Management: practice questions

A nurse is considering applying for a management job that will require the nurse to make many difficult decisions. What question should the nurse ask when considering his or her ability to make difficult decisions? a. "How comfortable am I with taking risks?" b. "Am I able to apply the nursing processes in varied circumstances?" c. "Am I usually able to please my coworkers?" d. "How quickly do I think?"

ANS: A Feedback: An individual's comfort level with risk has a major bearing on that person's ability and willingness to make difficult decisions. It also affects the outcomes of decisions. The nursing process can have application in the decision-making process, but it is not among the most common decision-making models in management situations. A focus on pleasing other people may make it difficult to arrive at a decision when there are not ideal options available. Quick thinking can be beneficial when making some decisions, but people who are more methodical thinkers are not necessarily at a disadvantage. Quick thinking does not always lead to wise decisions.

The unit manager has created a decision grid in order to assist with a difficult staffing decision that will affect many nurses. The decision grid will allow the manager to: a. examine alternatives visually and compare each against the same criteria. b. ensure that the decision is made objectively rather than subjectively. c. plot the outcomes of a decision over time and evaluate the decision-making process. d. predict when events must take place to complete a project on time.

ANS: A Feedback: A decision grid allows one to visually examine the alternatives and compare each against the same criteria. This assists with the decision-making process, but it cannot guarantee that the decision will be completely objective. A decision grid is not a tool for tracking the outcomes of a decision. Decision grids are not synonymous with project planning tables.

Twenty-first-century leadership models generally emphasize the importance of: a. relationships. b. incentives. c. motivation. d. consequences.

ANS: A Feedback: A transition has occurred in the 21st century from industrial age leadership to relationship age leadership. Most of the contemporary models of leadership have some form of emphasis on relationships. Incentives, consequences, and motivation are not ignored, but relationships are highly prioritized.

The clinic leader tends to make decisions independently and closely supervises and controls the practice of the nurses at the clinic. What type of leadership is being exemplified? a. Authoritarian b. Democratic c. Laissez-faire d. A contingency approach

ANS: A Feedback: Authoritarianism is associated with decision making that does not involve others and strong control. Democratic leadership emphasizes broad participation in decision making, and a laissez-faire approach highly permissive with low control. A contingency approach emphasizes the need for flexibility in leadership, not high control and centralized decision making.

The nurse-manager has been approached by three different families in recent weeks, all of whom have described a particular nurse as giving exceptional care. The manager has relayed this feedback to the nurse and nominated the nurse for an organization-wide award. How should the manager's actions be best interpreted? a. The manager is giving an example of democratic leadership. b. The manager's actions are likely to cause accusations of favoritism. c. The manager is following the Great Man theory of leadership. d. The manager's actions may inadvertently discourage the other nurses.

ANS: A Feedback: Democratic leadership involves the use of awards and feedback. The Great Man theory posits that leadership is an inherent trait, not a learned trait; the manager's actions do not point to this. There is no reason to believe that a commendation may discourage the nurse's peers. Accusations of favoritism are unlikely, provided the manager's commendation is evidence-based.

A new nurse-manager has set a goal of implementing authentic leadership. What is the manager's best initial action? a. Identify and reflect on her own principles. b. Examine the source of her power in the organization. c. Differentiate colleagues who are allies from those who are potential threats. d. Delegate management activities so she can focus on leadership.

ANS: A Feedback: In authentic leadership, the leader's principles and values are paramount. Identifying these is a logical starting point for implementing authentic leadership. Separating people into allies and enemies is likely to result in conflict and authoritarianism. Authentic leadership does not require that all management activities must be delegated; authentic leadership can occur in a blended leadership-management role. Examining sources of power may be a necessary practical concern, but this is not a focus of authentic leadership and its focus on principles and values.

The preoperative admitting nurse witnessed a client sign an operative consent form. The nurse then cosigned the same document as a witness. The client suffered an injury during surgery and names the nurse in the suit because the nurse witnessed the consent form. What is the most likely outcome? a. The nurse is not likely liable because the signature only specifies that the nurse witnessed the client signing the consent form. b. The nurse is likely not liable because surgery is beyond the nurse's scope of practice. c. The nurse may be liable because cosigning the consent form makes the nurse an equal member of the surgical team. d. The nurse is liable because cosigning the consent form confirms that the client fully understood the risks of surgery.

ANS: A Feedback: Informed consent is obtained by a physician; therefore, in most cases, a nurse is not legally responsible for informed consent but is confirming that the client signed the consent form. If the nurse acts solely in the role of a witness, there are not likely to be legal consequences for the nurse. The nurse would not be considered to be a full member of the surgical team if his or her role was limited to admitting the client. Surgery is beyond the nurse's scope of practice, but this does not form the basis for the nurse's likely exemption from liability.

What statement by a manager best reflects the principles of interactional leadership? a. "People's motives are important, and motives change over time." b. "People perform to their fullest potential and then they're under pressure." c. "A person can't simultaneously act as a manager and a leader." d. "Organizations run best when there is no formal, centralized authority."

ANS: A Feedback: Interactional leadership emphasizes the fact that people's motives are very important and that these are constantly changing. Interactional leadership does not prioritize pressure as a form of incentive or motivation, and it does not deny a role for authority or for the integration of leadership and management principles.

A nurse-manager is planning to apply a decision-making model to a clinical challenge. When using a decision-making tool, what should the manager do? a. Be aware that the tool cannot eliminate the risk of human error. b. Have an impartial colleague apply the tool, if possible. c. Apply the tool as quickly as possible. d. Recognize that the tool will negate the effect of the manager's values.

ANS: A Feedback: Management decision-making aids are subject to human error and do not remove the effects of individual values, which always affect decision making. There is no particular reason that a tool would have to be applied by another person. Making the correct decision can take time; moving too quickly can compromise the quality of the process.

What action by a nurse-manager best demonstrates servant leadership? a. Prioritizing the interests of others over the manager's own interests b. Cultivating a personal relationship with each subordinate c. Making decisions on the basis of customer service d. Communicating a clear vision for the future and asking subordinates to share it

ANS: A Feedback: Managers who are servant leaders put serving others, including employees, customers, and the community, as the number one priority. This attitude is not dependent, however, on having a personal relationship with every subordinate. Customer service is valued, but the servant leader also emphasizes the needs of employees and the community. Servant leadership has a place for vision, but this is not a specific characteristic of this type of leadership.

A nurse-manager had to intervene in a conflict between a client and a staff member. The manager chose to make a decision "in the moment" rather than applying a methodical or deliberate decision-making tool. How should this manager's actions be best interpreted? a. The manager applied heuristics to a problem that required a quick solution. b. The manager should have used a decision-making tool before responding. c. The manager's decision was likely made on the basis of emotion. d. The manager demonstrated an autocratic leadership style.

ANS: A Feedback: Most individuals rely on discrete, often unconscious processes known as heuristics, which allows them to solve problems more quickly and to build on experiences they have gained in their lives. This manager's prompt decision making exemplifies this rapid approach. This does not necessarily lead to worse outcomes than a slower, more methodical approach. Heuristics can be based on experience and knowledge and are not simply expressions of emotion. Heuristics and rapid decision making are not synonymous with an autocratic leadership style that downplays input from others.

A subordinate has accused a manager of favoritism after the manager created the work assignment for the day. How should the manager best apply the principles of emotional intelligence? a. Identify and reflect on the feelings that she experiences after being accused. b. Recognize that the subordinate's statement was likely based on emotion rather than evidence. c. Involve a colleague in the situation who has no emotional investment in the situation. d. Choose a response that will diffuse the subordinate's emotions.

ANS: A Feedback: Self-awareness is a key component of emotional intelligence that involves the ability to recognize and understand one's moods, emotions, and drives as well as their effects on others. The manager should apply this aspect of emotional intelligence by self-reflection. This self-awareness can often help the manager address a challenging situation without having to involve an impartial third party. Emotional intelligence requires a manager to empathize with others' emotions, but this does not mean that decisions should be made with the sole goal of diffusing people's emotions. The manager must acknowledge the role of emotion but should not assume that a subordinate's complaint is exclusively emotional and lacking a rational basis.

A state Nurse Practice Act is an example of which source of law? a. Statutes b. Constitution c. Administrative d. Judicial

ANS: A Feedback: Statutes are the only laws made by official enactment by the legislative body. A Nurse Practice Act is an example of a "law that governs." As a statute, a Nurse Practice Act is not a form of constitutional, administrative, or judicial law.

A new leader-manager is planning to implement the principles of strengths-based leadership after being hired for a new position. What action will best facilitate this plan? a. Creating a team with diverse abilities and talents b. Identifying his or her personal strengths and utilizing them c. Appraising team members on a scale that runs from "weaker" to "stronger" d. Organizing the flow of work to match his or her strengths

ANS: A Feedback: Strengths-based leadership posits that effective leaders surround themselves with people who have different strengths than they do. The leader should focus on addressing areas where he or she is weaker, not relying solely on existing strengths. This model does not rank people on a two-dimensional scale because there are diverse ways of being strong.

Which activity best supports the principles of strengths-based leadership in a health-care organization? a. Funding for staff to become educated in areas where they are naturally talented b. Providing remedial services to staff who have committed a medication error c. Mental health counseling for staff who have depression or 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. Investing in staff to develop areas where they are naturally talented is an example of this. Remedial learning, counselling, and treatment address problems or vulnerabilities, not strengths.

Accreditors are scheduled to visit a hospital site, and staff members have been made aware of what they will be assessing. What staff behavior would most clearly suggest the presence of the Hawthorne effect? a. The nurses consciously improve their performance because they know it is being scrutinized. b. The nurses avoid contact with the accreditors because they fear criticism. c. The manager blames individual nurses for deficits identified in the accreditation report. d. The manager temporarily adopts a leadership role.

ANS: A Feedback: The 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. Avoiding scrutiny does not demonstrate this effect, which involves improving one's performance, knowing that it is being observed. Blame shifting does not reflect this deliberate improvement in performance, or does adopting a leadership role on a temporary basis, which may or may not be seen as beneficial.

What management activity characterizes the priorities that existed during the human relations era of management? a. Collaborative decision making b. Punishing workers who were unproductive c. Granting equal rights to men and women d. Application of laissez-faire leadership

ANS: A Feedback: The human relations era of management science emphasized concepts of participatory and humanistic management in which participative management was espoused. This included workers in decision making, which was innovative at the time. This did not mean that men and women gained equal rights. Leadership became more democratic but was not characterized as laissez-faire. Punitive actions were not central to human relations management.

Which statement by a subordinate demonstrates the greatest challenge for the leader? a. "Your plans for the change can't realistically be implemented." b. "I don't think you heard what the rest of us had to say." c. "Do you have an idea what direction we need to go?" d. "Can you tell me why my suggestion will not work?"

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 subordinate is not making a statement that leads to dialogue and solutions. The other statements express openness to explanation by and with the subordinate and leader.

A nurse is facing a malpractice suit after a client was injured in a fall. When establishing whether the nurse committed a breach of duty, the court will consult with: a. other nurses who practice in similar settings and specialties. b. members of public who have been treated in similar care settings. c. the administrators of the health facility where the fall occurred. d. medical experts from the same area of specialty.

ANS: A Feedback: The testimony of other nurses in the same specialty as the defendant may be used to prove breach of duty. These people are considered a reliable and valid source of information by the court, more so than members of the public, administrators, or medical experts.

The manager of a busy emergency department is primarily concerned with the practical, day-to-day operations of the department. This manager is most clearly demonstrating what type of leadership? 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. Transformational leadership prioritizes longer term vision and empowerment. Bureaucratic leadership emphasizes rules and regulations, whereas interactional leadership focuses on the link between personality and situations.

The nurse is applying the traditional problem-solving model when mediating in a conflict between two colleagues. When applying this model, the nurse should prioritize what task? a. Identifying the root cause of the conflict b. Implementing a solution as quickly as possible c. Eliciting input from other nurses d. Encouraging each nurse to reflect on his or her actions

ANS: A Feedback: The traditional problem-solving model attempts to identify the root problem in situations, a task that can require much time and energy. Efficiency is desirable, but trying to implement a solution as quickly as possible can result in a hasty and incorrect solution. Reflective thinking is always beneficial, but this is not a specific component of the traditional problem-solving model. Outside input may or may not be necessary; this varies with each individual problem.

The leader-manager provides oversight on a busy medical-surgical unit. There has recently been an incident where two nurses were not honest about neglecting a controversial new protocol and misled the leader. How can the leader-manager best prevent similar episodes? a. Support employees' right to disagree with proposed changes. b. Ensure that employees know the consequences of misleading the manager. c. Avoid making decisions that displease large numbers of employees. d. Identify allies who can be trusted to report employees who may mislead the

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 manager can often not avoid making unpopular decisions. Enacting punitive measures (consequences) has not been shown to encourage honesty. The use of "informants" is likely to cultivate mistrust and is likely to increase dishonesty.

A nurse-manager has proposed a change in the skills mix on a hospital unit, with fewer registered nurses and more nursing assistants. What outcome best demonstrates that the nurse is applying the principles of thought leadership? a. Skeptics of the plan have begun to see it as innovative and beneficial. b. Individuals who oppose the plan have become isolated by their peers. c. Nurses and nursing assistants will both participate in the operations planning. d. The ultimate decision on the matter will be based on rational ideas rather than emotions.

ANS: A Feedback: Thought leadership refers to any situation in which one individual convinces another to consider a new idea, product, or way of looking at things. The theory does not advocate achieving this through ostracizing dissenters. Inclusive leadership groups are beneficial, but this is not a particular characteristic of thought leadership. Thought leadership does not imply a rejection of emotion.

A nurse-manager will soon be introducing a significant change in the way that overtime shifts are allocated on a hospital floor. What action by the manager will best demonstrate the principles of thought leadership? a. Convincing employees that the change will be beneficial and innovative b. Relating the change to the fact that the floor has been required to cut costs c. Delegating the implementation of the change to the nurses themselves d. Describing clear expectations for nurses' adherence to the new policy

ANS: A Feedback: Thought leadership refers to any situation in which one individual convinces another to consider a new idea, product, or way of looking at things. Thought leadership does not emphasize financial realities, delegation, or the need for rigid adherence.

A novice nurse has been trying to apply the nursing process to each client interaction. What should the nurse do to enhance the effectiveness of this process for making decisions and solving problems? a. Ensure that specific goals are identified during the planning process. b. Conduct assessment and diagnosis simultaneously whenever possible. c. Prioritize ethics during each phase of the nursing process. d. Avoid evaluating the process until every outcome has been met.

ANS: A abirb.com/test Feedback: The weakness of the nursing process, like the traditional problem-solving model, is in not requiring clearly stated objectives. Goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured. Assessment and diagnosis often cannot be performed at the same time. Ethics should always be considered, of course, but this variable is not identified as enhancing the overall effectiveness of the nursing process. Evaluation is recommended as an ongoing, iterative process that is not reserved for when all outcomes have been met. Indeed, it is impossible to determine whether outcomes have been met without performing evaluation.

The failure to engage in which activities are considered a fatal flaw of leadership? Select all that apply. a. Collaboration with colleagues b. Communication with employees c. Self-improvement d. Staff development e. Determining salary scales for employees

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. Variables related to pay scales are more suggestive of a management role; this particular activity is not identified as a fatal flaw of leadership.

Which activities are associated with a leadership role? Select all that apply. a. Mentoring two new managers b. Establishing goals for the coming year c. Advocating for nurses to receive more professional development opportunities d. Providing a motivational speech at the new employee orientation e. Finding a nurse to cover another nurse's shift

ANS: A, B, C, D Feedback: Leadership roles include mentoring, decision making, advocating, and energizing. Risk taking is also considered a leadership role. Day-to-day functions such as staff scheduling are more closely associated with a management role.

What actions by the nurse-manager are consistent with relationship age leadership? Select all that apply. a. Communicating regularly and openly with employees b. Encouraging teamwork to solve problems and address issues c. Including committee representatives from all areas that will be affected by a change d. Recognizing staff members who have contributed to the organization's goals e. Encouraging competition between staff members to increase overall efficiency

ANS: A, B, C, D Feedback: People skills, transparent communication, cooperation, and valuing staff knowledge are all characteristics of the relationship age leader. Promoting competition is characteristic of an industrial age leader.

Which statements demonstrate a characteristic of a critical thinker? Select all that apply. a. "Since that didn't work effectively, let's try something different." b. "The solution has to be something the client is willing to do." abirb.com/test c. "I'll talk to the client's primary care giver about the problem." d. "Maybe there is no new solution to this particular problem." e. "It's important that we not give up; our clients deserve it."

ANS: A, B, C, E Feedback: A critical thinker displays persistence, empathy, and assertiveness. Trying a new approach shows persistence. Considering the client's participation shows empathy. Speaking to the care provider on the client's behalf shows assertiveness. Concluding that there is no solution to a problem reflects an inability to think outside the box. Stating "It's important that we not give up; our clients deserve it" shows persistence and empathy.

The leadership of a health-care organization has chosen to implement human capital theory. What actions should the organization promote in order to meet this goal? Select all that apply. a. Giving subsidies to nurses who want to advance their education b. Increasing the frequency of performance appraisals for managers c. Providing in-services and workshops for nurses and other care providers d. Increasing opportunities for families to participate in care planning e. Providing salary increases of 2% for all nonmanagement staff

ANS: A, C Feedback: Human capital theory emphasizes the benefits of investing in education and professional development. Making performance appraisals more frequent for managers is inconsistent with this focus on education and professional development. Salary increases are invariably popular but do not build capacity by increasing knowledge and skills. Similarly, including families is beneficial to the quality of care but is not a direct example of human capital theory.

Which characteristics are associated with a Highly Capable Individual in Collin's Level 5 Leadership model? Select all that apply. a. Possesses useful knowledge b. Builds effective interdisciplinary teams c. Galvanizes members to achieve goals d. Has the talent and skills needed to do a good job e. Works effectively to help a team succeed

ANS: A, D Feedback: In Level 1 of this model, a 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 and teamwork are Level 2 characteristics, whereas galvanizing members to achieve goals is demonstrated by Level 4 leaders.

A team of nurse-managers is considering the purchase of pressure-reducing mattresses to reduce the incidence of pressure ulcers among long-term care residents. In order to use a payoff table to assist with the decision making, what must the managers know? Select all that apply. a. The cost for each new mattress b. Clients' expectations for how a mattress should feel c. The prognosis for recovery from a pressure ulcer d. The cost of treating pressure ulcers e. The amount of time between ordering the mattresses and their delivery

ANS: A, D Feedback: Payoff tables can be used to make decisions involving cost, profit, and volume. To make a decision, the team would need to know how much it costs to introduce a mattress and how much it costs to treat a pressure ulcer. Other variables such as client expectations, timing, and prognosis would be considered when making a decision, but these variables would not be quantified into a payoff table.

The nurse-manager of the perioperative department is attempting to apply the full-range leadership model (FRLM) when overseeing the department. The nurse should attempt to integrate what types of leadership? Select all that apply. a. Laissez-faire b. Scientific c. Autocratic d. Transactional e. Transformational

ANS: A, D, E Feedback: The FRLM integrates the principles of laissez-faire, transactional, and transformational leadership. This model does not emphasize practices associated with autocratic leadership. Scientific management is an antiquated model of management that was influential in the early 20th century, not in contemporary models of leadership such as FRLM.

The nurse-manager of a community clinic is applying the principles of interactional leadership when addressing a challenging situation. What variables should the nurse prioritize when applying this model of leadership? Select all that apply. a. The characteristics of the nurse's personality b. The financial resources available to the nurse c. The consequences of failure d. The factors that motivate the employees of the clinic e. The specifics of the clinical challenge that the nurse is addressing

ANS: A, E 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. The nurse would not ignore other variables, such as finances, employee motivation, and the risks for failure, but these are not the central considerations in the model of interactional leadership.

A nurse-manager has realized that the data gathering process before a recent decision may have been influenced by confirmation bias. How can the manager best prevent this in the future? a. Delegate data gathering to a trusted colleague who has different values. b. Make sure not to prioritize information that supports the manager's beliefs. c. Consider all of the implications of an alternative before making a decision. d. Collect only the minimum quantity of data before making a decision.

ANS: B Feedback: Confirmation bias refers to our tendency to search for and favor information that confirms our beliefs while simultaneously ignoring or devaluing information that contradicts our beliefs. Self-awareness and reflection can reduce this tendency. Delegating the data-gathering process may be beneficial in some situations, but every person is prone to confirmation bias, although in differing ways. Considering the implications of a decision is an important part of decision making but does not address the issue of confirmation bias. Minimizing data collection may reduce confirmation bias but could compromise the quality of a decision.

Caregivers at a public health center believe that their manager adheres to Theory X. What action by the manager best confirms this suspicion? a. The manager collaborates with senior staff to set quarterly goals for the center. b. The manager insists on accompanying nurses to community events and observes them closely. c. The manager is difficult to access when there is a problem or crisis in the center. d. The manager allocates rewards based on the outcomes of nurses' work.

ANS: B Feedback: Theory X managers believe that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs. Close scrutiny of nurses' performance would suggest this perspective. Being inaccessible during a crisis is an undesirable trait in a manager, but this does not directly suggest a Theory X perspective. Collaboration and the distribution of rewards would be more closely associated with a Theory Y approach, which is more optimistic.

The nurse-manager is applying the decision-making process when addressing a nurse's high rate of absenteeism. This process should result in: a. an outcome that is desired by all. b. a chosen course of action. c. an action that guarantees success. d. a new understanding of the problem.

ANS: B Feedback: A decision is made when a course of action has been chosen. A decision may not always be pleasing to everyone involved in the situation, and success can never be fully guaranteed. The manager should seek to fully understand the problem, but this is a phase in decision making, not the result of the process.

Which response is most characteristic of a servant leader? a. "I don't think you have the skills necessary to be effective." b. "Let me think about that request for 24 hours and get back to you." c. "Do whatever it takes to get it done fast." d. "I'll personally handle this situation."

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. Speed is not a priority within servant leadership.

What is the value of using a structured approach to problem solving for the novice nurse? a. Facilitates effective time management b. Supports the acquisition of clinical reasoning c. Supplements the orientation process d. Encourages professional autonomy

ANS: B Feedback: A structured approach to problem solving and decision making increases clinical reasoning and is the best way to learn how to make quality decisions because it eliminates trial and error and focuses the learning on a proven process. This is particularly helpful to the novice nurse with limited clinical experience and intuition. The other options are outcomes of the possession of critical thinking skills and clinical reasoning.

The manager of a care facility advocates traditional management science. What is this manager most likely to prioritize? a. Ensuring that workers are satisfied in their roles b. Identifying and addressing barriers to efficiency c. Empowering workers to make decisions independently d. Providing rewards for exceptional caring

ANS: B Feedback: Classical, or traditional, management science focuses on production in the workplace and on delineating organizational barriers to productivity and efficiency. Little attention was given to worker job satisfaction, and workers were assumed to be motivated solely by economic rewards. This management style tends to be more authoritarian than empowering. Rewards are more likely to be conferred on workers who increase efficiency rather than those who exemplify psychosocial concepts, such as caring.

A leader is applying the principles of emotional intelligence? What outcome indicates successful application of these principles? a. Emotions are held in check. b. Emotions are used effectively. c. Emotions dominate decision making. d. Expression of emotion indicates success.

ANS: B Feedback: Emotional intelligence (EI) 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; EI does not demand this. EI does not require that emotions dominate decision making or that the expression of emotion is the marker of success.

Two nurses have approached the manager and have asked the manager to speak to a nurse on the unit who has a reputation for being difficult to get along with. How can the manager best implement authentic leadership? a. Meet with the "difficult" nurse to assess emotions. b. Analyze the facts of the situation before making a decision. c. Encourage all three nurse to meet without the manager present. d. Encourage all three nurses to disregard their emotions.

ANS: B Feedback: Four factors cover the components of authentic leadership. One of these is balanced processing, which involves analyzing data rationally before making decisions. This model acknowledges the salience of emotions, and it would not be appropriate or realistic to ask people to ignore them. Authentic leadership focuses on affective ways of being and does not prescribe specific actions like arranging meeting.

A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action? a. Share that information with the charge nurse on the previous shift. b. Document the incident and follow it up as per hospital policy. c. Write a memo to the nurse who made the error requesting an incident report be written. d. Document in the client's chart that an incident report will be completed.

ANS: B Feedback: It is the responsibility as manager to immediately document the error according to hospital policy. Because policies concerning such situations vary, it is vital to know and follow established policies. It is not generally appropriate to make such a note on the client's chart. Speaking to another nurse or manager is not a sufficient response, although this may be one part of the follow-up process.

Which statement regarding the characteristics of a good leader is true? a. They are brave in all situations. 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. No one can be brave in each and every situation. Many good leaders have strong charisma, but this is not always the case.

Which represents the management functions that are incorporated into the management process? a. Planning, directing, organizing, staffing, and transforming b. Planning, organizing, staffing, directing, and controlling c. Inspiring, planning, staffing, directing, and evaluating d. Organizing, staffing, planning, empowering, 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. Inspiring, empowering, and transforming are more often associated with a leadership role.

Which statement concerning the role of the most powerful individuals in organizational decision making is true? a. They exert less influence on decisions than was previously thought. b. They often make decisions that are in congruence with their own values. c. They tend to delegate decision making rather than making decisions themselves. d. They usually make the important decisions with consideration of effect on others.

ANS: B Feedback: Not only does the preference of the powerful influence decisions of others in the organization but the powerful are also able to inhibit the preferences of the less powerful. Powerful people in organizations are more likely to have decisions made that are congruent with their own preferences and values. Powerful people tend to make decisions on their own rather than delegating them. Often, the effect on others is not prioritized as highly as it should be.

Two registered nurses have disagreed about their scope of practice regarding medication administration. What resource should the nurse consult? a. The attorney general's office b. The Nurse Practice Act c. The nursing standards of practice d. The code of ethics

ANS: B Feedback: Nurse Practice Acts define and limit the practice of nursing, stating what constitutes authorized practice as well as what exceeds the scope of authority. An attorney general's office cannot supersede the provisions of a Nurse Practice Act. Ethical guidelines do not establish a nurse's scope of practice. Standards of practice describe the quality of a nurse's care but not the legal scope.

A nurse manager-leader is experiencing many challenges overseeing the care in a health-care organization. What statement most clearly indicates a need to apply quantum leadership principles? a. "There's a lot of conflict, not just between nurses but also between members of other disciplines." b. "Our workplace is in a constant state of change. Each part of our work is unpredictable and always shifting." c. "Historically, many decisions seem to have been made on the basis of emotion, and I'd really like to change that." d. "There's a rift between management and employees and it affects communication."

ANS: B Feedback: Quantum leadership posits that today's workplace is a highly fluid, flexible, and mobile environment, and this calls for an entirely innovative form of leadership. Quantum leadership encompasses varied aspects of this uncertainty, such as conflict and emotion, but these are not the central focuses of this theory.

An experienced nurse-manager has been described as being a "right-brain thinker." This manager's decision-making process likely prioritizes what characteristic? a. Linear analysis b. Intuition c. Transparency d. Efficiency

ANS: B Feedback: Right-brained thinkers have traditionally been characterized as being creative and intuitive. Linear analysis is more closely aligned with left-brained thinking. Transparency and efficiency are desirable qualities that are not particularly aligned with either of these two paradigms.

The nurse is working with a group of students who are learning a high-risk procedure. How should the nurse best ensure learning while protecting the safety of clients? a. Create an unfolding case study featuring the procedure. b. Use simulation for the students to learn and practice the skill. c. Help the students use a decision-making model to choose the safest technique. d. Teach the students about the traditional problem-solving process before they practice the procedure.

ANS: B Feedback: Simulation provides learners opportunities for problem solving that have little or no risk to clients or to organizational performance while providing models, either mechanical or live, to provide experiences for the learner. Simulation is generally considered to be more realistic (and conducive to learning) than a case study and no less safe. A decision-making or problem-solving model is not normally implemented when learning new skills or procedures.

A nurse has been hired to oversee the operations of a series of ambulatory clinics. The nurse can best promote the success of the organization by: a. promoting management skills among all employees. b. integrating leadership skills and management skills. c. clearly communicating to employees that they will be required to follow. d. advocating for the organization to hire a leader for each site.

ANS: B Feedback: Success and high achievement are best promoted when leadership and management functions are integrated by individuals. Promoting certain management skills among employees can be beneficial, but this cannot replace the importance of the leader-manager's own skill set. Followership cannot be mandated; it must be earned. The presence of multiple leaders can make it more difficult to effect change because of diverse visions.

A nurse-manager has recently been accused of assigning work unequally. The manager has recognized the need to revise the process for assigning work to nurses. How can the manager best apply the principles of Theory Z? a. Making a decision independently and imposing it on the nurses b. Gathering input from employees in order to reach a consensus c. Making a decision based on the pros and cons of each option d. Identifying as many different alternatives as possible

ANS: B Feedback: The characteristics of Theory Z include consensus decision making. Autocratic decision making, formal analysis of pros and cons, and maximizing the number of alternatives are not major characteristics of this leadership theory.

A nurse has recently begun a leadership-management role and is most likely to face challenges in: a. resolving tensions between baccalaureate-educated nurses and nurses without a degree. b. promoting best outcomes for clients while reducing costs. c. educating nurses about their legal scope of practice. d. marketing the organization to members of the community.

ANS: B Feedback: The fiscal realities of nursing and health care are known to make great demands on managers and leaders, regardless of their setting. For this reason, this challenge is more likely than intraprofessional tensions, which are more likely to be isolated. Marketing is not normally the responsibility of the nurse manager-leader. Scope of practice affects what nurse can and cannot do, but it is not the manager's responsibility to educate them about this; most professionals have a grasp of this before beginning a job.

The nurses on a medical unit are using several different techniques for performing wound care and the manager recognizes a need to implement evidence-based practice (EBP). What should the manager do first when applying the principles of EBP? a. Identify the main peer-reviewed journals in field of wound care. b. Formulate a specific, searchable clinical question about wound care. c. Perform a review of the literature about wound care. d. Identify how expert nurses typically perform wound care.

ANS: B Feedback: The implementation of EBP usually follows a linear approach that begins with formulating a specific question that can be used to guide a literature search. This should be done before starting a literature review or consulting experts in the field.

The nurse who manages an ambulatory clinic is well known as being a visionary leader who is skilled at empowering others with this vision. What type of leader is this nurse? a. Transactional b. Transformational c. Interactional d. Bureaucratic

ANS: B Feedback: Transformational leadership is characterized by the presence of a vision. Transformational leaders impart this to others, creating a collective purpose. The traditional manager, concerned with the day-to-day operations, was termed a transactional leader. Transactional leaders are not typically known as being visionaries. Bureaucratic leaders are focused on functions and processes, not vision. 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; vision is not a central focus.

Which statement is true regarding decision making? a. Scientific methods provide identical decisions by different individuals for the same problems. abirb.com/test 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. It is not possible for a nurse to fully "set aside" personal beliefs when making a decision, even if the nurse applies the principles of self-reflection.

What aspect of the way that work is organized on a nursing unit best reflects the management theories of Max Weber? a. A committee that includes employees and managers has been established to plan the work on the unit. b. The hierarchy of authority and the policies and procedures on the unit are clearly posted. c. Quarterly awards are granted to employees who have demonstrated exceptional service. d. Employees are allowed to self-schedule their vacation time and must work out any conflicts on their own.

ANS: B Feedback: Weber saw the need for legalized, formal authority and consistent rules and regulations for personnel in different positions. Clear expectations around authority and processes reflect Weber's beliefs. Weber did not emphasize collaborative decision making, using awards to incentivize work, or autonomy in workers' decision making.

What is the best reason that nurse-managers have an ongoing responsibility to be aware of legislation affecting nursing practice? a. Laws are created by people who are not nurses. b. Laws are fluid and subject to change. c. Awareness will help ensure ethical practice. d. Awareness is included in nursing standards of practice.

ANS: B Feedback: When using doctrines as a guide for nursing practice, the nurse must remember that all laws are fluid and subject to change. Laws are not static. It is the responsibility of each manager to keep abreast of legislation and laws affecting both nursing practice and management practice. It is true that laws are made by people who are not nurses, but this does not necessarily create a need for managers to stay abreast of laws. Standards of practice do not explicitly guide nurses to remain aware of changes in legislation. Awareness is unlikely to have a direct effect on ethical practice, which is rooted in values and beliefs about what is good.

A nurse oversees the care on a hospital unit in the role of an integrated leader-manager. What characteristics should this nurse exhibit? Select all that apply. a. The nurse describes herself has an "inward thinker." b. The nurse's thinking includes long-term issues. c. The nurse consciously attempts to motivate the employees. d. The nurse has influence that goes beyond her own group. e. The nurse is always conscious of political realities.

ANS: B, C, D, E 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; and they think in terms of change and renewal.

The manager at a long-term care facility has intervened in a conflict between two staff members about the timing and length of lunch and coffee breaks. What management function is this manager demonstrating? a. Planning b. Organizing c. Directing d. Evaluating

ANS: C Feedback: Directing entails 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. Evaluation is not one of the five specific functions in the management process.

A nurse failed to supervise a confused client, and the client fell while transferring to the bathroom. The client was unharmed, but the client's family has launched a malpractice suit, citing the nurse's breach of duty. What is the most likely outcome of this case? a. The outcome will depend on the extent to which the client was responsible for the incident. b. It will likely be successful, provided the family can prove the event was reasonably foreseeable. c. It will likely be unsuccessful because the client was not injured. d. The outcome will depend on how the nurse's actions compare to the established standard of care.

ANS: C Feedback: A malpractice suit requires evidence of actual injury to the offended party. The fact that this client was unharmed would likely jeopardize the suit, regardless of the client's role or the standard of care. Even if the event was foreseeable, the absence of injury removes a key criterion of malpractice.

What characteristic of a nurse-manager best demonstrates left-brained thinking? a. The manager highly values innovation and intuition when making decisions. b. The manager's relationships with peers are prioritized when evaluating decisions. c. The manager applies a linear, analytical model when making a decision. d. The manager is open to feedback from staff when making a decision.

ANS: C Feedback: Analytical, linear, left-brain thinkers process information differently from creative, intuitive, right-brain thinkers. Placing a value on relationships and being open to feedback are not specifically associated with one or the other sides of the brain.

A manager has proposed to the hospital board that it hire 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. There is no mention of the role of emotions or emotional intelligence. Quantum leadership focuses on the dynamic and multifactorial nature of leadership, but this is not evident in the scenario. Transformational leadership focuses on influencing and promoting vision; these are not evident in the scenario.

A client is preparing to be discharged from the health-care facility and has told the nurse that he would like to read his medical record. What is the nurse's best initial action? a. Arrange for the medical record to be provided to the client. b. Inform the client that this request will be communicated to the facility's ethics committee. c. Confirm the facility's policy around providing medical records to clients. abirb.com/test d. Check whether this provision is included in the jurisdiction's Nurse Practice Act.

ANS: C Feedback: Clients possess a right to view their medical records, but the protocols for facilitating this vary. Consequently, the nurse should check this facility's policy before acting. It would likely be premature for the nurse to provide the medical record to the client before communicating with other members of the care team or administrators to ensure policy is followed. This matter is outside the purview of ethics committees because it does not involve a dilemma. The Nurse Practice Act focuses on scope of practice and other regulatory issues, not client rights.

Which statement is true concerning critical thinking? a. It is a simple approach to decision making. b. It is narrower in scope than decision making. c. It requires reasoning and creative analysis. d. It is a synonym for the problem-solving process.

ANS: C Feedback: Critical thinking has a broader scope and is more complex than decision making and problem solving. It is sometimes referred to as reflective thinking. Critical thinking also involves reflecting on the meaning of statements, examining the offered evidence and reasoning, and forming judgments about facts.

The nurse is applying a decision-making process to a clinical challenge. When applying this process, the nurse must: a. analyze the root causes of a situation. b. begin by solving the underlying problem. c. choose between different courses of action. d. prioritize the maximum good for the maximum number of people.

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. It is not always realistic for the nurse to solve each of the problems contributing to a larger challenge, especially at the beginning of the decision-making process. The nurse often lacks the time, information, or resources to analyze the root causes of a situation. Many times, the nurse makes a decision that benefits the largest number of people, but this is not always feasible or desirable.

The novice nurse can reduce the likelihood of being sued for malpractice by: a. beginning his or her career in a lower acuity setting. b. avoiding performing interventions without a witness present. c. establishing positive, therapeutic relationships with clients and families. d. engaging in lifelong learning.

ANS: C Feedback: It has been shown that despite technical competence, nurses who have difficulty establishing positive interpersonal relationships with patients and their families are at greater risk for being sued. Relationship building is a skill that consequently has the potential to reduce a nurse's risk of a lawsuit. Many malpractice suits originate in lower acuity settings, such as long-term care, so practicing in such an environment may not necessarily reduce the nurse's risk of a lawsuit. It is unrealistic and unnecessary to perform all interventions with a witness, and there is no evidence that this would reduce the risk of a lawsuit. Lifelong learning is beneficial but is not noted to reduce the nurse's risk of a lawsuit.

A nurse was 20 minutes late returning from a scheduled lunch break and a colleague's break was consequently cut short. What response by the manager best demonstrates a laissez-faire leadership approach? a. Ask each of the nurses to speak with the manager separately to discuss the implications of this event. b. Ask the nurses to attend a short meeting together in the manager's office. c. Allow the two nurses to dialogue about this event and observe for evidence of a satisfactory resolution. d. Impose a meaningful consequence on the first nurse and have the nurse apologize to the colleague.

ANS: C Feedback: Laissez-faire leadership is generally understood to be a "hands-off" approach. The manager using this approach would likely allow the two nurses to self-manage this event and reach a solution independently. Requiring a meeting would be a more authoritarian or autocratic approach. Punishing the nurse and requiring an apology would be a strongly autocratic approach.

A nurse-manager demonstrates Level 5 leadership by performing what action? a. Keeping emotions in check b. Accepting nothing less than perfection from subordinates c. Taking responsibility for errors that he or she makes d. Avoiding conflict unless absolutely necessary

ANS: C Feedback: Level 5 leaders know when to ask for help, accept responsibility for the errors they or their team make, and are incredibly disciplined in their work. This model does not have a particular emphasis on avoiding conflict or keeping emotions in check. Rejecting anything short of perfection is unrealistic and is not cited as a characteristic of a Level 5 leader.

The nurse-manager is preparing to use the PERT tool when making a staffing decision. This tool will primarily address what component of the decision-making process? a. Values b. Consequences c. Timing d. Ethics

ANS: C Feedback: PERT is a popular tool to determine the timing of decisions. This tool does not explicitly address some of the other relevant considerations when making decisions, including values and ethics. This tool does not focus on the evaluation (consequences) component of decision making.

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. The nurse is enacting what model of leadership? a. Favoritism 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. This action is performance-based, so it would be difficult to characterize it as favoritism. Servant leadership prioritizes the interests of others; creating incentives to address the misalignment of goals is not central to servant leadership. Quantum leadership is a holistic theory of leadership that does not mainly focus on the alignment of disparate goals.

An organization is facing budget cuts and the manager has openly shared the details, rationale, and implications of the cuts with staff. The manager has also expressed feelings of disappointment about the cuts. What component of authentic leadership has the manager demonstrated? 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, as this manager has done. 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 or her behavior, and self-awareness alludes to a knowing of self so as to make sense of the world.

The chief nursing officer is assembling a leadership team. The nurse is ensuring that the team is made up of people who have a diverse range of natural talents and skills. This leader is most clearly exemplifying what theory of leadership? a. Level 5 Leadership b. Emotional intelligence c. Strengths-based leadership d. Authentic leadership

ANS: C Feedback: Strengths-based leadership emphasizes the need to not only identify one's own strengths but also to surround oneself with people who have different strengths. Emotional intelligence prioritizes the importance of values, emotions, and feelings. Level 5 Leadership focuses on the affective traits of strong leaders. Authentic leadership is a holistic model that encompasses many more variables than just strengths.

What statement by a leader most clearly demonstrates the Great Man theory of leadership? a. "Leadership is grounded in close, supportive relationships." b. "Leadership and management are two different manifestations of one skill set." c. "Some people are born to lead, and some are born to be led." d. "Leadership can't exist without earning people's respect."

ANS: C Feedback: The Great Man theory purports that some people are born to lead and some are born to follow. This early theory of leadership did not emphasize the role of relationships or earning the respect of others. This theory did not state that leadership and management were a synonymous skill set.

The nurse-manager is applying an evidence-based approach to a clinical question around client mobilization. When using a PICO format to search for evidence, the nurse should identify what? a. The role of intuition in the decision-making process b. The preferences of clients and their families c. The clients for whom the intervention would be relevant d. Costs associated with a potential change in practice

ANS: C Feedback: The PICO (patient or population, intervention, comparison, and outcome) format is used in evidence-based practice to guide the search for the current best evidence to address a problem. Client and family preferences and cost are included in evidence-based practice but are not explicit components of the PICO format. Intuition is a component of decision making but is not specifically included in the PICO format.

The nurse-manager of a short-staffed unit needs to make a decision about a nurse's request for an unpaid leave of absence. In order to increase the chance of making a good decision, the manager should: a. involve as many people in the decision-making process as possible. b. begin the decision-making process by presuming the status quo to be the best option. c. generate as many different alternatives as possible. d. prioritize the option that is most innovative.

ANS: C Feedback: The greater the number of alternatives that can be generated by the decision maker, the better the final decision will be. Generating multiple alternatives may require involving more people in the decision-making process, but the process can easily become unwieldy if too many people are involved. The manager should always consider the status quo as a possible option, but this is not always considered to be the default option. Innovation is often a desirable characteristic, but it would be inappropriate to choose an option solely because it is innovative; many other values must be considered.

A health-care provider prescribes a medical procedure that the staff nurse has reason to believe will harm the client. Which principle should guide the nurse's choice of action? a. The staff nurse cannot be held legally liable for any harm to the client if the procedure is carried out with due care. b. The nurse may lose his or her license by refusing to carry out the procedure. c. The nurse can be held legally liable for any harm if the procedure is carried out without questioning it. d. Liability rests with the health-care provider, not the nurse.

ANS: C Feedback: The rule of personal liability says that every person is liable for his or her own conduct, even if someone else prescribed the intervention. The law does not permit a wrongdoer to avoid legal liability for his or her own wrongdoing, even though someone else also may be sued and held legally liable. "Due care" does not negate the consequences of the nurse's actions or release the nurse from liability if he or she knowingly committed an unsafe act. Refusal to carry out the procedure would not be a basis for losing a nursing license.

The nurse-manager who seeks to exemplify emotional intelligence should: a. attempt to remove emotion from decision making. b. prioritize emotion over reason when making decisions. c. regulate his or her own emotions and those of others. d. effectively manipulate the emotions of others to achieve goals.

ANS: C Feedback: Theorists studying emotional intelligence posit that the ability to regulate the emotions of self and others is key to effective leadership. Emotional intelligence does not involve removing emotion from decision making; conversely, it does not claim that emotion should trump reason. Management of emotions is not the same as manipulating the emotions of others, which is unethical.

Which statement best depicts leadership? a. Strong leaders can coerce people into following them. abirb.com/test b. A leadership position has a narrower scope than a management position. c. People will follow a person in a leadership position only by choice. d. Leadership requires meeting organizational goals.

ANS: C Feedback: Those individuals who choose to follow a leader do so by choice, not because they have to; "followership" cannot be coerced. Leadership is a much broader concept than management, which implies a more specific and finite role. Leadership is not necessarily dependent on meeting organizational goals.

What characteristic of a nurse-manager suggests that he or she is acting in the role of a traditional manager rather than an integrated leader-manager? a. The manager is conscious of the important role of politics and is politically astute. b. The manager has an outward view, extending to the larger organization. c. The manager's influence is limited to his or her group. d. The manager emphasizes the importance of vision and values.

ANS: C Feedback: Traditional managers influence those in their own groups, whereas integrated leaders influence others beyond their own group. Political astuteness, an outward view, and an emphasis on vision and values are all characteristics of the integrated leader-manager.

A nurse-leader has set a goal of becoming a more transformational leader. What outcome will best indicate progress toward achieving this goal? a. The nurse maximizes efficiency when allocating scarce resources. b. The nurse's subordinates demonstrate respect and loyalty. c. The nurse empowers others to reach their full potential. d. The nurse provides praise for good work performances.

ANS: C Feedback: Transformational leadership is characterized by empowering others and instilling them with vision. Transactional leadership is more management-oriented and includes functions around rewarding performance and allocating resources. Transactional and transformational leadership can both result in loyalty and respect.

A nurse has accepted a management position in a busy ambulatory clinic and recognizes that the day-to-day operations of the clinic will require many decisions. What is the nurse's best initial action when preparing for this new role? a. Identify staff who are likely to be allies. b. Determine where organizational power exists in the clinic. c. Clarify and reflect on his or her own values. d. Collaborate with the previous manager of the clinic.

ANS: C Feedback: Values clarification is an imperative first step when preparing for a role that requires decision making and problem solving. This form of internal examination must precede strategic interactions with others or an analysis of where power lies in the organization. Internal examination should come before external examination.

A sales representative is describing the benefits of a new brand of incontinence brief to a manager. The representative states, "These are a superior product. With what you're currently using, you're actually causing harm to your clients." How should the manager best interpret this statement? a. The representative is analogy. b. The representative is overgeneralizing about the new briefs. c. The representative is overgeneralizing about the briefs the unit currently uses. d. The representative is affirming the consequences.

ANS: D Feedback: Affirming the consequences is a logical fallacy where a person decides that if B (i.e., the new brief) is good and he or she is doing A (i.e., using the old brief), then A must not be good. The fact that the new brief is good does not mean the old brief is bad. Overgeneralizing involves extending characteristics of an individual to a group. Arguing from analogy is illogical thinking that applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects. The representative is not suggesting that the two types of briefs are alike.

There are current and future paradigm shifts in health care that affect the leadership skills needed by nurses in the 21st 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. Increasing disparities between health outcomes for wealthy clients and poorer clients 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 nurse-managers are actively involved in greatly needed health-care reform and in addressing a persistent, and likely growing, international nursing shortage. Healthy disparities exist at regional and national levels, not organizational levels.

Which function of the management process involves the performance evaluation of employees? 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. 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. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff.

Which statement is true regarding an economic man style manager? a. The manager may lack complete knowledge and generate few alternatives. b. The manager makes decisions that may not be ideal but result in solutions that have an adequate outcome. c. The manager is primarily motivated by his or her own financial gain. d. The manager gathers as much information as possible and produces many alternatives.

ANS: D Feedback: Economic managers gather as much information as possible and generate many alternatives. However, most management decisions are made by using the administrative man model of decision making, in which the manager never has complete knowledge and generates fewer alternatives. The term economic man does not suggest that the manager is motivated by personal financial gain. The administrative man carries out decisions that are only satisficing, a term used to describe decisions that may not be ideal but result in solutions that have adequate outcomes.

The nurse-manager is faced with a difficult decision in a situation that involves the manager's values. What is the manager's best action? a. Try to base a decision on intuition rather than values. b. Set aside his or her values and make a rationale decision. c. Defer the decision to a colleague with different values. d. Identify and reflect on his or her own values.

ANS: D Feedback: Every person has a value system, and this cannot be simply "set aside." Awareness and reflection are necessary to make good decisions in the context of one's own values. Intuition and values are not counterpoints, and prioritizing intuition does not negate the importance of values. Values influence every decision to varying degrees, and it is impractical to defer every value-laden decision to someone else.

A nurse has been hired to oversee a day surgery clinic. What action will best ensure good outcomes for this nurse, the clients, and the employees of the clinic? a. Implement the principles of authoritative leadership. b. Teach all employees about the financial considerations at the clinic. c. Consciously develop the ability to be charismatic. d. Integrate nursing management and nursing leadership roles and practices.

ANS: D Feedback: For managers and leaders to function at their greatest potential, the two roles must be integrated. This helps ensure positive outcomes for all. Authoritative leadership is generally not preferred in the 21st century because it has poorer results than more contemporary models. Charisma can be beneficial in a leadership position, but it is not among the major traits of successful leadership and management. A focus on finances with all employees is not normally necessary and is not linked to high-level outcomes.

A manager demonstrates one of the four principles of scientific management when he or she: a. shows an interest in employees' personal lives and emotional health. b. engages in lifelong learning and expects employees to do the same. c. allows employees to do their jobs independently, with minimal oversight. d. hires and promotes employees on the basis of their competence and skills.

ANS: D Feedback: Frederick W. Taylor, the "father of scientific management," had the idea that workers should be hired, trained, and promoted based on their competence and abilities. Scientific management did not emphasize relationships between managers and employees, lifelong learning, or high levels of independence for workers.

The leaders of a health-care organization ascribe to human capital theory and are planning the budget for the next year. What activity should the team prioritize in the budget to promote the goals of this theory? a. Signing bonuses for nurses who are hired from outside the region b. Incentives for staff members who provide exemplary care and who make no errors c. Community outreach activities that will increase engagement between staff and residents d. Reimbursement of tuition to nurses who are upgrading their education

ANS: D Feedback: Human capital theory prioritizes the long-term benefits of investing in training and education. Incentives, signing bonuses, and community outreach do not run contrary to this theory, but these actions are not direct examples of prioritizing skills acquisition and educational development.

The nurse-manager is addressing a nurse's suspected breach of client confidentiality in a social media posting. What function of the management process is this nurse-manager demonstrating? a. Organizing b. Staffing c. Directing d. Controlling

ANS: D Feedback: Legal and ethical issues, such as violations of confidentiality, are categorized within the controlling function. 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. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff. Directing entails human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration.

When applying the principles of quantum leadership, the nurse-manager should prioritize: a. careful management of emotions. b. his or her own values, beliefs, and moral character. c. the difference between personal goals and organizational goals. d. the fact that workplaces are complex and dynamic.

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. Quantum leadership does not prioritize the difference between personal and organizational goals or the management of emotions.

A nurse-manager has to make some difficult decisions around the allocation of vacation time during the holiday season. When making a decision, what should the manager do first? a. Elicit ideas from as many staff members as possible. b. Consider how the issues has been addressed in the past. c. Think of as many alternatives as possible. d. Clearly identify each of the desired objectives in the situation.

ANS: D Feedback: Regardless of what decision-making or problem-solving tool a manager is going to use, the process must necessarily begin with clear identification of the objectives. Once these are determined, subsequent steps like engaging stakeholders, creating alternatives, and considering previous approaches can be performed.

A nurse-manager has been attending several conferences and workshops in order to network with colleagues and build relationships with people outside the organization. How should a nurse best interpret this manager's actions? a. The manager is building on his or her strengths. b. The manager's self-regulation is likely to grow because of this activity. c. The manager is demonstrating servant leadership, which will ultimately benefit the whole organization. d. The manager is applying the social skills necessary for emotional intelligence.

ANS: D Feedback: Social skills are a component of emotional intelligence and involve proficiency in handling relationships and building networks in an effort to find common ground. Servant leadership is characterized by selfless acts, which are not in evidence in this scenario. Similarly, there is no obvious evidence of the manager building on his or her strengths. Self-regulation is a component of emotional intelligence, but it involves controlling or redirecting disruptive impulses or moods; there is no indication that the manager is doing this.

The nurse has accepted a job in a workplace where organizational power has a pronounced effect. This characteristic may have what effect on the nurse and the workplace? a. Many decisions will be delegated to the nurse by supervisors. b. There will be high levels of mistrust and suspicion at the workplace. c. Communication will be compromised in the workplace. d. The nurse may have to accept decisions contrary to his or her own values.

ANS: D Feedback: The ability of the powerful to influence individual decision making in an organization often requires adopting a private personality and an organizational personality. The nurse will often have to accept decisions that solely reflect the values of more powerful individuals. This may lead to a feeling of powerlessness but not necessarily mistrust and lack of communication. Delegation of decision making is likely to be rare, not common, because it is concentrated with those in power.

A nurse-manager has made a decision and is now preparing to evaluate the decision. What question should best guide the nurse's evaluation process? a. Is evaluation necessary when using a good decision-making model? b. Can evaluation be eliminated if the problem is resolved? c. Is every party happy with the outcomes of the decision? d. Did the outcomes align with the original objectives?

ANS: D Feedback: The evaluation phase is necessary to find out more about one's ability as a decision maker and to find out where the decision making was faulty. This step cannot be eliminated from the decision-making process because it provides the means for determining whether a good decision was made. Happiness is not the criterion by which decisions are usually evaluated. Rather, evaluation is done by comparing actual outcomes to desired outcomes.

How can a manager best implement the principles of situational or contingency leadership theory? a. By establishing rules and norms that can be applied in all conditions in the organization b. By avoiding punitive consequences when addressing workers' lack of performance c. By deferring to employees for day-to-day management decisions d. By adapting his or her leadership style to a particular circumstance

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 and is central to contingency (situational) leadership. This model of leadership does not emphasize workers' autonomy in decision making, rigid rules and norms, or the avoidance of consequences.

An organization has hired six RNs who are recent immigrants. 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. Hold a sharing session so all RNs can share information about their cultures and differences in client care.

ANS: D Feedback: This situation has varied nuances that require the manager to address many factors. 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 because 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.

One of the nurses on the unit said, "My Vietnamese patient won't look me in the eye, but I know that Asian patients avoid making eye contact as a way of showing respect." This nurse is demonstrating what type of illogical thinking? a. Affirming the consequences b. Arguing from analogy c. Deductive reasoning d. Overgeneralizing

ANS: D Feedback: This type of "crooked" thinking occurs when one believes that because one person has a particular characteristic, every other person in the same category also has the same characteristic. It is an overgeneralization to assign one meaning to an action to every person from an entire continent. This kind of oversimplified deduction is exemplified when stereotypical statements are used to justify arguments and decisions. When affirming the consequences, one decides that if B is good and he or she is doing A, then A must not be good. When arguing from analogy, the nurse applies a component that is present in two separate concepts and then states that because A is present in B, then A and B are alike in all respects.

What action by the nurse-manager in a health organization best demonstrates transformational leadership? a. The manager readily takes responsibility after making a scheduling error. b. The manager's employees are reminded that they must submit evidence of renewing their license. c. The manager informs each employee about the new criteria that will be the basis of the performance reviews. d. The manager holds a workshop to outline a new vision for patient-centered care.

ANS: D Feedback: Transformational leadership often involves the communication of a vision and empowering employees to share in it. Functions involving performance review, scheduling, and licensure are more consistent with a transactional role. Taking responsibility is a trait of effective transformational and transactional leadership.