Exam Leadership Roles and Management Functions in Nursing 10th Edition Marquis Huston Test, Exams of Nursing

Download Exam Leadership Roles and Management Functions in Nursing 10th Edition Marquis Huston Test and more Exams Nursing in PDF only on Docsity! 1 Chapter 1 Making, Problem Solving, Critical Thinking, and Clinical Reasoning: Requisites for successfulleadership and management 1. What statement is true regarding decision making? A) It is an analysis of a situation B) It is closely related to evaluation C) It involves choosing between courses of action D) It is dependent upon finding the cause of a problem Ans: C Feedback: Decision making is a complex cognitive process often defined as choosing a particular course of action. Problem solving is part of decision making and is a systematic process that focuses on analyzing a difficult situation. Critical thinking, sometimes referred to as reflective thinking, is related to evaluationand has a broader scope than decision making and problem solving. 2. What 1. A) Its need for implementation time 2. B) Its lack of a step requiring evaluation of results 3. C) Its failure to gather sufficient data Leadership Roles and Management Functions in Nursing 10th Edition MarquisHuston Test Bank 2 4. D) Its failure to evaluate alternatives Ans: A Feedback: The traditional problem-solving model is less effective when time constraints are a consideration. Decision making can occur without the full analysis required in problem solving. Because problemsolving attempts to identify the root problem in situations, much time and energy are spent on identifying the real problem. 3. Which of the following statements is true regarding decision making? 5 Ans: B Feedback: Good decision makers seem to have antennae that make them particularly sensitive to other people and situations. Left-brain thinkers are typically better at processing language, logic, numbers, andsequential ordering, whereas right-brain thinkers excel at nonverbal ideation and holistic synthesizing. does knowledge about good decision making lead one to believe? 6. What 1. A) The planning process of management 2. B) The evaluation phase of the executive role 3. C) One step in the problem-solving process 4. D) Required to justify the need for scarce items Ans: C Feedback: Decision making is a complex, cognitive process often defined as choosing a particular course of action.Decision making, one step in the problem-solving process, is an important task that relies heavily on critical thinking and clinical reasoning skills. is the best definition of decision making? Page 2 6 7. If decision making is triggered by a problem with what does it end? 1. A) An alternative problem 2. B) A chosen course of action 3. C) An action that guarantees success 4. D) A restatement of the solution Ans: B Feedback: 7 A decision is made when a course of action has been chosen. Problem solving is part of decision makingand is a systematic process that focuses on analyzing a difficult situation. Problem solving always includes a decision-making step. 8. Why do our values often cause personal conflict in decision making? 1. A) Some values are not realistic or healthy 2. B) Not all values are of equal worth 3. C) Our values remain unchanged over time 4. D) Our values often collide with one another Ans: D Feedback: Values, life experience, individual preference, and individual ways of thinking will influence a persons decision making. No matter how objective the criteria will be, value judgments will always play a part ina persons decision making, either consciously or subconsciously. 9. Which statement is true concerning critical thinking? 1. A) It is a simple approach to decision making 2. B) It is narrower in scope than decision making 3. C) It requires reasoning and creative analysis 10 Ans: D Feedback: The evaluation phase is necessary to find out more about ones ability as a decision maker and to findout where the decision making was faulty. 12. Which statement concerning the role of the powerful in organizational decision making is true? 1. A) They exert little influence on decisions that are made 11 2. B) They make decisions made that are in congruence with their own values 3. C) They allow others to make the decisions however they wish 4. D) They make all the important decisions with consideration to others Ans: B Feedback: Not only does the preference of the powerful influence decisions of others in the organization, but the powerful are also able to inhibit the preferences of the less powerful. Powerful people in organizations are more likely to have decisions made that are congruent with their own preferences and values. needs to be considered in evaluating the quality of ones decisions? Page 4 13. One of the nurses on the unit said, iMale patients have a low threshold for pain.i This is anexample of what type of illogical thinking? A) B) C) D) Ans: Feedback: 12 This type of icrookedi thinking occurs when one believes that because A has a particular characteristic,every other A also has the same characteristic. This kind of thinking is exemplified when stereotypical statements are used to justify arguments and decisions. 14. What effect of organizational power on decision making is often reflected in the tendency ofstaff? 1. A) Making decisions independent of organizational values 2. B) Not trusting others to decide 3. C) Desiring personal power 15 Management decision-making aides are subject to human error. Some of these aides encourage analytical thinking, others are designed to increase intuitive reasoning, and a few encourage the use of both hemispheres of the brain. Despite the helpfulness of these tools, there is a strong tendency for managers to favor first impressions when making a decision, and a second tendency, called confirmationbiases, often follows. 17. What 1. A) Discrete, unconscious process to allow individuals to solve problems quickly 2. B) Set of rules to encourage learners to discover solutions for themselves 3. C) Formal process and structure in the decision-making process 4. D) Trial-and-error method or rules-of-thumb approach Ans: A Feedback: Most individuals rely on discrete, often unconscious processes known as heuristics, which allows them to solve problems more quickly and to build upon experiences they have gained in their lives. Thus, heuristics use trial-and-error methods or a rules-of- thumb approach, rather than set rules, and in doingso, encourages learners to discover solutions for themselves. 18. Which statement is true regarding an economic man style manager? 1. A) Lacks complete knowledge and generates few alternatives 2. B) Makes decisions that may not be ideal but result in solutions that have an adequate 16 outcome 3. C) Makes most management decisions using the administrative man model of decision making 4. D) These managers gather as much information as possible and generate many alternativesAns: D Feedback: Economic managers gather as much information as possible and generate many alternatives. Mostmanagement decisions are made by using the administrative man model of decision making. The administrative man never has complete knowledge and generates fewer alternatives. 17 is heuristics? Page 6 19. What is a characteristic of a left-brain thinker? A) Creative B) Intuitive C) Analytical D) Holistic Ans: C Feedback: Analytical, linear, left-brain thinkers process information differently from creative, intuitive, right-brain thinkers. Left-brain thinkers are typically better at processing language, logic, numbers, and sequential ordering, whereas right-brain thinkers excel at nonverbal ideation and holistic synthesizing. 20. What type of brain dominance creates a management style that is highly organized and detailoriented? 1. A) Upper left brain 2. B) Upper right brain 3. C) Lower left brain 4. D) Lower right brain Ans: C Feedback: Individuals with lower-left-brain dominance are highly organized and detail oriented and individuals with upper-left-brain dominance truly are analytical thinkers who like working with 20 23. What is the value of using a structured approach to problem solving for the novice nurse? 1. A) Facilitates effective time management 2. B) Supports the acquisition of clinical reasoning 3. C) Supplements the orientation process 4. D) Encourages professional autonomy 21 Ans: B Feedback: A structured approach to problem solving and decision making increases clinical reasoning and is the best way to learn how to make quality decisions because it eliminates trial and error and focuses the learning on a proven process. This is particularly helpful to the novice nurse with limited clinical experience and intuition. The other options are outcomes of the possession of critical thinking skills andclinical reasoning. 24. Which situation is characteristic of the weakness of the nursing process? 1. A) The frequent absence of well-written patience-focused objectives 2. B) The confusion created by the existence of numerous nursing diagnoses 3. C) The ever-increasing need for effective assessment skills required of the nurse 4. D) The amount of nursing staff required to implement the patients plans of care Ans: A Feedback: The weakness of the nursing process, like the traditional problem-solving model, is in not requiring clearly stated objectives. Goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured. While the remaining options relate to the nursing process, theyare not directly a result of the process itself. Page 8 25. What is the advantage of using a payoff table when applicable? 22 A) It assures the correct decision when dealing with financial situations B) It is very helpful when quantitative information about the topic is available C) It assists in the visualization of the available historic and current data D) It is easy to construct even for the novice decision maker Ans: CFeedback: Payoff tables do not guarantee that a correct decision will be made, but they assist in visualizing data.While it does lend itself to the use of quantitative data that are not its strength, the table may not be 25 3. What 1. A) Workers will naturally put forth effort 2. B) Workers need threats to be motivated 3. C) Workers are diligent and responsible 4. D) Workers are in tune with organizational needs Ans: B Feedback: Theory X managers believe that their employees are basically lazy, need constant supervision anddirection, and are indifferent to organizational needs. assumption about workers does Theory X hold? Page 1 4. What does the Hawthorne effect implied about people? A) Human beings under investigation will respond to the fact that they are being studied B) Production will increase or decrease as light in a factory is increased or decreased C) Membership in small groups forms social control 26 D) People are inherently good and will seek out work Ans: AFeedback: Hawthorne effect indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. The other statements donot reflect implied beliefs about people. 5. Managing conflict among staff members would occur in which part of the management process? 1. A) Planning 2. B) Organizing 3. C) Directing 27 4. D) Evaluating Ans: C Feedback: Directing sometimes includes several staffing functions. However, this phases functions usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining afiscal course of action; and managing planned change. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals. 6. What is the idea that workers should be hired, trained, and promoted based on theircompetence and abilities related to? 1. A) Part of the management functions identified by Fayol 2. B) The result of the human relations studies 3. C) The outcome of studies done by Mayo at the Hawthorne Works 4. D) One of the four overriding principles of scientific management Ans: D Feedback: Frederick Taylor, the ifather of scientific management,i had the idea that workers should be hired, trained, and promoted based on their competence and abilities. This concept is not associated with anyof the other options. Page 2 30 1. A) High relationship behavior is much more essential to a good manager than high task behavior 2. B) This leadership model is effective in bureaucratic organizations because it is task focused 3. C) Management should be consistent in different situations so workers understand what isexpected of them 4. D) The leadership style chosen by a manager should reflect the task/relationship behavior ofthose being managed Ans: D 31 Feedback: The idea that leadership style should vary according to the situation or the individuals involved was firstsuggested almost 100 years ago by Mary Parker Follett, one of the earliest management consultants andamong the first to view an organization as a social system of contingencies. The other options present statements that are incorrect. Page 3 10. Which statement depicts leadership? 1. A) A leadership position is assigned 2. B) A leadership position carries a legitimate source of power 3. C) Members of a group will follow a person in a leadership position only by choice 4. D) Leadership requires meeting organizational goals Ans: C Feedback: A leader is the person who guides direction, opinion, and course of action without having an assigned position within the formal organization and so people choose to follow them. The other options are notaccurate descriptions of leadership. 32 11. Gardner states that integrated leaders-managers distinguish themselves from more traditional managers in six ways. Which is a distinguishing trait of a traditional manager rather than an integratedleader-manager? 1. A) They are politically astute 2. B) They look outward, toward the larger organization 3. C) They extend influence only to their own group 4. D) They emphasize vision, values, and motivation Ans: CFeedback: 35 14. What type of leader is the person who is committed, has a vision, and is able to empowerothers with this vision? 1. A) Transactional 2. B) Transformational 3. C) Interactional 4. D) Bureaucratic Ans: B Feedback: Transformational leadership positively impacts the leader and the follower, who have a collectivepurpose. The traditional manager, concerned with the day-to-day operations, was termed a transactional leader. The remaining options are not associated with these characteristics. 15. How many primary leadership styles have been identified? 1. A) One 2. B) Two 3. C) Three 4. D) Four 36 Ans: C Feedback: Three primary leadership styles have been identified: authoritarian, democratic, and laissez- faire. Page 5 16. What type of management was emphasized in the human relations era of management? A) Participatory B) Authoritarian 37 C) Democratic D) Laissez-faire Ans: A Feedback: The human relations era of management science emphasized concepts of participatory and humanisticmanagement. Three primary leadership styles have been identified: authoritarian, democratic, and laissez-faire. 17. What 1. A) Inward thinkers 2. B) Long-term thinkers 3. C) Concerned with employee motivation 4. D) Possess influence beyond their own group Ans: B, C, D Feedback: Gardner asserted that integrated leader-managers possess six distinguishing traits: They influence others beyond their own group; they emphasize vision, values, and motivation; they think longer term;they look outward, toward the larger organization they are politically astute; they think in terms of change and renewal. is a distinguishing trait of integrated leader-managers? Select all that apply. 40 There are nine factors impacting leadership style and its impact on followers; five are transformational,three are transactional, and one is a nonleadership or laissez-faire leadership factor. 20. What 1. A) Transactional 2. B) Transformational 3. C) Interactional 41 4. D) Bureaucratic Ans: A Feedback: The traditional manager, concerned with the day-to-day operations, is termed a transactional leader.This is not a characteristic of the other options. type of manager is concerned with the day-to-day operations? 21. What 1. A) Establishing a legitimate source of power 2. B) Delegating responsibilities to staff members 3. C) Formulate the budget to achieve the stated goals 4. D) Direct attention to the management of unwilling subordinates Ans: A, B, C Feedback: The manager is typically involved in the delegation of responsibilities through the power of the legitimate power associated with the position. To manipulate people, the environment, money, time, and other resources to achieve organizational goals is also a managers focus. Attention to both willingand unwilling subordinates as well as established responsibilities is associated with the role of the manager. 42 is the typical focus of managers? Select all that apply. Page 7 22. Which activity is associated with a leadership role? Select all that apply. 1. A) Mentoring two new managers 2. B) Establishing goals for the coming year 3. C) Advocating for employee regarding personal policies 4. D) Providing a motivational speech at the new employee orientation 45 4. D) Controlling Ans: D Feedback: Controlling is the function that includes performance appraisals, fiscal accountability, quality control,legal and ethical control, and professional and collegial control. Chapter 3 Twenty-First-Century Thinking About Leadership and Management 1. What concept is servant leadership based upon? A) Trusting and valuing employees B) Genuinely liking your colleagues C) A laissez-faire style of leadership D) A dynamic leadership charisma Ans: AFeedback: Collaboration Communication Self-improvement Staff development A, B, C, D Page 8 25. Which function of the management process involves the performance evaluation of staff? 1. A) Planning 2. B) Organizing 3. C) Staffing These managers, termed servant leaders, put serving others, including employees, customers, and the community, as the number-one priority. In addition, servant leaders foster a service inclination in othersthat promotes collaboration, teamwork, and collective activism. The servant leader is not necessarily associated with the concepts identified in the other options. 46 2. What is the critical leadership skill when attempting to build a cooperative and effective team? 47 A) Showing their true feelings B) Empathizing with followers C) Identifying existing emotions in themselves and others D) Manipulating the emotions of all involved to achieve stated goals Ans: CFeedback: Theorists studying emotional intelligence posit that the ability to identify emotions in themselves and in others is a critical ingredient of leaders, enabling them to build a cooperative and effective team. While the other options may have value, they do not represent the critical skill related to team building. 3. Which principle will help increase the likelihood that followers do not mislead their leader? 1. A) Support the followers right to disagree 2. B) Rely only on facts and discount intuition 3. C) Discourage acceptance until the facts are proved 4. D) Identify who to rely upon and who not to listen to Ans: A Feedback: There is no guarantee that followers will not mislead leaders, but adhering to certain principles, such asmaking sure that followers are allowed to disagree, will guard against this happening. The remaining options are flawed in the principles they support. Page 1 50 1. A) The leadership role is most important in nursing today 2. B) Leadership is most important in managing health-care costs 3. C) The most important nursing leadership role is being charismatic 4. D) There is a need to integrate nursing management and nursing leadership Ans: D Feedback: 51 For managers and leaders to function at their greatest potential, the two roles must be integrated. Theother statements are not true. Page 2 7. What is the conclusion of interactional theories regarding successful leadership? A) Leaders,followers, and the situation were all variables that interacted B) The situation had the most profound effect on success in leadership C) The situation has a greater effect on outcomes than followers do D) Good results would occur if leaders led well Ans: AFeedback: The successful leader will diagnose the situation before applying strategies from a large repertoire ofskills that involve assessing the various variables presented by the leader, the followers and the situation. The remaining options are not related to interactional leadership theory. 8. What 1. A) Emotions are held in check 2. B) Emotions are used effectively 3. C) Expression of ones emotions is expected 4. D) Expression of ones emotions is encouraged 52 Ans: B Feedback: Emotional intelligence refers to the ability to use emotions effectively and is required by leader- managers in order to enhance their success. Holding ones emotions in check can be unhealthy. Theremaining options do not address the usefulness of emotions. 9. A manager has proposed to the hospital board that it hires someone to teach management andleadership classes and that head nurses are paid to attend the classes. What is this an example of? 55 1. A) Challenging the status quo 2. B) Learning new technology 3. C) Keeping up with current nursing knowledge 4. D) Being a transformational leader Ans: A Feedback: Thought leadership applies to a person who is recognized among his or her peers for innovative ideas and who demonstrates the confidence to promote those ideas. Thus, thought leadership refers to any situation in which one individual convinces another to consider a new idea, product, or way of looking atthings. None of the other options is a focus of thought leadership. is a focus of thought leadership? Page 4 12. What statement describes the concept of quantum leadership? A) Ability to use emotions effectively that is required by leader-managers in order to enhance their success B) In order to lead, leaders must be true to themselves and their values and act accordingly C) One individual convinces another to consider a new idea, product, or way of 56 looking at things D) The environment and context in which people work is complex and dynamic and that this has adirect impact on organizational productivity Ans: D Feedback: Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers inorder to enhance their success. Authentic leadership suggests that in order to lead, leaders must be trueto themselves and their 57 values and act accordingly. Thought leadership refers to any situation whereby one individual convincesanother to consider a new idea, product, or way of looking at things. 13. A transition has occurred in the twenty-first-century industrial age leadership to what type ofleadership? 1. A) Relationship age 2. B) Quantum 3. C) Authentic 4. D) Thought Ans: A Feedback: A transition has occurred in the twenty-first-century industrial age leadership to relationship age leadership. Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead,leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things. Page 5 14. There are current and future paradigm shifts in health care that affect the leadership skills needed by nurses in the twenty-first century. What issue at the organizational and unit levels are nurse-leaders being directed to address? 1. A) Active involvement in greatly needed health-care reform 2. B) Persistent and growing international nursing shortage 60 1. A) The ability to recognize and understand ones moods, emotions, and drives as well as theireffects on others 2. B) The ability to control or redirect disruptive impulses or moods as well as the propensity tosuspend judgment 3. C) A passion to work for reasons that go beyond money or status; a propensity to pursue goalswith energy and commitment 4. D) The ability to understand and accept the emotional makeup of other people 61 Ans: A Feedback: Self-awareness: The ability to recognize and understand ones moods, emotions, and drives as well as their effects on others. Self-regulation: The ability to control or redirect disruptive impulses or moods aswell as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people. 17. Goleman in his best seller Emotional Intelligence built upon work in his identification of five components of emotional intelligence. Which component of emotional intelligence is occurring when aperson is proficiently handling relationships and building networks? 1. A) Self-regulation 2. B) Motivation 3. C) Empathy 4. D) Social skills Ans: DFeedback: Social skills: Proficiency in handling relationships and building networks; an ability to find common ground. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money orstatus; a propensity to pursue goals with energy and commitment. Empathy: The ability to understandand accept the emotional makeup of other people. Page 7 62 18. Shirey suggests there are five distinguishing characteristics of authentic leaders. Which characteristic is occurring when authentic leaders link between purpose and passion by havingcongruence in beliefs and actions? 1. A) Purpose 2. B) Values 3. C) Heart 65 4. D) Self-awareness Ans: C Feedback: Relational transparency refers to openly sharing feelings and information appropriate to a situation. Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guidehis/her behavior, and self-awareness alludes to a knowing of self so as to make sense of the world. 21. Which action is associated with relationship age leadership? Select all that apply. 1. A) Communicates regularly with subordinates 2. B) Encourages teamwork to achieve problem solving 3. C) Includes committee representatives from all areas that will be affected by the change 4. D) Recognizes staff members who have contributed plausible problem-solving solutionsAns: A, B, C, D Feedback: People skills, cooperation, and valuing staff knowledge are all characteristics of the relationship ageleader. Focus on fact gathering rather than finding the meaning of the data is characteristic of an industrial age leader. 66 22. A manager demonstrating an understanding of the principles of Human Capital theory willschedule which staff in-service? Select all that apply. 1. A) Effective communication skills 2. B) Financial planning for retirement 3. C) Advanced cardiopulmonary resuscitation 4. D) Meeting the needs of the patients family Ans: A, C, D Feedback: 67 Human capital can refer to a groups collective knowledge, skills, and abilities. Human capital theory suggests that individuals and/or organizations will invest in education andprofessional development if they believe that such an investment will have a future payoff. Communication, meeting family needs, and cardiopulmonary resuscitation are all skills and abilities thatwill enhance the individuals professional development and ultimately the services of the facility. The other options are related to the personal interests of the staff. Page 9 23. Which activity supports the principles of strengths-based leadership? 1. A) Tuition reimbursement for LPN to RN transition programs 2. B) Rehab services to staff diagnosed with abuse problems 3. C) Mental health counseling for depression and anxiety 4. D) Smoking cessation support classes Ans: A Feedback: Strengths-based leadership, which grew out of the positive psychology movement (began in the late 1990s), focuses on the development or empowerment of workers strengths as opposed to identifyingproblems, improving underperformance, and addressing weaknesses and obstacles. 24. Which characteristics are associated with Collins Highly Capable Individual level of leadership?Select all that apply. 70 3. C) The conflict, power, and interdependency associated with the way we live 4. D) What our conduct and actions should be regarding what is right and good Ans: D Feedback: Ethics is the systematic study of what a persons conduct and actions should be with regard to self, other human beings, and the environment; it is the justification of what is right or good and the study of whata persons life and relationships should be, not necessarily what they are. 71 2. What 1. A) A problem that can be solved using empirical data 2. B) A situation that has clearly delineated facts for decision making 3. C) A problem that when handled effectively has a mutually agreed-upon solution 4. D) A situation that requires choosing between two or more undesirable alternatives Ans: D Feedback: The most difficult of all moral issues is termed a moral or ethical dilemma, which may be described asbeing forced to choose between two or more undesirable alternatives. The problem is not generally solved with a solution that is mutually satisfying nor does it lend itself to empirical or delineated facts. 3. The practice of allocating organs for transplantation based on a persons iworth to societyi is anexample of what ethical principle for decision making? 1. A) Autonomy 2. B) Beneficence 3. C) Utility 4. D) Justice 72 Ans: D Feedback: Justice: Seek fairness, treat iequalsi equally, and treat iunequalsi according to their differences. Autonomy: Promotes self-determination and freedom of choice. Beneficence: Actions are taken in aneffort to promote good. Utility: The good of the many outweighs the wants or needs of the individual. is an ethical dilemma? Page 1 75 2. B) Duty based 3. C) Rights based 4. D) Intuitionism Ans: B Feedback: The duty framework says that some things should be done just because there is a duty to do them or refrain from doing them. Utilitarianism states that the good of the many outweighs the wants or needsof the individual. The remaining options are not relevant to the situation. Page 2 7. What is the role of the American Nurses Association Code of Ethics and Interpretive Statements? 1. A) Outlines minimum levels of ethical behavior that nurses must maintain 2. B) Functions as a guide to the highest standards of ethical practice for nurses 3. C) Is a legally binding document that directs a nurses ethical and moral behavior 4. D) Mandates the ethical behavior prerequisite for maintaining a nursing licensure Ans: B Feedback: The ANA Code of Ethics outlines the important general values, duties, and responsibilities that flow fromthe specific role of being a nurse in order to achieve and maintain the highest standards. The document is not legally binding nor is it a mandate of behavior. 76 8. Which statement regarding ethical decision making is true? 1. A) Outcomes are the basic criterion for evaluating ethical decision making 2. B) Only desirable alternatives are identified when solving ethical dilemmas 3. C) Critical ethical decisions are made quickly so the situation does not worsen 4. D) Accepting some ambiguity and uncertainty are a part of ethical decision making Ans: D Feedback: 77 Ethical decision makers choose between two or more undesirable alternatives, and because they canuse only the information and resources available at the time, they must live with some ambiguity anduncertainty. The remaining options are not true statements regarding the ethical decision-making process. 9. Which ethical framework involves an individualized decision-making framework? 1. A) Duty based 2. B) Rights based 3. C) Utilitarian 4. D) Intuitionist Ans: D Feedback: Intuitionist states that each case weighed on a case-by-case basis to determine relative goals, duties,and rights. Utilitarian provides the greatest good for the greatest number of people. Duty based is a duty to do something to refrain from doing something. Rights- based individuals havebasic inherent rights that should not be interfered with. Page 3 10. What does the morale principle of autonomy govern? A) A persons right to make his or her owndecision B) The obligation to do good and prevent harm 80 1. A) Outcomes 2. B) Decision-making process 3. C) Multiple alternatives 4. D) Data gathering Ans: A, B Feedback: Outcomes should never be used as the sole criterion for assessing the quality of ethical problem solving,because many variables affect outcomes that have no reflection on whether the problem solving was appropriate. Quality, instead, should be evaluated both by the outcome and the process used to make 81 the decision. If a structured approach to problem solving is used, multiple alternatives are analyzed, anddata gathering is adequate, then, regardless of the outcome, the manager should feel comfortable that the best possible decision was made at that time with the information and resources available. The satisfaction of the involved parties is not a reliable factor. 14. Collecting data about the ethical problem and identifying who should be involved in thedecision-making process is accomplished in which phase of the MORAL decision- making model? 1. A) Massage the dilemma 2. B) Outline options 3. C) Review criteria and resolve 4. D) Affirm position and act Ans: A Feedback: Massage the dilemma: Collect data about the ethical problem and who should be involved in the decision-making process. Outline options: Identify alternatives, and analyze the causes and consequences of each. Review criteria and resolve: Weigh the options against the values of those involved in the decision. This may be done through a weighting or grid. Affirm position and act: Developthe implementation strategy. 15. Which statement is correct regarding the distinction between legal and ethical obligations indecision making? 1. A) Ethical controls are clearer and philosophically impartial 82 2. B) Ethical controls are much clearer and individualized 3. C) Legal controls are clearer and philosophically impartial 4. D) Legal controls are much less clear and individualized Ans: C Feedback: In general, legal controls are clearer and philosophically impartial; ethical controls are much less clearand individualized. Page 5 85 they have made. Leadership roles and management functions are involved in management ethics. Whatis an example of a leadership role? 1. A) Uses a systematic approach to problem solving and decision making when facedwithmanagement problems with ethical ramifications 2. B) Identifies outcomes in ethical decision making that should always be sought oravoided 3. C) Uses established ethical frameworks to clarify values and beliefs 4. D) Role models ethical decision making, which is congruent with the AmericanNursesAssociation Code of Ethics and Interpretive Statements and Professional standard Ans: D Feedback: A leadership role is role models ethical decision making, which is congruent with the American Nurses Association Code of Ethics and Interpretive Statements and Professional standard. Uses a systematic approach to problem solving and decision making when faced with management problems with ethicalramification, identifies outcomes in ethical decision making that should always be sought or avoided, and uses established ethical frameworks to clarify values and beliefs are examples of management functions. 19. Using both a systematic approach and proven ethical tools and technology allows managers tomake better decisions and increases the probability that they will feel confident about the decisions they have made. Leadership roles and management functions are involved inmanagement ethics. What is an example of a management function? 1. A) Is self-aware regarding own values and basic beliefs about the rights, duties, and goals ofhuman beings 86 2. B) Accepts that some ambiguity and uncertainty must be a part of all ethical decision making 3. C) Accepts that negative outcomes occur in ethical decision making despite high- qualityproblem solving and decision making 4. D) Identifies outcomes in ethical decision making that should always be sought or avoided Ans: D Feedback: 87 Management function identifies outcomes in ethical decision making that should always be sought or avoided. Leadership roles include the following: Is self-aware regarding own values and basic beliefs about the rights, duties, and goals of human beings; accepts that some ambiguity and uncertainty mustbe a part of all ethical decision making; accepts that negative outcomes occur in ethical decision makingdespite high-quality problem solving and decision making. Page 7 20. There are many terms used to describe moral issues faced by nurses, including moral uncertainty, moral conflict, moral distress, moral outrage, and ethical dilemmas. Which statementdescribes how moral uncertainty occurs? 1. A) Occurs when an individual is unsure which moral principles or values apply andmay eveninclude uncertainty as to what the moral problem is 2. B) Occurs when the individual knows the right thing to do but organizationalconstraints make itdifficult to take the right course of action 3. C) Occurs when an individual witnesses the immoral act of another but feelspowerless to stop it 4. D) Occurs when being forced to choose between two or more undesirable alternatives Ans: A Feedback: Moral uncertainty occurs when an individual is unsure which moral principles or values apply and mayeven include uncertainty as to what the moral problem is. Moral distress occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action. Moral outrage occurs when an individual witnesses the immoral act of another but feels powerless to stop it. Ethical dilemma is being forced to choose between two or more undesirable alternatives. 90 organizations societal status should not be considered when making ethical decisions. Page 8 22. Which ethical principle associated with an adult child is legally given the right to make medicaldecisions for a cognitively impaired parent? 1. A) Justice 2. B) Fidelity 3. C) Paternalism 4. D) Beneficence Ans: C Feedback: Paternalism is when one individual assumes the right to make decisions for another. Justice requires that a person seek fairness, treat iequalsi equally, and treat iunequalsi according to their differences. Fidelity involves the need to keep promises. Beneficence involves actions that are taken in an effort topromote good. Ans: A, B, C Feedback: The managers ethical obligation is tied to the organizations purpose, and the purpose of the organization is linked to the function that it fills in society and the constraints society places on it. So, theresponsibilities of the nurse-manager emerge from a complex set of interactions. Society helps to definethe purposes of various institutions, and the purposes, in turn, help to ensure that the institution fulfills specific functions. However, the specific values and norms in any particular institution determine the focus of its resources and shape its organizational life. The values of people within institutions influence actual management practice. The 23. Which term is used to identify a persons feelings of powerlessness to stop unethical behavior inanother person or institution? 91 1. A) Moral conflict 2. B) Moral outrage 92 3. C) Ethical relativism 4. D) Ethical universalism Ans: B Feedback: Moral outrage occurs when an individual witnesses the immoral act of another but feels powerless to stop it. Moral uncertainty or moral conflict occurs when an individual is unsure which moral principles orvalues apply and may even include uncertainty as to what the moral problem is. Ethical relativism suggests that individuals make decisions based only on what seems right or reasonable according to their value system or culture. Ethical universalism holds that ethical principles are universal and constant and that ethical decision making should not vary as a result of individual circumstances or cultural differences. Page 9 24. Which statement concerning autonomy and the employee is true? Select all that apply. 1. A) It is a form of personal liberty 2. B) Its legal equivalent is self determination 3. C) It is based on a persons right to make a choice 4. D) It is supported by the process of progressive employee discipline Ans: A, B, C, D Feedback: 95 The 51 Nurse Practice Acts representing the 50 states and the District of Columbia are examples of statutes. These Nurse Practice Acts define and limit the practice of nursing, stating what constitutes authorized practice as well as what exceeds the scope of authority. Although Nurse Practice Acts mayvary among states, all must be consistent with provisions or statutes established at the federal level. The other options lack thecomprehensiveness and focus of a states Nurse Practice Act. 96 2. How is the question of whether a nurse acted with reasonable care generally proven? 1. A) The expert testimony of nursing witnesses 2. B) The defendants explanation of what the nurse did 3. C) The trial judge, after checking the outcome of prior similar court cases 4. D) The testimony of expert medical witnesses Ans: A Feedback: The testimony of other nurses in the same specialty as the defendant may be used to prove breach ofduty. The other options are not considered qualified to testify to this matter. 3. A doctor orders a medical procedure that the staff nurse has reason to believe will harm the patient. Which statement accurately states the legal consequences of carrying out, or refusing to carryout, the procedure? 1. A) The staff nurse cannot be held legally liable for any harm to the patient if the procedure iscarried out with due care 2. B) The nurse may lose his or her license by refusing to carry out the procedure 3. C) The nurse can be held legally liable for any harm if the procedure is carried out withoutquestion 4. D) The nurse can be held accountable for practicing medicine without a license Ans: C Feedback: 97 All nurses have personal liability, which means that every person is liable for his or her own conduct.None of the remaining options describes that liability or its outcomes accurately. Page 1 4. The nurse witnesses a patient sign an operative permit form. Legally, what does the nursessignature imply? 1. A) Observed the client sign the consent form