Nursing Management and Leadership, Exams of Nursing

Download Nursing Management and Leadership and more Exams Nursing in PDF only on Docsity!

RN 400A FINAL EXAM NEWEST ACTUAL

EXAM 2024-2025 QUESTIONS AND

DETAILED CORRECT ANSWERS

(VERIFIED ANSWERS)| A+ GRADE

An experienced RN has seen a significant increase in the need for delegation skills over the past several years. This change is most likely attributable to: A) increased numbers of uninsured clients. B) increased lengths of stay. C) increases in the use of NAP. D) decreases in nurse-client ratios Correct Answer C) increases in the use of NAP. A subordinate is reluctant to accept a task that the nurse- manager wants to delegate. The manager suspects that the subordinate's reluctance is due to a lack of self- confidence. What is the manager's best initial action? A) Teach the subordinate about the value of self- confidence. B) Try to empower the subordinate. C) Offer a reward to the subordinate in order to motivate. D) Restate the importance of the task to the subordinate Correct Answer B) Try to empower the subordinate. The nurse-manager has asked an NAP for an update on delegated tasks, and the NAP has said, "I'm swamped right now." What is the manager's best response?

A) "Don't be afraid to let me know if you feel the project is overwhelming you." B) "Time management is key to keeping on schedule with your tasks." C) "I can give you a few solutions to help manage this heavy workload." D) "Do you want more time to complete your work?" Correct Answer C) "I can give you a few solutions to help manage this heavy workload." A nurse has successfully completed a difficult and complex task that the manager delegated. What is the manager's best action? A) Document the fact that the nurse completed the task. B) Assign a slightly more difficult task the next time. C) Acknowledge the nurse's significant accomplishment. D) Ask the nurse to act as a role model for other staff members Correct Answer C) Acknowledge the nurse's significant accomplishment. A nurse-manager has delegated some administrative tasks to an experienced RN. How does this act of delegation differ from the usual practice of assigning work to subordinates? Select all that apply. A) The nurse's task will be beyond his or her scope of practice. B) The manager transfers the authority for the task to the nurse. C) The nurse is practicing on the manager's license. D) The manager is released of the need to oversee the nurse.

E) The manager remains accountable for the task Correct Answer B) The manager transfers the authority for the task to the nurse. E) The manager remains accountable for the task A nurse-manager has begun a new role in a community health center and will need to delegate tasks often to subordinates. What actions should the manager perform when delegating tasks? Select all that apply. A) Choose the most time-consuming tasks to delegate to subordinates. B) Evaluate the skills and education of subordinates before delegating. C) Ensure that subordinates know the goal of any delegated task. D) Avoid monitoring the subordinate unless there is evidence of a problem. E) Evaluate subordinates' performance after they have completed a task Correct Answer B) Evaluate the skills and education of subordinates before delegating. C) Ensure that subordinates know the goal of any delegated task. E) Evaluate subordinates' performance after they have completed a task. A nurse 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 why the nurse did not complete the delegated tasks.

B) Assertively state the expectation that delegated tasks will be completed on time. C) Document the nurse's insubordination and arrange a private meeting. D) Take action to reestablish the authority power gap Correct Answer A) Determine exactly why the nurse did not complete the delegated tasks. A registered nurse has been leading teams of NAP for several years and will soon be leading licensed practical nurses for the first time. In preparation for delegating to these nurses, the RN should: A) delegate the same tasks to the LPNs that the RN normally delegated to NAPs. B) review the practical nurse scope of practice in the jurisdiction where they are working. C) ask each LPN what tasks he or she is comfortable performing. D) consult a decision tree for delegation to unlicensed assistive personnel. Correct Answer B) Review the practical nurse scope of practice in the jurisdiction where they are working. A health-care organization has laid off several RNs and hired numerous NAPs in their place. What effect is this change most likely to have on the remaining RNs? A) There will be a risk of the RNs underdelegating. B) The RNs' level of liability will increase. C) Cultural variables will become a larger consideration. D) The RNs' scope of practice will become expanded Correct Answer B) The RNs' level of liability will increase.

The nurse-manager is preparing for negotiations. When negotiating, what is the manager's most appropriate action? A) Be willing to win at any cost. B) Communicate only when asked direct questions. C) Compromise only as a last resort. D) Begin with a high but realistic expectations Correct Answer D) Begin with a high but realistic expectations A charge nurse has assisted two employees to resolve their conflict, with the outcome being that the two opposing goals were discarded, and new goals were adopted. What is this an example of? A) Smoothing of conflict by the leader B) Facilitating collaboration C) A majority rule approach D) A good lesson in compromising Correct Answer B) Facilitating collaboration Which is a true statement about destructive negotiation tactics? A) Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic. B) Most managers successfully resist the helplessness tactic because of their nursing preparation. C) Negotiation tactics can sometimes be manipulative; thus, managers must be cognizant of the other party's motives. D) Nurses are known to be particularly vulnerable to the tactic of flattery Correct Answer C) Negotiation tactics can

sometimes be manipulative; thus, managers must be cognizant of the other party's motives. What statement about conflict most closely reflects the interactionist theories of organizational conflict? A) "The most important response to conflict is to deal with it immediately." B) "Conflict can actually be a good thing and can help us to grow." C) "The presence of conflict in our workplace shows that there is bad management." D) "The best organizations are places where there is no conflict." Correct Answer B) "Conflict can actually be a good thing and can help us to grow." A nurse-manager has accepted a new position on a hospital unit. An experienced nurse on the unit tells the manager, "We all work really well with each other. There's never any conflict." How should the manager interpret this statement? A) The unit may be lacking in growth and new ideas. B) There is a need for the manager to introduce conflict. C) The manager needs to ensure that this characteristic continues. D) There is likely conflict that the nurse is not recognizing or acknowledging. Correct Answer A) The unit may be lacking in growth and new ideas. Which nurse is experiencing intrapersonal conflict? A) A manager who has received a negative performance appraisal and who wishes to dispute the findings

B) A manager who has to confront a nurse who made a medication error but did not follow up with documentation C) A manager who is in conflict with a long-standing employee who often ignores the manager's directives D) A manager who perceives a dilemma between loyalty to staff and loyalty to the organization in a particular situation Correct Answer D) A manager who perceives a dilemma between loyalty to staff and loyalty to the organization in a particular situation Which of the following workplace situations would be categorized as latent conflict? A) A nurse expresses frustration to a colleague who did not perform some tasks that were clearly delegated. B) A nurse expresses anger to the manager, accusing the manager of preferential treatment toward other nurses. C) The most experienced nurses on a unit are allowed to self-schedule, but less experienced nurse are not. D) Two nurses were in conflict about inequities in their work assignment but were able to resolve the conflict Correct Answer C) The most experienced nurses on a unit are allowed to self-schedule, but less experienced nurse are not. A nurse-manager was involved in conflict where the other individual adopted a competing approach. This approach is evident in what circumstances? A) When fair play is important to all involved parties B) When one party wins at the expense of the others C) When managers need to control a volatile situation

D) When an appropriate political strategy is necessary Correct Answer B) When one party wins at the expense of the others A nurse is in a conflict with a colleague, but both nurses are committed to collaboration. To promote collaboration, the nurses should: A) identify a common goal that is important to both of them. B) possess the ability to negotiate without having emotion get involved. C) have a relationship that existed before the conflict. D) ask a neutral third party to mediate in the conflict Correct Answer A) identify a common goal that is important to both of them. A registered nurse reports to the nurse-manager that the team's nursing assistant regularly fails to complete assigned tasks. The nurse-manager responds that it is the nurse's initial responsibility to talk with the nursing assistant about this problem. The manager is engaged in what aspect of conflict? A) Conflict avoidance B) Conflict smoothing C) Encouraging competitive conflict resolution D) Facilitating conflict resolution Correct Answer D) Facilitating conflict resolution Which statement best defines conflict? A) It involves an internal struggle resulting from value- related discord.

B) Its basis is the violation of personal rights or values. C) It centers on either internal discord or external discord between individuals. D) It is the outcome of a visible struggle between individuals Correct Answer C) It centers on either internal discord or external discord between individuals. A nurse-manager will be participating in negotiations around the skills mix in the organization. Before these negotiations begin, the manager should perform what action first? A) Identify the ideal skills mix for the organization. B) Choose an appropriate negotiation strategy. C) Interact with the other party to identify any hidden agendas. D) Learn as much as possible about the issue Correct Answer D) Learn as much as possible about the issue A nurse-manager is participating in negotiations around the allocation of resources in the organization. During the negotiations, the manager should: A) try to speak the same amount or slightly more than the other party. B) use open-ended questions rather than yes or no questions. C) declare his or her bottom line at the start of negotiations. D) ensure that the negotiations proceed at a rapid pace. Correct Answer B) use open-ended questions rather than yes or no questions.

The nurse-manager is negotiating for the funds necessary to purchase several new isolettes for the facility's newborn nursery. The chief financial officer (CFO) states, "I've always been curious about that piece of equipment; how does it actually work?" What negotiation action has the CFO engaged in? A) Collaborating B) Smoothing C) A diversionary tactic D) Appropriate fact finding Correct Answer C) A diversionary tactic 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) Assuring the RNs that every effort is being made to streamline the current scheduling system B) Asking the RNs to circulate a partition to be signed by employees who support the change C) Arranging for the RNs to air their views at the next staff meeting D) Sharing with the RNs that they need to address the issue with upper management Correct Answer C) Arranging for the RNs to air their views at the next staff meeting The nurse-manager has learned that two employees are in conflict. The manager's fact gathering reveals that the conflict exists because each employee misunderstands the job description and role of the other employee. What

conflict management strategy should the manager implement first? A) Responsibility charting B) Confrontation C) Behavior change D) Third party consultation Correct Answer A) Responsibility charting 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) Encourage the employee to speak directly with the coworker. B) Ask the employee to e-mail or text message the complaints to the coworker. C) Arrange for third-party mediation. D) Acknowledge and document the employee's complaints Correct Answer A) Encourage the employee to speak directly with the coworker. 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) Offer support and encouragement to the newly hired nurse. B) Confront the more experienced nurses directly about their behavior.

C) Implement a structure change so the experienced nurses no longer work at the same time as the new nurse. D) Arrange for third-party consultation involving the more experienced nurses, the manager and the new nurse Correct Answer B) Confront the more experienced nurses directly about their behavior. Which of the following behaviors should the nurse- manager identify as workplace violence, incivility, or bullying? Select all that apply. A) A group of nurses consistently refuse to help a nurse when that nurse has a heavy workload, despite having time to do so. B) Staff members assign an unwanted nickname to a colleague. C) A nurse's specific vacation request is denied by the manager for 2 years in a row. D) A nurse asks a colleague to assess a known verbally abusive client without warning to see how the colleague will respond. E) A nurse tells a nursing student to rush to room 311, knowing that the unit has no room 311 Correct Answer A) A group of nurses consistently refuse to help a nurse when that nurse has a heavy workload, despite having time to do so. B) Staff members assign an unwanted nickname to a colleague. D) A nurse asks a colleague to assess a known verbally abusive client without warning to see how the colleague will respond.

E) A nurse tells a nursing student to rush to room 311, knowing that the unit has no room 311 Two groups in the health-care organization have been unable to reach an agreement after prolonged negotiation. The groups have agreed to arbitration. What will happen during this process? A) A neutral party will facilitate new negotiations, starting from the beginning. B) A neutral party will listen to both groups and then present a binding recommendation. C) A neutral third party will act as a "go between" in the negotiations. D) Negotiations will continue in a court setting, and a lawyer will mediate between the groups Correct Answer B) A neutral party will listen to both groups and then present a binding recommendation. A nurse-manager is attempting to help a group of staff members reach a consensus on a sensitive issue. What is a consequence of using a consensus-based approach? A) One group will be perceived as the "winner" and one group as the "loser." B) It is likely that neither group will achieve their desired "ideal" outcome. C) A solution that is ideal to both groups will be selected. D) There is an increased risk for similar conflict in the future. Correct Answer B) It is likely that neither group will achieve their desired "ideal" outcome.

An employee who is involved in a dispute has sought the assistance of the organization's ombudsperson. What role will the ombudsperson play in resolving the employee's conflict? A) Providing expert testimony in conflict cases B) Providing psychosocial support to employees in distress C) Investigating the employee's grievance against the other party D) Monitoring the implementation of the terms of a conflict's compromise Correct Answer C) Investigating the employee's grievance against the other party A negotiating session has just concluded with a compromise agreement. What is the manager's best action? A) Clearly restate the terms of the compromise to all involved before dispersing. B) Give feedback to the members of the other negotiating team on their behavior and performance. C) Evaluate the fairness of the compromise to all involved parties. D) Restate each party's original bottom line Correct Answer A) Clearly restate the terms of the compromise to all involved before dispersing. A nurse-manager is engaged in a negotiation with staff representatives when the discussion becomes controlled by a particularly aggressive member. Which action will the nurse-manager take to assure that the process is successful?

A) Ask that the aggressive individual recognize the rights of all the other members. B) State, "I need to have time to think over all that we have discussed." C) Halt any discussion until new representatives can be appointed. D) Share with the members that aggressiveness negatively impacts the negotiations Correct Answer B) State, "I need to have time to think over all that we have discussed." Which personal characteristics will best help meet the psychological needs of conflict negotiation? A) Perseverance and assertiveness B) Calmness and self-assuredness C) Compassion and reflectiveness D) Organization and self-reflection Correct Answer B) Calmness and self-assuredness By contract, employees are to receive overtime pay when their workday exceeds 8 hours. A staff member attended a mandatory, hospital-sponsored CPR certification class after working an 8-hour shift. What type of paycheck adjustment can the employee expect? A) Overtime for the time spent in the class B) Regular pay for the class because there was no charge for the class C) No pay for the class because it was identified as mandatory

D) Equal compensated time back during the next pay period Correct Answer A) Overtime for the time spent in the class An affirmative action plan has been established in the jurisdiction where a nurse works. The nurse should understand what characteristic of this program? A) The terms of the plan are laid out in United States Equal Employment Opportunity legislation. B) It aims to prevent workplace discrimination on the basis of age or sexual orientation. C) It actively seeks members of underemployed groups to fill job vacancies. D) Few affirmative action programs still exist because they encourage reverse discrimination Correct Answer C) It actively seeks members of underemployed groups to fill job vacancies. What is an inappropriate reason for delegation? A) To empower subordinates by "stretching" them in their work assignment B) To free the manager to address more complex unit needs C) The manager does not find the task intellectually challenging. D) Someone else is better qualified to do the task. Correct Answer C) The manager does not find the task intellectually challenging.

A performance appraisal states that the manager often under delegates. What is potential cause of this delegation error? A) A high degree of trust in subordinates B) A democratic leadership style C) A need for perfectionism D) Sufficient time to accomplish unit goals alone Correct Answer C) A need for perfectionism A manager needs to delegate some tasks. What consideration should the manager prioritize when identifying the appropriate person to whom to delegate a specific task? A) Whose turn it is to delegate a task B) The qualifications of the person regarding the task C) The fiscal cost of delegating the task D) Whether the person has experience with similar tasks Correct Answer B) The qualifications of the person regarding the task A nurse-manager delegates many tasks in the course of a day. Which practice should the manager reconsider or discontinue? A) The manager grants temporary authority to support completion of a delegated task. B) The manager confirms that the person to whom a task is delegated is adequately qualified. C) The manager provides employees with exact instructions for each step of completing the task. D) The manager asks for regular updates from the employee when tasks take a long time. Correct Answer C)

The manager provides employees with exact instructions for each step of completing the task. A manager's subordinate is having difficulty carrying out a delegated task. What is the manager's best initial action? A) Release the subordinate from the task so he or she will not become demoralized. B) Be available to the employee as a role model and resource for the task. C) Assign another more experienced employee to help with the task. D) Reassign the employee a different, less complex task. Correct Answer B) Be available to the employee as a role model and resource for the task. What principle should guide the nurse's delegation of tasks to unlicensed nursing assistive personnel (NAP)? A) It is safe to assume that the NAP has at least a high school diploma as a minimum hiring criterion. B) Like all members of the care team, NAP stands to lose their licensure in case of negligent practice. C) No federal or community standards have been established for training the broad classification of NAP. D) The nurse is protected from liability when allowing the NAP to perform only those tasks the employer includes in their job description. Correct Answer C) No federal or community standards have been established for training the broad classification of NAP. Which statement is true regarding the general delegation liability of the registered nurse (RN)?

A) It is minimal because subordinates alone are held accountable for practicing within the accepted scope of practice for their job classification. B) It is high because the RN is automatically held liable for the tasks delegated to all recognized subordinates. C) It is reduced when the RN delegates appropriately and supervises the completion of the tasks. D) It is avoided entirely as long as the nurse delegates only other licensed personnel Correct Answer C) It is reduced when the RN delegates appropriately and supervises the completion of the tasks. What action should the nurse-manager perform when supporting the delegation of a task to a subordinate? A) Holding the subordinate's professional development as the highest priority B) Frequently reassuring the employee that if they are incapable of completing a delegated task, it will be reassigned C) Drafting a preliminary plan of how the task will be redone if the outcome does not meet stated expectations D) Occasionally providing learning or "stretching" opportunities for employees Correct Answer D) Occasionally providing learning or "stretching" opportunities for employees Periodically during the day, the RN checks with the team members to determine whether they are having difficulty completing their assigned tasks. This describes which manager role? A) Skills evaluation

B) Client safety C) Effective delegation D) Micromanagement Correct Answer D) Micromanagement A member of the team has been delegated some tasks and reports, "I've been given too much to do and I'm not going to be able to complete the work on time." What is the RN's best initial action? A) Assign the work to another team member. B) Take on the responsibility of the tasks. C) Have the team member perform only the most necessary tasks. D) Examine the workload and assist the individual in reprioritizing. Correct Answer D) Examine the workload and assist the individual in reprioritizing. Which assessment should the RN prioritize when assigning tasks to nursing assistive personnel (NAP)? A) Determining the NAP's skills and knowledge level B) Assessing which tasks the NAP is motivated to perform C) Evaluating the NAP's ability to follow instructions D) Asking colleagues to appraise the NAP's strengths and weaknesses Correct Answer A) Determining the NAP's skills and knowledge level Which task would the director of a home health agency not delegate another staff RN? A) Assigning home health aides to specific client care B) Serving on a diabetic study committee of community resources

C) Meeting with the agency's administration regarding budget cuts D) Reviewing the care assignment for the following shift Correct Answer C) Meeting with the agency's administration regarding budget cuts What must managers delegate to another RN in order to assure completion of a task? A) Time and space B) Leadership and creativity C) Authority and responsibility D) Personnel and knowledge Correct Answer C) Authority and responsibility A nurse-manager is new to the unit and is worried about being perceived as incompetent or underqualified by subordinates. The manager should recognize that this creates a risk for what problem? A) Underdelegating B) Overdelegating C) Improper delegating D) Inappropriate delegating Correct Answer A) Underdelegating The nurse-manager is overseeing a culturally diverse group of staff. The manager should consider what variables when planning delegation? Select all that apply. A) Communication style B) Concepts of time C) Intelligence D) Biological variations

E) Social organization Correct Answer A) Communication style D) Biological variations E) Social organization An RN is leading a care team on a busy hospital unit. What tasks is the RN justified in delegating to NAP? Select all that apply. A) Feeding a client who has unilateral weakness B) Repositioning an immobile client every 2 hours C) Assessing a client's surgical wound D) Weighing a client who has chronic heart failure E) Transporting a client to a diagnostic test Correct Answer A) Feeding a client who has unilateral weakness B) Repositioning an immobile client every 2 hours D) Weighing a client who has chronic heart failure A senior manager is ensuring that organizational policies for compensation align with the Equal Pay Act of 1963. What domains of work should the manager examine? Select all that apply. A) The potential for promotion or advancement in the job B) The working conditions associated with the job C) The amount of responsibility that the job carries D) The effort that is required to perform the job E) The level of job satisfaction associated with the job F) The skill that is needed to perform the job Correct Answer B) The working conditions associated with the job C) The amount of responsibility that the job carries D) The effort that is required to perform the job F) The skill that is needed to perform the job

Under which circumstance could the manager of an oncology unit deviate from the federal guidelines for handling chemotherapy agents? A) The state has instituted a policy that is more restrictive than the federal one. B) The director of nurses requested more personalized guidelines be put in place. C) The organization has been accident-free for the last 10 years. D) The state has a less restrictive policy that supersedes the federal one. Correct Answer A) The state has instituted a policy that is more restrictive than the federal one. Which statement concerning the 1967 and 1987 Age Discrimination and Employment Acts is true? A) Maximum age restrictions were lifted for almost all job categories. B) Employees can be forced to retire at age 70 years if their health is poor. C) Underage minors can be employed up to 20 hours per week. D) Individuals seeking retirement before the age of 60 years may be exempt from company pension plans. Correct Answer A) Maximum age restrictions were lifted for almost all job categories. Which action by the manager is most likely to reduce the incidence of sexual harassment in the workplace?

A) Limit one-on-one interaction between female and male employees whenever possible. B) Encourage workers to confront the "harasser" directly and resolve the conflict. C) Provide desensitivity training to minimize employee reactions. D) Actively pursue an investigation of all complaints Correct Answer D) Actively pursue an investigation of all complaints A nurse executive wants to decrease the chances of unionization of the nursing service department. To accomplish this goal, where should financial and energy resources best be directed? A) Publicizing the potential cost and harm of unionization B) Increasing the quality and amount of equipment available to nurses C) Implementing a shared decision-making model in the department D) Emphasizing the identity of nursing as a "helping" profession that prioritizes others' needs Correct Answer C) Implementing a shared decision-making model in the department A nurse who provides care at a county hospital is involved in a unionization drive. This nurse's right to unionize is enacted in which of the following? A) Civil Rights Act of 1964 B) Fair Labor Standards Act C) The Equal Pay Act of 1963

D) Kennedy Executive Order 10988 Correct Answer D) Kennedy Executive Order 10988 During orientation to a new job, a nurse is reviewing the relevance of labor standards to the new position. What aspects of the job will these standards affect? Select all that apply. A) The number of hours that the nurse will work B) The nurse's right to a safe workplace C) The way the nurse's salary is determined and paid D) The nurse's continuing education requirements E) The nurse's accountability to his or her supervisor Correct Answer A) The number of hours that the nurse will work B) The nurse's right to a safe workplace C) The way the nurse's salary is determined and paid Which members of a private health-care organization have their right to join a union protected by the National Labor Relations Act (NLRA)? Select all that apply. A) A registered nurse with 6 months of experience in the organization B) A licensed practical nurse C) A first-level manager D) A registered nurse with 2 years' experience in the organization E) A mid-level manager Correct Answer A) A registered nurse with 6 months of experience in the organization B) A licensed practical nurse D) A registered nurse with 2 years' experience in the organization