Leadership Chapter 10

The nurse has attended a "how to" refresher course on successful delegation. Which statement indicates successful learning has taken place? A. "I knew that effective delegation made my job easier, but I never thought about how it could benefit the hospital." B. "The clients on our unit come and go so frequently that delegation is of little benefit." C. "I just don't understand why people think delegation is difficult; all you have to do is tell other people what to do." D. "Now I know that effective delegation means telling my nursing staff when they need to have their regular work done."

A. "I knew that effective delegation made my job easier, but I never thought about how it could benefit the hospital."

Which statements would be important for the charge nurse to make when delegating a responsibility? A. "I think it would be important to our organization if you represent the unit on the policy and procedure committee." B. "I have assigned you to be the unit's representative because I don't have enough time to go." C. "I think your attendance at the task force meeting will be a good reflection on our unit." D. "I chose you to attend the meeting because it seems as though you have the lightest assignment." E. "I would like you to be the unit's representative on the client education task force committee."

A. "I think it would be important to our organization if you represent the unit on the policy and procedure committee." C. "I think your attendance at the task force meeting will be a good reflection on our unit."

In order to delegate, which must be present? A. Accountability for the assignment on the part of the delegate B. Accountability for the assignment on the part of the delegator C. Authority by the delegator to assign the task to the delegate D. Responsibility for task completion on the part of the delegator E. Authority of the delegate to accomplish the task as assigned

A. Accountability for the assignment on the part of the delegate B. Accountability for the assignment on the part of the delegator C. Authority by the delegator to assign the task to the delegate E. Authority of the delegate to accomplish the task as assigned

Which situations are examples of ineffective delegation? A. After delegating committee attendance to a staff nurse, the nurse manager also attends the meetings. B. The unit clerk asks the nurse manager to "listen for the phones" so the clerk can go to the hospital's celebration of hospital week. C. The nurse manager asks the staff nurse to collect information about a new type of hospital bed being considered for purchase. D. The staff nurse asks the UAP to provide simple discharge instructions to a client. E. The staff nurse often bathes clients because "I like to give bed baths."

A. After delegating committee attendance to a staff nurse, the nurse manager also attends the meetings. B. The unit clerk asks the nurse manager to "listen for the phones" so the clerk can go to the hospital's celebration of hospital week. D. The staff nurse asks the UAP to provide simple discharge instructions to a client. E. The staff nurse often bathes clients because "I like to give bed baths."

During the first staff meeting, a newly promoted nurse manager says, "I would like a commitment from all the nurses to review and improve the way delegation is done on the unit." Why would the manager be interested in delegation? A. Effective delegation allows the manager to focus more time on management tasks. B. Efficiency is increased by effective delegation. C. If the manager has more time to focus on managerial duties, there is more chance of career advancement. D. The nurse manager thinks unlicensed assistive personnel (UAPs) provide better bedside care than nurses. E. The manager is interested in developing the entire staff to its maximum potential.

A. Effective delegation allows the manager to focus more time on management tasks. B. Efficiency is increased by effective delegation. C. If the manager has more time to focus on managerial duties, there is more chance of career advancement. E. The manager is interested in developing the entire staff to its maximum potential.

A health care organization has provided intensive education to staff regarding benefits and correct methods of delegation. Why has the organization spent the time and money to sponsor these sessions? A. Good delegation helps to reduce overtime. B. Absences decrease when delegation is used correctly. C. Delegation is required by state boards of nursing. D. Patient satisfaction scores increase when care is efficient and effective. E. Good delegation increases productivity.

A. Good delegation helps to reduce overtime. B. Absences decrease when delegation is used correctly. D. Patient satisfaction scores increase when care is efficient and effective. E. Good delegation increases productivity.

Which statement represents a situation is which delegation is ineffective or inappropriate? A. The RN asks the LPN to assist with admissions by assessing the clients as they get to their rooms. B. The RN delegates administration of oral medications for a group of clients to the LPN. C. The LPN directs the unlicensed assistant to report vital sign changes on a post-operative client to the RN. D. The nurse manager asks the RN to act as chairperson for today's unit council meeting since the charge nurse went home sick.

A. The RN asks the LPN to assist with admissions by assessing the clients as they get to their rooms.

Which situations would cause concern about liability with regard to delegation? A. The nurse asks the LPN to change a central line dressing. B. The nursing supervisor asks the nurse for details about a client's history. C. The nursing assistant asks a nurse to check the status of a client on the team. D. The supervisor asks the charge nurse to give a nurse a difficult assignment. E. The charge nurse asks a staff nurse's opinion on the client's surgical incision.

A. The nurse asks the LPN to change a central line dressing. B. The nursing supervisor asks the nurse for details about a client's history. D. The supervisor asks the charge nurse to give a nurse a difficult assignment.

The job description of the staff nurse states the nurse is responsible for attending hospital committee meetings as assigned. The nurse manager asking the staff member to attend a risk management meeting is an example of which concept? A. Work assignment B. Overdelegation C. Ineffective delegation D. Transfer of authority

A. Work assignment

The nurse supervisor would like to delegate accreditation preparation activities to the nurse manager. The manager is unsure of what is expected and has no experience with accreditation. How should the manager respond? A. "I'll be glad to work on this task." B. "I will need some education on the accreditation process before I can accept this task." C. "I don't have time to add that to my work." D. "Please tell me more about what this assignment entails." E. "I'm not interested in working on this project."

B. "I will need some education on the accreditation process before I can accept this task." D. "Please tell me more about what this assignment entails."

Which situations are examples of the nurse directing rather than delegating? A. A nurse manager asks a staff nurse to participate in a standing hospital committee. B. A staff nurse asks the assistant to sit with the roommate of a client who has just died. C. During a code blue situation, a nurse tells another nurse to start an IV. D. A nurse tells an assistant to move a client into the hallway during severe weather. E. A nurse reminds assistants of standard protocol for evacuation in case of fire.

B. A staff nurse asks the assistant to sit with the roommate of a client who has just died. C. During a code blue situation, a nurse tells another nurse to start an IV. D. A nurse tells an assistant to move a client into the hallway during severe weather.

The nurse prepares the medication ordered for the client. The nurse asks the nurse assistant to give the medication when the client receives breakfast and to report on the task at its completion. The nurse assistant agrees. Which component of the steps of delegation was violated by this request? A. Defining the task B. Deciding on the delegate C. Determining the task D. Reaching agreement

B. Deciding on the delegate

A nurse asks an unlicensed assistant to help with discharging clients since so many are going home at one time. The nurse states, "Can you help get these clients ready to go home by helping them pack?" Which option best describes the statement with regard to effective delegation? A. The delegation is ineffective since the nurse has no responsibility to pack the client's belongings. B. Delegation would have been more effective had the nurse been more specific about which clients and when it should be completed. C. The delegation is ineffective because the nurse has no authority to ask the unlicensed assistant to help with client discharge. D. Delegation could have more effective had the nurse gone with the assistant to ensure the assistant did the packing as requested.

B. Delegation would have been more effective had the nurse been more specific about which clients and when it should be completed.

A nurse manager is delegating a new, complex task to the unit secretary. Which strategies should the manager use? A. Begin the instruction with a statement such as "It would be good if you could help me with this project." B. Make eye contact with the secretary when explaining the task. C. Talk to the secretary in person rather than by telephone or in e-mail. D. Introduce the generalities of the task with a promise that details such as a time line will follow shortly. E. Discuss the importance of the task to the organization.

B. Make eye contact with the secretary when explaining the task. C. Talk to the secretary in person rather than by telephone or in e-mail. E. Discuss the importance of the task to the organization.

The nurse manager gave the unit secretary complete responsibility for the unit's staffing, including finding replacements for call-ins and disciplining nurses with excessive call-ins. This is an example of which type of delegation? A. Effective delegation B. Overdelegation C. Reverse delegation D. Underdelegation

B. Overdelegation

Which situation indicates the nurse needs additional training on effective delegation? A. The charge nurse tells the unlicensed assistant to help prepare rooms for new clients. B. The office nurse calls in orders for admission on a client following a surgical complication. C. A rehabilitation nurse asks a physical therapy assistant to assist a client with ambulation around the facility. D. A home health nurse calls the office and asks another nurse to make the visit on her next client.

B. The office nurse calls in orders for admission on a client following a surgical complication.

The nursing supervisor is assessing a unit that has received several written complaints. The nurse manager seems overwhelmed and stressed trying to address many client situations. The charge nurse is trying to help everyone at once. Based on this assessment, what might this supervisor conclude? A. The nurse manager is inexperienced and needs time to adjust. B. The unit culture may foster distrust and poor communication among staff. C. Client complaints are usually an indicator of a larger unit problem. D. Nurses on the unit are in need of additional training and skills. E. The unit is short staffed.

B. The unit culture may foster distrust and poor communication among staff. C. Client complaints are usually an indicator of a larger unit problem. D. Nurses on the unit are in need of additional training and skills.

Which statement made by the nurse manager is an example of the first step of delegation? A. "I must choose a person with good time management skills to be the delegate for this task." B. "I plan to evaluate the outcomes of your work in 6 months." C. "I am going to delegate the responsibility of creating the vacation schedule." D. "I have some additional information that will help you in this task."

C. "I am going to delegate the responsibility of creating the vacation schedule."

What action is necessary by a delegate accepting delegation? A. Accept all aspects of the task delegated. B. Assume the delegator will serve as a mentor. C. Clarify the time line and expectations. D. Realize the delegate and delegator share responsibility.

C. Clarify the time line and expectations.

A newly licensed nurse is concerned about the legal aspects of delegation. What is the most important question for the nurse to consider prior to delegating a task? A. Do other nurses in the facility delegate similar tasks? B. How long has the assistant worked at the facility? C. Does this task involve nursing judgment? D. How busy is the delegate?

C. Does this task involve nursing judgment?

The nurse manager needs to delegate specific tasks to the charge nurse of the unit. Which action is an appropriate use of delegation? A. Instructing the charge nurse to assume a client team B. Asking the charge nurse to discipline a nurse on the unit C. Having the charge nurse lead a nursing quality assurance task force D. Evaluating all unlicensed personnel assigned to the unit

C. Having the charge nurse lead a nursing quality assurance task force

Which is the most important reason that practicing and mastering effective delegation skills is essential for nurses? A. Higher job satisfaction B. Greater confidence in skills C. Higher client satisfaction D. Increased time for other tasks

C. Higher client satisfaction

Which situation is an example of reverse delegation? A. The nurse manager asks the staff nurse to attend an in-service on a new product. B. The nursing supervisor asks the nurse manager to attend a meeting with the physicians. C. The licensed practical nurse asks the nurse manager to administer insulin to her client. D. The staff nurse asks the licensed practical nurse to record intake and output in his client's charts.

C. The licensed practical nurse asks the nurse manager to administer insulin to her client.

A staff nurse asks the nurse manager, "What assignment are you delegating to me today? I would like to begin to organize my day before shift report begins." What is the error inherent in this statement? A. There is no way for the nurse to know how to organize until the assignment is clear. B. The nurse manager would not make assignments. C. The nurse manager is not delegating but rather making daily assignments. D. Assignment occurs after shift report.

C. The nurse manager is not delegating but rather making daily assignments.

For the nurse to effectively and legally delegate, which document must be consulted and followed to reduce the likelihood of liability? A. The American Nurses Association Bylaws B. The National Council of State Boards of Nursing C. The regulations of the state nurse practice acts D. The rules of the governing specialty organization

C. The regulations of the state nurse practice acts

Which situation represents an obstacle to delegation? A. Most of the nursing staff deliver highly skilled care B. The entire organization has a team-centered culture C. There is a budget shortfall for the current fiscal year D. Each employee knows and executes job responsibilities

C. There is a budget shortfall for the current fiscal year

A nurse says, "I am always worried that I will be liable if someone I delegate a task to does something that hurts the client." What is the manager's best response to this concern? A. "You have lots of liability in your position as an RN." B. "The hospital will support you as long as you follow your job description." C. "You are at greater liability if you try to do everything yourself." D. "As long as you follow the five rights of delegation, your liability is minimal."

D. "As long as you follow the five rights of delegation, your liability is minimal."

The nursing supervisor would like to delegate an information-gathering task. All the people listed have the ability to perform the task. In general, whom should the supervisor ask to do this work? A. A nurse manager B. A staff nurse C. A licensed practical nurse D. An unlicensed nursing assistant

D. An unlicensed nursing assistant

The novice nurse manager is hesitant to delegate tasks to competent, experienced staff nurses. Fear of which factor is most likely to explain this hesitancy? A. Overburdening others B. Decreased personal satisfaction C. Increased liability D. Competition and criticism

D. Competition and criticism

The nursing supervisor states, "I really don't have the time to delegate this task to a nurse manager. I can do it faster!" What is the most likely basis for this statement? A. The nursing supervisor does not have time to delegate. B. The nursing supervisor's job description needs to be redefined. C. The nursing supervisor feels that he or she can do the job faster. D. The nursing supervisor is concerned that staff is ill-prepared to assume additional responsibilities.

D. The nursing supervisor is concerned that staff is ill-prepared to assume additional responsibilities.