Essentials of Nursing Leadership & Management exam with complete solutions.docx, Exams of Leadership and Team Management

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Essentials of Nursing Leadership &

Management exam with complete

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The essence of leadership is the leader's ability to: - ANSWER- A) Get people to work together B) Influence other people C) Help others meet their personal goals D) Influence the group to follow the leader's way of thinking Answer: A According to "trait theories," the most common traits of a good leader are: - ANSWER- A) Information giving and decision-making B) Public speaking and nonrisk behaviors C) Intelligence and initiative D) Verbal and written communication skills Answer: C Of the following qualities, which would least likely be attributed to an effective nursing leader? - ANSWER- A) Energy and integrity B) Pessimism and stress C) Courage and initiative D) Optimism and perseverance Answer: B Behaviors of an effective leader include: - ANSWER- A) Denying the exchange of information B) Inability to communicate effectively C) Giving only negative feedback D) Developing oneself and others Answer: D

Sally has been working only 3 months after graduating from her nursing program. She confides in a friend that she wants to develop herself as a "good follower." Her friend says, "Anyone can follow—just walk behind someone and do nothing." How might Sally respond? - ANSWER- A) "I don't mean now, but when I become a nurse manager." B) "Effective followers need to be active participants in the workings of this unit." C) "Effective followers need to do everything the administrators want." D) "Effective followers need to always question the status quo and strive to make changes." Answer: B Jim has demonstrated strong leadership skills during his first year as an RN. He observes that one of his coworkers appears very anxious when dealing with demanding families. Jim displays emotional intelligence when he: - ANSWER- A) Reports to the nurse manager that his friend is very anxious when dealing with demanding families. B) Says to his friend, "Dealing with these demanding families can be very anxiety- producing." C) Says to his friend, "You seem very anxious when dealing with these families; maybe you should seek counseling help." D) Ignores the behavior because everyone takes a different time to adjust to the role of an RN. Answer: B Linda believes she should begin demonstrating leadership skills on her unit. She speaks with her nurse manager about how to do this. The nurse manager, who wants to encourage Linda's leadership development, responds by saying: - ANSWER- A) "Just watch me closely—it will come to you eventually." B) "Develop perseverance—just hang in there and do your work well—someone higher than I will notice you." C) "It takes a lot of energy to be a leader. You might want to sign up at the local gym." D) "Understand yourself first—what leadership skills do you want to develop?" Answer: D Which skills will not be useful in becoming a better follower? - ANSWER- A) Supporting the ideas of your colleagues B) Becoming an effective listener C) Demonstrating energy and enthusiasm in the workplace D) Contradicting others if their ideas are not useful to the team Answer: D

Nancy is supervising a patient care assistant and a licensed practical nurse. When giving them assignments she states, "You two decide how you want to divide up the patients." This is an example of what type of leadership? - ANSWER- A) Autocratic B) Laissez-faire C) Democratic D) Situational Answer: B Emotional intelligence is also an important part of leadership. Which of these qualities is not part of emotional intelligence? - ANSWER- A) Understanding self B) Listening skills C) Acknowledging others D) Responding quickly to a crisis Answer: D The major hallmark of situational leadership is: - ANSWER- A) Understanding the readiness of the follower B) Major focus on interpersonal relationships C) Effective listening skills D) Motivating others Answer: A Matthew is completing his first year of employment as an RN on a medical- surgical unit. A new graduate has just started her orientation on his unit. He found her crying in the patient lounge stating, "I can't do this. This is just not like we learned in school." What response from Matthew demonstrates his leadership skill? - ANSWER- A) "If you are already crying this is not the career for you." B) "I remember those feelings—come on—let's talk about it." C) "Why don't you talk to the nurse manager? Maybe she can give you a lighter load." D) "I would consider a transfer to an easier unit." Answer: B The role of the manager includes: - ANSWER- A) Interpersonal, informational, and decisional actions B) Extroverted personality, hidden agenda, and personal gain C) Introversion, asking questions, and inability to take action D) Extreme prejudice, being unknowledgeable, and being uncaring

Answer: A Sally meets with all the staff to get input on the governance of the unit. Her management style is most likely: - ANSWER- A) Autocratic B) Participative C) Directive D) Permissive Answer: B During a code Sue begins giving order to the staff. Her management style at this time is: - ANSWER- A) Nondirective B) Permissive C) Controlling D) Participative Answer: C An example of a human relations-oriented manager is one who: - ANSWER- A) Motivates employees to work to their highest potential B) Uses control rather than guidance C) Assumes close supervision over staff development D) Implements punishment rather than rewards potential Answer: A Which of the following qualities would be detrimental to effective nursing management? - ANSWER- A) Leadership B) Clinical expertise C) Business sense D) Minimum communication Answer: D Michelle believes that her employees operate from the Theory Y philosophy. Based on this, how would she assist them in developing a scheduling plan for the unit? - ANSWER- A) Send a completed schedule for 2 months out over e-mail. B) Ask for a committee of volunteers to develop the schedule. C) Meet with each employee to get his or her input about the best scheduling plan. D) Delegate scheduling to her assistant nurse manager. Answer: C

Nancy has been working as an RN in long-term care for 4 months. She has been offered the evening supervisor position at a local nursing home. The salary is attractive. What should be her main consideration prior to accepting this position? - ANSWER- A) Her clinical expertise, business sense, and leadership skills. B) Staffing ratios and number of RNs on the evening shift. C) Vacation, sick time, and tuition reimbursement. D) Mission and philosophy of the facility. Answer: A Which of the following actions would be typical for a manager who adheres to the scientific management approach? - ANSWER- A) Reads research studies on management B) Stays in touch with his or her feelings C) Carefully works out the time each nursing task should take D) Allows staff to develop and enforce their own holiday schedule Answer: C Servant leadership is best described as: - ANSWER- A) An "employees first" attitude B) Emphasis on serving the patient C) A laissiz-faire approach D) Multi-tasking as much as possible Answer: A Which of the following is an example of the decisional activities of a manager? - ANSWER- A) Providing leadership B) Encouraging continuing education C) Coaching employees D) Completing staff evaluations Answer: D What is the "essence" of management? - ANSWER- A) Providing close supervision B) Getting work done through others C) Constant monitoring of unit expenses D) Staff development Answer: B

A new graduate has been offered a nurse manager position. What is the graduate's best response? - ANSWER- A) "Thank you, but I'm not ready to be a manager." B) "When can I start?" C) "What is the starting salary?" D) "Tell me what the benefits of the positions are." Answer: A Wilhelmina, an RN for over 6 years, had her license suspended because an audit of her continuing education credits showed that she had not met the mandatory course requirements. The Board of Nursing has the ability to do this based on: - ANSWER- A) Case law B) Administrative law C) Civil law D) Statutory law Answer: B Jeremy graduated from an associate degree nursing program 2 years ago. He is brought before the State Board of Nursing for offering to give physicals for summer camp for $25. Because Jeremy has violated the Nurse Practice Act in his state, he is charged with committing a: - ANSWER- A) Misdemeanor B) Felony C) Civil law D) Common law Answer B Which of the following would not be considered one of the elements for a negligence claim? - ANSWER- A) Duty B) Breach of duty C) Spontaneous duty D) Harm Answer: C Lorena, an RN, is flying from Los Angeles to New York. The flight attendant requests the help of a nurse or physician if one is on board. Lorena approaches the flight attendant and asks if she can assist. Lorena is protected by the Good Samaritan Act because the act states that a licensed health-care provider can: - ANSWER- A) Administer care any time B) Provide care that any other prudent individual with the same education would provide C) Provide the same care as a paramedic

D) Provide care outside the scope of her practice as long as she knows how to perform the required procedure Answer: B Larry was brought to the hospital by two police officers. He was combative and verbally abusive. After waiting for over an hour, Larry tells the nurse he is leaving. The nurse removes Larry's clothes from the room, leaving him only in his underwear. The nurse may be charged with: - ANSWER- A) Cruel and unusual punishment B) Slander and libel C) False imprisonment D) Assault and battery Answer: C Jose and his girlfriend are driving on the highway and witness a motor vehicle accident. He calls 911 and pulls over to the side of the road. He immediately begins to assess the victim to determine what he can do until the paramedics arrive. His girlfriend says, "This guy can't give you permission to help him; maybe you should just leave him alone." Jose explains that he has implied consent. Implied consent is assumed when a client: - ANSWER- A) Sees a physician or nurse by appointment in the office or clinic setting B) Arrives in the operating suite C) Is admitted to the hospital D) Is treated at the scene of an accident Answer: D Three nursing students are in the elevator and overhear Evan, one of the staff nurses, discussing his neighbor who was hospitalized last night for liver failure. Evan told his colleague that a mutual friend told him that the neighbor was "known for liking his brandy." A family member was in the elevator and also overheard the conversation. Evan may be charged with: - ANSWER- A) Slander B) Libel C) Fraud D) Breach of confidentiality Answer: A Juliana, an RN, is caring for Mary Lewis, 80 years old. Ms. Lewis falls and injures herself. Which of the following actions should Juliana take to decrease her liability? - ANSWER- A) Document the incident carefully on an incident report form. B) Chart the facts surrounding the client's fall, condition, and follow-up care.

C) Do not document anything about the fall. D) Just tell the on-coming nurse that Mary fell. Answer: D An action that can lead to a malpractice suit would be: - ANSWER- A) Assessing a client more than once per shift. B) Listening to the physician explain the benefits and risks of a procedure as they are being explained to the client. C) Reporting that he or she has witnessed a coworker using controlled substances when working. D) Altering a client's record. Answer: D Mr. Phillipe has suffered a stroke. His daughter brings DNR and power of attorney documents to the hospital. The purpose of the DNR is to: - ANSWER- A) Document the terminal nature of the client's condition B) Allow an alternative to the universal standing order to provide cardiopulmonary resuscitation to all clients C) Provide an opportunity for the client, family, and caregivers to discuss the nature of the client's condition and the best possible course of action if the client has a cardiac arrest D) Provide legal protection for nurses who believe a client should not be resuscitated Answer: B Marie, an RN, accompanies the surgeon to Ms. Allen, a diabetic with gangrene of the lower left extremity. The surgeon explains to Ms. Allen that he will perform a below-the-knee amputation that will remove the infection. He will give her some antibiotics, and she will probably go home in a few days. After the surgeon leaves, Marie brings in the consent forms and asks Ms. Allen to tell her what the surgeon said. Ms. Allen states, "Oh, he is going to remove the infection and give me antibiotics and then I can go home. I feel so much better now because my other doctor told me they were going to cut off my leg!" Based on this information, Marie's next step should be to: - ANSWER- A) Have Ms. Allen sign the consent form B) Draw a picture of a below-the-knee amputation for Ms. Allen C) Tell Ms. Allen that she did not hear what her doctor told her D) Call the surgeon and explain the situation to him Answer: D

Glenn is an RN on a busy medical-surgical unit. He comes to work today for his usual shift after working a double shift yesterday. At the end of this day, two RNs call in, and the nurse manager tells Glenn he needs to stay and cover the next shift. Glenn may refuse to accept an assignment if: - ANSWER- A) He is being asked to care for too many difficult clients B) He believes his assignment is unsafe C) He is being asked to work overtime D) He believes there are not enough nurses to work with him Answer: C The health-care provider orders an injection for a pediatric client. The client's legal guardian refuses to allow the nurse to administer the medication, however, the nurse proceeds to administer the injection. Legally, the nurse has committed:

• ANSWER- A) An assault B) A battery C) An invasion of privacy D) False imprisonment Answer: B After administering an incorrect dosage of a medication the nurse realizes that too little medication was given to the client. The nurse then administers a second dose in order to give the correct dosage. Legally, the nurse must: - ANSWER- A) Not tell anyone about the error B) Document that the correct medication was administered C) Document the error in the nursing notes D) Both A and B Answer: C A nursing student is preparing for the NCLEX. Which of the following activities would be most appropriate 2 days before the student is to take the examination? - ANSWER- A) Pack a bag of items that may be needed during the test. B) Map out the route to the exam site. C) Eat a diet high in fats and carbohydrates. D) Both A and B Answer: D Which of the following would be considered an extrinsic value? - ANSWER- A) Food B) Water C) Money D) Shelter

Answer: C Mrs. Chou has been suffering from senile dementia Alzheimer's type for over 5 years. Her family has kept her at home, and each member has participated in her care. The community health nurse has been supporting the family in this effort. Recently, Mrs. Chou has stopped interacting with the family, refuses to eat, and sleeps a great deal. The family is conflicted over how to care for their dying mother. The nurse understands that her role in this conflict is to: - ANSWER- A) Say nothing; this is a family issue. B) Speak with the members individually and persuade them to do "what is best for their mother." C) Discuss the conflicting opinions with the physician. D) Persuade the family members to meet together to express their feelings to one another. Answer: D Mr. Jeremy received the wrong dose of a narcotic, and the error was caught during the shift's narcotic count. The nurse performing the count was not the nurse who signed out the medication. The nurse's next action should be to: - ANSWER- A) Speak about the error with the nurse who gave the medication. B) Report the medication error without first consulting the nurse who signed out the medication. C) Call the nurse manager and ask her to handle the situation. D) Write out an incident report. Answer; A A family insists that their father, Alvin Shure, 68 years old, not be told he is dying of lung cancer. While hanging his IV medication, Mr. Shure asks the nurse, "I never had a medication in a bag like that. What is it for?" The nurse knows that the medication is an antineoplastic agent. The best response by the nurse is: - ANSWER- A) "This is a new drug your physician ordered." B) "This medication is often used in the treatment of cancer." C) "This medication has more than one use, and I am not sure why you are receiving it." D) Request that the family tell him why he is getting the medication. Answer: B Mrs. Brandon has breast cancer. She was diagnosed quite late in the illness and is terminal. She knows that she has breast cancer and has undergone a mastectomy, however, no one has told her the extent of her illness. The nurse comes in to change her dressings and hang her medication. Mrs. Brandon looks

at the nurse and asks, "What is happening to me? Why won't anyone explain what is happening to me?" Her husband, Mike, and two daughters look at the nurse and shake their heads, "No." The best response by the nurse is: - ANSWER- A) "You seem distressed; let's talk about your concerns." B) "You know you are ill; let's talk about dying." C) "You seem concerned about your health; talk to the doctor when he comes in to see you." D) "Mike, you need to talk to your wife and tell her what is really happening." Answer: A Nonmaleficence means: - ANSWER- A) Freedom to make decisions for oneself B) Doing no harm, either deliberately or unintentionally C) Doing good for the benefit of others D) Treating everyone equally, regardless of gender, race, religion, or disease Answer: B The role of ethics committees is to: - ANSWER- A) Resolve ethical dilemmas B) Prevent the physician from getting the institution into legal confrontations C) Establish guidelines to eliminate ethical dilemmas D) Provide appropriate guidance for the health-care team, family members, and the client Answer: D Beneficence means: - ANSWER- A) Freedom to make decisions for oneself B) Doing no harm, either deliberately or unintentionally C) Doing good for the benefit of others D) Treating everyone equally, regardless of gender, race, religion, or disease Answer: C Yana and Jonathan carry the gene for a rare genetic disorder that causes severe mental retardation and physiological problems incompatible with life. Yana has conceived twice, however, both children had the disorder and died within 2 months after birth. Yana has come to the fertility clinic. While her history is being taken, Yana says to the nurse, "After you harvest my eggs and fertilize them with Jonathan's sperm, throw out all the bad ones, and give me only the good ones." The best response made by the nurse is: - ANSWER- A) "Now, that's not very nice." B) "We never implant bad embryos; we have a reputation to keep." C) "You have to take the good with the bad." D) "Let's talk about your concerns regarding the health of these embryos." Answer: D

A nurse working in the critical care unit is described as being an excellent friend and critical thinker. This would be considered an example of: - ANSWER- A) Virtue ethics B) Moral ethics C) Nursing ethics D) Power ethics Answer: A A common theme in both the ANA and the ICN code is: - ANSWER- A) A focus on the importance of compassionate care B) Nurses making decisions for clients C) Promoting nursing practice acts D) Maintaining continuing education Answer: A Sharing decision-making responsibilities may be difficult for some managers for which of the following reasons? - ANSWER- A) They believe that empowered staff members have higher levels of job-related tension. B) There is inadequate staffing on the unit. C) There is a lack of time and situational support. D) They may be reluctant to give up their control. Answer: D The two basic channels of communication are: - ANSWER- A) Verbal and interpretive B) Nonverbal and interpretive C) Nonverbal and verbal D) Verbal and written Answer: C Liu Chen, an RN, is taking a client history. She is entering the information into her handheld as the client speaks to her and asks questions clearly and concisely. However, Liu asks questions regarding information the client has already given. The client says to Liu, "Are you listening to me?" Of the following, which best indicates Liu is listening to the client? - ANSWER- A) Maintaining appropriate eye contact. B) Glancing around the room and writing a note. C) Asking another question immediately after receiving an answer to the first question. D) Typing notes on the computerized record while the client is speaking.

Answer: A Maggie is a new UAP. She has been working the 7:00 p.m. to 7:00 a.m. shift on a busy telemetry unit for 3 months. She is perpetually late to work. The other UAPs on the unit are complaining about the situation. Of the following responses, which demonstrates the best example of assertive communication? - ANSWER- A) "You are always late; what are you going to do about this situation?" B) "Being late is unacceptable; you need to change this behavior." C) "I noticed that you often arrive late; I think we need to discuss how this affects your performance." D) "Lateness creates a situation that leads to a negative day; I think it is time to work out a plan to eliminate this problem." Answer: D Communication has the best chance of being interpreted accurately when: - ANSWER- A) Face-to-face communication is used B) The message is repeated by the sender C) Sent electronically D) More than one mode is used Answer: D The health-care institution where Cori is a nurse manager has moved to e-mail as a method of communication. When using this communication method, it is important to remember that: - ANSWER- A) Professional e-mail must use formal headings. B) Professional e-mail may remain informal. C) E-mail does not require the same level of courtesy as a formally written communication. D) Professional e-mail should be written in all capital letters. Answer: B A new nurse manager plans to give a performance evaluation to a staff nurse who has worked on the unit for 15 years. The staff nurse has had multiple complaints regarding the delivery of client care from clients and other staff. The best statement by the nurse manager in beginning the performance appraisal would be: - ANSWER- A) "Tell me how you view your delivery of client care?" B) "I have reviewed your past evaluations and cannot believe that you are still here!" C) "The other day I noticed how well you taught your client about his new medications." D) "I think that the acuity on this unit is too difficult for you."

Answer: A A problem-solving process used in the nurse-client relationship is known as: - ANSWER- A) Case management B) Nursing process C) Evaluation techniques D) Remediation theory Answer: B Mr. Reynolds is admitted through the emergency department after being involved in a motor vehicle accident. His airbag failed to deploy, and he was hit in the abdomen with the steering wheel. He has an IV of 0.9% NS @ 100 mL/hr, BP 92/58, and complains of weakness, fatigue, and abdominal pain. On assessment, the nurse discovers that Mr. Reynolds is nauseated and just vomited 560 mL. The nurse is quite busy and decides to delegate client care activities to the nursing assistant. Of the following activities, which should the nurse keep? - ANSWER- A) Taking and recording vital signs every 15 minutes B) Recording accurate intake and output C) Obtaining a baseline weight to guide therapy D) Increasing the IV rate to 250 mL/hr if the blood pressure drops to 85/ Answer: D Mrs. Dillon, a client recovering from CHF, is being discharged this afternoon. She needs teaching reinforced. The most appropriate caregiver to complete this activity is: - ANSWER- A) An LPN/LVN B) A UAP C) A unit secretary D) A second-year nursing student working as a nurse tech on the unit Answer: A Of the following clients, which one could be assigned to a UAP? - ANSWER- A) A client with a recent head injury B) A fresh postoperative laparoscopy client for the removal of an ovarian cyst C) A client with stable angina D) A client with a sepsis Answer: C The RN who is the team leader gives assignments to all the team members. The decision is based on: - ANSWER- A) The number of staff willing to work B) The age and desires of the team members

C) The RN needing to take orders and write client outcomes D) The condition and needs of each client Answer: D When making assignments, two legal responsibilities the RN must take into consideration are: - ANSWER- A) Knowing the job requirements and evaluating the outcomes. B) Assessing how much supervisory time is necessary and assessing the competence of each staff member C) Writing job descriptions and communicating them to all staff members D) Making sure the supervisor's and the employee's strengths are matched and giving adequate supervision Answer: B Kimberly has been a nurse for 10 years, and she is precepting Loren, a new RN. Loren is having difficulty prioritizing client care. Kimberly explains to her that prioritizing client care is based on: - ANSWER- A) The nursing process B) Virchow's triad C) Client requests D) Maslow's hierarchy Answer: D Which of the following non-profit agency or organization completed the report that now serves as the foundation and strategy for health system reform? - ANSWER- A) The Joint Commission B) The U.S. Senate C) The American Medical Association D) The Institute of Medicine Answer: D In many states there is a legal requirement to report: - ANSWER- A) Adverse events B) Skill-based errors C) Safety gaps D) Near misses Answer: A To promote safe, quality health care, the American Nurses Association (ANA): - ANSWER- A) Mandates safe RN staffing levels to health-care agencies B) Regulates RN competency to practice at the bedside C) Maintains oversight of the National Database of Nursing Quality Indicators

D) Funds research promoting consumer protection from RN mistakes and errors Answer: C Crossing the Quality Chasm identified six aims of health care. Health care should be safe, effective, timely,: - ANSWER- A) Efficient, cost effective, and government- managed B) Equitable, free, and decisive C) Accessible, efficient, and equitable D) Patient-centered, efficient, and equitable Answer: D The Institute of Medicine (IOM): - ANSWER- A) Was unable to quantify the prevalence or significance of health-care quality issues B) Was organized after efforts of the AMA failed to improve health-care system quality C) Was given authority to legislate health-care system quality and safety deficits D) Authored a series of reports that provided the foundation for health-care system reform Answer: D Which of the following is NOT accurate regarding the organization and agency efforts to support quality and safety in the health-care system? - ANSWER- A) The U.S. Department of Health and Human Services is the primary agency responsible for protecting health in America. B) The American Nurses Association manages a database of unit-specific nurse- sensitive data known as NDNQI. C) Nonprofit organizations such as the Robert Wood Johnson Foundation and Leapfrog Group all have the singular focus to improve health-care outcomes for the underserved. D) The purpose of the Joint Commission is to provide voluntary accreditation of hospitals and health-care organizations. Answer: C State and federal agencies oversee legislation, licensure, and reporting programs as well as administer quality and safety initiatives such as: - ANSWER- A) The Hospital Quality Initiative B) The National Database of Nursing Quality Indicators (NDNQI) C) The Health Effectiveness Data Information Set (HEDIS) D) The Magnet Recognition Program Answer: A

In order to manage time effectively it is important to: - ANSWER- A) Do the tasks that take the least amount of time first B) Do the tasks that take the most amount of time first C) Prioritize tasks according to importance D) Alternate shorter tasks with longer tasks Answer: C According to OSHA, employers must provide all of the following EXCEPT: - ANSWER- A) Tuberculosis testing and hepatitis B vaccine B) Client rooms that are painted with pleasant colors C) Protective equipment, such as gloves, gowns, and masks D) Immediate treatment after exposure to bloodborne pathogens Answer: B