CH 1: Leadership and Management

Question 1

authority over your actions based on the scope of practice for your role; ability to act independently and make decisions without authorization

Answer 1

responsiblity

Question 2

ownership for your actions; makes independent decisions; ultimate responsibility

Answer 2

accountability

Question 3

Which of the following actions best reflects a nurse’s professional accountability in ensuring patient safety?

A) Reporting staffing concerns to the unit manager
B) Reviewing new policies in the hospital’s newsletter
C) Mentoring colleagues to demonstrate professional behaviors
D) Following personal protocols when administering medications

Answer 3

A) Reporting staffing concerns to the unit manager

Rationale: Professional accountability requires nurses to be responsible for patient safety, which includes reporting concerns related to staffing ratios. Adequate staffing directly affects patient care quality and safety. Mentoring colleagues is important but not directly tied to patient safety in this context. The other options do not directly address responsibility for patient safety.

Question 4

The nurse leader is responsible for fostering a “spirit of inquiry” in their team. Which of the following best exemplifies this concept?

A) Encouraging staff to attend workshops and educational seminars
B) Asking staff members to follow evidence-based protocols without question
C) Encouraging open discussions on how to improve clinical practice and patient care
D) Assigning all staff the same continuing education modules

Answer 4

C) Encouraging open discussions on how to improve clinical practice and patient care

Rationale: A “spirit of inquiry” involves fostering an environment where staff feel comfortable discussing and questioning practices to improve patient care and outcomes. Encouraging open discussions supports this. The other options are related to continuing education but do not emphasize questioning or improving clinical practices.

Question 5

According to the ANA Code of Ethics, which action reflects the nurse’s responsibility to be answerable for their actions?

A) Delegating patient care tasks to unlicensed assistive personnel
B) Recommending a colleague for a clinical position based on personal preference
C) Documenting all interventions performed for each patient
D) Failing to follow hospital protocol when administering a medication

Answer 5

C) Documenting all interventions performed for each patient

Rationale: The ANA Code of Ethics emphasizes that nurses must be answerable for their actions. This is exemplified by thorough documentation of interventions to ensure accountability for patient care. Delegation (option A) and failure to follow protocols (option D) could violate accountability principles, while personal recommendation (option C) does not address the ethics of practice directly.

Question 6

A nurse manager is involved in creating protocols for patient care. Which of the following is the primary purpose of the nurse manager’s involvement in developing these protocols?

A) To ensure personal preferences are reflected in the guidelines
B) To develop protocols that will increase nurse satisfaction
C) To ensure the guidelines are based on evidence-based practice
D) To maintain the status quo in nursing practice

Answer 6

C) To ensure the guidelines are based on evidence-based practice

Rationale: The primary role of the nurse manager in developing protocols is to ensure they are grounded in evidence-based practice to promote the best possible patient outcomes. This aligns with professional accountability and safety. While nurse satisfaction and personal preferences may be considered, they are not the primary focus.

Question 7

Which of the following actions contribute to professional accountability in nursing practice? (Select all that apply.)

A) Demonstrating professional behaviors for others to follow

B) Ignoring staffing concerns if the unit appears to function well

C) Participating in ongoing professional development activities

D) Refusing to follow protocols due to personal judgment

E) Engaging in problem-solving to address increasing workloads

Answer 7

A) Demonstrating professional behaviors for others to follow
C) Participating in ongoing professional development activities
E) Engaging in problem-solving to address increasing workloads

Rationale: Professional accountability includes modeling professional behaviors (A), engaging in continuous professional development (C), and actively addressing challenges like increasing workloads through problem-solving (E). Ignoring staffing concerns (B) and refusing to follow protocols (D) undermine professional accountability and patient safety.

Question 8

A nurse is mentoring a new graduate nurse and is explaining the importance of evidence-based practice in professional accountability. Which of the following actions by the new graduate would demonstrate a commitment to evidence-based practice?

A) Adopting new nursing techniques without researching their effectiveness
B) Recommending personal anecdotal experiences as treatment protocols
C) Reviewing current research and integrating findings into patient care
D) Following the same routine for patient care without considering the latest guidelines

Answer 8

C) Reviewing current research and integrating findings into patient care

Rationale: Evidence-based practice involves using current research to guide clinical decisions and improve patient outcomes. The new graduate’s commitment is best demonstrated by actively reviewing research and applying evidence to practice. The other options reflect practices that do not involve critical thinking or adherence to the latest research.

Question 9

Leadership or management?

• Use of individual traits & personal power to influence & guide strategy development
• Personal experiences

Answer 9

leadership

Question 10

Leadership or management?

• Leading by example
• Influences others to respond

Answer 10

leadership

Question 11

Leadership or management?

• Act of planning, organizing, staffing, directing & controlling
• All can be taught

Answer 11

management

Question 12

Leadership or management?

• Way of behaving that influences others to respond
• Help others to identify and focus on goals

Answer 12

leadership

Question 13

Leadership or management?

• Focus on personal development
• May not have a titled position

Answer 13

leadership

Question 14

Leadership or management?

• Problem oriented focus
• Focus is on the group process

Answer 14

management

Question 15

Leadership or management?

• What is needed to achieve a goal:
• Structure
• Resources
• Direction
• Power & authority granted by an organization

Answer 15

management

Question 16

Leadership or management characteristics?

Communication
Conflict management
Role model
Motivator
Visionary
Skilled

Answer 16

leadership

Question 17

Leadership or management characteristics?

Planning
Organizing
Staffing
Directing
Controlling
Hold a formal position of authority

Answer 17

management

Question 18

Name this type of leadership style.

Nurse manager decides everything, is controlling, does not encourage autonomy

A. Authoritative
B. Democratic
C. Laissez-faire
D. Transformational

Answer 18

A. Authoritative

Question 19

Name this type of leadership style.

Incorporates input from all

A. Authoritative
B. Democratic
C. Laissez-faire
D. Transformational

Answer 19

B. Democratic

Question 20

Name this type of leadership style.

Employees allowed to work in any way they want to, no guidance/supervision of the nurse manager. Employees are responsible for problem-solving on their own

A. Authoritative
B. Democratic
C. Laissez-faire
D. Transformational

Answer 20

C. Laissez-faire

Question 21

Name this type of leadership style.

Uses positive motivation & inspiration encouraging employees to “do their best.” Focus is toward a common vision.

A. Authoritative
B. Democratic
C. Laissez-faire
D. Transformational

Answer 21

D. Transformational

Question 22

What is the role of the nurse manager?

Answer 22

to guide and lead the frontline nurses while contributing to an organization’s success

Question 23

A first-level nurse manager is responsible for ensuring compliance with regulatory and professional standards. Which of the following actions best demonstrates this responsibility?

A) Conducting routine staff meetings to discuss employee concerns

B) Ensuring staff complete mandatory training on infection control protocols

C) Scheduling nursing staff based on their preferences rather than hospital policies

D) Allowing experienced nurses to bypass annual competency assessments

Answer 23

B) Ensuring staff complete mandatory training on infection control protocols

Rationale: First-level nurse managers must ensure that all personnel comply with regulatory and professional standards, such as infection control training, to maintain patient safety and legal compliance. While staff meetings (A) are beneficial for communication, they do not directly enforce regulatory compliance.

Question 24

Which of the following best describes the unique position of a first-level nurse manager?

A) They focus exclusively on patient care rather than administrative duties.

B) They work solely as a liaison between the hospital board and nursing staff.

C) They manage the day-to-day operations of a specific unit while balancing staff and upper management expectations.

D) They primarily handle strategic planning for the entire hospital system.

Answer 24

C) They manage the day-to-day operations of a specific unit while balancing staff and upper management expectations.

Rationale: First-level nurse managers oversee unit operations, personnel, and regulatory compliance while serving as a bridge between staff and upper management. Their role requires balancing daily workflow with strategic planning at the unit level.

Question 25

A first-level nurse manager is responsible for fostering interdisciplinary, collaborative relationships. Which of the following actions align with this responsibility? (Select all that apply.) A) Encouraging open communication between nurses and other healthcare team members B) Organizing interdisciplinary meetings to discuss patient care plans C) Assigning patient care tasks without consulting other departments D) Implementing conflict resolution strategies between nursing staff and physicians E) Limiting team collaboration to nurses only to maintain consistency in patient care

Answer 25

A) Encouraging open communication between nurses and other healthcare team members B) Organizing interdisciplinary meetings to discuss patient care plans D) Implementing conflict resolution strategies between nursing staff and physicians Rationale: Fostering interdisciplinary relationships requires open communication (A), collaboration in patient care (B), and resolving conflicts effectively (D). Assigning tasks without input (C) and restricting collaboration (E) hinder interdisciplinary teamwork.

Question 26

Which of the following best demonstrates a first-level nurse manager’s responsibility for personnel development? A) Assigning new nurses to the most experienced staff for mentorship B) Ensuring the unit’s budget remains within financial limits C) Handling disciplinary actions without providing constructive feedback D) Reassigning nurses frequently to different units without explanation

Answer 26

A) Assigning new nurses to the most experienced staff for mentorship Rationale: Personnel development includes mentorship, training, and career growth opportunities. Pairing new nurses with experienced staff promotes learning and competency development, which supports overall unit performance and patient care quality.

Question 27

A first-level nurse manager notices an increase in medication errors on the unit. What is the most appropriate initial action? A) Immediately terminate the nurses involved in medication errors B) Report all staff to upper management for evaluation C) Ignore the issue since medication errors occasionally happen D) Implement an educational program on safe medication administration

Answer 27

D) Implement an educational program on safe medication administration Rationale: Nurse managers are responsible for ensuring staff competency and compliance with professional standards. Addressing medication errors through education promotes patient safety, professional accountability, and staff development.

Question 28

Which of the following are key strategic planning responsibilities of a first-level nurse manager? (Select all that apply.) A) Developing unit-based quality improvement initiatives B) Forecasting future staffing needs based on patient acuity trends C) Making decisions for the entire hospital organization D) Ensuring nurses meet professional development goals E) Monitoring unit budget and resource allocation

Answer 28

A) Developing unit-based quality improvement initiatives B) Forecasting future staffing needs based on patient acuity trends D) Ensuring nurses meet professional development goals E) Monitoring unit budget and resource allocation Rationale: Strategic planning at the first-level nurse manager role includes quality improvement (A), staffing projections (B), professional development (D), and budgeting (E). Making decisions for the entire hospital (C) falls outside their scope, as that responsibility lies with upper management.

Question 29

A nurse manager is implementing a new policy requiring staff nurses to complete a bedside safety checklist at the beginning of each shift. Which of the following best describes the primary reason for this initiative? A) To increase workload and ensure staff stay busy during their shifts B) To foster interdisciplinary collaboration between nurses and management C) To meet organizational goals without concern for patient outcomes D) To enhance patient safety and promote adherence to regulatory standards

Answer 29

D) To enhance patient safety and promote adherence to regulatory standards Rationale: A first-level nurse manager must ensure compliance with professional standards, and implementing a bedside safety checklist helps improve patient safety, prevent errors, and align with regulatory expectations.

Question 30

A middle-level nurse manager is responsible for evaluating whether unit policies are meeting the needs of patients and staff. Which of the following is the most effective way to assess this? A) Conducting quarterly staff and patient satisfaction surveys B) Relying on informal feedback from first-level managers C) Reviewing complaints from patients and assuming changes are necessary D) Asking nurses during daily huddles if they have concerns

Answer 30

A) Conducting quarterly staff and patient satisfaction surveys Rationale: Conducting structured surveys provides objective data to assess whether unit policies align with patient and staff needs. Informal feedback may lack comprehensive data, and assuming changes are needed based on complaints alone is not an evidence-based approach.

Question 31

A middle-level nurse manager is developing strategies to facilitate the professional growth of staff. Which of the following actions support this initiative? (Select all that apply.) A) Implementing mentorship programs for newly hired nurses B) Encouraging participation in shared governance councils C) Requiring all nurses to pursue advanced degrees without exception D) Providing continuing education opportunities and leadership training E) Assigning nurses to projects that align with their career interests

Answer 31

A) Implementing mentorship programs for newly hired nurses B) Encouraging participation in shared governance councils D) Providing continuing education opportunities and leadership training E) Assigning nurses to projects that align with their career interests Rationale: Professional growth is supported by mentorship, shared governance, continuing education, and aligning projects with career goals. Requiring advanced degrees for all nurses is not realistic and may not align with individual career paths.

Question 32

A middle-level nurse manager notices increased nurse turnover in several units. What is the most appropriate action? A) Conducting exit interviews to determine reasons for staff turnover B) Requesting upper management hire more nurses without reviewing data C) Assuming the issue is due to poor first-level management and replacing unit managers D) Mandating overtime to compensate for staffing shortages

Answer 32

A) Conducting exit interviews to determine reasons for staff turnover Rationale: Exit interviews provide critical insight into why nurses are leaving, allowing leadership to address underlying issues. Making assumptions or implementing quick fixes without data-driven decisions can worsen staff dissatisfaction.

Question 33

Which of the following best describes the role of a middle-level nurse manager in strategic planning? A) Overseeing the hospital’s financial planning and budgeting B) Providing direct patient care while ensuring policy compliance C) Setting and revising goals for patient care based on unit trends D) Implementing daily nurse assignments for each shift

Answer 33

C) Setting and revising goals for patient care based on unit trends Rationale: Middle-level managers assess patient care trends and adjust goals to enhance quality. Financial oversight is handled by upper management, while direct patient care and daily assignments are primarily the responsibilities of first-level managers.

Question 34

A middle-level nurse manager must balance the responsibilities of both first-level and upper management. Which of the following tasks align with their role? (Select all that apply.) A) Evaluating the effectiveness of unit policies B) Coordinating interdisciplinary collaboration across multiple units C) Providing daily direct supervision of bedside nurses D) Analyzing staff workload trends to adjust staffing models E) Acting as a liaison between first-level managers and upper management

Answer 34

A) Evaluating the effectiveness of unit policies B) Coordinating interdisciplinary collaboration across multiple units D) Analyzing staff workload trends to adjust staffing models E) Acting as a liaison between first-level managers and upper management Rationale: Middle-level managers evaluate policies, facilitate interdisciplinary collaboration, analyze staffing trends, and bridge communication between leadership levels. Direct supervision of bedside nurses is primarily the responsibility of first-level managers.

Question 35

A middle-level nurse manager is implementing a shared governance model. Which action best supports this initiative? A) Allowing nurses to participate in decision-making regarding policies and procedures B) Requiring nurses to follow all policies without input or feedback C) Eliminating first-level managers to give staff more autonomy D) Creating a top-down management structure with less staff involvement

Answer 35

A) Allowing nurses to participate in decision-making regarding policies and procedures Rationale: Shared governance empowers nurses to have a voice in decision-making, improving job satisfaction and patient outcomes. Excluding staff from input contradicts this model, and eliminating first-level managers disrupts leadership structures.

Question 36

A middle-level nurse manager is assessing the effectiveness of delegation on the unit. Which of the following best demonstrates effective delegation? A) Distributing tasks evenly among all staff regardless of skill level B) Expecting first-level managers to handle all delegation decisions without oversight C) Assigning tasks to staff members based on their competencies and scope of practice D) Assigning tasks only to nurses, avoiding delegation to unlicensed personnel

Answer 36

C) Assigning tasks to staff members based on their competencies and scope of practice Rationale: Effective delegation requires assigning tasks based on staff skills, scope of practice, and competency to ensure safe and efficient care. Equal task distribution and limiting delegation do not maximize efficiency, and middle-level managers should oversee delegation strategies.

Question 37

A middle-level nurse manager is revising policies to align with professional standards. What is the best approach to ensure staff compliance? A) Enforcing the new policies without staff input B) Removing consequences for noncompliance to encourage voluntary adherence C) Expecting first-level managers to communicate policy changes without further discussion D) Providing staff education on the rationale behind policy changes

Answer 37

D) Providing staff education on the rationale behind policy changes Rationale: Educating staff on policy changes fosters understanding and compliance. Strict enforcement without input, lack of consequences, and delegating responsibility without discussion can lead to resistance and noncompliance.

Question 38

Which of the following best describes the primary responsibility of an upper-level nurse manager, such as a Chief Nursing Officer (CNO)? A) Direct supervision of bedside nurses to ensure quality patient care B) Handling individual patient complaints and resolving bedside conflicts C) Implementing and revising organizational nursing policies to align with strategic goals D) Conducting routine staff performance evaluations at the unit level

Answer 38

C) Implementing and revising organizational nursing policies to align with strategic goals Rationale: Upper-level managers, such as the CNO, focus on strategic planning, policy development, and aligning nursing practice with organizational objectives. Their role is not focused on direct patient care or unit-level staff management, which falls under the responsibilities of middle- and first-level managers.

Question 39

An upper-level nurse manager is involved in strategic decision-making for the hospital system. Which of the following tasks align with this role? (Select all that apply.) A) Collaborating with executives to establish long-term nursing goals B) Developing policies to improve patient safety and quality of care C) Supervising first-level managers in their daily tasks D) Representing the nursing department in hospital-wide leadership meetings E) Implementing shared governance models to enhance nursing practice

Answer 39

A) Collaborating with executives to establish long-term nursing goals B) Developing policies to improve patient safety and quality of care D) Representing the nursing department in hospital-wide leadership meetings E) Implementing shared governance models to enhance nursing practice Rationale: Upper-level nurse managers play a crucial role in strategic planning, policy development, and advocating for nursing at the executive level. They do not engage in daily supervision of first-level managers, as this is the responsibility of middle-level managers.

Question 40

A hospital system is preparing for accreditation, and the Chief Nursing Officer (CNO) is leading efforts to ensure compliance with regulatory standards. Which of the following is the most appropriate action? A) Reviewing hospital policies to ensure they align with accreditation requirements B) Conducting one-on-one performance evaluations of nursing staff C) Delegating all compliance responsibilities to first-level managers D) Assigning nurse managers to complete bedside audits without further oversight

Answer 40

A) Reviewing hospital policies to ensure they align with accreditation requirements Rationale: As a senior leader, the CNO is responsible for ensuring hospital-wide policies align with accreditation standards and regulatory guidelines. This high-level oversight ensures compliance and improves patient care.

Question 41

An upper-level nurse manager is implementing a hospital-wide initiative to improve nurse retention. Which of the following best demonstrates an effective approach? A) Mandating overtime to address short-staffing issues B) Requiring nurses to commit to multi-year contracts with financial penalties for early departure C) Developing strategies to enhance nurse job satisfaction and professional growth D) Reducing benefits to balance the hospital’s financial budget

Answer 41

C) Developing strategies to enhance nurse job satisfaction and professional growth Rationale: Upper-level nurse managers focus on long-term strategies to retain staff by improving job satisfaction, creating career advancement opportunities, and fostering a supportive work environment.

Question 42

An upper-level nurse manager is working to improve interdisciplinary collaboration within the hospital system. Which of the following strategies would support this goal? (Select all that apply.) A) Establishing hospital-wide committees that include nursing, physicians, and other disciplines B) Encouraging open communication between nursing leadership and other department heads C) Directly managing daily interdisciplinary rounds on every unit D) Developing policies that require collaborative care planning between disciplines E) Advocating for nursing representation in executive decision-making discussions

Answer 42

A) Establishing hospital-wide committees that include nursing, physicians, and other disciplines B) Encouraging open communication between nursing leadership and other department heads D) Developing policies that require collaborative care planning between disciplines E) Advocating for nursing representation in executive decision-making discussions Rationale: Upper-level nurse managers enhance interdisciplinary collaboration by creating inclusive committees, fostering communication, and ensuring that nursing has a voice in hospital-wide decision-making. Directly managing daily interdisciplinary rounds is not within their primary scope, as this responsibility typically falls to unit managers or department leads.

Question 43

An upper-level nurse manager is assessing whether hospital-wide nursing policies are effectively meeting patient care needs. Which of the following is the best strategy? A) Reviewing patient outcome data and nurse feedback to determine necessary policy revisions B) Relying solely on middle-level managers to report concerns from the units C) Conducting random patient interviews without involving nurse managers D) Mandating strict adherence to all existing policies without considering staff concerns

Answer 43

A) Reviewing patient outcome data and nurse feedback to determine necessary policy revisions Rationale: Effective policy assessment involves using both patient outcomes and nursing staff feedback to make informed decisions about necessary improvements.

Question 44

Which of the following best describes the role of an upper-level nurse manager in delegation? A) Delegating all operational decisions to middle-level managers and having no involvement in implementation B) Personally assigning tasks to bedside nurses to ensure proper delegation C) Handling only physician-related delegation concerns and avoiding nursing-specific delegation issues D) Establishing hospital-wide delegation policies and ensuring compliance across all nursing units

Answer 44

D) Establishing hospital-wide delegation policies and ensuring compliance across all nursing units Rationale: Upper-level nurse managers develop and enforce delegation policies to ensure proper task assignment and adherence to legal and ethical guidelines across the hospital system. They do not personally delegate tasks at the unit level.

Question 45

a staff nurse with managerial responsibility; no title

Answer 45

charge nurse

Question 46

Nurse with recognized clinical expertise who can mentor less experienced nurses.

Answer 46

resource nurse

Question 47

A charge nurse is preparing patient assignments for the shift. Which of the following considerations is the most important when making assignments? A) Ensuring each nurse has an equal number of patients B) Assigning complex patients to newer nurses for learning opportunities C) Balancing patient acuity with staff skill level and experience D) Rotating assignments daily to promote variety in patient care

Answer 47

C) Balancing patient acuity with staff skill level and experience Rationale: The charge nurse must ensure safe, effective patient care by considering acuity, nurse experience, and workload distribution rather than focusing solely on equal numbers or learning opportunities.

Question 48

A charge nurse is responsible for troubleshooting issues that arise during the shift. Which of the following are appropriate actions? (Select all that apply.) A) Assisting nurses with resolving conflicts between staff members B) Escalating urgent staffing shortages to the nurse manager C) Addressing immediate patient care concerns before contacting the provider D) Ignoring minor patient complaints to focus on critical issues E) Reallocating resources when a unit experiences an unexpected surge in admissions

Answer 48

A) Assisting nurses with resolving conflicts between staff members B) Escalating urgent staffing shortages to the nurse manager C) Addressing immediate patient care concerns before contacting the provider E) Reallocating resources when a unit experiences an unexpected surge in admissions Rationale: The charge nurse plays a critical role in problem-solving, staff support, and resource management while ensuring patient safety. Ignoring patient complaints is not appropriate, even if they seem minor.

Question 49

During the night shift, a charge nurse notices a trend of delayed medication administration. What is the best initial action? A) Report the issue to the nurse manager immediately B) Observe the workflow and discuss challenges with the nursing staff C) Notify the pharmacy that medications are not arriving on time D) Instruct staff to prioritize medication administration over documentation

Answer 49

B) Observe the workflow and discuss challenges with the nursing staff Rationale: The charge nurse should assess the situation and collaborate with staff to identify barriers before escalating the issue to management or other departments.

Question 50

A charge nurse is mentoring a newly hired nurse who is struggling with time management. What is the best approach? A) Assigning the nurse fewer patients until they become more efficient B) Encouraging the nurse to take breaks only when all tasks are completed C) Providing guidance on prioritization and delegating when appropriate D) Suggesting the nurse work overtime to improve skills faster

Answer 50

C) Providing guidance on prioritization and delegating when appropriate Rationale: A charge nurse mentors new staff by helping them develop time management strategies, prioritize tasks, and delegate effectively rather than reducing workload or overworking them.

Question 51

The charge nurse serves as a liaison between staff working the current shift and off-shift personnel. Which of the following are appropriate responsibilities in this role? (Select all that apply.) A) Communicating important patient updates to the next shift during handoff B) Addressing staff concerns and relaying them to the nurse manager as needed C) Ensuring that staff shortages are covered before the end of the shift D) Reprimanding staff for performance issues without consulting the nurse manager E) Facilitating smooth shift transitions by organizing necessary resources

Answer 51

A) Communicating important patient updates to the next shift during handoff B) Addressing staff concerns and relaying them to the nurse manager as needed C) Ensuring that staff shortages are covered before the end of the shift E) Facilitating smooth shift transitions by organizing necessary resources Rationale: The charge nurse plays a key role in shift transitions, communication, and problem-solving while ensuring staffing needs are met. Disciplinary actions are typically the responsibility of the nurse manager.

Question 52

A charge nurse notices a patient’s condition is deteriorating. The primary nurse appears unsure about the next steps. What is the charge nurse’s best immediate action? A) Assume care of the patient and call the provider B) Notify the nurse manager to address the issue C) Wait for the primary nurse to recognize the problem independently D) Guide the primary nurse in recognizing the urgency and taking appropriate actions

Answer 52

D) Guide the primary nurse in recognizing the urgency and taking appropriate actions Rationale: The charge nurse should provide mentorship and clinical support while ensuring that the primary nurse takes the necessary steps to address the patient’s condition.

Question 53

A resource nurse is assisting a newer nurse who lacks confidence in performing a complex dressing change. What is the most effective action? A) Perform the dressing change while the new nurse observes B) Encourage the nurse to attempt the dressing change without guidance C) Demonstrate the procedure, then allow the nurse to perform it with supervision D) Delegate the dressing change to a more experienced nurse

Answer 53

C) Demonstrate the procedure, then allow the nurse to perform it with supervision Rationale: A resource nurse supports skill development by providing a demonstration and allowing supervised practice to build confidence and competence.

Question 54

Name the 3 skills that both leadership and management share.

Answer 54

communication delegation motivation

Question 55

A nurse enters the room and finds a patient on the floor. What should the nurse do first? A. Assess the patient for injuries B. Call for help C. Call the physician D. Tell the patient to call when getting out of bed

Answer 55

A. Assess the patient for injuries

Question 56

What task can the RN assign to an LPN? A. Administer blood to a patient B. Do intake on a new admission C. Develop a care plan D. Observe the patient hourly if he is a fall risk

Answer 56

D. Observe the patient hourly if he is a fall risk

Question 57

Which of the following is described as the use of individual traits and personal power to influence and guide strategy development and be future oriented and visionary? A. Leadership B. Management C. Team leader D. Nurse manager

Answer 57

A. Leadership

Question 58

4. Which of the following describes the act of planning, organizing, staffing, and directing? A. Management B. Leadership C. Mentoring D. Supervising

Answer 58

A. Management

Question 59

Leadership traits include drive, persistence, creative problem solving, initiative, self-confidence, ability to influence others, and intelligence. The thought is that these traits when put into practice will result in positive outcomes. What theory considers that leaders are presumed to possess certain traits that are leadership specific? A. Trait theory B. Behavioral theory C. Contingency theory D. Contemporary

Answer 59

A. Trait theory

Question 60

6. Which of the following lists balancing efficiency and patient safety, promoting trust, creating and managing change; implementing shared decision making around work design and flow; and establishing a learning environment? A. Institute of Medicine B. Board of Nursing C. Institutional Review Board D. American Nurses Credentialing Center

Answer 60

A. Institute of Medicine

Question 61

Identify the problem, gather relevant information, identify the alternatives, weigh the evidence, choose among alternatives, take action, and review your decision and evaluate the consequences are the steps in: A. Decision making B. Nursing process C. Plan of care D. Autonomy

Answer 61

A. Decision making

Question 62

8. The nurse manager, or head nurse, that is responsible for supervising the work of nonmanagerial personnel and the day-to-day activities of a specific work unit or units is the: A. Middle-level manager B. First-level manager C. Middle-level manager D. Upper-level manager

Answer 62

B. First-level manager

Question 63

9. A program that will support a nurse during a move into a management role is: A. Mentorship B. Transition to practice C. Orientation D. Proctoring

Answer 63

B. Transition to practice

Question 64

Which of the following is a structure and process for partnership, equity, accountability, and ownership? A. Transformational leadership B. Inspirational motivation C. Shared governance D. Nursing theory

Answer 64

C. Shared governance

Question 65

Nurses can be leaders without being managers. Which nursing actions demonstrate leadership? a. Assisting a new nurse with enteral tube feedings b. Counseling a new nurse regarding attendance c. Adjusting assignments after a staff member calls in sick d. Calling a physician for new order clarification

Answer 65

a. Assisting a new nurse with enteral tube Rationale: Leaders act as role models and mentor new staff. The other options are incorrect because they are management responsibilities and not leadership roles.

Question 66

Which nursing actions demonstrate the role of management in nursing? a. Encouraging autonomous decision making b. Observing the documentation of appropriate charges to patients c. Assisting in a code d. Asking the patient/family about advance directives

Answer 66

b. Observing the documentation of appropriate charges to patients Rationale: Managers are responsible for the budget of their units. The other options are incorrect because those are leadership or mentoring roles.

Question 67

Much like a politician, a nurse manager must exhibit leadership that inspires and motivates. In which instance is a nurse demonstrating leadership qualities? a. A staff nurse becomes aware of increased infection rates following cardiac surgery. The nurse takes it upon herself to research the possible causes and prevention measures and to make suggestions to better protect patients. b. A staff nurse acts quickly when a cardiac arrest is called on her patient. c. A staff nurse notifies another staff member that she is being “pulled” today. d. A new nurse volunteers to work when another staff member must leave work because her child is ill.

Answer 67

a. A staff nurse becomes aware of increased infection rates following cardiac surgery. The nurse takes it upon herself to research the possible causes and prevention measures and to make suggestions to better protect patients. Rationale: Nurse leaders are interested in changing practice based on evidence. Options B and D are incorrect because they are actions taken by nurses as part of the functional structure of the unit. Option C is incorrect because it is an action taken by a manager.

Question 68

A nurse has accepted a position on a nursing unit where the nurse manager promotes autonomy and staff involvement in decision making. What would the nurse expect to observe on this unit? a. Nurse manager mandates changes. b. Staff takes responsibility for assignments. c. Staff participates on hospital committees. d. Nurses are recognized for excellence in practice.

Answer 68

c. Staff participates on hospital committees. Rationale: Work environments that promote autonomy and decision making encourage participation on hospital committees so that staff may become involved in the decisions that are made. Option A is incorrect because this is not an environment in which staff are encouraged to participate in decision making. Option B is incorrect because it should be seen in all environments regardless of autonomy. Option D is incorrect because excellence in practice is not seen solely in autonomous environments.

Question 69

The fundamental element of any patient care delivery combines work allocation with a. patient acuity. b. leadership. c. clinical decision making. d. delegation.

Answer 69

c. clinical decision making. Rationale: Work allocation is necessary in any patient care delivery system. The other options are incorrect because it is not necessarily useful in determining the appropriate patient care delivery systems needed.

Question 70

The management process consists of six functions: planning, staffing, organizing, directing, controlling, and decision making. What might be seen in the planning step of the process? a. Identifying the problem of the lack of ICU beds b. Organizing a meeting to address the problem c. Establishing an alternate site within the hospital for these patients d. Assigning experienced staff to implement care of these patients

Answer 70

a. Identifying the problem of the lack of ICU beds Rationale: Establishing objectives should be seen in the planning step following identification of the problem. Option B is the organizing step. Option C is the directing step. Option D is the controlling step.

Question 71

A nurse manager encourages the nursing staff using a transformational leadership environment. The nurse manager interprets that a successful transformational environment is one in which (Select all that apply.) a. a staff nurse provides advice and guidance to new nurses. b. a clinical ladder is used for advancement. c. a staff nurse researches an increase in surgical wound infections and makes recommendations to prevent them. d. annual performance appraisals are provided with competitive raises. e. decisions are made from the top down

Answer 71

a. a staff nurse provides advice and guidance to new nurses. b. a clinical ladder is used for advancement. c. a staff nurse researches an increase in surgical wound infections and makes recommendations to prevent them. Rationale: Options A, B, and C are correct because a transformational leadership environment encourages consultation and collaboration, empowering and motivating staff. The other options are examples of transactional leadership.