Chapter 10 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
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

Correct Answer: 3

Rationale 1: Since assuming a client assignment is included in the charge nurses job description, this is assignment, not delegation.

Rationale 2: Disciplining a nurse on the unit is the responsibility of the manager. Discipline should not be delegated.

Rationale 3: Delegation is the mutual transfer of responsibility and authority that occurs on the basis of competence and trust. The nurse manager can delegate both the responsibility of leading this task force and the authority to make decisions regarding this role. Both must be delegated for the delegation to be successful.

Rationale 4: The process of evaluation is the responsibility of the manager, and this authority cannot be transferred to a delegate.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-1: Describe how delegation involves responsibility, accountability, and authority.

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.

Correct Answer: 3

Rationale 1: Choosing the person to delegate to can only be accomplished after the task to be delegated is identified and defined.

Rationale 2: Information regarding the task, such as when it will be evaluated, is given to the delegate as part of the delegation process. This cannot be done until the task is defined and the delegate is chosen.

Rationale 3: The first step of the process is to identify and define the task that will be delegated.

Rationale 4: Additional information can only be offered when the delegate has been chosen, and the delegate can be chosen only after the task has been identified.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-3: Discuss how to be an effective delegator.

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

Correct Answer: 2

Rationale 1: Effective delegation is the process by which responsibility and authority for performing a task is transferred to another person. It is critical that the task is one that can be delegated.

Rationale 2: Overdelegation occurs when the delegator loses control over a situation by providing the delegate with too much authority or responsibility. Discipline of an employee is a responsibility of the manager that cannot be delegated because of the confidentiality and controversy associated with it.

Rationale 3: Reverse delegation occurs when a person with a lower rank (unit secretary) delegates to someone with authority (nurse manager).

Rationale 4: Underdelegation occurs when full authority and responsibility are not transferred in a situation where delegation would otherwise be appropriate.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-1: Describe how delegation involves responsibility, accountability, and authority.

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

Correct Answer: 2

Rationale 1: The task was defined, but is inappropriate.

Rationale 2: The violation occurred at the step of deciding on a delegate. Nurse assistants cannot administer medications.

Rationale 3: The task was determined, but is inappropriate.

Rationale 4: The nurse and nurse assistant reached agreement, but the delegation was inappropriate.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-5: Explain how liability affects delegation.

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

Correct Answer: 4

Rationale 1: Even the novice nurse manager should realize that delegating is part of the role.

Rationale 2: Fear of decreased personal satisfaction should be diminished by the increased opportunity to explore new challenges and gain other skills and experiences.

Rationale 3: The novice nurse manager would not fear increased liability if delegating to competent, more experienced nurses.

Rationale 4: The novice nurse manager may be insecure and fear that another staff member could perform the task more effectively. There is a fear that a successful delegate could threaten the nurse managers credibility as a leader.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-4: Identify obstacles that can impede effective delegation.

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.

Correct Answer: 3

Rationale 1: It is appropriate for a person with more authority (nurse manager) to delegate a task to someone with a lower rank (staff nurse).

Rationale 2: It is appropriate for a person with more authority (nursing supervisor) to delegate a task to someone with a lower rank (nurse manager).

Rationale 3: Reverse delegation occurs when someone with a lower rank (licensed practical nurse) delegates a task to someone with more authority (nurse manager).

Rationale 4: It is appropriate for a person with more authority (staff nurse) to delegate a task to someone with a lower rank (licensed practical nurse).

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-1: Describe how delegation involves responsibility, accountability, and authority.

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

Correct Answer: 3

Rationale 1: A staff that is comprised of many competent nurses enables the nurse manager to delegate and still have other nurses to rely on to deliver quality nursing care.

Rationale 2: Democratic leadership styles facilitate delegation and provide good role models.

Rationale 3: Resources such as qualified nurses, finances, and educational resources may be limited, which are obstacles to delegation.

Rationale 4: Environmental factors such as a norm of crisis management as a result of poor job descriptions and unclear chains of command are unsupportive to delegation.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-4: Identify obstacles that can impede effective delegation.

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.

Correct Answer: 4

Rationale 1: It is the responsibility of the supervisor to develop the staff. Failing to delegate is the time waster.

Rationale 2: An effective managers role is to develop staff in such roles as delegate.

Rationale 3: The fact that the nurse supervisor could do the job faster does not help to facilitate staff development.

Rationale 4: Even though it may appear that these statements are straightforward and that the supervisor is just trying to save time, statements such as this often suggest a lack of trust and confidence in the abilities of the staff.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-4: Identify obstacles that can impede effective delegation.

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.

Correct Answer: 3

Rationale 1: The delegate has the option to negotiate for those aspects of a task the individual feels can be accomplished.

Rationale 2: The delegator may have no intention of mentoring the delegate.

Rationale 3: It is important for the delegate to make sure the time line and expectations are clearly defined, and he or she may opt to outline the specifications in writing.

Rationale 4: Accepting delegation means accepting full responsibility for the outcomes and the benefits or liabilities associated with a task.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-2: Describe how effective delegation benefits the delegator, the delegate, the unit, and the organization.

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

Correct Answer: 1

Rationale 1: This assignment reflects duties listed in the nurses job description so asking the nurse to attend a meeting is work assignment.

Rationale 2: Overdelegation occurs when the delegator loses control over a situation by giving too much authority to the delegate.

Rationale 3: Ineffective delegation occurs when authority and responsibility are given but the steps of effective delegation are not followed.

Rationale 4: Assignments are a bureaucratic function and no transfer of authority occurs.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-1: Describe how delegation involves responsibility, accountability, and authority.

Question 11

Type: MCMA

Which statements would be important for the charge nurse to make when delegating a responsibility?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. I think it would be important to our organization if you represent the unit on the policy and procedure committee.

2. I have assigned you to be the units representative because I dont have enough time to go.

3. I think your attendance at the task force meeting will be a good reflection on our unit.

4. I chose you to attend the meeting because it seems as though you have the lightest assignment.

5. I would like you to be the units representative on the client education task force committee.

Correct Answer: 1,3

Rationale 1: Key behaviors in delegating tasks are describing the task and providing the delegate with the benefit gained for the task.

Rationale 2: Delegating should be done for the right reasons and not to dump tasks for purely personal reasons.

Rationale 3: Key behaviors in delegating tasks are describing the task as well as the benefits to be gained.

Rationale 4: The delegate should be assigned because the task meets the delegates abilities.

Rationale 5: The delegator should make the delegate aware of the reason for and the benefits gained from the delegation.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-3: Discuss how to be an effective delegator.

Question 12

Type: MCMA

In order to delegate, which must be present?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Accountability for the assignment on the part of the delegate

2. Accountability for the assignment on the part of the delegator

3. Authority by the delegator to assign the task to the delegate

4. Responsibility for task completion on the part of the delegator

5. Authority of the delegate to accomplish the task as assigned

Correct Answer: 1,2,3,5

Rationale 1: The delegator and delegate share accountability to accomplish the task.

Rationale 2: The delegator and delegate share accountability to accomplish the task.

Rationale 3: The delegator must have the authority to assign the task.

Rationale 4: The delegate takes on the responsibility for completion of the task.

Rationale 5: Effective delegation transfers authority to the delegate to empower the delegate for success.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 10-1: Describe how delegation involves responsibility, accountability, and authority.

Question 13

Type: MCSA

Which is the most important reason that practicing and mastering effective delegation skills is essential for nurses?

1. Higher job satisfaction

2. Greater confidence in skills

3. Higher client satisfaction

4. Increased time for other tasks

Correct Answer: 3

Rationale 1: Higher job satisfaction occurs when delegation skills are improved, but this is not the most important outcome.

Rationale 2: Effective delegation may result in greater confidence in skills, but this is not the most important outcome.

Rationale 3: When effective delegation takes place in an organization, everyone benefits. This leads to higher client satisfaction, which is the ultimate goal of nursing care and nursing management.

Rationale 4: If delegation skills improve, the delegator should have increased time for other endeavors. This is not the most important outcome of increasing delegation skills.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-2: Describe how effective delegation benefits the delegator, the delegate, the unit, and the organization.

Question 14

Type: MCSA

The nurse has attended a how to refresher course on successful delegation. Which statement indicates successful learning has taken place?

1. I knew that effective delegation made my job easier, but I never thought about how it could benefit the hospital.

2. The clients on our unit come and go so frequently that delegation is of little benefit.

3. I just dont understand why people think delegation is difficult; all you have to do is tell other people what to do.

4. Now I know that effective delegation means telling my nursing staff when they need to have their regular work done.

Correct Answer: 1

Rationale 1: Delegation can benefit every level of the organization.

Rationale 2: Delegation can be successfully used in any unit.

Rationale 3: Delegation does not consist of just telling other people what to do.

Rationale 4: The regular work of the staff is done by assignment, not delegation. Delegation is more than just telling staff when to have work done.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 10-2: Describe how effective delegation benefits the delegator, the delegate, the unit, and the organization.

Question 15

Type: MCSA

A nurse asks an unlicensed assistant to help with discharging clients since so many are going home at one time. The nurse states, Can you help get these clients ready to go home by helping them pack? Which option best describes the statement with regard to effective delegation?

1. The delegation is ineffective since the nurse has no responsibility to pack the clients belongings.

2. Delegation would have been more effective had the nurse been more specific about which clients and when it should be completed.

3. The delegation is ineffective because the nurse has no authority to ask the unlicensed assistant to help with client discharge.

4. Delegation could have more effective had the nurse gone with the assistant to ensure the assistant did the packing as requested.

Correct Answer: 2

Rationale 1: The nurse has ultimate responsibility to ensure that the client is ready for discharge, which includes packing the clients belongings as necessary.

Rationale 2: Effective delegation occurs when the delegator gives specific information to the delegate about the requested task. The nurse request in the stem was not specific enough.

Rationale 3: The nurse has the authority to delegate this task to the unlicensed assistant.

Rationale 4: There is no need for the nurse to go with the assistant to oversee the packing process.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-3: Discuss how to be an effective delegator.

Question 16

Type: MCMA

The nursing supervisor is assessing a unit that has received several written complaints. The nurse manager seems overwhelmed and stressed trying to address many client situations. The charge nurse is trying to help everyone at once. Based on this assessment, what might this supervisor conclude?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The nurse manager is inexperienced and needs time to adjust.

2. The unit culture may foster distrust and poor communication among staff.

3. Client complaints are usually an indicator of a larger unit problem.

4. Nurses on the unit are in need of additional training and skills.

5. The unit is short staffed.

Correct Answer: 2,3,4

Rationale 1: There is nothing in this scenario to suggest that the nurse manager is inexperienced.

Rationale 2: The unit clearly is having problems getting client responsibilities completed in a timely manner, resulting in stress and complaints. Reasons behind this might include distrust, poor communication, and a lack of delegation training.

Rationale 3: When multiple client complaints are lodged against one unit, there is generally an overall problem with some aspect of the unit.

Rationale 4: A lack of delegation training may result in chaos and client complaints.

Rationale 5: There is no indication that the unit is short staffed.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 10-4: Identify obstacles that can impede effective delegation.

Question 17

Type: MCSA

Which statement represents a situation is which delegation is ineffective or inappropriate?

1. The RN asks the LPN to assist with admissions by assessing the clients as they get to their rooms.

2. The RN delegates administration of oral medications for a group of clients to the LPN.

3. The LPN directs the unlicensed assistant to report vital sign changes on a post-operative client to the RN.

4. The nurse manager asks the RN to act as chairperson for todays unit council meeting since the charge nurse went home sick.

Correct Answer: 1

Rationale 1: The RN is the only caregiver legally responsible for assessing clients. Thus, the RN cannot delegate this to the LPN, and this is an example of overdelegation.

Rationale 2: It is within the LPNs scope of practice to administer oral medications.

Rationale 3: The LPN can delegate tasks to the unlicensed assistant. Reporting vital sign changes to the RN is within the scope of an unlicensed assistant.

Rationale 4: The nurse manager can delegate to the RN. An RN is a logical substitute for the charge nurse in this situation.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-4: Identify obstacles that can impede effective delegation.

Question 18

Type: MCSA

For the nurse to effectively and legally delegate, which document must be consulted and followed to reduce the likelihood of liability?

1. The American Nurses Association Bylaws

2. The National Council of State Boards of Nursing

3. The regulations of the state nurse practice acts

4. The rules of the governing specialty organization

Correct Answer: 3

Rationale 1: The ANA Bylaws do not set out legal rules or regulations for delegation.

Rationale 2: NCSBN does not set the legal rules and regulations of delegation.

Rationale 3: Nurses in each state are governed by their own states nurse practice act, and these regulations must be consulted and followed.

Rationale 4: Specialty organizations do not set the legal rules and regulations of delegation.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 10-5: Explain how liability affects delegation.

Question 19

Type: MCSA

Which situation indicates the nurse needs additional training on effective delegation?

1. The charge nurse tells the unlicensed assistant to help prepare rooms for new clients.

2. The office nurse calls in orders for admission on a client following a surgical complication.

3. A rehabilitation nurse asks a physical therapy assistant to assist a client with ambulation around the facility.

4. A home health nurse calls the office and asks another nurse to make the visit on her next client.

Correct Answer: 2

Rationale 1: The charge nurse can delegate the responsibility of preparing rooms to the unlicensed assistant.

Rationale 2: Unless the office nurse is an advanced practice nurse, the office nurse cannot call in orders not signed off by a physician or nurse practitioner. This opens the organization up to problems with liability.

Rationale 3: The physical therapy assistant is part of the rehabilitation nurses team and can legally accept direction from that nurse.

Rationale 4: A home health nurse might be delayed at a visit and need another nurse to visit the next client. It would be inappropriate for the nurse to ask an unlicensed assistant to make the visit.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 10-5: Explain how liability affects delegation.

Question 20

Type: MCMA

Which situations would cause concern about liability with regard to delegation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The nurse asks the LPN to change a central line dressing.

2. The nursing supervisor asks the nurse for details about a clients history.

3. The nursing assistant asks a nurse to check the status of a client on the team.

4. The supervisor asks the charge nurse to give a nurse a difficult assignment.

5. The charge nurse asks a staff nurses opinion on the clients surgical incision.

Correct Answer: 1,2,4

Rationale 1: The LPN cannot usually work with central lines and cannot legally change the dressing for the RN.

Rationale 2: Confidential information cannot be shared with individuals not directly involved in the clients care. Under normal circumstances, the nursing supervisor would not need information about a clients history.

Rationale 3: It is acceptable for a nursing assistant to ask the nurse to check on a client.

Rationale 4: Requesting that a nurse be given a difficult assignment is leaving the organization open to liability issues.

Rationale 5: It is common and acceptable for nurses to ask other nurses for consultation on client care.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-5: Explain how liability affects delegation.

Question 21

Type: MCSA

A staff nurse asks the nurse manager, What assignment are you delegating to me today? I would like to begin to organize my day before shift report begins. What is the error inherent in this statement?

1. There is no way for the nurse to know how to organize until the assignment is clear.

2. The nurse manager would not make assignments.

3. The nurse manager is not delegating but rather making daily assignments.

4. Assignment occurs after shift report.

Correct Answer: 3

Rationale 1: Organization takes many forms and is different for every nurse. Some nurses may use the time prior to shift report to organize.

Rationale 2: Depending on the structure of the unit, assignments may be made by the charge nurse or the nurse manager.

Rationale 3: Assignment is a bureaucratic function that reflects job descriptions and client or organizational needs. Daily work allotment from nurse manager to staff nurse is an assignment, not delegation.

Rationale 4: Team assignments occur prior to shift report. In some institutions all nurses working on the unit listen to shift report on all clients. In other institutions the nurse receives report only on the assigned team.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 10-1: Describe how delegation involves responsibility, accountability, and authority.

Question 22

Type: MCMA

A health care organization has provided intensive education to staff regarding benefits and correct methods of delegation. Why has the organization spent the time and money to sponsor these sessions?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Good delegation helps to reduce overtime.

2. Absences decrease when delegation is used correctly.

3. Delegation is required by state boards of nursing.

4. Patient satisfaction scores increase when care is efficient and effective.

5. Good delegation increases productivity.

Correct Answer: 1,2,4,5

Rationale 1: When delegation is appropriate, work gets done in a timely manner and overtime decreases.

Rationale 2: Delegation helps get work done efficiently and effectively. Absences tend to decrease in this environment.

Rationale 3: Delegation is permitted by state boards of nursing, but it is not required.

Rationale 4: Delegation results in care that is efficient and effective. Efficient and effective care results in increased patient satisfaction.

Rationale 5: Delegation results in each part of the team working at their designated skill level. Nurses are not doing tasks that could be done by assistants. This results in increased productivity.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 10-2: Describe how effective delegation benefits the delegator, the delegate, the unit, and the organization.

Question 23

Type: MCMA

During the first staff meeting, a newly promoted nurse manager says, I would like a commitment from all the nurses to review and improve the way delegation is done on the unit. Why would the manager be interested in delegation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Effective delegation allows the manager to focus more time on management tasks.

2. Efficiency is increased by effective delegation.

3. If the manager has more time to focus on managerial duties, there is more chance of career advancement.

4. The nurse manager thinks unlicensed assistive personnel (UAPs) provide better bedside care than nurses.

5. The manager is interested in developing the entire staff to its maximum potential.

Correct Answer: 1,2,3,5

Rationale 1: The manager may be able to delegate some tasks to nurses if the nurses are not overloaded with client care that could be completed by unlicensed assistive personnel (UAPs).

Rationale 2: If delegation is done effectively, unit efficiency is increased.

Rationale 3: If the manager can get more done because delegation is effective there is a greater chance for career advancement.

Rationale 4: There is no evidence that this is the case.

Rationale 5: Development is stifled when the staff members are doing the wrong tasks.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-2: Describe how effective delegation benefits the delegator, the delegate, the unit, and the organization.

Question 24

Type: MCSA

A newly licensed nurse is concerned about the legal aspects of delegation. What is the most important question for the nurse to consider prior to delegating a task?

1. Do other nurses in the facility delegate similar tasks?

2. How long has the assistant worked at the facility?

3. Does this task involve nursing judgment?

4. How busy is the delegate?

Correct Answer: 3

Rationale 1: Whether or not other nurses delegate similar tasks is not as important as another question.

Rationale 2: Experience is important, but is not the most important question.

Rationale 3: The nurse should not delegate tasks that involve nursing assessment or judgment.

Rationale 4: The nurse should consider if the delegate has sufficient time to complete the task, but this is not the most important consideration.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 10-3: Discuss how to be an effective delegator.

Question 25

Type: MCSA

The nursing supervisor would like to delegate an information-gathering task. All the people listed have the ability to perform the task. In general, whom should the supervisor ask to do this work?

1. A nurse manager

2. A staff nurse

3. A licensed practical nurse

4. An unlicensed nursing assistant

Correct Answer: 4

Rationale 1: The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.

Rationale 2: The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.

Rationale 3: The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.

Rationale 4: The rule of thumb is to ask the lowest person in the hierarchy who has the requisite capabilities.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 10-3: Discuss how to be an effective delegator.

Question 26

Type: MCMA

Which situations are examples of the nurse directing rather than delegating?

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 manager asks a staff nurse to participate in a standing hospital committee.

2. A staff nurse asks the assistant to sit with the roommate of a client who has just died.

3. During a code blue situation, a nurse tells another nurse to start an IV.

4. A nurse tells an assistant to move a client into the hallway during severe weather.

5. A nurse reminds assistants of standard protocol for evacuation in case of fire.

Correct Answer: 2,3,4

Rationale 1: This is delegation.

Rationale 2: This situation is a crisis, so this is direction.

Rationale 3: This is a crisis situation, so this is direction.

Rationale 4: This is a crisis situation, so this is direction.

Rationale 5: Because this crisis is not occurring, this is delegation.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-3: Discuss how to be an effective delegator.

Question 27

Type: MCMA

A nurse manager is delegating a new, complex task to the unit secretary. Which strategies should the manager use?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Begin the instruction with a statement such as It would be good if you could help me with this project.

2. Make eye contact with the secretary when explaining the task.

3. Talk to the secretary in person rather than by telephone or in e-mail.

4. Introduce the generalities of the task with a promise that details such as a time line will follow shortly.

5. Discuss the importance of the task to the organization.

Correct Answer: 2,3,5

Rationale 1: The manager should use a more direct I statement such as, I need for you to take the lead on this project.

Rationale 2: Eye contact helps to ensure that the secretary is attending to the information presented.

Rationale 3: Face-to-face communication will be necessary for explanation and questions.

Rationale 4: It is important to have all the critical information available so that the delegate can make a logical decision about the task.

Rationale 5: It is important to let the delegate know the importance of the task.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-3: Discuss how to be an effective delegator.

Question 28

Type: MCMA

The nurse supervisor would like to delegate accreditation preparation activities to the nurse manager. The manager is unsure of what is expected and has no experience with accreditation. How should the manager respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Ill be glad to work on this task.

2. I will need some education on the accreditation process before I can accept this task.

3. I dont have time to add that to my work.

4. Please tell me more about what this assignment entails.

5. Im not interested in working on this project.

Correct Answer: 2,4

Rationale 1: The manager should not accept a task until it is clear.

Rationale 2: The manager should be clear about not having the required skill set, but should indicate willingness to take the job if education is provided.

Rationale 3: The problem is that the manager is not confident of his or her skills, not that time is not available.

Rationale 4: The manager should clarify the task before accepting or refusing it.

Rationale 5: Working on accreditation would help this nurse manager in career advancement.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-4: Identify obstacles that impede effective delegation.

Question 29

Type: MCSA

A nurse says, I am always worried that I will be liable if someone I delegate a task to does something that hurts the client. What is the managers best response to this concern?

1. You have lots of liability in your position as an RN.

2. The hospital will support you as long as you follow your job description.

3. You are at greater liability if you try to do everything yourself.

4. As long as you follow the five rights of delegation, your liability is minimal.

Correct Answer: 4

Rationale 1: The RN does have liability associated with job responsibilities, but if delegation is done correctly, liability is minimized. This response is not supportive of the RNs need to delegate.

Rationale 2: Hospital support is never a given when liability situations occur. This is not a response that would be supportive of the nurses need to delegate.

Rationale 3: This is not necessarily an accurate statement.

Rationale 4: The five rights of delegation outline accepted measures to take when delegating tasks. If these rights are followed, the nurse has fulfilled job responsibilities. The delegate is responsible for his or her own care.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 10-5: Explain how liability affects delegation.

Question 30

Type: MCMA

Which situations are examples of ineffective delegation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. After delegating committee attendance to a staff nurse, the nurse manager also attends the meetings.

2. The unit clerk asks the nurse manager to listen for the phones so the clerk can go to the hospitals celebration of hospital week.

3. The nurse manager asks the staff nurse to collect information about a new type of hospital bed being considered for purchase.

4. The staff nurse asks the UAP to provide simple discharge instructions to a client.

5. The staff nurse often bathes clients because I like to give bed baths.

Correct Answer: 1,2,4,5

Rationale 1: The purpose of delegating attendance to a staff nurse is so the manager will not need to attend the meeting. When the manager does attend, the staff nurses position is diminished. This is an example of underdelegation.

Rationale 2: When someone of lower rank, in this case the unit clerk, delegates a task to someone of higher rank, in this case the nurse manager, a situation of reverse delegation has occurred. This is ineffective delegation.

Rationale 3: The nurse manager has asked someone of lower rank to complete a task that is within that persons capabilities. This is effective delegation.

Rationale 4: Provision of education requires nursing knowledge and judgment and cannot be delegated to a UAP. This is an example of overdelegation.

Rationale 5: Bathing clients can be delegated to staff of lower rank. If the nurse is giving the bath for assessment purposes, this lack of delegation would be appropriate. If the nurse is not delegating baths because I like to give bed baths, the lack of delegation is inappropriate.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 10-4: Identify obstacles that impede effective delegation.

Sullivan, Effective Leadership and Management, 8/e Test Bank

Copyright 2013 by Pearson Education, Inc.

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