FUNCTIONS IN NURSING
THEORY AND APPLICATION
11TH EDITION
• AUTHOR(S)CAROL J. HUSTON
TEST BANK
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: A nurse manager must decide whether to implement a
new bedside handoff process after several near-miss
communication errors. The manager has conflicting staff
opinions and incomplete incident data. Which first step best
reflects a sound decision-making process?
A. Announce the change immediately to standardize practice.
B. Define clear objectives for the handoff process and gather
more data.
,C. Ask the most senior nurse to choose the process.
D. Pilot a different process on another unit without staff input.
Correct Answer: B
Rationale — Correct (B): Defining objectives and gathering data
aligns with critical elements of decision making: clarifying goals
and using evidence before action. This reduces premature
implementation risk and focuses evaluation metrics. Huston
emphasizes data-driven objectives as foundational.
Rationale — Incorrect:
• A: Implements change without data or staff buy-in, risking
resistance and unintended harm.
• C: Defers to hierarchy rather than systematic analysis; may
bias outcome.
• D: Piloting elsewhere without input avoids addressing local
context and staff engagement.
Teaching Point: Define objectives and collect data before
choosing actions.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
2
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: During a staffing shortage, a charge nurse must reassign
tasks to maintain patient safety. Which decision-making model
,best supports using both evidence and frontline input to create
a short-term staffing plan?
A. Rational decision-making model only.
B. Administrative (bounded rationality) decision-making model.
C. Intuitive decision-making model based solely on experience.
D. Random assignment by seniority.
Correct Answer: B
Rationale — Correct (B): The administrative model
acknowledges constraints (time, resources) and uses satisficing
— selecting a good-enough solution with available information
and stakeholder input. It balances practicality and evidence in
real-world limitations.
Rationale — Incorrect:
• A: Rational model assumes unlimited information and
time—unrealistic during shortages.
• C: Intuition alone risks bias without evidence or team
input.
• D: Seniority-based randomization ignores patient needs
and evidence-based priorities.
Teaching Point: Use bounded-rationality models when
constraints limit perfect decisions.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
3
, Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: A unit’s fall rates have increased. The nurse manager
convenes a team to analyze causes. Which decision-making tool
will best help the team map possible causes and choose
interventions?
A. Decision grid.
B. Payoff table.
C. Fishbone (cause-and-effect) logic model.
D. Randomized trial design.
Correct Answer: C
Rationale — Correct (C): A cause-and-effect (logic) model helps
teams systematically identify multiple contributing factors
(environmental, staffing, patient factors) and organize
interventions tied to causes—ideal for quality issues like falls.
Rationale — Incorrect:
• A: Decision grids compare alternatives but don’t map root
causes.
• B: Payoff tables focus on outcomes and probabilities, not
causal mapping.
• D: Randomized trials are impractical at unit level for rapid
quality improvement.
Teaching Point: Use logic models for root-cause analysis
and linked interventions.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.