Leadership Exam 1

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

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

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

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

Patients were often denied basic human rights until when? A) 1940s B) 1950s C) 1960s D) 1970s

Ans: C Feedback: Until the 1960s patients had few rights; in fact, patients before then often were denied basic human rights. Conditions improved by the 1970s.

A verdict of suspension or loss of licensure represents what type of law? A) Criminal B) Civil C) Administrative D) Judicial

Ans: C Feedback: A verdict of suspension or loss of licensure represents administrative law. This type of law is not based on any of the other options.

A doctor orders a medical procedure that the staff nurse has reason to believe will harm the patient. Which statement accurately states the legal consequences of carrying out, or refusing to carry out, the procedure? A) The staff nurse cannot be held legally liable for any harm to the patient 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 question D) The nurse can be held accountable for practicing medicine without a license

Ans: C Feedback: All nurses have personal liability, which means that every person is liable for his or her own conduct. None of the remaining options describes that liability or its outcomes accurately.

Thirty-eight percent of the people who attended a smoking cessation clinic were not smoking 1 year after the clinic closed. What type of audit provided this type of data? A) Structure B) Process C) Outcome D) Concurrent

Ans: C Feedback: An outcome audit determines what outcomes resulted from specific nursing interventions for clients. That is the function of the remaining options.

What is a characteristic of a left-brain thinker? A) Creative B) Intuitive C) Analytical D) Holistic

Ans: C Feedback: Analytical, linear, left-brain thinkers process information differently from creative, intuitive, right-brain thinkers. Left-brain thinkers are typically better at processing language, logic, numbers, and sequential ordering, whereas right-brain thinkers excel at nonverbal ideation and holistic synthesizing.

Protecting patient confidentiality respects the client's right to A) self-esteem B) self-defense C) self-determination D) self-incrimination

Ans: C Feedback: Confidentiality is a foundation of both medical and nursing ethics, and it respects the client's right to self-determination. While the other options are worthy of respect, they are not associated with confidentiality.

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

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

Malpractice or professional negligence is the failure of a person with professional training to act in a reasonable and prudent manner. How many components must be present for an individual to be found guilty of malpractice? A) Three B) Four C) Five D) Six

Ans: C Feedback: Five components must be present for a professional to be held liable for malpractice: duty to use care, failure to meet standard of care, foreseeability of harm, direct relationship between failure to meet the standard of care and injury can be proved, and injury.

Which statement is correct regarding the distinction between legal and ethical obligations in decision making? A) Ethical controls are clearer and philosophically impartial B) Ethical controls are much clearer and individualized C) Legal controls are clearer and philosophically impartial D) Legal controls are much less clear and individualized

Ans: C Feedback: In general, legal controls are clearer and philosophically impartial; ethical controls are much less clear and individualized.

Who plays a primary role in ensuring that workers have reasonable, working schedules? A) Unions B) Top administrators C) Managers D) Federal government

Ans: C Feedback: In workplace advocacy, the manager works to see that the work environment is both safe and conducive to professional and personal growth for subordinates. The other options play a role in such situations but the manager has the primary responsibility.

What type of brain dominance creates a management style that is highly organized and detail oriented? A) Upper left brain B) Upper right brain C) Lower left brain D) Lower right brain

Ans: C Feedback: Individuals with lower-left-brain dominance are highly organized and detail oriented and individuals with upper-left-brain dominance truly are analytical thinkers who like working with factual data and numbers. These individuals deal with problems in a logical and rational way. Individuals with upper-right-brain dominance are big picture thinkers who look for hidden possibilities and are futuristic in their thinking. Individuals with lower-right-brain dominance experience facts and problem solve in a more emotional way than the other three types.

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

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

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

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

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.

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

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

Which statement demonstrates 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 patient is willing to do." C) "I'll talk to the patient's primary care giver about the problem." D) "Maybe there is no new solution to this particular problem."

Ans: A, B, C Feedback: A critical thinker displays persistence, empathy, and assertiveness. The remaining option reflects limited thinking and an inability to think outside the box.

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

Ans: D Feedback: Self-power, sometimes referred to as feminist power, is power over self rather than over other people. The concept of self power/feminist power is not described accurately by any of the other options.

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

Ans: D Feedback: The only true statement here is that power is likely 10 bring more power in an ascending cycle, whereas powerlessness often generates more powerlessness

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

A Feedback: A person's response to authority is conditioned early through authority figures and experiences in the family unit. While the other options may influence an individual, none are the primary influence.

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

Ans : C Feed back: Individuals who have the queen bee syndrome do not empower others, because they want to keep all the power for themselves. None of the other options are associated with the queen bee syndrome.

What does proactive political strategy include? A) Assuming authority to do something if it is not expressly prohibited B) Using competitive approaches to the decision-making process C) Attempting 10 appear as a victim so future gains can be made D) Verbalizing discontent with the politics of an organization

Ans: A Feedback: Assuming authority to do something that is not prohibited allows the individual to accomplish goals for the organization, which will lead to greater empowerment. None of the remaining options are associated with the proactive political strategy.

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

Ans: A Feedback: By serving as a role model of an empowered nurse, the individual encourages others to become empowered. The remaining options are not examples of effective empowering strategies

What is one of the most politically serious errors one can make? A) Dispensing fictitious information B) Promoting the advancement of subordinates C) Withholding or refusing to divulge information D) Delaying decision making until there is additional information

Ans: A Feedback: Lying to others is a serious political error. The other options represent appropriate behaviors.

What are the reasons for losing power? I. Being politically naive 2. Failure to use appropriate political strategies 3. The lack of a dynamic and powerful personality 4. Association with others who desire similar power A) I, 2 B) I, 3 C) 2,4 D) 3, 4

Ans: A Feedback: Power gained may be lost because one is politically naive fails to use appropriate political strategies. The other options are not major factors in the loss of power.

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

Ans: A Feedback: The term manager power may explain subordinates ' response to the manager's authority. The more power subordinates perceive a manager to have, the smaller the gap between the right to expect certain things and the resulting fulfillment of those expectations by others. None of the other options present a positive outcome of manager power.

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

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

What is the foundation of referent power? A) Association with others B) Ability to grant favors C) Personality D) Fear

Ans: A Feedback: Referent power is power that a person has as others identify with that leader or with what that leader symbolizes. Referent power also occurs when one gives another person, feelings of personal acceptance or approval. It may be obtained through association with the powerful. Reward power, charismatic, and coercive are the powers associated with the other options.

What does the moral principle of autonomy govern? A) A person's right to make his or her own decision B) The obligation to do good and prevent harm C) Doing what is right and fair D) Truth telling

Ans: A Feedback: Autonomy, or self-determination, is also referred to as freedom of choice and accepting the responsibility for one's choice. None of the other options addresses this concept.

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

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

Which situation is characteristic of the weakness of the nursing process? A) The frequent absence of well-written patient-focused objectives B) The confusion created by the existence of numerous nursing diagnoses C) The ever-increasing need for effective assessment skills required of the nurse D) The amount of nursing staff required to implement the patients' plans of care

Ans: A 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. While the remaining options relate to the nursing process, they are not directly a result of the process itself.

What are necessary components of leadership and management? I . Power 2. Authority 3. Empowerment 4. Authority-power gap A) I, 2 B) I, 3 C) 2, 4 D) 3, 4

Ans: A Feedback: Power and authority are necessary components of leadership and management. The gap that sometimes exists between a position of authority and subordinate response is called the authority-power gap. Empowerment is the concept of sharing power.

Which factors are associated with the empowerment of staff? I . Allow 2. Develop 3. Enable 4. Lead A) I, 2, 3 B) I, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: A Feedback: The empowerment of staff is a hallmark of transformational leadership. Empowerment means to enable, develop, or allow. Leading is not associated with empowerment.

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

Ans: A Feedback: *Level 1:* Highly capable individual makes high quality contributions with their work; possesses useful levels of knowledge; and has the talent and skills needed to do a good job. Team building is a Level 2 characteristic. *Level 2: Contributing Team Member* Leader uses knowledge and skills to help their team succeed; works effectively, productively, and successfully with other people in their group Organizational skills are associated with Level 3 *Level 3: Competent Manager* Leader is able to organize a group effectively to achieve specific goals and objectives while galvanizing members to achieve goals is demonstrated by Level 4 leaders. *Level 4: Effective Leader* Leader is able to galvanize a department or organization to meet performance objectives and achieve a vision *Level 5: Great Leader* Leader has all of the abilities needed for the other four levels, plus a unique blend of humility and will that is required for true greatness

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

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

What statement regarding management decision-making aides is true? A) They are subject to human error B) They ensure good decision making C) They eliminate uncertainty and risk D) They tend to save management time

Ans: A Feedback: Management decision-making aides are subject to human error. Some of these aides encourage analytical thinking, others are designed to increase intuitive reasoning, and a few encourage the use of both hemispheres of the brain. Despite the helpfulness of these tools, there is a strong tendency for managers to favor first impressions when making a decision, and a second tendency, called confirmation biases, often follows.

Refusing to work with a staff member who dresses unprofessionally most closely represents which change strategy? A) Power-coercive B) Normative-reeducative C) Rational-empirical D) Resistance-withdrawal

Ans: A Feedback: The power-coercive strategy assumes that people are often set in their ways and will change only when faced by negative sanctions or some other method that demonstrates power and/or coercion. This is not the principle guiding any of the other options.

What does a decision grid allow the decision maker to do? A) Examine alternatives visually and compare each against the same criteria B) Quantify information C) Plot a decision over time 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. Although any criteria may be selected, the same criteria are used to analyze each alternative.

Which leadership role is associated with advocacy? A) Create a climate where advocacy and its associated risk-taking are valued B) Give subordinates and patients adequate information to make informed decisions C) Ensure that rights and values of patients supersede those of the health-care providers D) Seek appropriate consultation when advocacy results in intrapersonal or interpersonal conflict

Ans: A Feedback: A leadership role associated with advocacy is to create a climate where advocacy and its associated risk-taking are valued. Management functions include the following: give subordinates and patients adequate information to make informed decisions; ensure that rights and values of patients supersede those of the health-care providers; and seek appropriate consultation when advocacy results in intrapersonal or interpersonal conflict.

Which management function is associated with advocacy? A) Awareness of current legislative efforts affecting nursing practice and organizational and unit management B) Role modeling proactive involvement in health-care policy through both formal and informal interactions with the media and legislative representatives C) Participation in professional nursing organizations and other groups that seek to advance the profession of nursing D) Assertively advocating on behalf of patients and subordinates when an intermediary is necessary

Ans: A Feedback: A management function associated with advocacy is awareness of current legislative efforts affecting nursing practice and organizational and unit management. Leadership roles include the following: role models' proactive involvement in health-care policy through both formal and informal interactions with the media and legislative representatives; participates in professional nursing organizations and other groups that seek to advance the profession of nursing; assertively advocate on behalf of patients and subordinates when an intermediary is necessary.

What is the definition of a standard? A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care C) Process of measuring products, practices, and services against those of best-performing organizations D) Identify not only what and how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Ans: A Feedback: A standard is a predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced. The remaining options all fail to accurately define a standard.

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

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

Which activity best demonstrates a nursing unit manager's attention to the ethics standards of practice required of that position? A) Membership on the institution's ethic board B) Terminates a staff member for absenteeism C) Assures staff and patients that unit decisions are ethically sound D) Holds membership in the local and state American Nurses Association (ANA)

Ans: A Feedback: ANA standards for ethics related to nurse administrators identifies participants on multidisciplinary and interdisciplinary teams that address ethical risks, benefits, and outcomes as a criteria measurement. The remaining options while addressing ethical behaviors on the administrator's part are not as directly identified by the ANA.

Which statement about a national Patient Bill of Rights is accurate? A) Not yet been enacted by the federal government B) Became the law of the land C) Became legally binding in every state D) Has not been beneficial to patients

Ans: A Feedback: Although there has been significant progress in the field of patient rights since 1960, there is still no comprehensive federal legislation directed at the granting and protection of patient rights.

Which would be a normal and expected behavioral response during the unfreezing phase of change? A) Anger B) Withdrawal and acceptance C) Open acceptance D) Active collaboration

Ans: A Feedback: During the unfreezing stage, people become discontented, and even angry, with the status quo. Ironically, they may also become angry that change is needed, because of the resistance that is a normal and expected part of the change process. The other options are not usually associated with the unfreezing phase of change.

Which behavior/attitude makes it likely that a planned change will be unsuccessful? A) The suggested change is brought forward after the plan has been formalized B) Individuals affected by the change are involved in planning for the change C) The change agent is aware of the organization's internal and external environment D) An assessment of resources to carry out the plan is completed before unfreezing

Ans: A Feedback: Employees should be involved in the change process. When information and decision making are shared, subordinates will be more accepting of the change. The other options support the change.

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

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

What document permits a registered nurse to offer special skills and knowledge to the public in a particular jurisdiction when such practice would otherwise be unlawful? A) A state nursing license B) Institutional licensure C) ANA certificate D)ANA practice standards

Ans: A Feedback: In general, a license is a legal document that permits a person to offer special skills and knowledge to the public in a particular jurisdiction when such practice would otherwise be unlawful. A state nursing license allows for the practice of nursing in a specific state. Some professionals have advocated shifting the burden of licensure, and thus accountability, from individual practitioners to an institution or agency. Proponents for this move believe that institutional licensure would provide more effective use of personnel and greater flexibility. The ANA is not capable of permitting a person to practice nursing.

The nurse witnesses a patient sign an operative permit form. Legally, what does the nurse's signature imply? A) Observed the client sign the consent form B) Is certain the client understands the proposed procedure C) Believe the client is capable of understanding the proposed procedure D) Assumes the client has had an adequate evaluation to agree to the procedure

Ans: A Feedback: Informed consent is obtained by a physician; therefore, a nurse is not legally responsible for informed consent but is confirming that the client signed the consent form. The other options are the responsibilities of the professional performing the procedure.

Which intervention is associated with the nursing leadership role? A) Inspiring staff to establish and maintain high standards regarding patient care B) Being aware of the changes in quality control regulations C) Reviewing research results upon which to base changes D) Identifying outcomes that support quality nursing care

Ans: A Feedback: Inspiring subordinates to establish and achieve high standards of care is a leadership skill. The remaining options are management roles.

Which change is easier to make? A) Personal behavior B) Group behavior C) Group knowledge D) Personal attitudes

Ans: A Feedback: It is much easier to change a person's behavior than it is to change an entire group's behavior. It is easier to change knowledge levels than attitudes.

Which action is reflective of the leadership role necessary for a successful planned change to occur? A) Demonstrates flexibility in goal setting B) Recognizing the need for a planned change C) Identifying the resources that are available to support a change D) Support the staff during the implementation of a planned change

Ans: A Feedback: Leaders demonstrate flexibility in goal setting in a rapidly changing health-care system. The other options are associated with management functions associated with change.

Collecting data about the ethical problem and identifying who should be involved in the decision-making process is accomplished in which phase of the MORAL decision-making model? A) Massage the dilemma B) Outline options C) Review criteria and resolve D) Affirm position and act

Ans: A Feedback: Massage the dilemma: Collect data about the ethical problem and who should be involved in the decision-making process. Outline options: Identify alternatives, and analyze the causes and consequences of each. Review criteria and resolve: Weigh the options against the values of those involved in the decision. This may be done through a weighting or grid. Affirm position and act: Develop the implementation strategy.

What is one way to promote open communication between patients and practitioners? A) Involving health-care consumers as active members of the health-care team B) Promoting the creation of cultures of patient safety in health-care organizations C) Establishing a federal leadership locus for advocacy of patient safety and health-care quality D) Building an evidence-based information and technology system that impacts patient safety and pursue proposals to offset implementation costs

Ans: A Feedback: One way to promote open communication between patients and practitioners is involving health-care consumers as active members of the health-care team. Pursing patient safety initiatives prevent medical injury by promoting the creation of cultures of patient safety in health-care organizations; establishing a federal leadership locus for advocacy of patient safety and health-care quality; and building an evidence-based information and technology system that impacts patient safety and pursue proposals to offset implementation costs.

Which statement is true regarding political action committees (PACs)? A) They attempt to persuade legislators to vote in a particular way B) They are comprised of volunteers who are interested in politics C) Their focus is the passage of specific pieces of legislature D) They appear to have little influence with law makers

Ans: A Feedback: PACs of the Congress of Industrial Organizations attempt to persuade legislators to vote in a particular way. Lobbyists of the PAC may be members of a group interested in a particular law or paid agents of the group that wants a specific bill passed or defeated. Currently, PACs appear to have a significant amount of influence on law makers and the legislative process.

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

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

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

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

What are the four evidence-based standards identified by the Leapfrog Group to reduce medical errors? A) Computerized physician-provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Practices scores B) Computerized physician-provider order entry, evidence-based visiting nurse referral, ED physician staffing, and the use of Leapfrog Safe Practices scores C) Computerized primary care provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Medication scores D) Computerized nurse practitioner-provider order entry, evidence-based outpatient referral, ED physician staffing, and the use of Leapfrog Safe Medication scores

Ans: A Feedback: The Leapfrog Group identified four evidence-based standards that they believe will provide the greatest impact on reducing medical errors: computerized physician-provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Practices scores.

Which practice has the U.S. Food and Drug Administration suggested in order to decrease the risk of medication errors? A) Computerized order entry with a drug bar code system B) Medications automatically dispensed to patients at predetermined times C) Use of medication nurses to administer all ordered medications D)Have patients' medications kept at the bedside for self-administration

Ans: A Feedback: The U.S. Food and Drug Administration has suggested that a drug bar code system coupled with a computerized order entry system would greatly decrease the risk of medication errors.

How is the action of advocacy described? A) Informing others of their rights and making certain they have sufficient information to make decisions B) Learning about the need for a decision and then making a good decision for other people C)Supporting an individual's right to make a decision even when they do not have accurate information D) Protecting the rights of patients in accordance with the law

Ans: A Feedback: The advocate informs others of their rights and makes certain they have sufficient information to make decisions. The remaining options are incorrect when describing the action associated with advocacy.

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

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

What is the basic argument for the use of rational-empirical change strategies? A) Information supports change B) Peer influence brings about change C) Reward-based incentives influence change D) Punishment supports the acceptance of change

Ans: A Feedback: The change agent using this set of strategies assumes that resistance to change comes from a lack of knowledge and that humans are rational beings who will change when given factual information documenting the need for change. Normative-reeducative strategies use group norms and peer pressure to socialize and influence people so that change will occur. Power-coercive strategies, features the application of power by legitimate authority, economic sanctions or rewards, or political clout of the change agent.

In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? A) Developing a program for recruitment of young talent B) Rewarding employees by promoting from within C) Having set pay increases mandated annually D) Using longevity to determine committee selection

Ans: A Feedback: The constant influx of young talent brings new ideas to the organization. The other options are not as relevant to the prevention of stagnation and promotion of renewal.

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

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

Whose rights do the legislative controls of nursing practice primarily protect? A) Patients B) Subordinates C) Managers D) Administrators

Ans: A Feedback: The legislative controls of nursing practice primarily protect the rights of patients. Protection of those identified by the other options while important is the primary focus of the nursing practice legislative bodies.

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

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

How is the question of whether a nurse acted with reasonable care generally proven? A) The expert testimony of nursing witnesses B) The defendant's explanation of what the nurse did C) The trial judge, after checking the outcome of prior similar court cases D) The testimony of expert medical witnesses

Ans: A Feedback: The testimony of other nurses in the same specialty as the defendant may be used to prove breach of duty. The other options are not considered qualified to testify to this matter.

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

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

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

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

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

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

Distributing flyers that charge arbitrary action on the part of an employer in an effort to garner interest in employee unionization would be a part of what phase of planned change? A) Unfreezing B) Movement C) Refreezing D) Resistance

Ans: A Feedback: Unfreezing occurs when the change agent coerces members of the group to change, or when guilt, anxiety, or concern can be elicited. This is not observed in the other options.

Which task is a management function associated with quality control? A)Periodic evaluation of unit mission and philosophy B) Making out the daily patient care assignments C) Creating a yearly budget D) Distributing holiday staffing policies

Ans: A Feedback: Unit mission, philosophy, goals, and objectives are the blocks on which policies and standards rest. All these must be in place to measure whether quality is being achieved on the unit. The other options are not related to quality control

What is an example of an unintentional tort? A) Professional negligence B) Assault C) Battery D) False imprisonment

Ans: A Feedback: While professional negligence is considered to be an unintentional tort, assault, battery, false imprisonment, invasion of privacy, defamation, and slander are intentional torts.

How can nurses act as advocates? Select all that apply. A) Helping others make informed decisions B) Directly intervening on behalf of others C) Providing consent to treat for the cognitively impaired patients D)Making health-care decisions for those who are not able to do so

Ans: A, B Feedback: Nurses may act as advocates by either helping others make informed decisions (A), by acting as intermediary in the environment, or by directly intervening on behalf of others (B). Advocates do not make decisions or provide consent but rather educate patients so they can be informed.

Which factor should be considered when assessing the quality of ethical problem solving? Select all that apply. A) Outcomes B) Decision-making process C) Multiple alternatives D) Data gathering

Ans: A, B Feedback: Outcomes should never be used as the sole criterion for assessing the quality of ethical problem solving, because many variables affect outcomes that have no reflection on whether the problem solving was appropriate. Quality, instead, should be evaluated both by the outcome and the process used to make the decision. If a structured approach to problem solving is used, multiple alternatives are analyzed, and data gathering is adequate, then, regardless of the outcome, the manager should feel comfortable that the best possible decision was made at that time with the information and resources available. The satisfaction of the involved parties is not a reliable factor.

Which statement is true regarding criminal law cases? Select all that apply. A) Incarceration is a likely consequence of being found guilty of a criminal offense B) Intentionally giving an overdose of a potent narcotic is a criminal offense C)A guilty verdict requires evidence beyond a reasonable doubt D) Most malpractice cases are tried in criminal court

Ans: A, B, C Feedback: In criminal cases, the individual faces charges generally filed by the state or federal attorney general for crimes committed against an individual or society. In criminal cases, the individual is always presumed to be innocent unless the state can prove his or her guilt beyond a reasonable doubt. Incarceration and even death are possible consequences for being found guilty in criminal matters. Nurses found guilty of intentionally administering fatal doses of drugs to patients would be charged in a criminal court. Most malpractice cases are tried in civil court.

Which action demonstrates appropriate management regarding legal issues? Select all that apply. A) Remains current on all institutional policies and procedures B) Delegates with consideration to appropriate scopes of practice C) Requires physical proof of appropriate professional licensure each year D) Provides yearly in-services on the operation of newly acquired equipment

Ans: A, B, C Feedback: Sound management functions regarding legal issues include understanding and adhering to institutional policies and procedures delegating to subordinates wisely, looking at the manager's scope of practice and that of the individuals he or she supervises, and monitoring subordinates to ensure they have a valid, current, and appropriate license to practice nursing. In-services should be held frequently especially when related to issues that affect care delivery. The reliance on peers for advice in such matters is not prudent; the institution's legal advisor is much better prepared for this task.

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

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

Which characteristic of an organization has influence on the ethical decisions its managers' make? Select all that apply. A) Purpose B) Societal role C) Societal constraints D)Values

Ans: A, B, C Feedback: The manager's ethical obligation is tied to the organization's purpose, and the purpose of the organization is linked to the function that it fills in society and the constraints society places on it. So, the responsibilities of the nurse-manager emerge from a complex set of interactions. Society helps to define the purposes of various institutions, and the purposes, in turn, help to ensure that the institution fulfills specific functions. However, the specific values and norms in any particular institution determine the focus of its resources and shape its organizational life. The values of people within institutions influence actual management practice. The organization's societal status should not be considered when making ethical decisions.

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

Ans: A, B, C, D Feedback: As a result, some women view power as dominance versus submission; associated with personal qualities, not accomplishment; and dependent on personal or physical attributes, not skill. Also, some women believe that they do not inherently possess power but instead must rely on others to acquire it. Thus, rather than feeling capable of achieving and managing power, some women feel that power manages them. The end result has been that so far too many women have remained unskilled in the art of the political process.

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

Ans: A, B, C, D Feedback: Empowerment, as discussed in Chapter 2, can be defined as decentralization of power. Empowerment occurs when leaders communicate their vision; employees are given the opportunity to make the most of their talents; and learning, creativity, and exploration are encouraged. While an open-door policy supports communication, it is not associated with empowerment.

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

Ans: A, B, C, D Feedback: Trying to induce change when one is a new employee is not an appropriate power building strategy while the other options are all appropriate for a new employee to engage in.

Which nursing intervention demonstrates attention to the nursing values central to patient advocacy? Select all that apply. A) Assuring the patient that their wishes will be respected regarding the care they receive B) Identifying the patient's religious dietary practices when discussing a prescribed diet C) Answering the patient's questions regarding the alternatives to a proposed procedure D) Suggesting to a patient that a social services consult would help with discharge needs

Ans: A, B, C, D Feedback: The nursing values central to advocacy emphasize caring, autonomy, respect, and empowerment. While appropriate, comforting a patient is not an act of advocacy in this situation.

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

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

Which force is driving change in today's health-care environment? Select all that apply. A) Increased cost of health-care services B) Decrease in health-care professionals and providers C) Decreased third-party reimbursement of health-care services D) Increased need to update health-care-related technologies

Ans: A, B, C, D Feedback: Many forces are driving change in contemporary health care, including rising health-care costs, declining reimbursement, workforce shortages, increasing technology, the dynamic nature of knowledge, and a growing elderly population. Contemporary health-care agencies then must continually institute change to upgrade their structure, promote greater quality, and keep their workers. Wages for health-care professions and providers have not contributed significantly to the changes in today's health-care environment.

It is appropriate to make a change for which reason? Select all that apply. A) To solve an existing problem B) To increase staff efficiency C) To reduce unnecessary workload D) To improve staff productivity

Ans: A, B, C, D Feedback: Change should be implemented only for good reasons such as the solution of an existing problem, increasing staff efficiency, eliminating unnecessary workload and improving productivity. Boredom alone is not a sufficient reason to institute change.

Which statement concerning autonomy and the employee is true? Select all that apply. A) It is a form of personal liberty B) Its legal equivalent is self determination C) It is based on a person's right to make a choice D) It is supported by the process of progressive employee discipline

Ans: A, B, C, D Feedback: A form of personal liberty, autonomy is also called freedom of choice or accepting the responsibility for one's choice. The legal right of self-determination supports this moral principle. The use of progressive discipline recognizes the autonomy of the employee. The employee, in essence, has the choice to meet organizational expectations or to be disciplined further. If the employee's continued behavior warrants termination, the principle of autonomy says that the employee has made the choice to be terminated by virtue of his or her actions, not by that of the manager. Therefore, nurse-managers must be cognizant of the ethical component present whenever an individual's decisional capacity is in question. To take away a person's right to self-determination is a serious but sometimes necessary action.

A lawsuit pertaining to professional negligence must include duty, breach of duty, injury, and a causal relationship between breach of duty and injury. What else must be included? Which element is necessary to prove professional negligence? Select all that apply. A) Breach of duty B) Presence of injury C) Ability to foresee harm D) Causal relationship

Ans: A, B, C, D Feedback: A lawsuit pertaining to professional negligence must include duty, breach of duty, injury, a causal relationship between breach of duty and injury, and the ability to foresee harm. Intent to cause injury is not a requirement.

Which intervention demonstrates that the nurse-manager is to advocate for patients in common areas of concern? Select all that apply . A)Staffing a unit with sufficient care providers B) Orienting staff to safely use a new patient lift C) Providing an in-service on culturally meeting end-of-life needs D) Arranging for patient consultations with members of the financial office

Ans: A, B, C, D Feedback: Common areas for managers to advocate for patients include distribution of resources; use of technology; end-of-life decisions; and health-care reimbursement. While aesthetics is an important consideration, it is not a common area for managers to act as advocators

Which are common areas requiring nurse-patient advocacy? Select all that apply. A) Securing patient consents B)Preventing medication errors C)Facilitating access to health-care services D) Respect for patient dignity and cultural values

Ans: A, B, C, D Feedback: Common areas requiring nurse-patient advocacy include inadequate patient consents; medical errors; access to health care; and respect for patient dignity and cultural values. While hospitalization is expensive, education on this subject is not considered a nursing advocacy role.

Who is involved in quality control measurement functions? Select all that apply. A) Facility staff B) Consumers C) All levels management D) Health-care professionals

Ans: A, B, C, D Feedback: Consumers, health professionals, staff, and all levels of management should be involved in quality control measurement. Community members become involved when they become health-care consumers.

Which situations is a nurse-manager legally responsible for reporting? Select all that apply. A) Suspected incidents of elder abuse B) Examples of substandard medical care C) Client-reported incidents of child abuse D) Confirmed case of a communicable disease

Ans: A, B, C, D Feedback: In addition, the manager, like all professional nurses, is responsible for reporting improper or substandard medical care, child and elder abuse, and communicable diseases, as specified by the Centers for Disease Control and Prevention. Disagreements are not mandated reportable situations.

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

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

Managerial advocacy has resulted in which profession of nursing characteristics? Select all that apply. A) Ethical code B) Legal recognition C)Nurse Practice Acts D)Professional licensing

Ans: A, B, C, D Feedback: Managers must be advocates for the nursing profession. It was nurses who pushed for accountability through state nurse practice acts and state licensing. Nurse-leaders collaborated on defining the profession, achieving legal recognition of the profession and establishing a culture for professional nursing which has continued to the present time. Advocating for professional nursing is a leadership role. Professional issues are always ethical issues. When nurses find a discrepancy between their perceived role and society's expectations, they have a responsibility to advocate for the profession. This includes speaking out on consumer issues, continuing and expanding attempts to influence legislation, and increasing membership on governmental health policy-making boards and councils. Only then will nurses be able to influence the tremendous problems facing society today.

Which characteristic associated with being a patient increases the need for advocacy? Select all that apply. A) Loss of physical freedom as a result of extended hospitalizations B) Decreased independence due to physical or psychosocial limitations C) Physical or psychosocial limitations negatively impacted autonomy D) Illness tends to make an individual more vulnerable to unethical activities

Ans: A, B, C, D Feedback: Patient advocacy is necessary because disease almost always results in decreased independence, loss of freedom, and interference with the ability to make choices autonomously. In addition, aging, as well as physical, mental, or social disability may make individuals more vulnerable and in need of advocacy. It is not true that cognitive function is impaired as a result of chronic and/or acute illness.

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

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

Which strategies would demonstrate an understanding of effective preparation for a television interview to discuss issues affecting nursing today? Select all that apply A) Be focused on key points. B) Introduce statistics that support the key points C) Repeat key points several times during the interview D) Provide background material related to the key points

Ans: A, B, C, D Feedback: The best strategies for a television interview are to be prepared and to stick to three or four key points that will drive home your message, and repeat them during the interview. Concentrating on popular points is not necessarily where the focus should be directed.

Which strategy demonstrates an understanding of the management's role as advocate for their subordinates? Select all that apply. A) Staff representatives on all unit committees B) Monthly "brown bag lunches" with the staff C) Requests revising criteria for granting a "leave of absence" D) Working with primary care providers to expand standing nursing orders

Ans: A, B, C, D Feedback: The following are suggestions for creating an environment that promotes subordinate advocacy: Invite collaborative decision making; get to know staff personally; "go to bat" for staff when needed; and promote nurse autonomy. Rather than anticipating educational needs, the manager advocates by asking for and then respecting their suggestions by planning accordingly.

A nurse-manager has been asked to write an article for the newspaper addressing a health-care issue of local concern. Which statement demonstrates the nurse understandings the appropriate way to response to such a request? Select all that apply. A)"I'll include the latest data on the subject." B) "When will you need to have the final draft of my article?" C) "Are you comfortable with me focusing on 3 key points related to this topic?" D) "That isn't my field of expertise but I will contact a peer with that knowledge."

Ans: A, B, C, D Feedback: Tips of effective interaction with the media include respecting and meeting their deadlines, having key facts ready to include, limiting key points to two or three, and not being afraid to say you lack that specific expertise. One should assume, until proven otherwise, that the reporter will be fair and accurate in his/her reporting.

To make appropriate ethical decisions the nurse-manager must have knowledge of what items to assist in making decisions? Select all that apply: A) Organizational processes B) Proven decision-making models C) Professional approach that eliminates trial and error D) Ethical principles and frameworks

Ans: A, B, C, D Feedback: To make appropriate ethical decisions then, the manager must have knowledge of ethical principles and frameworks, use a professional approach that eliminates trial and error and focuses on proven decision-making models, and use available organizational processes to assist in making such decisions. Knowledge of the involved parties' wishes is not a focus of the decision-making process.

Which statement is true regarding planned change? Select all that apply. A) Resistance to change should be expected as a natural part of the change process B) Change should be viewed as a chance to do something innovative C) Technical changes are more resisted by staff than social changes are D) Change affects the homeostasis of a group

Ans: A, B, D Feedback: Change should not be viewed as a threat but as a challenge and a chance to do something new and innovative. Change should be implemented only for good reason. Because change disrupts the homeostasis or balance of the group, resistance should be expected as a natural part of the change process. The level of resistance to change generally depends on the type of change proposed not the age of the staff affected by the change. Technological changes encounter less resistance than changes that are perceived as social or that are contrary to established customs or norms.

Which statement is true concerning the refreezing phase of the change process? Select all that apply. A) The focus of this phase is to integrate the change into the status quo B) Stabilization of change requires a 6- to 9-month period of time C) If refreezing is incomplete, prechange behavior will be resumed D) The change agent must remain involved until the refreeze stage is complete

Ans: A, C, D Feedback: During the refreezing phase, the change agent assists in stabilizing the system change so that it becomes integrated into the status quo. If refreezing is incomplete, the change will be ineffective and the prechange behaviors will be resumed. For refreezing to occur, the change agent must be supportive and reinforce the individual adaptive efforts of those affected by the change. Because change needs at least 3 to 6 months before it will be accepted as part of the system, the change agent must be sure that he or she will remain involved until the change is completed. The successfulness of the refreezing stage is dependent about the acceptance of change by all staff.

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

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

Which statement correctly identifies the composition of a letter to a legislator? Select all that apply. A) Identify yourself as a constituent in the first paragraph B) State your reason for writing in the second paragraph C) Sign the letter and include your contact information D)Address the legislator by title

Ans: A, C, D Feedback: Personal letters are more influential than formal letters, and the tone should be formal but polite. The letter should also be concise (not more than one page). Be sure to address the legislator properly by title. Establish your credibility early in the letter as both a constituent and a health-care expert. State your reason for writing the letter in the first paragraph, and refer to the specific bill that you are writing about. Then, state your position on the issue and give personal examples as necessary to support your position. Offer your assistance as a resource person for additional information. Sign the letter, including your name and contact information. Remember to be persistent, and write legislators repeatedly who are undecided on an issue. Display 6.5 displays a format common to letters written to legislators.

What is heuristics? Select all that apply: A) Discrete, unconscious process to allow individuals to solve problems quickly B) Set of rules to encourage learners to discover solutions for themselves C) Formal process and structure in the decision-making process D) Trial-and-error method or rules-of-thumb approach

Ans: A, D Feedback: Most individuals rely on discrete, often unconscious processes known as heuristics, which allows them to solve problems more quickly and to build upon experiences they have gained in their lives. Thus, heuristics use trial-and-error methods or a rules-of-thumb approach, rather than set rules, and in doing so, encourages learners to discover solutions for themselves.

Professional organizations generally espouse standards of care that have what relationship to those required by law? Select all that apply. A) Higher than those required by law B) The same as those required by law C)Are established after those required by law D) Are established prior to those required by law

Ans: A, D Feedback: Professional organizations generally espouse standards of care that are higher than those required by law. These voluntary controls often are forerunners of legal controls. The standards are written by health-care professionals while laws are written by legislatures.

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

Ans: B Feedback: A nursing certificatio n provides the proof of earned expert power such as having knowledge or skill not possessed by all nurses .

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

Ans: B Feedback: Coercive power is based on fear and punishment. Reward power is obtained by the ability to grant rewards to others. Legitimate power is the power inherent in one's position . Expert power is gained through knowledge or skill.

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

Ans: B Feedback: Empowerment is sharing power or authority with others but not relinquishing either power inherent in a position or its responsibility. Authoritarian leadership is not associated with empowerment.

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

Ans: B Feedback: Traditionally, women have been socialized to view power differently than men do. However, recent studies show that gender differences regarding power are slowly changing.

If decision making is triggered by a problem with what does it end? A) An alternative problem B) A chosen course of action C) An action that guarantees success D) A restatement of the solution

Ans: B Feedback: A decision is made when a course of action has been chosen. Problem solving is part of decision making and is a systematic process that focuses on analyzing a difficult situation. Problem solving always includes a decision-making step.

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

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

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

Which response is 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." 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.

When working on clinical practice guidelines for a mental health unit, the nursing committee will implement which intervention initially? A) Assessing the medical psychiatric staff for practice suggestions B) Implementing a search of the literature for current related research results C) Reviewing patient satisfaction data to identify the unit's strengths and weaknesses D) In-servicing all unit nursing staff on the need to adhere to established guidelines

Ans: B Feedback: Clinical practice guidelines reflect evidence-based practice; that is, they should be based on cutting edge research and best practices. The other options may be helpful but should occur after the review of the research literature.

How do administrative man managers make the majority of their decisions? A) After gathering all the facts B) In a manner good enough to solve the problem C) In a rational, logical manner D) After generating all the alternatives possible

Ans: B Feedback: Many managers make decisions that are just "good enough" because of lack of time, energy, or creativity to generate a number of alternatives. This is also called "satisficing." Most people make decisions too quickly and fail to systematically examine a problem or its alternatives for solution

What is the role of the American Nurses Association Code of Ethics and Interpretive Statements? A) Outlines minimum levels of ethical behavior that nurses must maintain B) Functions as a guide to the highest standards of ethical practice for nurses C) Is a legally binding document that directs a nurse's ethical and moral behavior D)Mandates the ethical behavior prerequisite for maintaining a nursing licensure

Ans: B Feedback: The ANA Code of Ethics outlines the important general values, duties, and responsibilities that flow from the specific role of being a nurse in order to achieve and maintain the highest standards. The document is not legally binding nor is it a mandate of behavior.

Which statement by a subordinate demonstrates the greatest problem for the leader? A) "Your plans for the changes will be difficult to implement." 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: B Feedback: The statement is a clear indication that the subordinate feels the leader is not listening and collaborating; this is a fatal flaw. The other statements are more open to explanation by and with the subordinate and leader

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

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

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

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

Which statement concerning the role of the powerful in organizational decision making is true? A) They exert little influence on decisions that are made B) They make decisions that are in congruence with their own values C) They allow others to make the decisions however they wish D) They make all the important decisions with consideration to 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.

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

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

Nursing students who scored in the top 5% on the examination studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided this type of data? A) Structure B) Process C) Outcome D) Concurrent

Ans: B Feedback: A process audit assumes that a relationship exists between the process used and the quality of the result. This is the only option that fulfills that function.

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.

Which statement is true regarding adverse drug events (ADEs)? A) They occur infrequently in accredited hospitals B) They are responsible for about 20% of hospitalized disabilities C) They usually involve either prescribing or pharmacy errors D) They occur because of individual recklessness

Ans: B Feedback: ADEs occur in all hospitals, are to blame for 20% of injury disabilities, and involve more than prescribing or pharmacy errors, but are rarely due to individual recklessness. They occur in both accredited and unaccredited facilities.

What results from the development of plan of correction associated with health-care delivery errors? A) Sentinel event B) Root cause analysis C) Quality assessment (QA) program D) Failure mode and effects analysis (FMEA)

Ans: B Feedback: Another Joint Commission priority is the development of root cause analysis with a plan of correction for the errors that do occur. A sentinel event is likely the trigger of the root cause analysis. FMEA examines all possible failures in a design—including sequencing of events, actual and potential risk, points of vulnerability, and areas for improvement. QA is an ongoing process that focuses on continued delivery improvement.

Which statement reflects an important factor to consider when implementing a planned change? A) Change should be implemented suddenly B) Change should be implemented gradually C) Change should be implemented arbitrarily D) Change should be implemented sporadically

Ans: B Feedback: Change should be planned and thus implemented gradually, not sporadically or suddenly and certainly not arbitrarily.

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

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

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

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

What do clinical practice guidelines provide? A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care C) Process of measuring products, practices, and services against those of best-performing organizations D) Identify not only what and how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Ans: B Feedback: Clinical practice guidelines provide diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care and yet control resource utilization and costs. The remaining options all fail to accurately identify what a clinical practice guideline provides.

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

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

Historically, many of the changes that have occurred in nursing or have affected the profession are the result of what type of change? A) Planned B) Change by drift C) Rational-empirical D) Normative-reeducative

Ans: B Feedback: Historically, many of the changes that have occurred in nursing or have affected the profession are the result of change by drift. While other types of changes have occurred, change by drift accounts for most of them.

What characteristic is associated with organizational groups assigned to manage the change process? A) Both formulate and implement the change B) Have representation from all key stakeholders C) Are made up of quality circles D) Are teams of resistance breakers

Ans: B Feedback: In some large organizations today, multidisciplinary teams of individuals, representing all key stakeholders in the organization, are assigned the responsibility for managing the change process. In such organizations, this team manages the communication between the people leading the change effort and those who are expected to implement the new strategies.

What is the responsibility of a charge nurse who discovers that a medication error was made on the previous shift? A) Share that information with the charge nurse on the previous shift B) Document the incident as per hospital policy C) Write a memo to the nurse who made the error requesting incident report be written D) Write a note 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. Since 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.

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

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

Which term is used to identify a person's feelings of powerlessness to stop unethical behavior in another person or institution? A) Moral conflict B) Moral outrage C) Ethical relativism D) Ethical universalism

Ans: B Feedback: Moral outrage occurs when an individual witnesses the immoral act of another but feels powerless to stop it. Moral uncertainty or moral conflict occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is. Ethical relativism suggests that individuals make decisions based only on what seems right or reasonable according to their value system or culture. Ethical universalism holds that ethical principles are universal and constant and that ethical decision making should not vary as a result of individual circumstances or cultural differences.

Which member of the health-care team is often placed in situations where they are expected to be agents for patients, physicians, and the organization simultaneously, all of which may have conflicting wants and goals? A) Physicians B) Nurses C) Nurse practitioners D) Social workers

Ans: B Feedback: Nurses are often placed in situations where they are expected to be agents for patients, physicians, and the organization simultaneously, all of which may have conflicting needs, wants, and goals. The nature of the patient contact of a nurse is more direct and involves more time than the other members of the health-care team.

Which behavior will best minimize a nurse's risk for a malpractice claim? A) Always carry a personal liability insurance policy B) Always function with the state's nursing practice act C)Ask for assistance when engaged in complicated procedures D) Devote time to establishing an effective nurse-patient relationship

Ans: B Feedback: Nurses can reduce the risk of malpractice claims by practicing within the scope of the Nurse Practice Act. Nurses should purchase their own liability insurance and understand the limits of their policies. Although this will not prevent a malpractice suit, it should help to protect a nurse from financial ruin should there be a malpractice claim. While the other options present reasonable advice, they will not necessarily help in the avoidance of a malpractice claim.

Which statement best describes the impact that the concept of respondeat superior has on the issue of nursing liability? A) It allows for joint liability among physicians, nurses, and health-care organizations B) It supports the sharing of blame among all involved sources of health-care services C) It encourages legal intervention when health care is thought to be substandard D) It implies that the institution is responsible for the acts of its employees

Ans: B Feedback: Nurses must remember that the purpose of respondeat superior is not to shift the burden of blame from the employee to the organization but rather to share the blame, increasing the possibility of larger financial compensation to the injured party. While the other options may be true statements, the correct option describes the more nurse-related implication of the concept.

Which factor is the greatest contributor to the resistance encountered with organizational change? A) Poor organizational leadership B) Presence of employee mistrust C) Ineffective organizational management D) Insufficient staff involvement in the process

Ans: B Feedback: Perhaps the greatest factor contributing to the resistance encountered with change is a lack of trust between the employee and the manager or the employee and the organization. While the other options may increase resistance, employee distrust is the primary barrier to change.

Which problem-solving learning strategy provides the learner with the most realistic, risk-free learning environment? A) Case studies B) Simulation C) Problem-based learning (PBL) D) Grand rounds

Ans: B Feedback: Simulation provides learners opportunities for problem solving that have little or no risk to patients or to organizational performance while providing models, either mechanical or live, to provide experiences for the learner. While the other options provide learning opportunities that include problem solving, simulation is the most realistic while also being low risk.

What defines the legal boundaries of nursing at the state level? A) The state's Attorney General B) The Nurse Practice Act C) The ANA standards of practice D) The ANA Code for Nurses

Ans: B Feedback: The 51 Nurse Practice Acts representing the 50 states and the District of Columbia are examples of statutes. These Nurse Practice Acts define and limit the practice of nursing, stating what constitutes authorized practice as well as what exceeds the scope of authority. Although Nurse Practice Acts may vary among states, all must be consistent with provisions or statutes established at the federal level. The other options lack the comprehensiveness and focus of a state's Nurse Practice Act.

What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)? A) Findings are not released to the public B) Only about half of managed care organizations have chosen to participate C) Performance indicators are process focused rather than outcome focused D) There are only 15 performance measures

Ans: B Feedback: The NCQA, a private nonprofit organization that accredits managed care organizations, has developed HEDIS. One of the most significant weaknesses of NCQA accreditation is that such accreditation is voluntary and only about half of managed care organizations currently undergo such review. The remaining options do not relate to the HEDIS

Which ethical framework would most likely be used to arrive at the nurse's decision to work overtime in spite of previous social plans? A) Utilitarianism B)Duty based C) Rights based D) Intuitionism

Ans: B Feedback: The duty framework says that some things should be done just because there is a duty to do them or refrain from doing them. Utilitarianism states that the good of the many outweighs the wants or needs of the individual. The remaining options are not relevant to the situation.

Which statement best describes mentorship? A) The intensity and duration of relationships are similar in mentorship and preceptorship B) Staff cannot be assigned to become mentors. It is a role voluntarily chosen by the mentor C) "Mentees" must be willing to put aside their personal goals and beliefs in an effort to identify more closely with their mentor D) Most nurses will have the opportunity for many mentor relationships during their careers

Ans: B Feedback: The mentor makes a conscious decision to assist the protégé in career development, with the relationship usually lasting several years. The remaining statements are not accurate regarding mentorships

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

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

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

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

What is the best reason that nurse-managers have an ongoing responsibility to be aware of legislation affecting nursing practice? A) This will prevent them from getting sued B) Laws are fluid and subject to change C) It will protect the agency from a lawsuit D) It will ensure that correct procedure is carried out

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. While the other options are correct, they do not describe the most encompassing reason that nurse-managers need to keep aware of current legislature affecting nursing practice.

Which characteristics are associated with change by drift changes? Select all that apply. A) They are planned B) They are accidental C) They are unplanned D) They are a result of a threat

Ans: B, C Feedback: Change by drift is unplanned or accidental. The other options are not characteristics of changes that are a result of change by drift.

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

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

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 than decision making and problem solving. It is sometimes referred to as reflective thinking. Critical thinking also involves reflecting upon the meaning of statements, examining the offered evidence and reasoning, and forming judgments about facts.

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

Ans: C Feedback: Less trust is lost between the manager and the subordinate when underpromising occurs than when a granted request is rescinded, as long as the subordinate believes !hat the manager will make a genuine effort to meet his or her request. Underpromising occurs when the manager explains the uncontrollable factors that affect granting the request. While being sick is uncontrollable, the issue is staffing at the time of the actual request.

Two of the organizational goals are to increase physician satisfaction and reduce costs. A unit goal is to increase professional RN staffing. Which statement best supports all the stated goals? A} Increasing the RN staff will cut down on nursing errors, prevent burn out, and decrease cos t associated with staff turnover B) Increasing the RN staff will result in increased patient safety and quality care, and thus improve physician satisfaction C) Increasing the RN staff will free more nurses to be available to answer doctors' concerns during their rounds and will reduce our costly use of overtime D) Increasing the RNs will lead to improved patient education and a reduction in costly patient stays

Ans: C Feedback: Politically wise requests should always be made using the goals of the organization; therefore, stating that increasing the staff would meet the organization's goals is most appropriate. The other options do not address all of the stated goals.

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

Ans: C Feedback: To gain power one needs entry in to informal lines of communication provided by informal power groups. The other options would be effective only after the correct option is achieved.

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

Ans: C Feedback: When a manager loses credibility, the authority power gap widens. None of the other options are relevant.

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

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

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

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

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

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

Which situation is associated with an aging organization? A) Retired staff is replaced with new graduate nurses B) State-of-the-art cardiac monitoring equipment is placed in the ICU C) The unit functions with strict adherence to institutional rules and policies D) A suggestion committee composed of staff and management meets monthly

Ans: C Feedback: The young organization is characterized by high energy, movement, and virtually constant change and adaptation. Aged organizations have established "turf boundaries," function in an orderly and predictable fashion, and are focused on rules and regulations. Change is limited.

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

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

What is the best course of action to stimulate staff nurses' involvement in quality control research on a nursing unit? A) Hire a well-qualified researcher to help staff design studies B) Create a joint medical/nursing staff research committee C) Provide staff with paid release time for research activities D)Ensure that research designs are well grounded and scientific

Ans: C Feedback: Staff should be involved in determining criteria or standards, reviewing standards, and collecting data. To stimulate staff nurses' involvement in quality control research, the best course of action would be to provide staff with paid release time for research activities. The other options fail to actually stimulate the nurse's involvement in the process.

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

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

Which statement regarding the responsibility of a manager in advocacy is accurate? A) Advocacy is a management function and not a leadership role B) Managers advocate only as needed to meet organizational goals C) Managers should advocate for patients as well as subordinates D) Professional advocacy is not a primary concern for most managers

Ans: C Feedback: Advocacy is helping others to grow and self-actualize. The manager must be an advocate for patients, subordinates, and the nursing profession. The remaining statements are not accurate descriptions of the manager's role as advocate.

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

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

Which statement is true regarding criteria for assuring that a quality control program will be effective? A) The primary purpose of the program is to satisfy various federal and state standards B) Developed standards should reflect minimally acceptable levels so the organization will score well on self-assessment audits C) A belief in the importance of quality control must be integrated through all levels of the organizational hierarchy D) The process should be reactive; in other words, quality improvement efforts should be initiated after problems are identified

Ans: C Feedback: For any quality control program to be effective, a belief in the importance of quality control must be integrated through all levels of the organizational hierarchy. The remaining statements are false.

What results from effective benchmarking? A) Two organizations become financially integrated under a capitated model B) Organizations compete for a "best practices" label from the National Committee for Quality Assurance (NCQA) C)An organization compares its performance with that of "best-performing institutions" D) Minimum practice guidelines are established for each health-care organization

Ans: C Feedback: In benchmarking, an organization compares its performance with that of "best-performing institutions." Benchmarking is not associated with the other options.

What element must be included in the process of securing informed consent? A) A timeline of when the treatment is expected to occur B) Written information on what the post procedure outcomes will be C) Information regarding the risks involved in the proposed procedure D) An explanation of the nature of all associated treatment provided by the nurse

Ans: C Feedback: Informed consent can be given only after the patient has received a complete explanation of the surgery, procedure, or treatment and indicates that he or she understands the risks and benefits related to it. Timeline and nursing responsibilities are not components that are included. Outcomes are identified as expected or desired; no guarantees are given.

Which factor has the greatest influence on a legislator? A) Form letters from group members B) Individual phone calls from constituents C) Meeting with a strong collective political group D) A personal visit by an individual constituent

Ans: C Feedback: Legislators and policy makers generally are more willing to deal with a group rather than individuals; thus, joining and supporting professional organizations allow nurses to become active in lobbying for a stronger nurse practice act or for the creation or expansion of advanced nursing roles.

Which statement regarding the MORAL decision-making model is true? A) It is a problem-solving model B) It does not include an evaluation step C) The identification and analysis of multiple alternatives for action is required D) The decision is arrived upon with only the involvement of the decision maker

Ans: C Feedback: MORAL is a decision-making model that is useful in clarifying ethical problems, and it requires the identification and analysis of multiple alternatives for action. The other options are not true statements regarding this decision-making model.

Which ethical principle associated with an adult child is legally given the right to make medical decisions for a cognitively impaired parent? A) Justice B) Fidelity C) Paternalism D) Beneficence

Ans: C Feedback: Paternalism is when one individual assumes the right to make decisions for another. Justice requires that a person seek fairness, treat "equals" equally, and treat "unequals" according to their differences. Fidelity involves the need to keep promises. Beneficence involves actions that are taken in an effort to promote good.

What is the advantage of using a payoff table when applicable? A) It assures the correct decision when dealing with financial situations B) It is very helpful when quantitative information about the topic is available C) It assists in the visualization of the available historic and current data D) It is easy to construct even for the novice decision maker

Ans: C Feedback: Payoff tables do not guarantee that a correct decision will be made, but they assist in visualizing data. While it does lend itself to the use of quantitative data that are not its strength, the table may not be difficult to construct that is not its strength since it is dependent on the inclusion of accurate data and effective evaluation of that data.

Which characteristics are required of a reasonable and prudent nurse? A) Years of clinically focused nursing experience B) Specialized nursing skills C) Average nursing judgment and skills D) Earned advanced nursing degree

Ans: C Feedback: Reasonable and prudent generally means the average judgment, foresight, intelligence, and skill that would be expected of a person with similar training and experience. The other options describe qualifications not required of a reasonable and prudent nurse.

Which is a true statement regarding TQM? A) It is based on the premise that the organization knows what is best for the consumer B) Its guiding purpose is to save the organization money C) It is based on the premise that the customer is the focal element on which production and service depend D) It assumes that inspection and removal of errors lead to the delivery of quality

Ans: C Feedback: TQM is based on the premise that the customer is the focal element on which production and service depend. The other options are false statements.

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

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

What role has the Joint Commission assumed in ensuring quality at the organizational level? A) Establishing clinical practice guidelines B) Reducing diagnosis-related group reimbursement levels C) Standardizing clinical outcome data collection D) Assessing monetary fines for hospitals that fail to meet standards

Ans: C Feedback: The Joint Commission ensures quality at the organizational level by requiring participating organizations to choose from among 60 acceptable performance measurement systems. The Joint Commission is not actively involved in any of the other options.

What is the first step in quality control? A) To take corrective action when standards have not been met B) To collect data to determine whether standards have been met C) To determine criteria and standards D) To determine who will measure the standard

Ans: C Feedback: The first step in quality control is to determine criteria and standards. Measuring performance or making corrections is impossible if standards have not been clearly established.

What component of professional negligence is represented when a nurse fails to look up an unfamiliar medication before administering it? A) Duty to use due care B) Failure to meet standard of care C) Foreseeability of harm D) A direct relationship between failure to meet the standard of care (breach) and injury can be proved

Ans: C Feedback: The nurse must have reasonable access to information about whether the possibility of harm exists not fulfilling this responsibility may result in a foreseeable harm to the client. None of the remaining options are relevant to this criterion.

What is the function of a nursing minimum data set? A) Compares the quality of nursing care and medical care B) Identifies minimal levels of quality necessary for nurses to maintain licensure C) Standardizes the collection of nursing data for use by multiple data users D) Identifies only "nursing-sensitive" patient outcome measures

Ans: C Feedback: The nursing minimum data set standardizes the collection of nursing data for use by multiple data users. None of the remaining options accurately describes the function of such a data set.

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

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

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

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

Which statement is true regarding the implications of a Good Samaritan law for a registered nurse? Select all that apply. A) A nurse has a legal responsibility to provide emergency services B) Such laws are universally worded so as to minimize state-to-state differences C) In order for protection to apply, the nursing care cannot be considered negligent D) A nurse who provided out-of-scope care is not protected by the Good Samaritan law

Ans: C, D Feedback: Nurses are not required to stop and provide emergency services as a matter of law, although most health-care workers feel ethically compelled to stop if they believe they can help. Good Samaritan laws suggest that health-care providers are typically protected from potential liability if they volunteer their nursing skills away from the workplace (generally limited to emergencies), provided that actions taken are not grossly negligent and if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. However, not being paid for your services alone will not provide Good Samaritan law protection. Good Samaritan laws apply only if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. Protection under Good Samaritan laws varies tremendously from state to state. In some states, the law grants immunity to RNs but does not protect LVNs or LPNs. Other states offer protection to anyone who offers assistance, even if they do not have a health-care background. Nurses should be familiar with the Good Samaritan laws in their state.

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

Ans: D Feed back: The empowerment of staff is a hallmark of transformational leadership. To empower means to enable, develop, or allow. Empowerment can be defined as decentralization of power. Empowerment occurs when leaders communicate their vision; employees are given the opportunity to make the most of their talents; and learning, creativity, and exploration are encouraged. Empowerment plants seeds of leadership, collegiality, self respect, and professionalism.

What is required to successfully implement the chaos theory of change? A) Most stakeholders accepting the need for change B) Finding solutions to resistance to change C) Changing attitudes more than increasing knowledge D) Finding underlying order in random data

Ans: D Feedback: Chaos theory requires finding underlying order in apparent random data.

Why do our values often cause personal conflict in decision making? A) Some values are not realistic or healthy B) Not all values are of equal worth C) Our values remain unchanged over time D) Our values often collide with one another

Ans: D Feedback: Values, life experience, individual preference, and individual ways of thinking will influence a person's decisio 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.

Which statement is true regarding an economic man style manager? A) Lacks complete knowledge and generates few alternatives B) Makes decisions that may not be ideal but result in solutions that have an adequate outcome C) Makes most management decisions using the administrative man model of decision making D) These managers gather as much information as possible and generate many alternatives

Ans: D Feedback: Economic man managers gather as much information as possible and generate many alternatives. Most management decisions are made by using the administrative model of decision making. The administrative man manager never has complete knowledge and generates fewer alternatives.

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

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

What needs to be considered in evaluating the quality of one's decisions? A) Is evaluation necessary when using a good decision-making model? B) Can evaluation be eliminated if the problem is resolved? C) Will the effectiveness of the decision maker be supported? D) Will the evaluation be helpful in increasing one's decision-making skills?

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.

One of the nurses on the unit said, "Male patients have a low threshold for pain." This is an example of 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 A has a particular characteristic, every other A also has the same characteristic. This kind of thinking is exemplified when stereotypical statements are used to justify arguments and decisions

Using both a systematic approach and proven ethical tools and technology allows managers to make better decisions and increases the probability that they will feel confident about the decisions they have made. Leadership roles and management functions are involved in management ethics. What is an example of a management function? A) Is self-aware regarding own values and basic beliefs about the rights, duties, and goals of human beings B) Accepts that some ambiguity and uncertainty must be a part of all ethical decision making C) Accepts that negative outcomes occur in ethical decision making despite high-quality problem solving and decision making D) Identifies outcomes in ethical decision making that should always be sought or avoided

Ans: D Feedback: Management function identifies outcomes in ethical decision making that should always be sought or avoided. Leadership roles include the following: Is self-aware regarding own values and basic beliefs about the rights, duties, and goals of human beings; accepts that some ambiguity and uncertainty must be a part of all ethical decision making; accepts that negative outcomes occur in ethical decision making despite high-quality problem solving and decision making.

The Patient's Bill of Rights established by which body has the most legal authority? A) A health-care organization B)A professional medical organization C) A regulation professional nursing organization D) A specific state

Ans: D Feedback: A bill of rights that has become law or state regulation has the most legal authority because it provides the patient with legal recourse. A bill of rights issued by health-care organization and professional associations is not legally binding but may influence federal or state funding and certainly should be considered professionally binding.

What component of professional negligence is represented when a patient experiences a seizure resulting from a medication error? A) Duty to use due care B) Failure to meet standard of care C) Foreseeability of harm D) A causal relationship

Ans: D Feedback: A direct causal relationship between failure to meet the standard of care (breach) and injury can be proved when a patient is harmed because proper care is not given. None of the remaining options are relevant to this criterion.

What is the guiding principle when attempting to address errors made in the delivery of health care? A) Reporting of errors must be both mandatory and voluntary B) Errors are a result of faulty organizational processes C) People are the root cause of health delivery errors D) Errors are either unavoidable or result from reckless behavior

Ans: D Feedback: A just organizational culture emphasizes the finding of the middle ground between the two extremes of error cause (people or system). It seeks to separate unavoidable error from reckless behavior and unjustifiable risk. Reporting of errors can be both mandatory and voluntary but this factor has less importance than the organization attitude regarding the cause of errors.

Using both a systematic approach and proven ethical tools and technology allows managers to make better decisions and increases the probability that they will feel confident about the decisions they have made. Leadership roles and management functions are involved in management ethics. What is an example of a leadership role? A) Uses a systematic approach to problem solving and decision making when faced with management problems with ethical ramifications B) Identifies outcomes in ethical decision making that should always be sought or avoided C) Uses established ethical frameworks to clarify values and beliefs D) Role models ethical decision making, which is congruent with the American Nurses Association Code of Ethics and Interpretive Statements and Professional standard

Ans: D Feedback: A leadership role is role models ethical decision making, which is congruent with the American Nurses Association Code of Ethics and Interpretive Statements and Professional standard. Uses a systematic approach to problem solving and decision making when faced with management problems with ethical ramification, identifies outcomes in ethical decision making that should always be sought or avoided, and uses established ethical frameworks to clarify values and beliefs are examples of management functions.

Which activity is associated with the movement stage of the development of a plan? A) Gather data B) Accurately diagnose the problem C) Decide if change is needed D) Develop a plan

Ans: D Feedback: A responsibility of the movement stage is to develop a plan. Responsibilities of the change agent in the unfreezing stage are as follows: Gather data, accurately diagnose the problem, and decide if change is needed.

Which situation is a reality for whistle-blowers? A) Retaliation against them is illegal B) Fellow workers are supportive of them C) Federal and State law protects them D) They are often afraid to speak out

Ans: D Feedback: Although whistle-blower protection has been advocated for at the federal level and has been passed in some states, many employees are reluctant to report unsafe conditions for fear of retaliation. Nurses should check with their state association to assess the status of whistle-blower protection in their state. Retaliation and resentment still exist against these individuals in many situations.

What statement is true concerning nurses as a political body? A) They are very committed to both their profession and the political process B) Many are active members of the American Nurses Association (ANA) C) Their primary focus is to speak out on consumer health-related issues D) They have not yet recognized the full potential of political activity

Ans: D Feedback: As a whole, the nursing profession has not yet recognized the full potential of collective political activity. Nurses must exert their collective influence and make their concerns known to policy makers before they can have a major impact on political and legislative outcomes. The remaining options are not true of nurses in general.

Even after a lengthy discussion concerning the ramifications, a patient wants to leave the hospital against medical advice (AMA). What would the nurse do in the role of patient advocate? A) Encourage the patient to wait until morning to leave the hospital B) Ask family members to help talk the patient out of the decision C)Call the security guard to escort the patient off hospital property D) Make sure the patient has appropriate follow-up appointments

Ans: D Feedback: As advocate for this patient, you have made sure he is informed of the ramifications of leaving AMA; however, it is a patient's right to refuse treatment. The other options fail to recognize the patient's right to make autonomous choices.

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

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

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

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

What do the critics of prospective payment system argue? A) Diagnosis-related groups have not helped to contain rising health care costs B) The system has increased the length of hospital stay C) Services provided under this system have only slightly increased D) On the whole quality of care has declines since its implementation

Ans: D Feedback: Critics of the prospective payment system argue that although DRGs may have helped to contain rising health-care costs, the associated rapid declines in length of hospital stay and services provided have resulted in declines in the quality of care.

Which statement regarding ethical decision making is true? A) Outcomes are the basic criterion for evaluating ethical decision making B) Only desirable alternatives are identified when solving ethical dilemmas C) Critical ethical decisions are made quickly so the situation does not worsen D) Accepting some ambiguity and uncertainty are a part of ethical decision making

Ans: D Feedback: Ethical decision makers choose between two or more undesirable alternatives, and because they can use only the information and resources available at the time, they must live with some ambiguity and uncertainty. The remaining options are not true statements regarding the ethical decision-making process.

Which statement best describes ethics? A) How our lives and relationships are led in our reality B) How people make decisions they see as legally and morally appropriate C) The conflict, power, and interdependency associated with the way we live D) What our conduct and actions should be regarding what is right and good

Ans: D Feedback: Ethics is the systematic study of what a person's conduct and actions should be with regard to self, other human beings, and the environment; it is the justification of what is right or good and the study of what a person's life and relationships should be, not necessarily what they are.

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

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

An RN is a supervisor in an organization that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. How does the RN practice TQM on the unit? A) Encouraging employees to think of a unit slogan B) Developing a quota system for number of patients cared for C) Explaining to the staff that "if it's not broke, don't fix it" D) Promoting teamwork rather than individual accomplishments

Ans: D Feedback: In TQM, team efforts are favored over individual accomplishments. Slogans, quota systems, and maintaining the status quo work against quality in this philosophy.

What is the best qualitative measurement in determining quality control for marketing? A) Morbidity and mortality rates B) Nursing care hours per patient day C)Average length of stay D) Patient surveys of general satisfaction

Ans: D Feedback: In determining quality control for marketing, the best qualitative measurement would be patient surveys. The other options are not necessarily qualitative measurements.

Which ethical framework involves an individualized decision-making framework? A) Duty based B) Rights based C) Utilitarian D) Intuitionist

Ans: D Feedback: Intuitionist states that each case weighed on a case-by-case basis to determine relative goals, duties, and rights. Utilitarian provides the greatest good for the greatest number of people. Duty based is a duty to do something to refrain from doing something. Rights-based individuals have basic inherent rights that should not be interfered with.

Which statement is true regarding the philosophy of nonlinear change theories? A) Change occurs in sequential steps B) Change is predictable C) Change success relies on policies and hierarchies D) Change is necessary because organizational stability is brief

Ans: D Feedback: Most twenty-first-century organizations experience fairly brief periods of stability followed by intense transformation.

Which description best describes the theory behind nonlinear change? A) It occurs in organized steps B) It must have a logical sequence C) It results in equilibrium D) It has unpredictable outcomes

Ans: D Feedback: Nonlinear change states that the dynamics and outcomes of change are always unpredictable. Nonlinear change does not involve the other statements.

Which statement is true regarding the factors that impact patient satisfaction with a hospitalization? A)The quality of care delivered is the primary factor related to B) The patient's understanding of his/her condition influences satisfaction C) The length of the hospital stay is the deciding influence on satisfaction D) The patient's satisfaction has little to do with actual health improvement

Ans: D Feedback: Patient satisfaction often has little to do with whether a patient's health improved during a hospital stay. It is important to remember that quality care, length of stay, and patient perception do not always equate with patient satisfaction.

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

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

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

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

How is the legal expansion of nursing roles accomplished? A) The expansion of job descriptions in an agency B) Written contracts between the nurse and the client C) A written agreement between the nurse and the physician D) Revision of the Nurse Practice Act

Ans: D Feedback: RN scope of practice is always determined by the Nurse Practice Act and any expansion of roles must occur through legislated changes in that statute. None of the remaining options are sufficient to expand nursing roles legally.

Which action represents a management function in planned change? A) Inspiring group members to be involved in planned change B) Visionary forecasting C) Role modeling high-level interpersonal communication skills in providing support for individuals undergoing rapid or difficult change D) Recognizing the need for planned change and identifying the options and resources available to implement change

Ans: D Feedback: Recognizing the need for planned change and identifying the options and resources available to implement change are management functions; the other choices are leadership functions.

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

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

Which standard of the American Nurses Association (ANA) Scope and Standards for Nurse Administrators suggests that nurse administrators should advocate for subordinates as well as patients? A) II B) III C)IV D) V

Ans: D Feedback: Standard V of the ANA Scope and Standards for Nurse Administrators suggests that nurse administrators should advocate for subordinates as well as patients. This issue is not addressed in the other options.

What effect of organizational power on decision making is often reflected in the tendency of staff? A) Making decisions independent of organizational values B) Not trusting others to decide C) Desiring personal power D) Having private beliefs that are separate from corporate ones

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.

Which activity does a change agent make a commitment to in order to best assure a successful implementation of a change? A) Helping followers arrive at total consensus regarding the change B) Encouraging subgroup opposition to change so many viewpoints can be heard C) Using change by drift if the resistance to change is too strong D) Being available to support those affected by a change until the change is complete

Ans: D Feedback: The change agent needs to offer support to others so that the change occurs. The other options are not as impactful on a successful transition to change.

Which activity associated with the unfreezing state of change will have the greatest impact on the success of the movement stage of the change process? A) Accurate identification of the problem requiring change B) Effective information gathering concerning the problem C) Key personnel voicing their opinions regarding the need for change D) The need for change is perceived by all those affected by the problem

Ans: D Feedback: The change agent should not proceed to the movement stage until the status quo has been disrupted and the need for change is perceived by the others. While the other options will affect the process, perception of the need to change by all affected by the change is the most impactful of the options provided.

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

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

What is an ethical dilemma? A) A problem that can be solved using empirical data B) A situation that has clearly delineated facts for decision making C) A problem that when handled effectively has a mutually agreed-upon solution D) A situation that requires choosing between two or more undesirable alternatives

Ans: D Feedback: The most difficult of all moral issues is termed a moral or ethical dilemma, which may be described as being forced to choose between two or more undesirable alternatives. The problem is not generally solved with a solution that is mutually satisfying nor does it lend itself to empirical or delineated facts.

The only treatment alternative left for a patient diagnosed with advanced cancer is a rare, highly experimental bone marrow transfusion with a 10% success rate. The insurance company refuses to authorize payment for the $200,000 procedure, arguing that the money could be better spent providing well-baby screening for 2,000 residents in the service area. What does this decision by the insurance company reflect? A) Unethical conduct B) Maleficence C) Paternalism D) Utility

Ans: D Feedback: The principle of utility states that what is best for the common good outweighs what is best for the individual. There is no indication of unethical or maleficence behavior on the part of the insurance company. Paternalism would be characterized by the insurance company making treatment decision without the patient having input.

There are many terms used to describe moral issues faced by nurses, including moral uncertainty, moral conflict, moral distress, moral outrage, and ethical dilemmas. Which statement describes how moral uncertainty occurs? A) Occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is B) Occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action C) Occurs when an individual witnesses the immoral act of another but feels powerless to stop it D) Occurs when being forced to choose between two or more undesirable alternatives

Ans:A Feedback: Moral uncertainty occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is. Moral distress occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action. Moral outrage occurs when an individual witnesses the immoral act of another but feels powerless to stop it. Ethical dilemma is being forced to choose between two or more undesirable alternatives.

Much of the difficulty people have in making ethical decisions results from a lack of formal education about problem solving. Research at the University of Pennsylvania found what percentage of the nurses and social workers reported having no ethics training? A) 15 B) 20 C) 25 D) 30

Ans:C Feedback: Research done at the University of Pennsylvania found that nearly 25% of the nurses and social workers reported having received no ethics training.

The practice of allocating organs for transplantation based on a person's "worth to society" is an example of what ethical principle for decision making? A) Autonomy B) Beneficence C) Utility D) Justice

Ans:D Feedback: Justice: Seek fairness, treat "equals" equally, and treat "unequals" according to their differences. Autonomy: Promotes self-determination and freedom of choice. Beneficence: Actions are taken in an effort to promote good. Utility: The good of the many outweighs the wants or needs of the individual.