Leadership Quizzes

1. A manager delegated some tasks to a nurse several hours ago. The manager has now learned that the nurse did not complete any of the delegated tasks. What is the manager's best initial action? a. Determine exactly what the nurse did not complete the delegated tasks b. Take action to reestablish the authority power gap c. Assertively state the expectation that delegated tasks will be completed on time d. Document the nurse's insubordination and arrange a private meeting

A. Determine exactly what the nurse did not complete the delegated tasks CORRECT

1. A nurse-manager is beginning a day and is responsible for completing numerous tasks, including one high-priority task, three medium-priority tasks, and several lower priority tasks. How should the manager plan the day? a. Complete some low-priority tasks first to make room for focusing on the high-priority task b. Complete the high-priority task as early in the day as possible c. Arrange the tasks according to the amount of time that they will require d. Complete the low-priority tasks first, then a medium priority task, and then focus exclusively on the high priority task

B. Complete the high-priority task as early in the day as possible CORRECT

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

D The nurse empowers others to reach their full potential. CORRECT i. Rationale- Page 50. Transformational leadership is characterized by motivating others and empowering them with a. vision. Transactional leadership is more management-oriented and includes functions around rewarding performance and allocating resources. Transactional and transformational leadership can both result in loyalty and respect.

1. An experienced nurse-manager describes a recently hired nurse as "very promising." The manager can best promote this nurse's career development by: a. providing the nurse with positive feedback. b. removing the nurse from client care responsibilities and assigning management tasks. c. asking other nurses to model their behavior on the new nurse's behavior. d. providing the nurse with increasingly challenging work assignments.

D a. providing the nurse with increasingly challenging work assignments. CORRECT i. Rationale- Page: 271. Providing challenging assignments is one way that the nurse's skills and knowledge can be enhanced, benefiting career development. Identifying the recent hire as a role model may place undue stress on the nurse and may create resentment from other nurses who have more experience. Giving the nurse positive feedback may validate the nurse's performance but will not necessarily promote career development. Removing the nurse from client care would be premature at this early stage.

1. The manager of a clinic is considering a change in the scheduling of vacation time in which nurses would self-schedule their vacation rather than having the manager respond to their submitted requests. A nurse has pointed out that it is possible that newer nurses may feel intimidated by more experienced nurses on the unit when scheduling their vacation. This observation constitutes what component of a SWOT analysis? a. O b. S c. T d. W

D. W CORRECT i. Page: 168. Weaknesses are those internal attributes that challenge an organization in achieving its objectives. In this case, possible intimidation within the culture of the unit would be considered an internal attribute that could complicate the proposed system. Threats are also potential confounding factors, but these are external, not internal, factors. Strengths and opportunities are positive attributes.

1. A performance appraisal states that the manager often underdelegates. What is potential cause of this delegation error? a. A need for perfectionism b. A democratic leadership style c. A high degree of trust in subordinates d. Sufficient time to accomplish unit goals alone

a. A need for perfectionism CORRECT i. Rationale- Page: 530. A manager with a need for perfectionism and control may believe that another person will not complete a task. Trust in subordinates and a democratic leadership style would support effective delegation. Delegating should not be based on the issue of time exclusively.

1. What activity is most likely to promote a nurse's continued competence? a. Acquiring new knowledge and skills on a regular basis b. Meeting minimal standards for relicensing c. Submitting to regular performance reviews d. Working in a variety of clinical settings

a. Acquiring new knowledge and skills on a regular basis CORRECT i. Rationale- Page: 277. Continued competence requires a conscious plan for the nurse to increase his or her knowledge and skills on an ongoing basis. This goes beyond meeting the minimum requirements for licensure. Regular performance reviews will not necessarily cause a nurse to promote continued competence. Similarly, a variety of clinical settings will not expose the nurse to new experiences but may not be accompanied by an increase in knowledge and skills.

1. Several RNs on the unit want to address the possibility of initiating flextime on the unit because they state that the current scheduling system is unfair. What is the manager's best initial response? a. Arranging for the RNs to air their views at the next staff meeting b. Asking the RNs to circulate a petition to be signed by employees who support the change c. Assuring the RNs that every effort is being made to streamline the current scheduling system d. Sharing with the RNs that they need to address the issue with upper management

a. Arranging for the RNs to air their views at the next staff meeting CORRECT i. Rationale-Page: 553. This manager should plan to let employees air their views at the next staff meeting. Nursing managers can no longer afford to respond to conflict traditionally (to avoid, deflect, or suppress conflict) because this is nonproductive. Putting off the nurses by providing false reassurance or referring them elsewhere is not a direct and respectful response to conflict.

1. A nurse-manager admits to feeling frustrated and confused by the fact that each day "just slips away," leaving many important tasks undone. How should this manager begin developing better time management skills? a. Complete a time inventory to identify how time is used b. Experiment with adjustments to the daily schedule c. Identify a mentor who can plan the manager's schedule d. Request a temporary reduction in workload

a. Complete a time inventory to identify how time is used CORRECT i. Rationale- Page: 221. A time inventory provides objective data that can be used to inform changes in the manager's behavior. It is unrealistic to expect a mentor to plan the manager's schedule, and this action would not improve the manager's ability to self-manage time. Adjustments should not be made without the necessary data from a time inventory. A reduction in workload will not improve the manager's time management skills.

1. A nurse-manager is participating in the budgeting process. What task should the manager perform first? a. Determining what needs to be covered in the budget b. Identifying the organization's strengths and weaknesses c. Creating a spending plan d. Determining how to maximize cost effectiveness

a. Determining what needs to be covered in the budgetCORRECT i. Rationale- Page: 240. The first step in the budgetary process involves assessment. That is, the manager must assess what needs to be covered in the budget. Creating a plan and maximizing cost-effectiveness occur after the assessment. Identifying the organization's larger strengths and weaknesses is not an explicit part of the budgetary assessment.

1. For several months, a nurse-manager has been rewarding employees' performance in an effort to motivate them. The nurse-manager should be aware of what unintended consequence of this practice? a. Employees' intrinsic motivation may become blunted b. Unhealthy competition may develop between coworkers. c. Employees may expect a corresponding increase in salary. d. Employees may set unrealistically high goals for themselves.

a. Employees' intrinsic motivation may become blunted CORRECT

1. A nurse is applying the ethical principle of justice when providing care for clients. What action best exemplifies this principle? a. Ensuring that time and resources are distributed equitably to clients b. Meeting continuing education requirements for license renewal c. Prioritizing actions that will benefit the largest number of clients d. Respecting clients' rights to make decisions about their care

a. Ensuring that time and resources are distributed equitably to clients CORRECT i. Rationale- Page 88. The principle of justice states that equals should be treated equally and that unequals should be treated according to their differences. Justice is frequently applied when there are scarcities or competition for resources or benefits. Meeting requirements for licensure is a legal issue, not a principle of ethics. The principle of utility involves prioritizing actions that will benefit the largest number of clients. Respecting clients' rights to make decisions demonstrates autonomy.

1. The manager is organizing a class to prepare nurses to function in the neonatal ICU. What is the manager's initial action? a. Identify the learning needs of the new nurses b. Evaluate the professional attributes of the nurses who already work on the unit. c. Evaluate the educational background and credentials of the new nurses. d. Identify available learning resources that will assist with role transition.

a. Identify the learning needs of the new nurses CORRECT

1. What principle should guide the nurse's delegation of tasks to unlicensed nursing assistive personnel (NAP)? a. No federal or community standards have been established for training the broad classification of NAP b. It is safe to assume that the NAP has at least a high school diploma as a minimum hiring criterion. c. The nurse is protected from liability when allowing the NAP to perform only those tasks the employer includes in their job description. d. Like all members of the care team, NAP stands to lose their licensure in case of negligent practice.

a. No federal or community standards have been established for training the broad classification of NAP CORRECT

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

a. People will follow a person in a leadership position only by choice. CORRECT

1. During the budgetary process, a nurse-manager and the other members of the fiscal planning team are considering factors that may affect the accuracy of the budget. What factor should the team prioritize? a. Possible changes in reimbursement policies b. Establishment of new HMOs in the region c. Legislation regarding client safety d. Depreciation of capital equipment

a. Possible changes in reimbursement policies CORRECT i. Rationale- Page: 254. Historically, there have been significant changes in reimbursement policies that have happened quickly. These changes threaten the accuracy of budgeting. Depreciation is more predictable and changes in client safety regulations usually do not have such significant effects on the budget process. The emergence of an HMO would not be expected to affect an organization's budget.

1. A recent graduate has begun working at a health center and finds the behaviors of colleagues stressful and intimidating. The nurse's colleagues whisper when she is around, roll their eyes at her, and laugh when she asks for assistance or clarification. What is this recent graduate's best action? a. Report these behaviors to the nurse-manager b. Avoid the offending colleagues whenever possible c. Organize a meeting to confront the colleagues about their behavior d. seek assistance from the organization's ombudsperson

a. Report these behaviors to the nurse-manager CORRECT

1. A nursing supervisor has been given the responsibility for increasing the frequency and thoroughness of nursing assessments on a hospital unit. However, the supervisor does not have the authority to enforce new guidelines for assessment or assign consequences for noncompliance. What is the most likely outcome of this scenario? a. The desired outcome will not be achieved. b. The assessments will improve as a result of collaboration. c. The supervisor will need to use unauthorized enforcement. d. The assessments will improve, but the nurses will be resentful.

a. The desired outcome will not be achieved. CORRECT

1. A nurse-manager has recently learned that the health-care facility will be moving toward a case management approach. What factor is most likely driving this change? a. The need to contain costs b. The need to obtain magnet designation c. The need to enhance professionalism throughout the organization d. The need to provide challenging work for nurses and other members of the care team

a. The need to contain costs CORRECT

1. The nurse-manager of a community health clinic is participating in budget planning for the next year. The manager will most likely assign the most money to what expenditure category? a. The personnel budget b. The operating budget c. Supplies and equipment d. Short-term capital acquisitions

a. The personnel budget CORRECT

1. A nurse-manager has been commissioned to create a new workplace committee that will focus on client safety issues. When forming this committee, the manager should: a. aim for diversity of genders and cultures among the membership b. give members permission to attend meetings as often or as rarely as they wish in order to accommodate their schedules. c. ensure that half of the members are the manager's subordinates and half are the manager's superiors. d. meet at least twice per week for the first month to create momentum.

a. aim for diversity of genders and cultures among the membership CORRECT i. rationale- Page: 313. When assigning members to committees, cultural and gender diversity should always be a goal. The manager should make efforts to accommodate members' schedules but giving members' permission to attend as rarely as they wish will compromise the group's cohesion and effectiveness. Momentum must be created after the committee is formed, but this does not necessarily require twice-weekly meetings. It is unnecessary and unrealistic to split the membership between the manager's subordinates and superiors.

1. A nurse has become dismayed at repeated instances of false documentation in the health-care organization. The nurse has become aware that documentation has been altered so that acts of negligence appear to be accidents. When preparing to blow the whistle on this behavior, the nurse should: a. carefully document any prior attempts to address the issue with supervisors b. resign from the health-care facility to reduce the risk of retaliation. c. seek permission from the nurse's immediate supervisor and head of the organization. d. attempt to edit the false documentation so that it is more accurate.

a. carefully document any prior attempts to address the issue with supervisors CORRECT

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

a. establishing positive, therapeutic relationships with clients and families CORRECT i. rationale- Page 116. It has been shown that despite technical competence, nurses who have difficulty establishing positive interpersonal relationships with patients and their families are at greater risk for being sued. Relationship building is a skill that consequently has the potential to reduce a nurse's risk of a lawsuit. Many malpractice suits originate in lower acuity settings, such as long-term care, so practicing in such an environment may not necessarily reduce the nurse's risk of a lawsuit. It is unrealistic and unnecessary to perform all interventions with a witness, and there is no evidence that this would reduce the risk of a lawsuit. Lifelong learning is beneficial but is not noted to reduce the nurse's risk of a lawsuit.

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

a. examine alternatives visually and compare each against the same criteria. CORRECT i. rationale- Page 22. A decision grid allows one to visually examine the alternatives and compare each against the same criteria. This assists with the decision-making process, but it cannot guarantee that the decision will be completely objective. A decision grid is not a tool for tracking the outcomes of a decision. Decision grids are not synonymous with project planning tables.

1. An experienced nurse has accepted a half-time management position on the unit. As well, the nurse works half-time providing direct client care on the unit. This nurse's immediate supervisor should identify the nurse's risk of: a. role ambiguity b. negative sanctions. c. role overload. d. exhaustion.

a. role ambiguity CORRECT

1. The RN overhears the nurses' aide speaking in a harsh tone to a client with early Alzheimer's memory loss. Which statement should the RN make to begin addressing this issue? a. "You must remember to watch your tone of voice with clients. Someone might overhear." b. "I am concerned about your conversation with the client. It sounded short and impatient." c. "I have decided to reassign that client to another aide." d. "Do you think it would be a good idea to have an in-service on dealing with Alzheimer's patients?"

b. "I am concerned about your conversation with the client. It sounded short and impatient." CORRECT

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

b. "Let me think about that request for 24 hours and get back to you." CORRECT i. Rationale-A servant leader always thinks before reacting. This leader also chooses words carefully so as to not damage those being led, provides directions toward goal achievement, and finds asking for input more important than personally providing solutions. Speed is not a priority within servant leadership.

1. One of the nurses comes to the manager and reports, "I didn't receive overtime pay when I acted as ambulance support last week. Our union contract says that we're supposed to. Will you please follow up and see that I get the overtime on my next check?" What is this an example of? a. A problem that needs to be reported to the director of nursing immediately b. An issue around the implementation of a contract c. A formal grievance about a contract d. An employee contributing to a toxic workplace setting

b. An issue around the implementation of a contract CORRECT

1. An RN is a team leader for a small module of clients. While listening to a recorded report on a client, one of the team members remarks, "My mother lives near him, and she says his home life is in chaos." How should the RN best respond? a. Politely ask the team member to be quiet b. Ask the team member how this information relates to the client's care c. Ignore the team member's comment d. Include the information in report for the next shift

b. Ask the team member how this information relates to the client's care CORRECT i. Rationale- Page: 492. The role of the leader is to encourage communication that is appropriate and discourage communication that is inappropriate among staff. The RN's question about the purpose of this communication helps to determine whether it was appropriate or not. This should be clarified before deciding how to proceed.

1. A nurse-manager is required to make decisions about the proper placement of employees within the organization. What practice should the manager follow? a. Placing new employees on units that have the greatest need for new staff b. Attempting to place employees in units where they have the greatest chance of success c. Avoiding overemphasizing the match between the employee and the unit in order to prevent discrimination suits d. Helping employees modify their personal values and beliefs to coincide with that of the unit on which they are placed

b. Attempting to place employees in units where they have the greatest chance of success CORRECT

1. A nurse with more than 15 years of experience in an adult medical setting has just transitioned to a job in the day surgery department. What should the manager of this department do to aid the resocialization of this experienced nurse? a. Arrange for a nurse residency to help the nurse transition to a new site. b. Avoid making assumptions about the nurse's ability to perform the job roles. c. Emphasize the importance of evidence-based practice in the culture of the unit. d. Encourage the nurse to mentor new graduates as a gesture of respect for the nurse's experience.

b. Avoid making assumptions about the nurse's ability to perform the job roles. CORRECT

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

b. By adapting his or her leadership style to a particular circumstance CORRECT i. Rationale- Page 48. The idea that leadership style should vary according to the situation or the individuals involved was first suggested almost 100 years ago by Mary Parker Follett and is central to contingency (situational) leadership. This model of leadership does not emphasize workers' autonomy in decision making, rigid rules and norms, or the avoidance of punitive consequences.

1. The manager has learned that some of the more experienced nurses on the unit have been playing pranks on a newly hired nurse and delegating their most challenging tasks to the nurse. What is the manager's best response after confirming that these events took place? a. Implement a structure change so the experienced nurses no longer work at the same time as the new nurse b. Confront the more experienced nurses directly about their behavior c. Arrange for third-party consultation involving the more experienced nurses, the manager and the new nurse d. Offer support and encouragement to the newly hired nurse

b. Confront the more experienced nurses directly about their behavior CORRECT i. Rationale- Page: 562. The manager must address bullying directly and promptly. The nurse should also offer support to the bullied nurse, but the priority is addressing the behaviors. Separating the group from the individual or having mediation may eventually be necessary, but the manager would first confront the behavior.

1. Interviews at a large health-care organization are conducted by various individuals and groups, due to the high number of positions and applicants. What action will best ensure interrater reliability when different individuals are conducting interviews? a. Have at least two, but not more than four, interviewers conduct each interview b. Create a structured interview format and adhere to it closely c. Use a semistructured format and have interviewers practice with one another d. Use yes-no questions whenever possible, rather than open-ended questions

b. Create a structured interview format and adhere to it closely CORRECT

1. The nurse-manager is frustrated by the quantity of paper clutter. How should the manager best deal with this time waster? a. Place additional recycling and trash receptacles throughout the unit b. Deal with paper correspondence as soon as possible after it arrives c. Require face-to-face communication between staff members rather than written documentation d. Set aside a block of time once per week to process documents

b. Deal with paper correspondence as soon as possible after it arrives CORRECT

1. Which statement is true regarding decision making? a. Scientific methods provide identical decisions by different individuals for the same problems. b. Decisions are greatly influenced by each person's value system c. Personal beliefs can be adjusted for when the scientific approach to problem solving is used. d. Past experience has little to do with the quality of the decision.

b. Decisions are greatly influenced by each person's value system CORRECT i. Rationale- Values, life experience, individual preference, and individual ways of thinking will influence a person's decision making. No matter how objective the criteria will be, value judgments will always play a part in a person's decision making, either consciously or subconsciously. It is not possible for a nurse to fully "set aside" personal beliefs when making a decision, even if the nurse applies the principles of self-reflection.

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

b. Document the incident and follow it up as per hospital policy CORRECT i. Rationale- Page 116. It is the responsibility as manager to immediately document the error according to hospital policy. Because policies concerning such situations vary, it is vital to know and follow established policies. It is not generally appropriate to make such a note on the client's chart. Speaking to another nurse or manager is not a sufficient response, although this may be one part of the follow-up process.

1. A multidisciplinary team has been assigned responsibility for managing the change process in a large health-care organization. What goal should this team set for their activities? a. Resistors will face workplace discipline. b. Employees will not sabotage the change process c. Change will happen as quickly as possible. d. Change will become a constant state in the organization.

b. Employees will not sabotage the change process CORRECT i. Rationale- page: 187. In some organizations, a team manages the communication between the people leading the change effort and those who are expected to implement the new strategies. Ultimately, this increases the chances of successful change and decreases the chance of sabotage. This is not achieved in a coercive way, such as punishing resistors. Rapid or constant changes are not typical goals; efficiency does not necessarily depend on speed.

1. A recent switch to a new laundry provider at a long-term care facility has been described as "cost-effective." What does this imply about the change in laundry service? a. The cost was anticipated b. It is worth the cost c. It is the least expensive service available d. It is reimbursable

b. It is worth the cost CORRECT

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

b. Make attempts not to prioritize information that supports the manager's beliefs CORRECT i. Rationale- Page 13. Confirmation bias refers to our tendency to search for and favor information that confirms our beliefs while simultaneously ignoring or devaluing information that contradicts our beliefs. Self-awareness and reflection can reduce this tendency. Delegating the data-gathering process may be beneficial in some situations, but every person is prone to confirmation bias, although in differing ways. Considering the implications of a decision is an important part of decision making but does not address the issue of confirmation bias. Minimizing data collection doesn't directly address confirmation bias and could compromise the quality of a decision.

1. A nurse-manager is working with a team of colleagues to update the organization's staffing and scheduling policies. What principle should the manager follow during this process? a. It is more important to communicate policies verbally than in writing. b. Policies should be written in a way that allows some flexibility c. Each employee should be given the right to opt into the type of system that he or she wishes. d. Each unit manager should be granted full control over scheduling and staffing.

b. Policies should be written in a way that allows some flexibility CORRECT

1. What is an inappropriate reason for delegation? a. To empower subordinates by "stretching" them in their work assignment b. The manager does not find the task intellectually challenging c. To free the manager to address more complex unit needs d. Someone else is better qualified to do the task.

b. The manager does not find the task intellectually challenging CORRECT i. Rationale- Page: 530. That the manager is not challenged by a task is not a valid reason for delegating that task to another. The other options are all appropriate reasons to delegate tasks to qualified staff.

1. A situation has occurred in a health-care organization where it is important to determine whether a particular nurse is categorized as a "staff nurse" or as a supervisor. What criterion should be used to make this differentiation? a. The nurse's level of influence on his or her peers and colleagues b. The percentage of time that the nurse spends as charge nurse versus giving direct client care c. The nurse's position in the hierarchy of the unit based on years of experienced d. The nurse position on the organization's salary scale

b. The percentage of time that the nurse spends as charge nurse versus giving direct client care CORRECT

1. Under which circumstance could the manager of an oncology unit deviate from the federal guidelines for handling chemotherapy agents? a. The organization has been accident-free for the last 10 years. b. The state has instituted a policy that is more restrictive than the federal one c. The state has a less restrictive policy that supersedes the federal one. d. The director of nurses requested more personalized guidelines be put in place.

b. The state has instituted a policy that is more restrictive than the federal one CORRECT

1. The manager of a busy emergency department is primarily concerned with the practical, day-to-day operations of the department. This manager is most clearly demonstrating what type of leadership? a. Interactional b. Transactional c. Transformational d. Bureaucratic

b. Transactional CORRECT i. Rationale- Page 50. The traditional manager, concerned with the day-to-day operations, is termed a transactional leader. Transformational leadership prioritizes longer term vision and empowerment. Bureaucratic leadership emphasizes rules and regulations, whereas interactional leadership focuses on the link between personality and situations.

1. A nurse-manager is implementing strategies to maintain adequate staff in the health-care organization. What action by the manager will best achieve this goal? a. Proactively plan to hire two RNs for each unit each year b. Use knowledge of turnover rates on their units for planning and hiring c. Look at staff-to-client ratios at other health-care organizations in the area d. Hire consultants to study national turnover rates to determine recruitment needs

b. Use knowledge of turnover rates on their units for planning and hiring CORRECT

1. The nurse-manager is chairing a committee, most of whose members are subordinates. When communicating with the members during meetings, the manager should: a. reserve the right to impose decisions on the committee. b. avoid overt demonstrations of power or authority c. avoid informality in speech or writing. d. ensure their contributions are recorded for performance appraisal purposes.

b. avoid overt demonstrations of power or authority CORRECT i. Rationale- Page: 313. During committee work, encouraging interaction that is free of status and power is important. Recording for performance appraisal purposes is likely to be intimidating for committee members. There is no reason for all communication to be formal in a committee setting.

1. A nurse has accepted a new position as the manager at an ambulatory clinic. The nurse can best model subordinate advocacy in this new position by: a. abolishing formal performance reviews. b. encouraging employees to participate in decision making c. adopting a laissez-faire leadership style. d. increasing the number of part-time employees and reducing the number of full-time employees.

b. encouraging employees to participate in decision making CORRECT i. rationale- Page 145. Collaborative decision making is associated with subordinate advocacy. However, the manager does not need to abolish rigorous practices (such as performance reviews) or adopt a laissez-faire style of leadership in order to promote subordinate advocacy. Doing away with full-time positions in favor of part-time positions is unlikely to be accepted as an example of advocacy; this will likely be perceived as threatening.

1. The nurse is admitting a new client who is facing a serious health problem. The nurse can best apply the skills of advocacy when working with this client by: a. providing evidence-based care. b. engaging closely and genuinely with the client and family. c. making decisions for the client and family in order to lessen their responsibilities. seeking opportunities to demonstrate professionalism

b. engaging closely and genuinely with the client and family. CORRECT

1. A nurse-manager works on a unit that has a decentralized self-scheduling system. When managing with this scheduling option, the manager should: a. avoid becoming involved with the system so that staff remain autonomous. b. oversee the system carefully to ensure sufficient staff coverage at all times. c. refer any disputes to the organization's personnel department. d. advocate for the most senior staff to receive the most desirable shifts.

b. oversee the system carefully to ensure sufficient staff coverage at all times. CORRECT

1. A nurse has asked a colleague for assistance with a complex wound dressing change. What response suggests that the colleague is at a novice level of nursing experience? a. "Definitely. I'll go and get the supplies and meet you at the bedside." b. "I'm really busy right now. Can we do it sometime this afternoon?" c. "Sure. Can you give me directions and then I'll do what you say?" d. "I can do it for you later, if that helps."'

c. "Sure. Can you give me directions and then I'll do what you say?" CORRECT i. Rationale- Page: 269. A novice typically requires clear directions and is oriented on following instructions and is less focused on thinking innovatively or independently. Deferring the other nurse's request or taking initiative would be less typical of a novice nurse.

1. The principle of autonomy would have the greatest bearing on what clinical situation? a. A client is unable to afford the treatment that carries the best chance for a cure. b. The nurse is caring for two clients in pain and must choose which to treat first. c. A client is discussing a do-not-resuscitate order with the care team. d. A nurse is considering whether to report a colleague's rough treatment of a client.

c. A client is discussing a do-not-resuscitate order with the care team. CORRECT i. Rationale- Page 87. Autonomy, or self-determination, is also referred to as freedom of choice and accepting the responsibility for one's choice. Deciding on resuscitation options involves this principle because the client's preference is the final determinant on the matter. Situations involving scarce resources or time are more closely aligned with issues of justice. The nurse's ethical decision making around reporting bad practice align most closely with duty-based reasoning and beneficence for clients.

1. A nurse filed a grievance against the employer and the matter has proceeded to arbitration. What is true about this employee's grievance? a. Arbitration is likely the initial step in resolving the grievance. b. The employer is likely trying to avert a strike. c. A neutral third party will impose a solution to the grievance. d. The grievance took place at a public health-care organization.

c. A neutral third party will impose a solution to the grievance. CORRECT

1. Which action should the nurse prioritize when trying to prevent malpractice claims? a. Devoting time to establishing an effective nurse-client relationship b. Asking for assistance when engaged in complicated procedures c. Always functioning with the scope of the nursing practice act d. Always carrying a personal liability insurance policy

c. Always functioning with the scope of the nursing practice act CORRECT i. Rationale- Page 116. 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. Asking for assistance when needed is prudent nursing practice but staying within the scope of practice is a more important guideline. Similarly, good nurse-client relationship has been shown to reduce the likelihood of malpractice, but this is a less significant guideline than staying in the scope of practice, which is paramount.

1. A nurse has accepted a position as a staff nurse and will practice primary care nursing. The nurse will be the only RN on the team. What is an appropriate role expectation for role fulfillment? a. Carrying out the majority of personal care for assigned patients b. Being responsible for care planning only during the shift when he or she works c. Assigning work according to the expertise of group members d. Planning nursing care independently of others

c. Assigning work according to the expertise of group members CORRECT i. Rationale-Page: 355. In primary nursing, the sole RN would not plan the care without others' input. The nurse is responsible for care planning for 24 hours per day. The RN leads the planning of care but may not carry out the majority of personal care.

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

c. Confirm the facility's policy around providing medical records to clients CORRECT i. Rationale-Page 123. Clients possess a right to view their medical records, but the protocols for facilitating this vary. Consequently, the nurse should check this facility's policy before acting. It would likely be premature for the nurse to provide the medical record to the client before communicating with other members of the care team or administrators to ensure policy is followed. This matter is outside the purview of ethics committees because it does not involve a dilemma. The Nurse Practice Act focuses on scope of practice and other regulatory issues, not client rights.

1. In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? a. Having set pay increases mandated annually b. Using length-of-service to determine committee selection c. Developing a program for recruitment of young talent d. Rewarding employees by promoting from within

c. Developing a program for recruitment of young talent CORRECT i. Rationale- Page: 200. The constant influx of young talent brings new ideas to the organization. Each of the other listed strategies may promote stagnation and inhibit the promotion of renewal.

1. A nurse-manager has identified the following objective for the care on the unit: "At least 95% of new clients' health records will contain a completed assessment for intimate partner violence." How should the manager improve this objective? a. Focus on client actions rather than documentation b. Include the rationale for the objective c. Include a time frame in the statement d. Increase the objective to 100% of health records

c. Include a time frame in the statement CORRECT i. Page: 178. For objectives to be measurable, they should have certain criteria. There should be a specific time frame in which the objectives are to be completed, and the objectives should be stated in behavioral terms, be objectively evaluated, and identify positive outcomes rather than negative outcomes. It is appropriate for an objective to include references to documentation and it may or may not be appropriate to expect 100% compliance, depending on many factors. The rationale is not normally included in an objective statement.

1. A leader has launched an organizational planning process that requires the development of new policies. How should the leader utilize subordinates during this process? a. Ask subordinates to brainstorm alternatives and then have industry experts evaluate each alternative b. Delegate the evaluation phase of organizational planning to subordinates c. Include subordinates early in the process and include them in all aspects of policy formation d. Limit the involvement of subordinates to developing unit-level policies and procedures

c. Include subordinates early in the process and include them in all aspects of policy formation CORRECT

1. A manager has been experiencing challenges during a planning process and must implement strategies to overcome barriers that impede planning. What is the manager's best action? a. Limit membership in the planning team to administrators, leaders, and executives b. Establish a fixed goal that is unaffected by changes in the organization c. Reevaluate whether the goals and objectives are appropriate and achievable d. Make the goals of the plan more general so that they can be more easily achieved

c. Reevaluate whether the goals and objectives are appropriate and achievable CORRECT

1. The care team is working with a client who has mental illness and who has been deemed a threat to self and others. It may be justified to take away the client's right to: a. Justice b. Confidentiality c. Self- determination d. Beneficence

c. Self- determination CORRECT i. Rationale- Page 87. When an individual's impaired decision making poses a threat to self or others, it may be in the interests of the client and other people to temporarily remove the client's right to self-determination. That is, to remove the client's right to reject treatment. This is ultimately an act of beneficence, even though the client may perceive otherwise. Justice is more closely aligned with the distribution of benefits between people. Confidentiality is maintained whether or not the client's right to self-determination remains in place.

1. An experienced nurse is applying for a position as a clinical nurse-leader (CNL). In addition to the nurse's clinical experience, what characteristic best qualifies the nurse for this position? a. The nurse currently sits on the hospital's ethics board. b. Specialty certification in a specific area of practice. c. The nurse has a master of science in nursing degree d. The nurse has consistently adhered to the standards of practice.

c. The nurse has a master of science in nursing degree CORRECT i. Rationale- Page: 364. The CNL, as an advanced generalist with a master's degree in nursing, is expected to provide clinical leadership at the point of care. CNLs have advanced knowledge and education in general practice as opposed to specialization in one primary discipline, like clinical nurse specialists. Adherence to standards of practice is a minimum requirement for nursing practice, not a specific qualifier for a CNL role. Similarly, sitting on an ethics board is a useful aspect of experience but not a specific qualifier for a CNL role.

1. What characteristic of a nurse best indicates the attainment of an "expert" level of nursing experience? a. The nurse identifies long-term goals for career advancement. b. The nurse is learning from experience how best to react in clinical situations.'' c. The nurse possesses an intuitive grasp of complex clinical situations. d. The nurse has more than 3 years of clinical experience.

c. The nurse possesses an intuitive grasp of complex clinical situations. CORRECT i. Rationale- Page: 269. Benner identifies the fact that the expert nurse has an intuitive grasp of complex situations. This normally requires more than 3 years of experience. Learning from experience and setting goals are characteristics of the earlier stages in Benner's continuum.

1. What strategy best increases the likelihood that a nurse-manager's communication will be accurately interpreted? a. Producing clear, simple, written communication b. Repeating the message as often as possible c. Using more than one method of communication d. Using face to face communication

c. Using more than one method of communication CORRECT

1. A rural hospital is considering a sharp reduction in the range and availability of the services it provides. Before making this change, the hospital's leadership should: a. decentralize its decision-making model. b. implement shared governance. c. consult with local stakeholders. d. review its organizational chart.

c. consult with local stakeholders. CORRECT i. rationale- Page: 305. The stakeholders are all the internal and external individuals and groups that have an interest in an organization's operations. In a rural community where few options for health care exist, it would be prudent to consult with local stakeholders before a major change in service. There is no obvious need for this organization to decentralize, implement shared governance, or review its organizational chart.

1. A unit manager has been instructed to complete a comprehensive audit of the unit's use of resources. The manager is daunted by the size of the task, which will likely take several weeks to complete. The manager should: a. set aside low- and medium-priority tasks until the project is complete. b. request clerical or secretarial assistance. c. divide the project into smaller components that can be more easily completed. d. delegate the project to subordinates and ask for weekly updates.

c. divide the project into smaller components that can be more easily completed. CORRECT i. rationale- Page: 215. Breaking up large projects into smaller pieces makes them much easier to accomplish and prevents procrastination. Delegation is often appropriate and efficient, but it would normally be inappropriate to delegate the entirety of a large project to subordinates. The manager must not neglect other tasks, even when there is a major project at hand. Secretarial support may provide some assistance with a larger project, but it is not likely to be the major determinant of success.

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

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

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

c. regulate his or her own emotions and those of othersCORRECT i. Page 68. Theorists studying emotional intelligence posit that the ability to regulate the emotions of self and others is key to effective leadership. Emotional intelligence does not involve removing emotion from decision making; conversely, it does not claim that emotion should trump reason. Management of emotions is not the same as manipulating the emotions of others, which is unethical.

1. A staff member asks the manager 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. "If you don't take any sick time before then, I'll give it to you." b. "I'd like to, but that would be unfair to the other nurses." c. "Be sure to get the written request in early." d. "I can't guarantee it right now but I will try to find a solution for you."

d. "I can't guarantee it right now but I will try to find a solution for you." CORRECT

1. A nurse-manager is aiming to project a powerful image of a team leader who empowers subordinates. What statement is most appropriate to this goal? a. "I'm in charge here, and so all requests need to come to me. Please let me know if you have any questions." b. "Is it okay with the rest of you if I do all the charting and you do the direct patient care?" c. "I'm too tired to deal with Dr. Jones today. When he gets here, tell him I've gone to lunch." d. "We have a great deal to accomplish today, but I am confident that we can do it by working together.

d. "We have a great deal to accomplish today, but I am confident that we can do it by working together. CORRECT

1. A nurse-manager oversees approximately 12 employees. What strategy should the manager prioritize when trying to motivate the employees? a. Apply punishments objectively and fairly. b. Advocate for an increase in pay c. Offer praise for exceptional performance d. Apply motivational strategies that are personally meaningful to each employee

d. Apply motivational strategies that are personally meaningful to each employee CORRECT

1. A nurse-manager recognizes the need to foster creativity among employees. What action will best promote creativity? a. Hire young employees whenever possible b. Demote employees who show a lack of creativity c. Encourage regular turnovers of employees d. Avoid micromanaging employee's behavior

d. Avoid micromanaging employee's behavior CORRECT

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

d. Creating a team with diverse abilities and talents CORRECT i. Rationale- Page 63. Strengths-based leadership posits that effective leaders surround themselves with people who have different strengths than they do. The leader should focus on addressing areas where he or she is weaker, not relying solely on existing strengths. This model does not rank people on a two-dimensional scale because there are diverse ways of being strong.

1. What action most directly addresses the projected nursing shortage? a. Increasing the number of unlicensed assistive personnel b. Increasing the number of nursing internships for recent graduates c. Expanding the nursing scope of practice d. Creating incentives for nurses to enter faculty roles

d. Creating incentives for nurses to enter faculty roles CORRECT

1. A busy medical unit has been increasing the use of agency nurses. The nurse-manager should anticipate what consequence of this staffing alternative? a. A need for 8-hour rather than 12-hour shifts b. Short-term cost savings c. Increased reliance on unlicensed assistive personnel by nurses d. Decreased continuity of care

d. Decreased continuity of care CORRECT

1. What is one of the most politically serious errors one can make? a. Withholding or refusing to divulge information b. Promoting the advancement of subordinates c. Delaying decision making until there is additional information d. Dispensing untrue information

d. Dispensing untrue information CORRECT i. Rationale- Page: 338. Lying to others is a serious political error. The other options represent appropriate behaviors.

1. What action by the manager of a community health center best demonstrates workplace advocacy? a. Asking clients to provide feedback on the care that they have received in their homes b. Assigning a different nurse to a client who had personality differences with his original nurse c. Phoning the home of a nurse who has called in sick to confirm that the nurse is genuinely ill d. Ensuring nurses have all the personal protective equipment they need to perform home visits

d. Ensuring nurses have all the personal protective equipment they need to perform home visits CORRECT i. Rationale- Page 145. Ensuring the safety or workers is one of the major demonstrations of workplace advocacy. Checking on a nurse who states that he or she is sick is likely to be perceived as an act of mistrust, not of advocacy. Asking for clients' feedback and assigning a client a new nurse are suggestive of client advocacy, not workplace advocacy.

1. The nurse-manager is working in a facility where 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 use of unlicensed assistive personnel will result in increased patient safety and quality care, and thus improve physician satisfaction. b. Increasing the RN staff will cut down on nursing errors, prevent burn out, and decrease the cost associated with staff turnover. c. Increasing the RN staff will lead to improved patient education and a reduction in costly patient stays. d. Increasing the RN staff will free more nurses to be available to address doctors' concerns during their rounds and will reduce our costly use of overtime.

d. Increasing the RN staff will free more nurses to be available to address doctors' concerns during their rounds and will reduce our costly use of overtime.CORRECT i. Rationale- Page: 338. 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. This option meets the organizational goals and the unit goal. None of the other listed options addresses each of these goals. Increased use of UAPs is unlikely to increase safety.

1. Which principle should guide the nurse-manager's use of nonverbal communication? a. It is generally consistent across cultures, unlike verbal communication. b. Nonverbal communication is a significant part of the communication exchange only when it is not congruent with the verbal exchange. c. Nonverbal communication should be minimized because it confuses the receiver regarding the true intent of the message. d. It supersedes verbal communication when the two are incongruent.

d. It supersedes verbal communication when the two are incongruent. CORRECT i. Rationale- Because nonverbal communication indicates the emotional component of the message, it is generally considered more reliable than verbal communication. It varies widely between cultures, and the manager does not normally have to make a conscious effort to minimize it. It is always significant regardless of how it aligns with the verbal message.

1. Which factor is the greatest contributor to the resistance encountered with organizational change? a. Poor organizational leadership b. Ineffective organizational management c. Insufficient staff involvement in the process d. Presence of employee mistrust

d. Presence of employee mistrust CORRECT Rationale- Page: 201. 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. Although the other options may increase resistance, employee distrust is the primary barrier to change

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

d. Skeptics of the plan have begun to see it as innovative and beneficialCORRECT i. Rationale - Page 70. Thought leadership refers to any situation in which one individual convinces another to consider a new idea, product, or way of looking at things. The theory does not advocate achieving this through ostracizing dissenters. Inclusive leadership groups are beneficial, but this is not a particular characteristic of thought leadership. Thought leadership does not imply a rejection of emotion.

1. A nurse is referencing the ANA code of ethics when making a decision about the best response to a challenging situation. What information will the nurse be able to obtain from this document? a. A model that will guide the nurse to make an ethical decision b. Legal guidelines to help the nurse make an ethical decision c. Guidelines that will help the nurse clarify his or her own values d. The principles that are most valued in nursing practice

d. The principles that are most valued in nursing practice CORRECT i. Rationale- Page 90. A professional code of ethics is a set of principles, established by a profession, to guide the individual practitioner. It is not, however, a decision-making model or a tool for clarifying one's own values. Codes of ethics are not legally binding documents.

1. Which characteristic of a planned change is most likely to threaten its success? a. The change agent is aware of the organization's internal and external environment. b. Individuals affected by the change are involved in planning for the change. c. An assessment of resources to carry out the plan is completed before unfreezing. d. The suggested change is introduced to staff after the plan has been formalized.

d. The suggested change is introduced to staff after the plan has been formalized. CORRECT i. Rationale- Page: 196. Employees should be involved in the change process. When information and decision making are shared early in the process, subordinates will be more accepting of the change. Awareness of the environment and assessment of resources support successful change.

1. According to Maslow, what statement best describes motivation a. Some individuals have hereditary needs b. All needs have equal power in motivation c. Lower-level needs are less valued d. Unsatisfied needs trigger behavior

d. Unsatisfied needs trigger behavior CORRECT

1. An employee has come to the manager with a long list of complaints about a coworker, all of which are attributable to personality factors rather than unsafe practice. What is the manager's best initial action? a. acknowledge and document the employee's complaints b. Ask the employee to email or text message the complaints to the coworker c. Arrange for third-party mediation d. encourage the employee to speak directly with the coworker

d. encourage the employee to speak directly with the coworker CORRECT

1. A nurse manager is in charge of a unit that consists of a generationally diverse group of staff nurses. The nurse manager knows that this type of staffing arrangement will: a. create a nursing environment that will be more structured and focused on the use of technology to provide the best care. b. require the baby boomer nurses have more flexibility in scheduling and time off as compared to the generation X nurses. c. allow generation Y and Z nurses to create a secure and stable work environment. d. establish a diverse working environment based on experience and technology.

d. establish a diverse working environment based on experience and technology. CORRECT

1. The nurse-manager can begin to promote the needs of a culturally diverse staff by: a. adopting a neutral teaching style that is equally accessible to all cultures. b. clustering staff members according to their culture whenever possible. c. focusing educational activities on the needs of staff from minority groups. d. viewing diversity as an opportunity rather than a threat

d. viewing diversity as an opportunity rather than a threat CORRECT