ANSWERS AND RATIONALES
5. This is an example of slander. It is a malicious, false statement that may
damage the nurse’s reputation.
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Leadership and Management
KEYWORDS
The following words include nursing/medical terminology, concepts, principles, and information relevant to content specifically addressed in the chapter or associated with topics presented in it.
English dictionaries, nursing textbooks, and medical dictionaries, such as Taber’s Cyclopedic Med- ical Dictionary, are resources that can be used to expand your knowledge and understanding of these words and related information.
Accountable, accountability Case management
Change theory Controlling Consensus Cooperation Creative Delegate Directing Documentation Efficiency Empower Feedback
Five Rights of Delegation:
Right task Right person
Right communication Right time
Right supervision Flexible
Human resource management Incentives
Job description Leadership
Leadership styles—classic:
Autocratic—directive
Democratic—participative, consultative Laissez-faire—nondirective, permissive Leadership styles—contemporary:
Charismatic leadership Connective leadership
Transactional leadership Transformational leadership Shared leadership
Managers:
First-line managers Unit managers Middle managers Nurse executives Motivation
Network Organization
Performance evaluation Power types:
Expert Influence Legitimate Referent Reward Preceptor Primary nursing Problem solving Productivity
Resistance to change Resource management Role model
Subordinate Systems theory Table of Organization Time management
QUESTIONS
1. An accurate assessment drives the rest of the steps of the nursing process. The nurse in charge understands that the management function that drives effective management is:
1. Planning 2. Directing 3. Organizing 4. Controlling
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2. Which action is an example of a nurse working independently?
1. Limiting fluids when a patient has an order for 1000 mL fluid restriction 2. Assigning another nurse to administer medications
3. Irrigating a patient’s wound with normal saline 4. Applying a warm soak on an infiltrated IV site
3. Which is most basic for a nurse new to a management position?
1. Strong interpersonal communication skills 2. Awareness of when to be confrontational 3. Knowledge of the role of a change agent 4. Recognition by peers as a leader
4. A unit manager mentors a new unit manager as part of orientation to the position.
Which type of power is being used by the unit manager mentor?
1. Influence 2. Coercive 3. Referent 4. Expert
5. A nurse manager considers that there are “Five Rights of Delegation”—right task, right person, right communication, right time, and right:
1. Place 2. Route 3. Feedback 4. Supervision
6. What should the manager do first to overcome resistance to change?
1. Ensure that the planned change is within the current beliefs and values of the group
2. Provide incentives to encourage commitment to the change 3. Implement change in small steps rather than large steps 4. Use informational power to ensure that goals are met
7. What activities does a nurse manager engage in who values the importance of positive role modeling?
1. Counseling subordinates who fail to meet expectations 2. Holding team meetings to review rules of the agency 3. Reviewing job descriptions with employees
4. Following the policies of the agency
8. When considering leadership styles, an “autocratic” leader is to “authoritarian” as a
“democratic” leader is to:
1. Directive 2. Permissive 3. Oppressive 4. Consultative
9. What nursing-care delivery model is based on case management?
1. Patient classification system 2. Diagnostic Related Groups 3. Critical pathways
4. Primary nursing
10. Which statement is most significant in relation to the concept of change theory in the health-care environment?
1. Weigh the risks and benefits
2. The stages of change are predictable
3. Change in activity results in positive outcomes
4. A large change is easier to adapt to than multiple smaller changes
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11. Several nurses complain to the nurse manager that one of the patient care aides constantly takes extensive lunch breaks. What should the nurse manager do?
1. Convene a group meeting of all the patient care aides to review their responsibilities related to time management
2. Talk with the patient care aide to explore the reasons for the behavior and review expectations
3. Arrange a meeting with the nurses so that they can confront the patient care aide as a group
4. Document the patient care aide’s behavior and place it in the aide’s personnel file 12. What should the nurse do to ensure efficiency when managing a daily assignment?
1. Give care to a patient in isolation first
2. Plan activities to promote nursing convenience 3. Organize care around legally required activities
4. Perform routine bed baths between breakfast and lunch
13. A supervisor communicates expectations about a task to be completed and then dele- gates the task. Which management function is being implemented by the supervisor?
1. Planning 2. Directing 3. Organizing 4. Controlling
14. A student nurse in the clinical area is given an appropriate patient assignment by the instructor. What should the student nurse do?
1. Accept the role of leader of the patient’s health-care team 2. Complete the care indicated on the patient’s plan of care
3. Assume accountability for the tasks that are assigned by the instructor 4. Help other students to complete their assigned tasks whenever necessary 15. Which statement is most significant in relation to the concept of change theory in
the health-care environment?
1. Barriers to change can be overcome by embracing new ideas uncritically 2. Change generates anxiety by moving away from the comfortable 3. Behaviors are easy to change when change is supported
4. Change is most effective when spontaneous
16. A patient is to be discharged from the hospital. Which discharge task can be delegate to a nursing assistant?
1. Teaching the patient how to measure weight using a standing scale 2. Obtaining the patient’s temperature, pulse, and respiratory rate 3. Determining if the patient knows how to measure fluid intake 4. Demonstrating to the patient how to use a walker
17. What is the major focus of nursing management?
1. Accomplishing an objective 2. Empowering others 3. Problem solving 4. Planning
18. A staff nurse must solve a complex problem. Which is the nurse’s most effective resource?
1. Organizational chart of the institution 2. Nursing procedure manual
3. Unit’s nurse manager 4. Nursing supervisor
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19. When delegating a specific procedure to a patient care aide, the aide refuses to perform the procedure. What should the nurse do first?
1. Assign the procedure to another patient care aide
2. Explain that it is part of the patient care aide’s job description 3. Explore why the patient care aide refused to perform the procedure
4. Send the patient care aide to the procedure manual to review the procedure 20. What is the first thing the nurse should do when planning to apply for a new
position within an agency?
1. Review the job description
2. Provide at least several positive references 3. Identify if power is associated with the position
4. Locate the position on the agency’s Table of Organization
21. The most important reason why a nurse aide must fully understand how to implement a delegated procedure is because the nurse aide must be able to:
1. Teach the procedure to another nurse aide 2. Explain the procedure to the patient 3. Complete the procedure safely 4. Perform the procedure quickly
22. The nursing team leader delegates a wound irrigation to a Licensed Practical Nurse (LPN). It has been a long time since the LPN performed this procedure. To ensure patient safety the nursing team leader should:
1. Verbally describe to the LPN how to perform the procedure 2. Have the LPN demonstrate how to perform the procedure 3. Assign another LPN to assist with the procedure
4. Delegate the procedure to another LPN
23. A nurse manager is informed that a large number of patients will be admitted in response to a terrorist attack. Which type of leadership style is most appropriate in this situation?
1. Collaborative 2. Authoritarian 3. Laissez-faire 4. Democratic
24. A nurse manager is experiencing staff resistance when implementing change. What is the most important action by the nurse manager to overcome resistance to change?
1. Identify the reason for the resistance 2. Restate the purpose of the change concisely 3. Modify the objectives to appeal to more key people 4. Emphasize the positive consequences of the change 25. What is the major focus of leadership?
1. Inspiring people 2. Creating change 3. Controlling others 4. Producing a product
26. The primary difference between effective leaders and managers is that managers have:
1. Vision 2. Charisma 3. Confidence 4. Responsibility
27. Which situation is most reflective of the saying, “A stitch in time saves nine?”
1. Obtaining the vital signs for the patients on the unit at the same time 2. Collecting equipment for a procedure before entering the room 3. Delegating some interventions to the Licensed Practical Nurse 4. Documenting the nursing care given every few hours
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28. A Registered Nurse delegates a procedure to a Licensed Practical Nurse. What is the primary purpose of delegation?
1. Create change 2. Establish a network 3. Improve productivity 4. Transfer accountability
29. A nurse manager plans to provide feedback to a subordinate who needs a change in behavior. What is the best intervention by the nurse manager?
1. Be assertive
2. Explore alternatives
3. Identify the unacceptable behavior
4. Document the content of the counseling session
30. What is the main reason the nurse manager achieves a consensus when making a decision within a group?
1. Explore possible alternative solutions 2. Demonstrate that staff members are flexible
3. Facilitate cooperative effort toward goal achievement 4. Ensure the use of effective autocratic decision making
31. The nurse manager evaluates the performance of a subordinate. Which management function is being implemented by the nurse manager?
1. Planning 2. Directing 3. Organizing 4. Controlling
32. Which is most related to systems theory?
1. End result 2. Linear format 3. Trial and error 4. Cyclical process
33. The nurse and a nursing assistant (unlicensed assistive personnel) are working together on a surgical unit. Which nursing activity should the nurse assign to the nursing assistant?
1. Assessing the results of blood glucose monitoring
2. Explaining to a patient how to use an incentive spirometer
3. Emptying a urine collection bag that is attached to continuous bladder irrigation 4. Assisting the postanesthesia care unit nurse to help a patient to make the
transition to the surgical unit
34. Which tasks should be delegated to a Registered Nurse? Select all that apply.
1. _____ Obtaining vital signs
2. _____ Providing discharge teaching
3. _____ Evaluating a patient’s response to morphine 4. _____ Administering a cleansing enema to a patient
5. _____ Transporting a patient to the operating room for surgery
35. Lewin’s planned change theory progresses through phases. Order these statements by the nurse manager as change moves through the process.
1. “Let’s implement a pilot project next week.”
2. “This is a new venture that should be exciting.”
3. “I know it may be difficult but you are doing a great job.”
Answer: _______________________
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ANSWERS AND RATIONALES
qualities. As a nurse manager grows into the role, peers will recognize the leadership ability of the nurse manager.
4. 1. This is not an example of influence power.
Influence power is the use of persuasion and communication skills to exercise power in- formally without using the power associated with formal authority.
2. This is not an example of coercive power.
The leader bases coercive power on the fear of the punitive withholding of rewards or retribution.
3. This is not an example of referent power.
Referent power is associated with respect for the leader because of the leader’s charisma and prior successes.