Chapter 12- Initiating the Leadership and Management Role My Nursing Test Banks

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Information Field: Client Needs

Information Field: Cognitive Level

Information Field: Difficulty

Information Field: Integrated Process

Information Field: Objective

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Highest Answer Letter: E

Multiple Keywords in Same Paragraph: No

Chapter: Chapter 12: Initiating the Leadership and Management Role

Multiple Choice

1. Which of the following statements accurately reflects the nurses responsibility for patient outcomes in todays workplace?

A) Tasks can be delegated, but accountability cannot be delegated.

B) In todays environment, authority is more often given to management.

C) Most nurses who are accountable have the authority to affect the situation or effect change.

D) Nurses are protected against legal action being taken in cases of malpractice in the hospital setting.

Ans: A

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Nursing Process

Objective: 1, 2

Page and Header: 428, Differentiating Between Accountability and Authority

Feedback: Tasks can be delegated, but accountability cannot; nurses who delegate tasks to assistive personnel continue to be accountable for that care. Many nurses experience frustration because they must be accountable for activities without the authority to affect the situation or create change. Authority is often shared in contemporary care settings. Nurses are legally responsible for the care they provide and are vulnerable to malpractice suits.

2. Which of the following statements accurately describes a basic guideline for using communication skillfully?

A) Managers should communicate how to perform a task even if it is something the subordinate has already learned.

B) Managers should not be afraid of making judgmental statements when dealing with a subordinate who has broken policy rules.

C) Managers should attempt to formulate a response to an individual who is still speaking to avoid awkward pauses in the conversation.

D) Managers should present direction as briefly as possible while still providing adequate data.

Ans: D

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 9

Page and Header: 445, Using Communication Skills in the Leadership Role

Feedback: Effective managers state the necessary information as briefly as possible while still providing enough data to be clear. Interruptions, judgmental statements, and repeated explanations are characteristics of ineffective communication.

3. What is the primary objective of a performance appraisal?

A) Establish written documentation of incompetent behavior to facilitate dismissal

B) Maintain and develop employee performance

C) Establish criteria for accreditation standards

D) Determine who receives pay raises

Ans: B

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Easy

Integrated Process: Communication and Documentation

Objective: 11

Page and Header: 447, Performance Appraisal

Feedback: The primary objectives of performance appraisal are to maintain or improve employee performance and to enhance the development of employees. They are not intended to be punitive measures or criteria for accreditation. Performance appraisals may have an influence on a nurses pay but this is not their primary objective.

4. Which of the following is a characteristic of an effective performance evaluation system?

A) The appraisal system operates outside of the scope of administration.

B) Employees do not know in advance who will be evaluating them.

C) The final disposition of the appraisal is shared with the employee.

D) Evaluation concentrates on the personality of the employee.

Ans: C

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 11

Page and Header: 448, Display 12.4

Feedback: A sound performance appraisal is shared with the employee who is the subject of the appraisal. The appraisal system should be strongly supported by administration and employees should be made aware of who will appraise them. An employees personality should not be the focus for appraisal.

5. A nursing student finds that she has difficulty with procrastination. Which of the following is a recommended guideline to help this student manage her time?

A) Start working on a project for 10 minutes, and quit if tired or bored.

B) Schedule 2 or 3 days a week in which to concentrate her tasks.

C) Avoid spending the time it takes to make to-do lists.

D) Schedule down-time first and work second.

Ans: A

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 12

Page and Header: 455, Dealing with Procrastination and Time Wasters

Feedback: Kanarek (1996) provides five suggestions for dealing with procrastination. First, she suggests that you start working on a project for 10 minutes and quit if tired or bored. Work times should be prioritized carefully and spread out over time. The creation of lists is a useful tool.

6. A nursing leader has expressed a desire to foster the characteristics and behaviors associated with transformational leadership. Which of the following actions best demonstrates transformational leadership?

A) The leader makes it clear to employees that positive work performance will be rewarded and that sub-standard performance will bring consequences.

B) The leader ensures that decisions are based on the consensus of every employee.

C) The leader prioritizes the needs of each individual employee over the interests of the larger organization.

D) The leader takes action to build trust and relationships between him or her and the employees.

Ans: D

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 3

Page and Header: 430, Table 12.1

Feedback: Leader activities associated with transformational leadership include creating a vision, building relationships, developing trust, and building self-esteem. An emphasis on rewards and punishment is associated with transactional leadership. Consensus is not appropriate for every decision, and the interests of individual employees cannot always supersede the interests of the organization.

7. The manager of a hospital unit has unilaterally decided on a change in the way that overtime is distributed among the nursing staff and has followed up this decision with an e-mail to all employees. What leadership style is exemplified by this manager?

A) Participative leadership

B) Permissive leadership

C) Laissez-faire leadership

D) Autocratic leadership

Ans: D

Client Needs: C

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 4

Page and Header: 431, Leadership/Management Styles

Feedback: In autocratic or authoritarian leadership, the leader/manager makes the majority of the decisions without direct consultation with employees. Laissez-faire or permissive leadership occurs when little or no direction or guidance is provided. Participative leadership involves extensive input from employees.

8. Experts have identified a close relationship between the practice of transformational leadership and the empowerment of employees. What action should a nursing leader take to foster employee empowerment?

A) Have the performance of each employee appraised by his or her peers rather than by a manager or leader.

B) Share information as openly as possible in order to make employees aware of problems.

C) Adopt a hands-off approach in order to allow leadership to organically emerge from within the group of employees.

D) Eliminate the practice of conducting performance appraisals of employees.

Ans: B

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 5, 6

Page and Header: 436, Empowerment

Feedback: Transformational leaders foster empowerment by openly sharing information with workers so that everyone is aware of problems and the need for action. Performance appraisals are not necessarily contrary to the philosophy or practice of transformational leadership, and these should not be conducted by an employees peers. Transformational leadership is characterized by constructive engagement, not a hands-off approach.

9. Jennifer is a registered nurse who works in a busy emergency department. As one of her goals for the current year, Jennifer has resolved to develop her emotional intelligence. How should Jennifer best meet her goal?

A) Try to remove emotion from her clinical decision-making whenever possible.

B) Become more assertive when responding to the emotional responses of patients, families, and coworkers.

C) Become more aware of the way that her emotions function and how they influence her actions.

D) Try to limit her expressions of emotion to times when she is not interacting with others.

Ans: C

Client Needs: C

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 7

Page and Header: 439, Enhancing Your Emotional Intelligence

Feedback: Self-awareness is one of the central aspects of emotional intelligence. Emotional intelligence does not necessarily involve removing emotion from decision-making or removing emotion from interpersonal interactions. Awareness of others emotions is a dimension of emotional intelligence, but the appropriate response to this is not normally increased assertiveness.

10. A recent nursing graduate has asked an expert nurse how best to foster her leadership abilities, since she wishes to explore leadership opportunities later in her career. How should the expert nurse best respond?

A) Even if you dont trust a decision that you have to make, act like you chose the best option.

B) Become as specialized as possible in your nursing experience.

C) Develop your interpersonal skills by having a wide variety of interactions.

D) Become as assertive as you can and take every opportunity to guide the behavior of others.

Ans: C

Client Needs: C

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 8

Page and Header: 443, Developing Your Leadership Style

Feedback: The development of sophisticated interpersonal skills is important to building leadership abilities. Effective leadership does not depend on feigned confidence, though self-confidence is a trait that can be fostered. In most cases, variety and depth of experience are superior to narrow specialization. Effective leadership is more nuanced and complex than simply directing the behavior of others or demonstrating assertiveness.

11. A nurse has responded to a patients call light for the fourth time in the past hour only to be berated by the patient for taking so long to come to the bedside. Rather than responding in a confrontational tone the nurse has paused to think of the best response to the patients statements. In doing so, the nurse has exhibited

A) self-regulation.

B) sympathy.

C) manipulation.

D) self-strategy.

Ans: A

Client Needs: C

Cognitive Level: Analysis

Difficulty: Easy

Integrated Process: Communication and Documentation

Objective: 7

Page and Header: 440, Self-Regulation

Feedback: Self-regulation refers to the ability to control inappropriate impulses and to think before acting or speaking. Research on mindfulness training indicates it is a positive strategy for managing emotionally charged situations. The nurse has not acted in a manipulative way. Sympathy involves feeling sorrow for another persons pain, a dynamic that is not evident in this interaction.

12. A patient is receiving a transfusion of packed red blood cells and consequently requires frequent vital signs. A set of vital signs was just due during the nurses scheduled lunch break and so a colleague took the patients vital signs. After returning from lunch, the nurse confirmed with the colleague that the scheduled vital signs were taken, to which the colleague replied, Yes, it seems like Im covering you a whole lot lately. How should the nurse best respond to the colleagues statement?

A) I dont think thats a fair thing to say because I cant help when a set of vitals are due.

B) If youre implying that I dont pull my weight I think that youre badly mistaken.

C) Well, what goes around comes around, right?

D) Could you explain what you mean by that?

Ans: D

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 10

Page and Header: 444, Communicating Effectively

Feedback: An important principle of communication is to ensure that meanings are clearly understood by both parties. This is especially true in the case of a statement that may be accusatory. Responding confrontationally or sarcastically is rarely appropriate.

13. The nurse manager of a busy medical unit prioritizes effective communication with the employees of the unit. In recent years, an increasing amount of this communication has involved e-mails and text messages. When using these communication media, the nurse should

A) take action to ensure that patient confidentiality is maintained.

B) cc upper management and human resources with all e-mails.

C) avoid using a smartphone on the unit whenever possible.

D) follow up e-mails with a paper copy of important messages.

Ans: A

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 10

Page and Header: 444, Communicating Effectively

Feedback: Patient privacy can be difficult to ensure when communicating electronically. As a result, nurse leaders must take measures to protect confidentiality. Electronic messages do not always need be followed up with paper copies and it is unnecessary to cc superiors on all communications. Smartphones are an effective communication tool, provided they are used in an appropriate manner.

14. It has been a frantic morning on the hospital unit and the nurse is unsure whether she will be able to complete her required tasks on time before her scheduled lunch break. Which of the following is the nurses most appropriate response to this problem?

A) Skip lunch or trade her lunch break with a colleague who is scheduled for a later break.

B) Determine if more of her tasks could be delegated to another member of the care team.

C) Ask the unit manager for advice.

D) Explain to a colleague that she will likely be unable to complete her required work.

Ans: B

Client Needs: A-1

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 12

Page and Header: 454, Principles of Time Management

Feedback: Delegation is an appropriate and useful strategy for effective time management. This would be a preferred approach over changing the lunch schedule. The nurse should attempt to delegate before approaching her manager for a solution or resigning herself to the fact that she will not complete her work.

Multiple Selection

15. All performance evaluations, whether formal or informal, should be based on appropriate standards of performance. In the context of a performance appraisal, which of the following are appropriate performance criteria? (Select all that apply.)

A) The managers experience base

B) The nurses written job description

C) The institutions policies and procedures

D) Nursing standards of practice

E) The nurses career goals

Ans: B, C, D

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 11

Page and Header: 448, Criteria for Evaluation

Feedback: Standards of performance include job descriptions, policies and procedures, and professional standards of practice. A leaders personal experience base and the nurses goals may be relevant but neither is an objective measure for appraising the nurses performance.

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