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Test Banks Leadership and Management
exam with complete solution
An unlicensed assistive person (UAP) is working on a rehabilitation unit. Which task would be appropriate for this person to delegate?
- Taking and recording vital signs
- Assisting with bathing
- Making a bed
- An unlicensed assistive person may not delegate tasks. Correct Answer: 4 Rationale 1: Taking and recording vital signs is an appropriate task for the registered nurse to delegate to the UAP. Rationale 2: Assisting with bathing is an appropriate task for the registered nurse to delegate to the UAP. Rationale 3: Making a bed is an appropriate task for the registered nurse to delegate to the UAP. Rationale 4: The unlicensed person may not delegate t An RN delegates the task of taking a newly admitted clients vital signs to a nurses aide. The clients blood pressure was 182/98, but did not get reported to the physician for several hours. Who is responsible for the lapse in time between discovery and action?
- Nurse manager
- Aide
- Client
- RN Correct Answer: 4 Rationale 1: The nurse manager did not delegate the task of vital signs so therefore is not responsible for the time lapse between discovery and action. Rationale 2: The aide did not delegate the task of vital signs so therefore is not responsible for the time lapse between discovery and action. Rationale 3: The client did not delegate the task of vital signs so therefore is not responsible for the time lapse between discovery and action.
Rationale 4: The RN is ultimately responsible for the action, reporting it, and following through on any action. Part of delegation is supervision and evaluation- ultimate responsibilities that belong to the RN. A nurse manager has the reputation of being an autocratic leader. Which of the following statements by this manager would support that reputation?
- Id like to hear from you (addressing the staff) what your ideas are for promoting better morale in this unit.
- Im putting a suggestion box in the break room if anyone has ideas that would be helpful to the unit.
- The new work schedule is posted for the next 6 weeks.
- I put the new procedure manual out. Please add your comments to the blank sheet of paper attached to the front. Correct Answer: 3 Rationale 1: This option is more reflective of a democratic style leader. Rationale 2: This option is more reflective of a democratic style leader. Rationale 3: An autocratic leader makes decisions for the group. This style is likened to a dictator in that the autocratic leader gives orders and directions to the group, determines policies, and solves problems without input from the group. Rationale 4: This option is more reflective of a democratic style leader. During a particularly heated staff meeting regarding staff assignments, the nurse manager makes this comment: When you all can come to a decision, let me know and well move on from there. This leader is best identified as which of the following?
- Democratic leader
- Permissive leader
- Bureaucratic leader
- Situational leader Correct Answer: 2 Rationale 1: The democratic leader encourages group discussion and decision making, provides constructive criticism, offers information, makes suggestions, and asks questions. Rationale 2: The permissive leader recognizes the groups need for autonomy and self-regulation by assuming a hands-off approach. Allowing the group to come to their own decision, then accepting that would be the case in this situation. Rationale 3: The bureaucratic leader relies on the organizations rules, policies, and procedures to direct the groups work efforts. Rationale 4: A situational leader is one who adapts his or her leadership style to the situation. A nurse manager allows the staff to make their own schedules and do their own client assignments on their shifts. However, during a code situation, the nurse
manager will make decisions for the staff by instructing which nurse to assume which responsibility in the code situation. This manager is exemplifying which style of leadership?
- Permissive
- Democratic
- Situational
- Bureaucratic Correct Answer: 3 Rationale 1: Permissive leaders assume a hands-off approach. Rationale 2: The democratic leader encourages group discussion and decision making. Rationale 3: According to contingency theorists, effective leaders adapt their leadership style to the situation. Unlike the singular style of authoritarian, democratic, and permissive leaders, the situational leader adapts his or her leadership to the readiness and willingness of the group to perform the assigned task. Rationale 4: A bureaucratic leader relies on the organizations rules, policies, and procedures to direct the groups work efforts. A group of community health nurses work together in the same office. They are each responsible for their own caseloads and scheduling of appointments. Their major leadership directives come from the state health office, several hundred miles away. This group of nurses is functioning under what type of leadership?
- Charismatic
- Shared
- Transformational
- Transactional Correct Answer: 2 Rationale 1: A charismatic leader is characterized by an emotional relationship between the leader and group members. Rationale 2: Shared leadership recognizes that a professional workforce is made up of many leaders. No one person is considered to have knowledge or ability beyond that of other members of the work group, as in this situation. Rationale 3: A transformational leader fosters creativity, risk taking, commitment, and collaboration by empowering the group to share in the organizations vision. Rationale 4: A transactional leader has a relationship with followers based on an exchange for some resource valued by the followers. A charge nurses responsibilities include the day-to-day management and coordination of therapies for the clients, client assignments, and scheduling. This is an example of which level of management?
- Top-level
- Middle-level
- First-level
- Upper-level Correct Answer: 3 Rationale 1: Upper-level (same as top-level) managers are organizational executives who are primarily responsible for establishing goals and developing strategic plans. Rationale 2: Middle-level managers supervise a number of first-level managers and are responsible for the activities in the departments they supervise. Rationale 3: First-level managers are responsible for managing the work of nonmanagerial personnel and the day-to-day activities of a specific work group (rehabilitation unit in this case). Rationale 4: Upper-level (same as top-level) managers are organizational executives who are primarily responsible for establishing goals and developing strategic plans. A nurse manager is working on new job descriptions for all nursing units of the hospital. This is an example of which function of management?
- Planning
- Organizing
- Directing
- Coordinating Correct Answer: 2 Rationale 1: Planning involves assessing a situation, establishing goals and objectives that identify priorities, delineating who is responsible, determining deadlines, and describing how the intended outcome is to be achieved and evaluated.. Rationale 2: Organizing is an ongoing process of management that involves determining responsibilities, communicating expectations (which job descriptions would fall under), and establishing the chain of command for authority and communication. Rationale 3: Directing is the process of getting the organizations work accomplished. Coordinating is the process of ensuring that plans are carried out and evaluating outcomes. Rationale 4: Coordinating is the process of ensuring that plans are carried out and evaluating outcomes. A hospital was named in a lawsuit after a client had to undergo a second surgical procedure because an arthroscopy was performed on the wrong knee during surgery. The hospital settled out of court with the client for damages. This is an example of which principle of management?
- Authority
- Responsibility
- Coordination
- Accountability Correct Answer: 4 Rationale 1: Authority is defined as the right to direct the work of others. Rationale 2: Responsibility is an obligation to perform a task. Rationale 3: Coordination is a function of management, not one of the principles. Rationale 4: Accountability is the ability and willingness to assume responsibility for ones actions and to accept the consequences of ones behavior. The hospital had a responsibility to the client for quality care and service. That was not the case; therefore, the hospital was willing to accept the consequences of the injury experienced by the client. A nurse manager has had to handle a particularly difficult physician who is demanding as well as demeaning. Through this situation, the nurse manager has learned that accuracy and honesty are attributes of which skill necessary for managers?
- Critical thinking
- Communication
- Networking
- Responsibility Correct Answer: 2 Rationale 1: Critical thinking is a creative process that includes problem solving and decision making. Rationale 2: Good communication skills are essential to managers and include assertiveness, clear expression of ideas, accuracy, and honesty. Rationale 3: Networking is a process whereby professional links are established through which people can share ideas, knowledge, and information; offer support and direction to each other; and facilitate accomplishment of professional goals. Rationale 4: Responsibility is one of the principles of management, not a management skill. A nursing student would like to do an observation on one of the inpatient units at a hospital. In assisting the student to meet this desire, the educator would look for which of the following?
- Mentor
- Manager
- Team leader
- Preceptor Correct Answer: 4 Rationale 1: A mentor acts in a more nurturing role, perhaps for a longer period of time, and provides support, guidance, assistance, advice, and inspiration to a younger nurse. Rationale 2: A manager is a different type of management role. Rationale 3: A team leader is a different type of management role.
Rationale 4: The preceptor is a person of experience who assists a new nurse in improving clinical skills and nursing judgment. A hospital is implementing a computerized charting system, and all nursing staff are required to be oriented to the system by a specific deadline. This is an example of which type of change?
- Overt change
- Covert change
- Unplanned change
- Drift Correct Answer: 1 Rationale 1: An overt change is one that is planned and that people are aware of. Implementing a new computer system is certainly a planned, purposeful event. Rationale 2: Covert change is hidden or occurs without the individuals awareness-it may be gradual, subtle, and unplanned. Rationale 3: An unplanned change is an alteration imposed by external events or persons and occurs when unexpected events force a reaction. Rationale 4: Drift is a type of unplanned change in which change occurs without effort on anyones part. The nursing staff is informed that the current system of record keeping is going to be changed to make it more efficient. This activity would be considered which stage of change?
- Refreezing
- Unfreezing
- Moving
- Drift Correct Answer: 2 Rationale 1: Refreezing is when the change is integrated and stabilized. Rationale 2: During the unfreezing stage, the need for change is recognized, driving and restraining forces are identified, alternative solutions are generated, and participants are motivated to change. Rationale 3: During the second stage, moving, participants agree that the status quo is undesirable and the actual change is planned in detail and implemented. Rationale 4: Drift is a type of unplanned change in which change occurs without effort on anyones part. . Which theories focus on what the leader does?
- Trait theories
- Behavioral theories
- Situational theories
- Transformational theories ANS: 2
Trait theories are concerned with what a leader is. 2 Behavioral theories are concerned with what a leader does. 3 Situational theories recognize that each situation is different and that leaders must consider a number of factors when deciding how to take action. 4 Transformational theories focus on the ability of the leader to communicate her vision in such a way that it inspires commitment among workers. At a recent nurse staff meeting, the chief nursing officer (CNO) announced that all nursing staff would work 12-hour shifts on a day-night rotation schedule that would alternate every 6 weeks. This decision was made to solve discord between the nurses who work the different shifts in order for all staff to appreciate the different job responsibilities. What type of leadership is the CNO displaying?
- Management
- Laissez-faire
- Democratic
- Authoritarian ANS: 4 There is no leadership style called "management." 2 A laissez-faire leader postpones making decisions or may never make a decision at all. Thus, laissez- faire leadership is really a lack of leadership. 3 A democratic leader shares the planning, decision making, and responsibility for outcomes with other members of the group. This type of leader tends to provide guidance rather than control. 4 The authoritarian leader makes decisions for the group as a whole, gives orders, and bears most of the responsibility for the outcomes. The nurse with 15 years of experience and 7 years of employment with an organization will provide guidance and advice to a new graduate nurse. What is the role of the experienced nurse?
- Mentor
- Manager
- Preceptor
- Leader ANS: 3 Feedback 1 A mentor is someone more experienced who provides career development information and serves as a role model. 2 A manager is an employee of an organization who has the power, authority, and responsibility for planning, organizing, coordinating, and directing the work of others. 3 A preceptor is someone with more experience who provides practical teaching and guidance for a student or new employee. 4 A leader is someone who has the ability to influence others and commit them to action. What is the first stage of the complex process of change?
- Recognizing resistance
- Unfreezing
- Forming a comfort zone
- Actively resisting ANS: 2 Recognizing resistance is an activity associated with change. 2 The first stage in the change process is unfreezing. In this stage, the person leaves the stable comfort zone that has existed and begins to make changes. 3 A comfort zone is formed after the new behavior is established. 4 Active resisting is an activity associated with change. An organization changed the documentation system a month ago; however, one staff nurse has missed every training session and continues to use the previous documentation system. What is this nurse demonstrating?
- Unfreezing
- Active resistance
- Passive resistance
- Comfort zone ANS: 3 In the first stage in the change process, a person begins moving out of the comfort zone, or unfreezing. 2 Active resistance can take the form of aggressive actions or outright refusals to comply, negative communications designed to demean the idea or the person who suggested it, quoting existing rules that make the change difficult to implement, or organizing others to resist the change. 3 Passive resistance behaviors include avoidance, canceling appointments todiscuss implementing change, being "too busy" to make the change, agreeing to the change but doing nothing to change, and simply ignoring the entire process as much as possible. 4 When a person knows what to expect and how to deal with whatever problems arise in the course of a day, that person is operating within a "comfort zone." The surgical unit is experiencing difficulty recruiting new RNs, although the hospital has an excellent reputation in the community and has no difficulty recruiting nurses for other units. A task force has been formed, consisting of one nurse from each shift on the unit, the unit manager, and the hospital nurse recruiter. The group has gathered data and identified the problem. What is the next step in this process?
- Generate possible solutions.
- Evaluate whether the problem has been resolved.
- Implement the solution changes.
- Evaluate suggested solutions.
ANS: 1
The next step in the process is to generate possible solutions. 2 As the final step, the task force critiques the process by evaluating whether the problem has been resolved. 3 From among that list, the best solution is chosen and then implemented. 4 Once several possibilities have been identified, each of the suggested solutions should be evaluated. A nurse with 2 years' experience frequently appears stressed, has difficulty completing work, and clocks out late even when the assignment is light. The charge nurse describes the nurse as "running from one duty to the next and having no organization or daily routine." Which situation most likely describes this nurse?
- Has time management problems
- Has a heavy patient load
- Works at a hospital that is understaffed
- Is in a management position ANS: 1 This nurse most likely has trouble managing time. Time management entails setting goals and organizing work. Although there will be difficult days, the nurse who consistently finishes late and has no organization to a daily schedule has a problem managing time. 2 The situation states that there is an issue even when the assignment is light. 3 There is no mention that the organization is understaffed. 4 There is no mention that the nurse is a manager. An expert nurse feels confident in the role as a clinician on the unit, enjoys the work, and feels in charge of career direction. Which leadership state is the nurse experiencing?
- Power-based authority
- Effective management skills
- Empowerment in the role
- Followership skills ANS: 3 This nurse may have power on the unit because of expertise, but there is no evidence that the nurse is an authority figure. 2 Empowerment is not always associated with management. Managers have authority by virtue of their position but do not always thrive in that role. 3 Empowerment is a psychological state, a feeling of competence, control, and entitlement that a person experiences. Empowerment refers to feelings, whereas power refers to action. The person who feels empowered has feelings of self-determination, meaning, competence, and
impact. 4 There is not enough information in the scenario to judge the nurse's followership skills. The managers of the physical therapy and nursing departments are having conflict about who is responsible for transporting patients for rehabilitation. All attempts at conflict resolution have failed. What is the next step the managers should take?
- Inform the nurses that they must take the patients to and from therapy.
- Inform the therapists that they must take the patients to and from therapy.
- Ask the hospital administrator to make an unbiased decision.
- Begin informal negotiations between the two departments. ANS: 4 Directing the nursing staff to perform this task is not a fair negotiation. 2 Directing the therapists to perform this task is not a fair negotiation. 3 The hospital administrator does not need to get involved. 4 One of a manager's responsibilities is to function as an informal negotiator when a resolution to conflict cannot be reached. The manager is conducting an informal negotiation between two staff members and is focusing on managing the emotions and setting the ground rules. Which stage does this demonstrate?
- Setting the stage
- Conducting the negotiation
- Making offers and counteroffers
- Agreeing on resolution of the conflict ANS: 2 A nurse observes a nursing assistive personnel (NAP) fail to wash her hands before and after placing a patient on a bedpan. What should the nurse do when providing negative feedback to the NAP?
- Be certain to offer constructive criticism about the task and do so in private.
- Ask the unit manager to be present to document responses of both parties.
- Call a meeting of all NAPs and stress hand washing to the entire group.
- Keep a record of the NAP's actions and save them for her annual formal review ANS: 1 It is important to provide negative feedback in private and also to offer constructive criticism. 2 It is not necessary for the nurse manager to be present because staff nurses are responsible for delegating to and supervision of NAPs. 3 The nurse should not call a meeting. It would be a waste of time for those who are already washing their hands properly, and it dilutes the effect of the feedback to the NAP who is not washing her hands. 4 The nurse should not allow this NAP to continue with her hand-washing errors until her annual formal review because
this can pose a threat to patient safety and increase the risk of transmitting infectious microbes. SWOT strengths, weaknesses, opportunities, threats The nurse manager is completing a SWOT analysis on personal attributes. What should the nurse include when focusing on the W of the analysis?
- Time constraints
- Work experience
- Changes in healthcare
- Inconsistent time management skills ANS: 4 1 Time constraints would be a threat. 2 Work experience is a strength. 3 Changes in healthcare would be an opportunity. 4 Inconsistent time management skills would be a weakness, or the W of the analysis.
. The nurse manager desires to use the SOAR process to improve the care area performance. On what should the manager focus when using SOAR for this analysis?
- Results
- Strengths
- Inspiration
- Opportunities ANS: 3 Feedback 1 Results are explained when SOAR is used to report on an analysis. 2 Strengths are explained when SOAR is used to report on an analysis. 3 When using the SOAR process to improve a care area, the manager should focus on inquire, imagine, innovate, and inspire. 4 Opportunities are explained when SOAR is used to report on an analysis. The nurse manager is in the midst of creating a budget for the next year. Which economic information should the nurse keep in mind when preparing this budget?
- Resources are scarce.
- The need for nurses will increase.
- The number of vacant positions for nurses will grow.
- There is an increased need for advanced practice nurses. ANS: 1 Feedback 1 Scarcity of resources is an economic issue that the nurse should keep in mind when planning the budget. 2 The need for nurses is an issue regarding the nurse labor market. 3 The number of vacant positions is an issue
about the nurse labor market. 4 The need for advanced practice nurses is a nurse labor market issue. The nurse manager is reviewing information about power to include in a staff presentation on empowerment. Which type of power does the manager possess?
- Reward
- Referent
- Expertise
- Legitimate ANS: 1 The nurse thanks a nursing assistive personnel (NAP) for helping with client care and praises the NAP's patience with a challenging client. What is the possible outcome from the feedback provided to the NAP?
- Motivation
- Time management
- Improved skill level
- Improved resource use ANS: 1 1 Positive feedback provides recognition and is an excellent motivator. 2 The positive feedback is not necessarily going to impact time management. 3 The positive feedback is not necessarily going to influence skill level. 4 The positive feedback is not necessarily going to impact resource use. A nursing assistive personnel (NAP) with limited direct care experience is assigned to help on a care area. Which task should the nurse safely delegate to the NAP to complete?
- Feeding
- Ambulating
- Transporting
- Vital sign measurement ANS: 3 Because the NAP has limited direct care experience, feeding would not be the best activity to delegate. 2 Because the NAP has limited direct care experience, ambulating would not be the best activity to delegate. 3 Because the NAP has limited direct care experience, transporting would be the best activity to delegate. 4 Because the NAP has limited direct care experience, vital sign measurement would not be the best activity to delegate The nurse desires to improve time management skills. What action should the nurse take first?
- Make a to-do list.
- Use a daily worksheet.
- Complete a time inventory.
- Focus on completing the most difficult tasks first. ANS: 3
- A to-do list is a time management strategy. 2 A daily worksheet is a time management strategy. 3 To begin managing time, the nurse needs to understand how time is being used. A personal time inventory helps estimate how much time is spent in different activities. 4 Completing difficult tasks first is a time management strategy. The nurse is identifying short-term goals for the day. Which statement exemplifies this type of goal?
- Register for a certification review course in a year.
- Complete documentation prior to hand-off communication.
- Discuss the implementation of a new checklist for staff to use.
- Plan a cruise with family after graduating from a master's degree program. ANS: 2 1 Registering for something a year in the future is a long-term goal. 2 A short- term goal is something to accomplish in the near future. Having documentation completed before hand-off communication is a short-term goal. 3 Discussing the implementation of a checklist for staff to use is a strategy to achieve a goal. 4 Planning a cruise with family after graduation is a long-term goal. The nurse plans to attend a seminar to learn how to become a legal nurse consultant because this has been a long-standing interest. What is the best way to describe this nurse's decision?
- Strategy
- Outcome
- Intervention
- Long-term goal ANS: 4 A strategy is an action taken to achieve a goal. 2 An outcome is the result of the strategy and is used to determine whether a goal has been achieved. 3 An intervention is an action taken to achieve a goal or outcome. 4 A long-term goal is something to accomplish in the future. Desiring to learn about legal nurse consulting would be a long-term goal.