productive work environments. At the national level, nurse-leaders and nursemanagers are actively involved in greatly needed health-care reform and in addressing a persistent, and likely growing, international nursing shortage. The other options, while describing noteworthy issues, do not include the issue that affects needed skills.

Which function of the management process involves the performance evaluation of staff? A) Planning B) Organizing C) Staffing D) Controlling

Ans: D Feedback: Controlling is the function that includes performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control.

Which statement concerning nursing leadership functioning at its potential is true? A) The leadership role is most important in nursing today B) Leadership is most important in managing health-care costs C) The most important nursing leadership role is being charismatic D) There is a need to integrate nursing management and nursing leadership

Ans: D Feedback: For managers and leaders to function at their greatest potential, the two roles must be integrated. The other statements are not true.

What is the idea that workers should be hired, trained, and promoted based on their competence and abilities related to? A) Part of the management functions identified by Fayol B) The result of the human relations studies C) The outcome of studies done by Mayo at the Hawthorne Works D) One of the four overriding principles of scientific management

Ans: D Feedback: Frederick Taylor, the ìfather of scientific management,î had the idea that workers should be hired, trained, and promoted based on their competence and abilities. This concept is not associated with any of the other options.

An organization has hired six RNs who have recently immigrated to the United States. The manager has noticed they interact very little with other staff, often speaking in their own language during their breaks, although they speak English while on duty. Which intervention would be the most helpful action for the manager to help these new RNs better assimilate? A) Explain to the new nurses the problem that their isolating is causing. B) Arrange to send them to an English language course at the local adult school. C) Ask the established RNs to make an effort to include the new nurses in after-work activities. D) Begin a short sharing session before client report, so all RNs can share information about their cultures and differences in client care.

Ans: D Feedback: Providing an opportunity for both groups of nurses to share their cultural heritage and differences in nursing care is an opportunity to promote acceptance among all members of the staff. It has been established that speaking the language is not a problem since they do so while on duty. Including them in after-work activities may demonstrate willingness on the staff's part but will not address work-related isolation. Merely presenting the problem to the new nurses does not show managing initiative.

What statement describes the concept of quantum leadership? A) Ability to use emotions effectively that is required by leader-managers in order to enhance their success B) In order to lead, leaders must be true to themselves and their values and act accordingly C) One individual convinces another to consider a new idea, product, or way of looking at things D) The environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity

Ans: D Feedback: Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead, leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things.

Goleman in his best seller Emotional Intelligence built upon work in his identification of five components of emotional intelligence. Which component of emotional intelligence is occurring when a person is proficiently handling relationships and building networks? A) Self-regulation B) Motivation C) Empathy D) Social skills

Ans: D Feedback: Social skills: Proficiency in handling relationships and building networks; an ability to find common ground. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people.

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.

Which statement about situational or contingency leadership theory is correct? A) High relationship behavior is much more essential to a good manager than high task behavior B) This leadership model is effective in bureaucratic organizations because it is task focused C) Management should be consistent in different situations so workers understand what is expected of them D) The leadership style chosen by a manager should reflect the task/relationship behavior of those being managed

Ans: D Feedback: The idea that leadership style should vary according to the situation or the individuals involved was first suggested almost 100 years ago by Mary Parker Follett, one of the earliest management consultants and among the first to view an organization as a social system of contingencies. The other options present statements that are incorrect.

17. 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.


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