Effective Leadership and Management in Nursing 8th Edition, Sullivan Test Bank

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Effective Leadership and Management in Nursing 8th Edition, Sullivan Test Bank

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Test Bank Effective Leadership Management Nursing 8th Edition, Sullivan

Chapter 1
Question 1
Type: MCSA
A nurse manager is participating in the health care organizations strategic planning committee. Which factor is the primary driving force and controlling factor in new initiatives this committee might recommend?
1. Cost of care
2. Access to care
3. Availability of care
4. Quality of care
Question 2
Type: MCSA
A nurse has been invited to discuss health care costs at a senior citizens club. What information should the nurse plan to include in this discussion?
1. While health care costs continue to rise, the percentage of the U.S. economy spent on health care has slowly declined to less than 12%.
2. Regulations brought about by the Patient Protection and Affordable Care Act (PPACA) should bring financial relief to health care consumers.
3. The United States spends more money on health care than any other country.
4. Health care spending in the United States is slowly declining due to passage of bills such as the Patient Protection and Affordable Care Act (PPACA).
Question 3
Type: MCSA
A 70-year-old client develops a catheter-induced urinary tract infection. Which statement by the nurse would indicate to the nurse manager a need for additional understanding of this situation?
1. I wonder if there was a break of sterility when this catheter was inserted.
2. Thankfully we can treat this with an antibiotic.
3. This could potentially cost the hospital a lot of money.
4. I will talk to my unlicensed assistants about proper urinary catheter care.
Question 4
Type: MCMA
Which health care situations reflect the philosophy of quality management as designed by Deming?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. A nurse asks visitors to leave because it is after visiting hours.
2. At 2:00 p.m. the nurse orders a lunch tray for a client who has just been removed from NPO status.
3. A nurse tells the manager that a housekeepers work is not up to standards.
4. A nurse volunteers to take a Spanish language class to be able to communicate with clients.
5. A nurse who has not made a medication error in two years asks for a salary increase.
Question 5
Type: MCMA
A client who was discharged yesterday is very upset about the quality of care received during hospitalization for gastric surgery. What options for reporting concerns does this client have?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. There is no mechanism for complaint as the client is no longer hospitalized.
2. The client can indicate dissatisfaction on the survey often sent to clients after discharge.
3. The client can call the hospital administration.
4. The client can make a formal complaint through the American Nursing Association.
5. The client can make a public report through the Agency for Healthcare Research and Quality.
Question 6
Type: MCSA
A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client should choose which hospital for care during this procedure?
1. The hospital closest to the clients home
2. The hospital that has done the greatest number of these surgeries in the last two years
3. The hospital chosen by the clients primary care physician
4. The hospital with the highest performance ratings for this procedure
Question 7
Type: MCSA
The quality management director of a large health care conglomerate wishes to initiate benchmarking strategies to assess care. Which directive should this manager publish?
1. We will compare outcome indicators with other health care conglomerates of similar size and organization.
2. Outcome data of hospitals within the organization will be compared to assess quality.
3. Each client care unit in the organization will establish specific unit goals for quality.
4. Each unit in the organization will create a quality monitor to assess how well unit policies are followed.
Question 8
Type: MCSA
The nurse manager has decided to use evidence-based practice (EBP) to solve an issue and has called staff nurses together for input. Which question, as posed by the manager, reflects the first step of the EBP process?
1. What outcomes are we expecting from this work?
2. Is anyone prepared to evaluate the statistics we will find?
3. What is the exact clinical issue with which we are dealing?
4. Where can we look for information?
Question 9
Type: MCSA
The nurse manager asks a staff nurse why a procedure is done in a certain manner. The nurse replies, I dont know why I started doing it this way. Ive never read any research on it, but this technique always works for me. The manager would place this technique into which category of evidence?
1. Case study
2. Anecdotal
3. Nonexperimental design research
4. Statistical
Question 10
Type: MCMA
A nurse manager is directing a team of staff nurses working to solve a clinical problem using evidence-based practice (EBP). Which manager statements would direct these nurses to the forms of strongest clinical evidence?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. We may find studies that use only one group of subjects.
2. Look for articles that report on how to use evidence in other clinical situations.
3. The studies we want are built around the scientific approach to solving problems.
4. Our focus should be on studies that use both experimental and control groups to determine intervention effectiveness.
5. Many articles will have information reported by someone who is an expert in the field.

Chapter 2
Question 1
Type: MCSA
Using the classical organizational theory model, what would be the most appropriate method for the nurse to voice concern over unfair client workload assignments?
1. Circulate a petition to all staff seeking support for change in assignment policy and present the signed petition to the nursing supervisor.
2. Discuss the problem with the nurses team leader and then the charge nurse if the problem remains unsolved.
3. Invite the vice president in charge of nursing to a unit meeting.
4. Organize a unit meeting to discuss the problem on all shifts.
Question 2
Type: MCSA
Which relationship is an example of staff authority in classical theory?
1. The shift supervisor directs the staff nurse to help another nurse admit two new clients.
2. The unit manager asks the staff nurse to participate in a unit conference.
3. The team leader asks the staff nurse to assume care of an extra client after another nurse goes home ill.
4. The staff nurses mentor calls to see how the nurses first day on a new unit progressed.
Question 3
Type: MCSA
The nurse manager has established a program that recognizes a different staff member each month for contributions to client care. As a result, overall staff productivity and the number of client compliments have increased. This is an example of which concept of organizational theory?
1. Span of control
2. Line authority
3. Hawthorne effect
4. Adhocracy
Question 4
Type: MCSA
A community-owned hospital has been purchased by a health care conglomerate. The staff is aware that the organizational theory governing the hospital is likely to change. Which statement indicates a lack of understanding of organizational theory on the part of a staff nurse?
1. If our new bosses want a classical organization, we can expect a strong hierarchy.
2. If we dont want to see lots of changes, we should hope our new bosses dont like chaos theory.
3. If this new company is based on systems theory, there will be a lot of focus on how much work we can produce.
4. If this new company is based on contingency theory, we will see lots of focus on how our environment impacts our work.
Question 5
Type: MCSA
During a performance evaluation the nurse manager states, My span of control is just too large. How should the unit supervisor interpret this statement?
1. The nurse manager is not capable of performing all the duties expected of the role.
2. The nurse manager may have too many staff members to manage.
3. The nurse manager is burned out and needs time away from the unit.
4. The nurse manager is not educationally prepared for the role.
Question 6
Type: MCSA
During a nurses interview for a new job, the health benefits are described as being provided by a health maintenance organization (HMO). What should the nurse expect from this coverage?
1. The nurse will have to choose a provider from within the HMO.
2. The nurse can obtain services from a nonparticipating provider and the HMO will pay for a portion of the charges.
3. For an additional premium, the nurse can choose any provider.
4. By joining this HMO, the nurse is entitled to unlimited treatment and services.
Question 7
Type: MCSA
A long-term care facilitys organization reflects a functional structure. Which facility practice reflects a basic weakness in this organizational strategy?
1. The nursing department is responsible for writing the clients comprehensive care plan.
2. The dietary department is responsible for nutritional assessment.
3. All nursing tasks fall under the nursing department.
4. Physical and occupational therapy departments coordinate and evaluate activities of daily living.
Question 8
Type: MCSA
A nurse practitioner and a physician have opened an office together. The nurse regularly collaborates with the physician in client care and is a general partner in the business of the office. This is an example of which diversification method?
1. Concentric diversification
2. Conglomerate diversification
3. Capitation
4. Joint venture
Question 9
Type: MCSA
A client who is being discharged from the hospital will need follow-up for wound care. The clients spouse is not capable of providing bed baths for the client. The nurse case manager who is planning care for this client should contact which agency?
1. Long-term-care facility
2. Public health department
3. Temporary service agency
4. Home health agency
Question 10
Type: MCSA
A nurse manager encourages nursing staff members to assist in developing a new creative staffing pattern that can respond quickly when staff resign or go back to school. This is an example of the use of which organizational theory?
1. Contingency theory
2. Closed-systems theory
3. Classical theory
4. Chaos theory

Chapter 3
Question 1
Type: MCSA
The nurse manager tells a newly hired nurse that the unit practices functional nursing. What should the new nurse expect?
1. One nurse has responsibility for all the medications on the unit.
2. One nurse has responsibility for all the needs of three clients.
3. One charge nurse and one respiratory therapist have responsibility for all clients.
4. One nurse and one nursing assistant have responsibility for ten clients.
Question 2
Type: MCMA
A large metropolitan hospital uses differentiated practice as part of the structure of nursing services. Following this plan, nursing responsibilities are assigned based on which criteria?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Seniority
2. Educational level
3. Experience
4. Nurse preference
5. Affordability
Question 3
Type: MCSA
The RN receives reports on eight clients in the morning. Client assignments are then delegated to an LPN and two nursing assistants. The morning is busy, with physician visits and new client orders, and the RN communicates these new orders to the LPN and nursing assistants. The RN also meets with the case manager to discuss nursing home placement for a client. What type of nursing care delivery system is in place in this hospital?
1. Critical pathways
2. Total patient care
3. Team nursing
4. Functional nursing
Question 4
Type: MCMA
As the RN team leader, identify potential disadvantages of using team nursing to deliver care to assigned clients.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Continuity of care may suffer.
2. Client/staff communication may be an issue.
3. There is little cost savings to the institution.
4. Delegation is necessary.
5. Not as many professional staff are required.
Question 5
Type: MCSA
The hospital is opening its first intensive care unit. The nurse executive should plan to staff this unit according to which model of care?
1. Functional nursing
2. Team nursing
3. Total patient care
4. Modular nursing
Question 6
Type: MCMA
The hospital administration is considering adopting primary nursing as its model of nursing care delivery. Disadvantages of this method are that
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The client may have multiple primary nurses if transfers within the facility are necessary.
2. Physician satisfaction is decreased.
3. Staff nurses cannot be held legally liable for care provided outside their work hours.
4. It requires a knowledge-based nursing practice model.
5. All persons caring for the client must have excellent communication skills.
Question 7
Type: MCSA
A newly licensed RN is beginning a job search. This nurse would be best served by working in an organization that provides which nursing care delivery system?
1. Primary nursing
2. Total nursing care
3. Functional nursing
4. Practice partnerships
Question 8
Type: MCSA
In order to organize services needed to achieve specific client outcomes, hospital administrators should consider what type of client care delivery system?
1. Functional nursing
2. Differentiated practice
3. Case management
4. Primary nursing
Question 9
Type: MCSA
The RN working on an orthopedic unit is caring for a postoperative client with a hip replacement who is not transferring well from bed to chair. The client is behind on the mobility training program. What action is the nurses priority?
1. Instruct physical therapy to increase treatments to four times daily.
2. Contact the family to discuss preoperative mobility problems.
3. Inform the case manager of variance in the critical pathway.
4. Discuss the problem with the clients surgeon.
Question 10
Type: MCSA
A hospital is concerned about low customer satisfaction ratings and poor evaluation on quality indicators. The nurse managers are asked to implement a nursing delivery system that is cost-effective and improves both customer satisfaction and quality of care. Which nursing delivery system should the managers implement?
1. Total patient care
2. Functional nursing
3. Team nursing
4. Patient-centered nursing

Chapter 4
Question 1
Type: MCSA
A nurse is working in a unit with several less-experienced nurses. Which attribute displayed by the senior nurse would make her leadership of the less-experienced nurses most effective?
1. Strong belief that the leader is accountable for actions taken by those working on the unit
2. Authority to carry out actions necessary to move the work of unit staff forward
3. Efficiency in actions and in words
4. Ability to inspire the others to commit to the teams goals
Question 2
Type: MCMA
According to the behavioral view of leadership, how are leaders formed?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. By being educated
2. From inborn traits
3. With training
4. Through life experiences
5. Through abilities
Question 3
Type: MCMA
The vice president for nursing services of a large teaching hospital has been aware that many of the problems in the nursing staff result from poor management at the unit level. What are reasons that nurse managers are sometimes ineffective in their role?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. There is little training available for nurse management positions.
2. Entry-level educational programs for nurses do not contain sufficient managerial content.
3. Management techniques are often learned on the job.
4. Nurses are not good managers.
5. Nurses often experience poor supervision in their own careers.
Question 4
Type: MCSA
The health care organizations monthly newsletter has a headline reading Nurse Promoted to Leader of Specialty Care Units. What is the error inherent in this headline?
1. One person cannot be the leader of all the specialty care units in an organization.
2. A person cannot be promoted to the role of leader.
3. Leaders have to be hired from outside the organization.
4. Nurses cannot serve as leaders over other nurses.
Question 5
Type: MCSA
A community hospital has been purchased by a large health care conglomerate. Nursing administration has the task of changing the nursing practice model that has been followed for 50 years. To best achieve this change, administration should appoint a nurse executive whose leadership style follows which theory?
1. Contingency theory
2. Quantum leadership
3. Transactional leadership
4. Transformational leadership
Question 6
Type: MCMA
A nursing committee has been organized to help plan a new intensive care service at the hospital. Which questions are essential for this committee to consider?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Where will the service be housed?
2. Why were the nurses asked to participate?
3. When will the service begin?
4. Who will provide the services?
5. How will money for the project be raised?
Question 7
Type: MCMA
The nurse manager has been assigned the task of developing and implementing a new staffing system for the emergency department. The nurse has reached the directing phase of this project. On which activities would the nurse focus at this point?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Deciding on the skill mix necessary for direct client care
2. Selling the new system to the current emergency department staff
3. Comparing the actual results of the new system to the projected results
4. Telling staff what to do
5. Coaching the staff through the implementation of a new schedule
Question 8
Type: MCSA
The nurse manager consistently refocuses the staff on achieving outcomes and directly involves the staff in decision making to achieve those outcomes. How would this style of leadership be described?
1. Quantum
2. Transactional
3. Contingency
4. Transformational
Question 9
Type: MCSA
The mother of a staff nurse is critically ill and the nurse must miss several shifts of work. If the leadership style of the nursing manager is transactional, which approach to covering these shifts is most likely?
1. I have made out a schedule of who will work to cover these shifts.
2. I can work an extra shift tomorrow night. Who can cover tonight?
3. How can we work together to cover these shifts to help our coworker?
4. If you work overtime tonight I will authorize double your hourly pay rate.
Question 10
Type: MCMA
Which topic would likely appear on the agenda for a staff meeting chaired by a nurse manager who follows transactional leadership theory?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Progress on request to increase personal day benefits
2. Review of policy and procedure for unit evacuation
3. The value of teamwork
4. Being empathetic with clients
5. Standardized first of shift assessments

Chapter 5
Question 1
Type: MCSA
The new chairperson of the nursing department has determined that the facultys teaching is stagnant and outmoded. The chairperson would like to encourage the faculty to adopt more innovative teaching strategies. According to Lewin, what is the first step in initiating this plan?
1. Bring an expert on innovative teaching strategies to campus for a meeting with faculty.
2. Include the staff in identifying problems related to teaching strategies.
3. Ask staff to assist in the development of a plan for implementing new teaching strategies.
4. Implement interventions to improve the teaching strategies currently used.
Question 2
Type: MCSA
The nursing supervisor identifies ineffective communication as a problem among the managers. According to Lippitts phases of change, which action by the supervisor reflects the final stage of improving this issue?
1. The supervisor uses outcome data to evaluate the amount of change that has occurred.
2. The supervisor has gradually withdrawn from the role of change agent.
3. The supervisor has developed strategies to maintain the change.
4. The supervisor has determined if anyone in the group is sabotaging change efforts.
Question 3
Type: MCSA
The nurse manager is planning to initiate new policies in the department and is reviewing several change theories. Which step of Havelocks model will the nurse find most closely resembles Lewins moving stage?
1. Self-renewal occurs among all participants.
2. Solutions are identified to create change.
3. Resources are acquired to facilitate change.
4. Relationships are formed among all participants.
Question 4
Type: MCSA
A new IV pump has just been purchased by the facility. Which statement by the nurse manager reflects Rogers first step in making the change to this new equipment?
1. The nursing staff will have the final decision on whether to change to this IV pump.
2. Before we make the final decision, we will do a 3-month test run of the equipment to make sure we like it.
3. I have looked at the pump and I like it.
4. I have information to share with you about the new IV pump we are considering for the unit.
Question 5
Type: MCSA
The nurse manager feels that changing the units method of assigning break times would benefit the flow of client care. What should be the managers first action associated with this idea?
1. Tell the staff that a change is coming, but that it is positive and they should not be worried.
2. Collect and analyze information about how the current system is working.
3. Mention in a staff meeting that the current system is causing a lot of trouble.
4. Identify how the manager would know if the change is benefiting the unit.
Question 6
Type: MCMA
A nursing administrator overhears nurses conversing during a break in a seminar on change. The administrator would interpret which statement as meaning that the nurse who made it is ready to become a change agent?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. I know that suggesting this change may backfire on me.
2. I dont expect too much conflict or resistance to this change.
3. I see an opportunity to make a difference in the way this facility provides nursing care.
4. I think the status quo is just fine for now.
5. This change is certainly going to be a challenge, but thats okay.
Question 7
Type: MCSA
Computerized charting will be initiated on select units of the hospital. Orientation to this new system will be provided to each nurse by a team of nurses educated in nursing informatics. This is an example of which type of change strategy?
1. Normative-reeducative strategies
2. Lippitts phases
3. Empirical-rational model
4. Power-coercive strategies
Question 8
Type: MCSA
Hospital administrators are considering changing from the traditional method of creating work schedules to a system in which the nurses will choose their own workdays. Choices will be made according to seniority. Which change strategy would likely be best for this endeavor?
1. A power-coercive strategy
2. A normative-reeducative strategy
3. An empirical-rational model
4. A driving force
Question 9
Type: MCSA
Which factor best represents a driving force in the process of change?
1. An ineffective nurse manager
2. An administration composed of long-term employees
3. A staff composed of long-term employees
4. A financial deficit of millions of dollars
Question 10
Type: MCSA
When faced with the prospect of change, the nurse states, We have always done it this way and never had any problems. A few weeks later, the same nurse remarks, This new way seems to work better than the old way did. This statement is characteristic of which type of change response?
1. Laggards
2. Early adopters
3. Early majority
4. Innovators

Chapter 6
Question 1
Type: MCSA
Which situation is an example of the overall goal of quality management in todays health care activities?
1. The nurse manager realizes a policy was ineffective in reducing incidents.
2. The administrator walks around making a list of potential problems.
3. The human resources department fires nonproductive employees.
4. The nurse wipes up a spilled drink before clients are allowed to enter a room.
Question 2
Type: MCSA
As part of the process of promoting quality improvement, the nursing manager is comparing data between two hospitals on average length of stay for a total hip replacement. This comparison is an example of which process or step?
1. Benchmarking
2. Outcome standard
3. Indicator
4. Process standard
Question 3
Type: MCSA
The hospital organization has developed a philosophy based on the client, organizational involvement, quantitative measurement of outcomes, and processes for improvement. In which quality management process are these characteristics typically seen?
1. Continuous quality improvement (CQI)
2. Total quality management (TQM)
3. Plan, Do, Check, Act (PDCA cycle)
4. Six Sigma
Question 4
Type: MCSA
The nursing task force is developing measurable goals for each client on the orthopedic unit. The statement Each client will have a written assessment and plan of care document within eight hours of admission is an example of which component of quality management?
1. Indicator
2. Structure standard
3. Benchmark
4. Process standard
Question 5
Type: MCMA
Which situation would be included in reporting for Joint Commission mandatory national patient safety goals?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The average wait time in the emergency department has increased by 5 minutes over last years average.
2. A client is left waiting in the hallway because the transport person did not make contact with the clients nurse.
3. A nurse gives a medication by the wrong route.
4. A client developed sepsis after insertion of a urinary catheter.
5. Surgery is done on a clients right eye instead of the left eye.
Question 6
Type: MCMA
Efforts to increase nurses use of evidence-based practice (EBP) to improve client care in the hospital have failed. Which answers are nurses likely to give when asked why this is occurring?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Im not interested in this program.
2. I dont have time to finish everything I already have to do each shift.
3. I dont want to practice nursing just like everyone else.
4. The library at our hospital doesnt have many journals.
5. If administration wanted us to use EBP, they would get us some more nurses to share the work.
Question 7
Type: MCSA
A client has been told that chemotherapy must be postponed until he is hydrated. The client refuses the intravenous hydration and demands to go home. How would the nurse best categorize this situation?
1. As a nonreportable incident
2. As a medical-legal incident
3. As client dissatisfaction with care
4. As a medication error
Question 8
Type: MCSA
Immediately following a barium swallow, a client noticed hives and a feeling of shortness of breath. Although there were no known allergies to food or drugs prior to this incident, the diagnosis was allergic reaction to the preservatives in the barium. Which is the correct risk category for this incident?
1. Medication error
2. Medical-legal incident
3. Procedure complication
4. This incident does not fall into a risk category.
Question 9
Type: MCSA
After shift change the nurse discovers that a clients IV heparin has been turned off at the IV controller. The amount of fluid left in the IV bag indicates that the client received half of the dose ordered. Which statement should be documented in the clients medical record?
1. IV heparin restarted. Physician notified. Clients vital signs unchanged.
2. IV heparin restarted at a rate to catch up dosage accidentally deleted.
3. IV heparin turned off by previous shift. Restarted.
4. IV heparin restarted and incident report completed.
Question 10
Type: MCSA
The following documentation was entered in the clients medical record: The client was found lying on the floor. Dr. X was notified. Apparently the restraints were improperly applied. Which statement best describes this documentation?
1. Appropriately written
2. Inappropriate because it places blame on an individual
3. Inappropriate because it does not include that the clients family was notified
4. Appropriately written because it only documents the facts

Chapter 7
Question 1
Type: MCSA
Which statement reflects the most important use of power in nursing?
1. The nurse manager uses power when evaluating staff.
2. The nurse can use power to impact and improve client care.
3. The nurse uses power in relationships with unlicensed personnel.
4. The nurse manager can use power to assist newly licensed nurses.
Question 2
Type: MCSA
There is a shortage of nurses on weekends. The unit manager asks nurses to work every other weekend in return for an additional 8 hours of paid vacation per month. Which type of power is this manager using?
1. Legitimate power
2. Expert power
3. Referent power
4. Reward power
Question 3
Type: MCSA
The local hospital has recently been acquired by a larger hospital corporation. The nurse manager encourages staff to attend the next unit meeting by hanging a poster announcing that the new wage scale and benefits package will be discussed. This is an example of which type of power?
1. Referent power
2. Information power
3. Legitimate power
4. Connection power
Question 4
Type: MCSA
One of the nurses often fails to attend educational offerings available to the staff. The nurse manager who implies the nurse may receive a negative evaluation is using which type of power?
1. Coercive power
2. Information power
3. Referent power
4. Reward power
Question 5
Type: MCMA
Leaders and managers often exercise power differently. Select the powers most frequently used by leaders.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Reward power
2. Information power
3. Legitimate power
4. Expert power
5. Referent power
Question 6
Type: MCSA
The nurse manager has decided that the only way to deal with an issue is to use coercive power. What strategy is important for this nurse manager to employ?
1. Administer behavioral warnings in public to alert other staff to the seriousness of the issue.
2. Reduce punishments for noncompliance after the majority of staff members have complied.
3. Wait at least 72 hours prior to responding to infractions so as to better control emotions during the meeting.
4. Investigate to get the facts of potential infractions before responding to them.
Question 7
Type: MCSA
As part of a shared visioning initiative, a new medication administration system has been adopted. A staff nurse has been chosen to relay the units dislike of the system to the evaluation committee. Which would be the most effective method to communicate the units disapproval?
1. Over 75 percent of the nurses on unit 3M want to return to the previous process for passing meds.
2. The physicians have complained about the new system and the nurses on 3M have voted to return to the old medication passing routine.
3. The nurses on 3M do not like the new system. Do other units agree?
4. There has been a 40 percent increase in medication errors on 3M since the new system began. We believe there is a problem.
Question 8
Type: MCSA
A staff nurse says, I have so much to do. Why should I spend time being politically aware and active? Which response by the nurse manager would be most appropriate?
1. Being politically active helps you influence events and the decisions of others.
2. You might want to run for political office someday.
3. It might help you increase your salary.
4. It will give you a better understanding of client rights.
Question 9
Type: MCSA
The nurse is working on a committee charged with the responsibility for making policy decisions for the health care organization. During the work, the nurse has developed a strong belief that the focus of the committee is incorrect. Which statement by the nurse would be most appropriate?
1. We are going about this all wrong.
2. We are a good team, but we need to look at this problem from a different viewpoint.
3. I have to intervene in our work. We are just wasting time.
4. This is going nowhere. I am resigning.
Question 10
Type: MCSA
The nurse has established a reputation for advocating for clients through honesty and hard work. The nurse has worked in the organization for 30 years and often volunteers in local and national political campaigns. This nurse is using which attribute to increase political effectiveness?
1. Image
2. Age
3. Beliefs
4. Political party

Chapter 8
Question 1
Type: MCSA
The nurse manager is challenged to find an innovative way to adequately staff the unit and provide quality nursing care. Which ability would be most useful to the nurse in this situation?
1. Creativity
2. Problem solving
3. Brainstorming
4. Decision making
Question 2
Type: MCSA
A nursing task force has been created to determine whether a new model of differentiated practice would be more effective than the current model. The task force analyzes data as a basis to examine alternatives. Which activity does this represent?
1. Group problem solving
2. Critical thinking
3. Groupthink
4. Satisficing
Question 3
Type: MCSA
The nursing group has been charged with the task of solving a patient care problem on the units. Which step should this group take first in this process?
1. Investigate what has already been tried to solve the issue.
2. Brainstorm about potential solutions.
3. Gather information to define the problem.
4. Categorize information in order of reliability.
Question 4
Type: MCMA
Currently clients on a unit are bathed in the morning between 8:00 am and 11:00 am. The nursing staff is contemplating changing that routine to bathing clients in the evening between 7:00 pm and 9:00 pm. Which statement reflects an underlying assumption that might affect the staffs ability to think critically about this change?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The day shift just wants to shift work onto the evening shift.
2. Everyone likes to bathe right before bed.
3. I read a research article that reported that clients sleep better if they have been bathed right before bedtime.
4. The physician staff will be upset if we change our morning routine.
5. If we let them change this, they will want to make lots of other changes, too.
Question 5
Type: MCMA
A nurse managers supervisor reports that many staff members have complained about the managers rigidity. What situations reflect this rigidity?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The manager has historically used trial and error as a decision-making strategy.
2. The manager takes unnecessary risks when staffing the unit.
3. The manager is not concerned when staff members arrive late to work.
4. The manager uses old ways of thinking to solve the day-to-day issues of the unit.
5. The manager does not consider the advice of the unit comanager when making a decision.
Question 6
Type: MCSA
The nurse manager has scheduled a series of meetings with employees to solve a unit problem. The manager purposefully created a 2-week gap in the meetings to allow which portion of the creative process to occur?
1. Farsight
2. Verification
3. Preparation
4. Incubation
Question 7
Type: MCMA
Which statement by the formal leader of a nursing unit reflects the personality required to energize the staff and promote creativity?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. I would like to change the format we use for shift report, but Im afraid it would upset staff members who have been here a long time.
2. This is the decision I have made, and there is no room for discussion.
3. I would like to thank everyone for your hard work and dedication while we have been short staffed.
4. I am certain that our new assignment system is going to make the workload more equitable.
5. I know this week has been rough. I feel a little like sandpaper myself.
Question 8
Type: MCSA
The nursing faculty would like to incorporate problem-based learning into the curriculum. Which action is essential?
1. Obtain funding for a simulation mannequin.
2. Write standardized scripts for volunteers who will portray clients.
3. Add more information to existing care plans as the study unfolds.
4. Assign client care debate topics to teams of three or four students.
Question 9
Type: MCSA
A newly promoted nurse manager would like staff to solve problems without relying on preconceived ideas. How should the manager role-model this ability?
1. When disagreements occur on the unit, the manager privately asks the dissenters to be silent about the issue at meetings.
2. Tell staff members that they must present one opinion regarding the solutions they desire.
3. Demonstrate a genuine desire to find our why there is dissention.
4. Develop tunnel vision when it comes to problems on the unit.
Question 10
Type: MCSA
The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that serve to maximize the achievement of the desired objective. Which decision-making model does this manager use?
1. Political decision-making model
2. Experimentation process
3. Rational decision-making model
4. Trial-and-error method

Chapter 9
Question 1
Type: MCSA
The nurse manager is concerned about a family members complaint regarding the professional behavior of a nurse on the unit. Which is the most effective method to address this issue?
1. Post a memo to the nursing staff about expected professional behavior.
2. Send an e-mail to the nursing staff about expected professional behavior.
3. Address the complaint with the individual nurse in a telephone conversation.
4. Discuss the complaint with the individual nurse face-to-face.
Question 2
Type: MCSA
The nurse plans to seek employment in an acute-care setting after graduation. Which form of communication would be most effective in applying for a position?
1. Send an e-mail to the nurse manager, requesting a job interview.
2. Send a written letter and rsum in the mail.
3. Call the nurse manager to ask if any jobs are open.
4. Drop into the nurse managers office to discuss employment options.
Question 3
Type: MCSA
The hospital chief operating officer holds monthly focus groups with the purpose of gaining ideas and insights from nursing administration and staff nurses. Which type of communication does this indicate?
1. Lateral communication
2. Downward communication
3. Diagonal communication
4. Grapevine communication
Question 4
Type: MCSA
The person who has just been promoted to nurse manager is male. If this nurse communicates in a way that is considered typical for men, what can the staff expect?
1. He will focus more on the issue than on personal experience.
2. He will strive to reach consensus within the group.
3. He will strive to avoid conflict within the group.
4. He will prefer to ask questions rather than make statements.
Question 5
Type: MCSA
The nurse manager has instituted a policy of sending information to the staff via e-mail. Many misunderstandings have occurred since this policy was implemented. What technique should the manager use to reduce this miscommunication?
1. Using text messaging instead of e-mailing
2. Requiring a return e-mail from everyone reading the information
3. Being certain that e-mails go only to the intended recipients
4. Sending all e-mails with a message line that says Important
Question 6
Type: MCSA
The nurse manager has determined the need to hire two staff nurses. Which factor is most critical as the nurse manager prepares to submit the request to administration?
1. Timing of the request
2. Negative inquiry
3. Compromise
4. Persistence
Question 7
Type: MCSA
What is the most important reason that excellent communication skills are essential for nurses?
1. Nurses must communicate with all disciplines.
2. All nursing activities occur in relationships.
3. Interpersonal skills get the work done.
4. Good communication ensures no problems occur.
Question 8
Type: MCSA
The staff nurse would like to improve personal communication with peers, patients, and the medical staff. Which strategy would be most effective for this nurse?
1. Plan to be more assertive in all communication.
2. Work to manage fear of conflict.
3. First learn to delegate clearly to others.
4. Attend the hospital-based communication training.
Question 9
Type: MCSA
Which example represents a qualifier that may interfere with the message to be communicated?
1. Please notify me when this task is complete.
2. Are you satisfied with the care you are receiving?
3. I hate to bother you with this, but we have a problem.
4. How can I help you solve your issues with this physician?
Question 10
Type: MCSA
The nurse has been concentrating on improving personal communication skills. Which option represents the final step in this nurses work to improve communication?
1. Think about the goals of the communication.
2. Develop an appropriate and thoughtful response.
3. Decide how to say what you want conveyed.
4. Ensure the communication is understood.

Chapter 10
Question 1
Type: MCSA
The nurse manager needs to delegate specific tasks to the charge nurse of the unit. Which action is an appropriate use of delegation?
1. Instructing the charge nurse to assume a client team
2. Asking the charge nurse to discipline a nurse on the unit
3. Having the charge nurse lead a nursing quality assurance task force
4. Evaluating all unlicensed personnel assigned to the unit
Question 2
Type: MCSA
Which statement made by the nurse manager is an example of the first step of delegation?
1. I must choose a person with good time management skills to be the delegate for this task.
2. I plan to evaluate the outcomes of your work in 6 months.
3. I am going to delegate the responsibility of creating the vacation schedule.
4. I have some additional information that will help you in this task.
Question 3
Type: MCSA
The nurse manager gave the unit secretary complete responsibility for the units staffing, including finding replacements for call-ins and disciplining nurses with excessive call-ins. This is an example of which type of delegation?
1. Effective delegation
2. Overdelegation
3. Reverse delegation
4. Underdelegation
Question 4
Type: MCSA
The nurse prepares the medication ordered for the client. The nurse asks the nurse assistant to give the medication when the client receives breakfast and to report on the task at its completion. The nurse assistant agrees. Which component of the steps of delegation was violated by this request?
1. Defining the task
2. Deciding on the delegate
3. Determining the task
4. Reaching agreement
Question 5
Type: MCSA
The novice nurse manager is hesitant to delegate tasks to competent, experienced staff nurses. Fear of which factor is most likely to explain this hesitancy?
1. Overburdening others
2. Decreased personal satisfaction
3. Increased liability
4. Competition and criticism
Question 6
Type: MCSA
Which situation is an example of reverse delegation?
1. The nurse manager asks the staff nurse to attend an in-service on a new product.
2. The nursing supervisor asks the nurse manager to attend a meeting with the physicians.
3. The licensed practical nurse asks the nurse manager to administer insulin to her client.
4. The staff nurse asks the licensed practical nurse to record intake and output in his clients charts.
Question 7
Type: MCSA
Which situation represents an obstacle to delegation?
1. Most of the nursing staff deliver highly skilled care
2. The entire organization has a team-centered culture
3. There is a budget shortfall for the current fiscal year
4. Each employee knows and executes job responsibilities
Question 8
Type: MCSA
The nursing supervisor states, I really dont have the time to delegate this task to a nurse manager. I can do it faster! What is the most likely basis for this statement?
1. The nursing supervisor does not have time to delegate.
2. The nursing supervisors job description needs to be redefined.
3. The nursing supervisor feels that he or she can do the job faster.
4. The nursing supervisor is concerned that staff is ill-prepared to assume additional responsibilities.
Question 9
Type: MCSA
What action is necessary by a delegate accepting delegation?
1. Accept all aspects of the task delegated.
2. Assume the delegator will serve as a mentor.
3. Clarify the time line and expectations.
4. Realize the delegate and delegator share responsibility.
Question 10
Type: MCSA
The job description of the staff nurse states the nurse is responsible for attending hospital committee meetings as assigned. The nurse manager asking the staff member to attend a risk management meeting is an example of which concept?
1. Work assignment
2. Overdelegation
3. Ineffective delegation
4. Transfer of authority

Chapter 11
Question 1
Type: MCSA
A newly hired nurse is asked to join a group working on unit protocols. This nurse is verbal and dominates the conversation of the group. The group leader identifies the disruption this nurse causes as being from which phenomenon?
1. Status incongruence
2. Group isolates
3. Emergence
4. Deviation
Question 2
Type: MCSA
The nurse manager asks staff members to work as a group in planning the activities for Nurses Week. The nurse manager should report to the supervisor that which type of group has been formed?
1. Command group
2. Task group
3. Competing group
4. Informal group
Question 3
Type: MCSA
While providing continuing education about group dynamics and team building, the nurse manager attempts to explain the difference between a group and a team. Which statement by the manager is most effective?
1. A team is bigger than a group.
2. Teams have authority; groups may be informal.
3. A group has similar goals, whereas a teams goals are dissimilar.
4. Groups are formally designated by the organization, while teams are generally informally organized.
Question 4
Type: MCSA
The chairperson of the nursing faculty leads the monthly meetings of the curriculum committee. This permanent group, which is designed to meet organizational goals, is which type of group?
1. Competing group
2. Command group
3. Task force
4. Informal group
Question 5
Type: MCSA
During the first meeting of a newly created task force, the nurse manager notices that individuals tend to cluster with members of their specific nursing units. The nurse manager begins the meeting with an explanation of the focus of this group. These behaviors are characteristic of which stage of Homanss group process?
1. Norming
2. Storming
3. Performing
4. Forming
Question 6
Type: MCSA
The leader of the task force group announces that tentative plans for Nurses Week activities have been approved by the hospital administration. The task force has also been given a new task of developing criteria for the nursing awards. What must the group accomplish now?
1. Forming
2. Adjourning
3. Rebuilding
4. Re-forming
Question 7
Type: MCSA
In a group meeting, one of the members always arrives early and places the chairs in a circle so all members can interact. This person is responsible for confirming that the room is available for the monthly meetings. Which person does this describe?
1. Gatekeeper
2. Procedural technician
3. Coordinator
4. Initiator-contributor
Question 8
Type: MCMA
The nurse manager is leading the monthly staff meeting for the professional nursing staff. Which statements by this leader reflect effective leadership?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. I will assume responsibility for developing the mission and goals of the group.
2. I have created an agenda that identifies the amount of time allotted for each step of the problem-solving process.
3. I realize there will be dissension; however, I prefer that we not take time from our agenda to address it.
4. The meeting will be called to order at noon and be adjourned in 1 hour.
5. It is important that each of you is fully engaged in the decision-making process.
Question 9
Type: MCMA
A nurse manager is focused on team building activities with a group chosen to write new unit policies. As a beginning step in this process, the manager should ask which questions to assess the groups context?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. How well has this group been able to relate to similar groups across the organization?
2. What are the groups current goals?
3. How have the members organized the group?
4. What is the general culture of the group?
5. How complex is the job the group has been assigned?
Question 10
Type: MCSA
Which statement may reveal that the team member making the comment has a hidden agenda?
1. I dont understand the second of the goals we are discussing.
2. Are we voting on this outcome or has it already been decided?
3. I have to remember to add membership on the team to my resume.
4. Are there other teams working on similar projects on other units in the hospital?

Chapter 12
Question 1
Type: MCMA
The nurse manager is facilitating the work of a collaborative team whose mission is to negotiate employment contracts with physicians. The nurse manager does not want to compromise the nurses concerns in favor of the doctors concerns. Which strategies would facilitate this outcome?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Accommodating
2. Compromising
3. Smoothing
4. Collaborating
5. Competing
Question 2
Type: MCSA
The nurse manager asks the staff nurse to work a double shift because the census is high. Although the nurse realizes the staffing for the night shift is low, the nurse has already made a family commitment for the same night. This is an example of which concept?
1. Intrapersonal conflict
2. Interpersonal conflict
3. Intragroup conflict
4. Intergroup conflict
Question 3
Type: MCSA
The nurse manager presents an issue to the nursing staff for a decision. The group assesses the problem, and a decision is made meeting the needs of both the nurse manager and the nursing staff. This is an example of which conflict management strategy?
1. Integrative decision making
2. Win-lose strategy
3. Accommodation
4. Consensus
Question 4
Type: MCSA
The nurse manager meets with the staff nurses to discuss ways to improve communication among the shifts. Which statement by the nurse manager best exemplifies the final stage of conflict management?
1. We need to clearly define the nature of the conflict.
2. I will evaluate the outcomes of our strategies on a monthly basis.
3. Lets create a time line for the implementation of our strategies.
4. Hopefully, each group can understand each others perceptions of the issue.
Question 5
Type: MCSA
The staff nurses and nursing administration are attempting to construct a method of scheduling that meets the needs of both the clients and the nursing personnel. Because nurses and nursing administration have experienced conflict about the issue, their intent is to arrive at an agreeable solution between both parties. Which option does this process best exemplify?
1. Negotiation
2. Accommodation
3. Forcing
4. Consensus
Question 6
Type: MCSA
A staff nurse has experienced disagreements with one of the medical residents about several issues. The resident reacts to this conflict by belittling the nurse in front of colleagues. This behavior is most characteristic of which type of conflict?
1. Competitive
2. Role
3. Perceived
4. Disruptive
Question 7
Type: MCSA
The day shift nurses and night shift nurses are in clear opposition regarding the responsibilities that each shift should be assigned. This opposition has created a we-they distinction on the unit. This is an example of which phenomenon?
1. Distancing
2. Suppression
3. Group withdrawal
4. Unification
Question 8
Type: MCSA
A conflict has arisen between two staff nurses who work on the same unit. Which strategy is most important for the nurse manager to consider?
1. Address the conflict in the break room.
2. Make a timely decision regarding if and when to intervene.
3. Accept full responsibility for developing a solution.
4. Redirect expressions of disagreement between the participants.
Question 9
Type: MCSA
A difference in opinion has arisen regarding methods to care for clients who are on mechanical ventilators. The nurse manager asks a group of nurses to meet and review evidence-based practice related to this client care situation. Each nurse volunteers to gather data prior to the next meeting. This is an example of which type of problem solving?
1. Negotiation
2. Collaboration
3. Compromise
4. Forcing
Question 10
Type: MCSA
The nurse manager assesses that there is conflict between two of the charge nurses. The decision is made to postpone an intervention and allow the conflict to escalate. Why might the nurse manager make this decision?
1. Allow sufficient time for the problem to spontaneously resolve.
2. Motivate the participants to seek resolution.
3. Give the nurse manager time to identify problem-solving strategies.
4. Relieve the nurse manager of the time commitment necessary to intervene.

Chapter 13
Question 1
Type: MCMA
Which strategies would decrease the amount of time the nurse manager spends with drop-in visitors to the managers office?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Set office hours to eliminate those visits.
2. Keep the office door closed.
3. Arrange furniture so the desk faces the door.
4. Stand up to greet the visitor and remain standing.
5. Encourage appointments for routine matters.
Question 2
Type: MCSA
The nurse manager routinely experiences stress related to deadlines for projects. What should be the nurses first action to control this stress?
1. Identify the actual stressor and the precipitating factors.
2. Plan activities to minimize time constraints to reduce stress.
3. Set aside a block of time each day for stress reduction.
4. Engage in distraction activities to minimize the stress.
Question 3
Type: MCSA
The nurse manager has decided to work on personal time-management skills. What should this manager do first?
1. Review patterns of time use.
2. Purchase a new notebook system for time management.
3. Identify essential job activities.
4. Set a goal of prioritizing tasks every morning.
Question 4
Type: MCSA
A nurse manager has identified that a major time waster is the amount of time spent on the telephone each day. Which strategy would help reduce this time?
1. Answer the phone, Hello, how are you?
2. Send all calls to voice mail.
3. Use e-mail for potentially troublesome issues.
4. Set a specific block of time to return calls.
Question 5
Type: MCSA
A nurse managers week is filled with handling routine and repetitive issues. Which strategy should the manager employ to make handling these tasks most effective and efficient?
1. Ask those involved to leave voice mail messages about any routine matter.
2. Encourage those involved in routine matters to call between 10:00 a.m. and 12:00 p.m. each day.
3. Keep the office door open to be accessible to those dealing with these routine tasks.
4. Hold a meeting each week especially for dealing with routine and nonurgent matters.
Question 6
Type: MCSA
The nurse manager has planned a meeting that all staff nurses have to attend. Which method would most efficiently notify the staff members of the meeting time?
1. E-mail
2. Voice mail
3. Memo
4. Telephone call
Question 7
Type: MCSA
The nurse manager is writing annual evaluations for each nurse. In order to promote professional development, it is vital for the nurse manager and nurse to become involved in which activity?
1. Personal organization
2. Priority setting
3. Goal setting
4. Limit setting
Question 8
Type: MCMA
What are reasons that nurses fail to manage time effectively?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Nurses do tasks they enjoy doing before the ones they do not enjoy.
2. Nurses do things that bring the most immediate closure first.
3. Nurses respond on the basis of who wants something.
4. Nurses do uninteresting jobs before interesting jobs.
5. Nurses work on things in the order of their arrival.
Question 9
Type: MCSA
A nurse frequently has to work late and has no time to do required training while at work. She has to do it on her days off. Choose the work-related time waster that commonly puts nurses in this position.
1. Unscheduled tasks delaying those that are scheduled
2. An overwhelming amount of work to do
3. Taking longer-than-scheduled breaks
4. Volunteering for extra responsibilities
Question 10
Type: MCSA
A novice nurse manager is devising a schedule to meet the needs of the staff, clients, and other disciplines on the unit. Which is the most important method to counteract wasted time in nursing?
1. Delegate routine activities to concentrate on other tasks.
2. Assign a staff member to attend management meetings.
3. Redesign the position so that the nurse manager works when the unit is not busy.
4. Strictly adhere to a rule that the manager will see only staff members who make appointments.

Chapter 14
Question 1
Type: MCSA
The nurse manager tells the staff that this years budget numbers will not change, even if census drops over the rest of the year. How should the staff interpret this information?
1. The budget is a fixed one.
2. The hospital uses incremental budgets.
3. The hospital uses a variable budget.
4. The hospital starts the budgeting process with a zero-based budget.
Question 2
Type: MCSA
The nurse manager identified that the census was higher than anticipated and the client acuity level was also high; however, there were fewer nursing hours paid. This variance is an example of which budgetary variance?
1. Efficiency
2. Nonsalary expenditure
3. Rate
4. Volume
Question 3
Type: MCSA
As a member of the budgeting committee, the nurse manager reviews the salaries for file clerks in the accounting department. These salaries should be included in which budget item?
1. The fixed cost
2. The variable cost
3. The indirect cost
4. The direct cost
Question 4
Type: FIB
The nurse has received a commendable progress evaluation and will receive a 3 percent merit raise. The base salary for an RN is $48,000. Based on this information, the new projected base salary for this RN will be $_____.
Standard Text:
Question 5
Type: MCSA
The nurse managers goal is to adequately staff the unit and use minimal supplementary staff. The manager has added the cost of this supplementary staff to the units operating budget. A colleague informs the manager it should have been added to which budget?
1. The personnel budget
2. The operating budget
3. The revenue budget
4. The fixed budget
Question 6
Type: MCSA
A clients spouse is concerned about the cost of hospitalization. The nurse says, Since your spouse is on Medicare, the hospital will be paid according to the DRG. What does the nurse mean by this statement?
1. Medicare will pay the total cost for the care provided.
2. Medicare will pay an average of the total costs.
3. Medicare will pay based on the usual cost of the treatments provided.
4. Medicare will pay based on a set amount for the specific condition for which the client was hospitalized.
Question 7
Type: MCSA
During an interview with a potential employee, the nurse manager tells the individual that an additional 10 percent of the hourly rate will be paid for working the 7:00 pm7:00 am shift. What is another way the manager could have described this difference in pay?
1. You will receive an additional 10 percent for overtime.
2. The night shift differential is 10 percent.
3. Your evening premium is 10 percent.
4. You

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