, Test Bank For Yoder-Wise's Leading And Managing
In Canadian Nursing, 2nd Edition, Patricia S.
Yoder's-Wise, Janice Waddell, Nancy Walton
1. A nurse manager aims to increase staff engagement in a quality improvement initiative.
Which leadership approach would be most effective for fostering intrinsic motivation and
commitment among the nursing team?
A. Transactional leadership, emphasizing contingent rewards for compliance
B. Transformational leadership, appealing to higher ideals and shared vision
C. Laissez-faire leadership, allowing complete autonomy in decision-making
D. Bureaucratic leadership, enforcing adherence to policies and procedures
Answer: B
Rationale: Transformational leadership inspires staff through a compelling vision and
intellectual stimulation, leading to higher engagement and intrinsic motivation. Transactional
leadership may produce compliance but not deep commitment. Laissez-faire offers too little
guidance, and bureaucratic leadership stifles creativity.
2. A nursing unit is transitioning to a new electronic medication administration record
(eMAR). The change leader has established a sense of urgency, created a guiding coalition,
and developed a vision. According to Kotter's 8-step model, what is the next critical step?
A. Communicate the change vision
B. Empower broad-based action
C. Generate short-term wins
D. Anchor new approaches in the culture
Answer: A
Rationale: After developing a vision, the next step in Kotter's model is to communicate that vision
to all stakeholders to build understanding and buy-in. Empowering action comes later,
short-term wins follow, and anchoring occurs at the end.
3. Two nurses on a unit disagree about the best approach to pain management for a
postsurgical patient. One advocates for non-pharmacological methods, while the other
emphasizes opioid analgesia. Which conflict management strategy would best preserve
team relationships while achieving a comprehensive care plan?
A. Competing: The nurse manager mandates use of both methods
B. Accommodating: The non-opioid advocate defers to the other
C. Compromising: Each nurse gives up some of their preferred approach
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,D. Collaborating: The nurses jointly develop a multimodal plan integrating both views
Answer: D
Rationale: Collaboration seeks a win-win solution that integrates input from all parties, fostering
mutual respect and a comprehensive plan. Competing and accommodating are less effective for
relationships, and compromising may result in a suboptimal mixed approach.
4. A nurse is caring for a patient with decision-making capacity who refuses a life-saving
blood transfusion due to religious beliefs. The nurse respects the refusal but feels conflicted.
Which ethical principle most strongly supports the patient's decision?
A. Beneficence: doing good for the patient
B. Non-maleficence: avoiding harm
C. Autonomy: respecting the right to self-determination
D. Justice: fair allocation of resources
Answer: C
Rationale: Autonomy is the principle that respects a patient's right to make their own healthcare
decisions, even if those decisions conflict with medical advice. Beneficence and non-maleficence
would favor intervention, while justice is not directly relevant here.
5. A quality improvement team is analyzing a run chart of monthly catheter-associated
urinary tract infection (CAUTI) rates after implementing a new insertion protocol. Which
pattern would indicate that the intervention had a sustained effect?
A. A single data point below the median
B. Six consecutive points above the median
C. A long run of 8 consecutive points below the median
D. A trend alternating above and below the median
Answer: C
Rationale: In run chart analysis, a sustained shift of 8 or more consecutive points on one side of
the median indicates a non-random pattern, suggesting the intervention had a real and
continued impact. A single point or alternating pattern may be random variation.
6. An interprofessional team is struggling with communication breakdowns during patient
rounds. Which strategy is most likely to improve team function and patient outcomes?
A. Asking the most senior physician to lead all discussions
B. Implementing a structured communication tool like SBAR
C. Reducing the number of team members to minimize conflict
D. Assigning one discipline to document all decisions
Answer: B
Rationale: SBAR (Situation, Background, Assessment, Recommendation) standardizes
communication, reducing information loss and enhancing clarity. Hierarchical leadership or
reducing team size may not address underlying communication issues, and single-discipline
documentation can create silos.
Page 2
, 7. A nurse is reviewing a dashboard of clinical indicators for the unit. The data shows that
the average pain score for post-surgical patients decreased from 5/10 to 3/10, but the
documentation compliance for pain assessments dropped from 95% to 80%. What is the
most appropriate interpretation?
A. The pain improvement is likely accurate despite documentation lapses
B. The drop in documentation may bias the pain score data, requiring investigation
C. Documentation compliance is irrelevant if patient outcomes improve
D. The dashboard should prioritize the pain score over documentation metrics
Answer: B
Rationale: Low documentation compliance can lead to selective reporting, where missing data
may skew the average pain score (e.g., undocumented high pain cases omitted). Both metrics
must be examined together to ensure data integrity. Ignoring documentation risks inaccurate
conclusions.
8. A root cause analysis (RCA) is conducted after a patient received a double dose of an
anticoagulant. The investigation reveals that two nurses independently administered the
same medication due to an unclear discontinuation order and a lack of a barcode scanning
system. Which of the following is the most effective system-level recommendation?
A. Provide additional education on medication administration policies
B. Discipline both nurses involved in the error
C. Implement independent double-check protocols for high-alert medications
D. Install a computerized provider order entry (CPOE) system with decision support
Answer: D
Rationale: System-level solutions, such as CPOE with decision support, prevent errors by
removing reliance on memory and vigilance. Education and discipline do not address latent
conditions like unclear orders. Double-checks can help but are less robust than a system that
prevents the error.
9. A new provincial policy mandates that all healthcare organizations adopt a standardized
patient safety framework aligned with the Canadian Patient Safety Institute's domains.
Which of the following best reflects the intent of such a policy?
A. To reduce provincial government accountability for adverse events
B. To shift responsibility for safety solely to front-line staff
C. To create consistent measurement and improvement strategies across institutions
D. To limit the role of professional colleges in safety oversight
Answer: C
Rationale: Standardized frameworks enable benchmarking and sharing of best practices,
promoting system-wide improvement. Accountability remains shared, and front-line staff are not
solely responsible. Professional colleges continue their role in standard-setting.
Page 3
In Canadian Nursing, 2nd Edition, Patricia S.
Yoder's-Wise, Janice Waddell, Nancy Walton
1. A nurse manager aims to increase staff engagement in a quality improvement initiative.
Which leadership approach would be most effective for fostering intrinsic motivation and
commitment among the nursing team?
A. Transactional leadership, emphasizing contingent rewards for compliance
B. Transformational leadership, appealing to higher ideals and shared vision
C. Laissez-faire leadership, allowing complete autonomy in decision-making
D. Bureaucratic leadership, enforcing adherence to policies and procedures
Answer: B
Rationale: Transformational leadership inspires staff through a compelling vision and
intellectual stimulation, leading to higher engagement and intrinsic motivation. Transactional
leadership may produce compliance but not deep commitment. Laissez-faire offers too little
guidance, and bureaucratic leadership stifles creativity.
2. A nursing unit is transitioning to a new electronic medication administration record
(eMAR). The change leader has established a sense of urgency, created a guiding coalition,
and developed a vision. According to Kotter's 8-step model, what is the next critical step?
A. Communicate the change vision
B. Empower broad-based action
C. Generate short-term wins
D. Anchor new approaches in the culture
Answer: A
Rationale: After developing a vision, the next step in Kotter's model is to communicate that vision
to all stakeholders to build understanding and buy-in. Empowering action comes later,
short-term wins follow, and anchoring occurs at the end.
3. Two nurses on a unit disagree about the best approach to pain management for a
postsurgical patient. One advocates for non-pharmacological methods, while the other
emphasizes opioid analgesia. Which conflict management strategy would best preserve
team relationships while achieving a comprehensive care plan?
A. Competing: The nurse manager mandates use of both methods
B. Accommodating: The non-opioid advocate defers to the other
C. Compromising: Each nurse gives up some of their preferred approach
Page 1
,D. Collaborating: The nurses jointly develop a multimodal plan integrating both views
Answer: D
Rationale: Collaboration seeks a win-win solution that integrates input from all parties, fostering
mutual respect and a comprehensive plan. Competing and accommodating are less effective for
relationships, and compromising may result in a suboptimal mixed approach.
4. A nurse is caring for a patient with decision-making capacity who refuses a life-saving
blood transfusion due to religious beliefs. The nurse respects the refusal but feels conflicted.
Which ethical principle most strongly supports the patient's decision?
A. Beneficence: doing good for the patient
B. Non-maleficence: avoiding harm
C. Autonomy: respecting the right to self-determination
D. Justice: fair allocation of resources
Answer: C
Rationale: Autonomy is the principle that respects a patient's right to make their own healthcare
decisions, even if those decisions conflict with medical advice. Beneficence and non-maleficence
would favor intervention, while justice is not directly relevant here.
5. A quality improvement team is analyzing a run chart of monthly catheter-associated
urinary tract infection (CAUTI) rates after implementing a new insertion protocol. Which
pattern would indicate that the intervention had a sustained effect?
A. A single data point below the median
B. Six consecutive points above the median
C. A long run of 8 consecutive points below the median
D. A trend alternating above and below the median
Answer: C
Rationale: In run chart analysis, a sustained shift of 8 or more consecutive points on one side of
the median indicates a non-random pattern, suggesting the intervention had a real and
continued impact. A single point or alternating pattern may be random variation.
6. An interprofessional team is struggling with communication breakdowns during patient
rounds. Which strategy is most likely to improve team function and patient outcomes?
A. Asking the most senior physician to lead all discussions
B. Implementing a structured communication tool like SBAR
C. Reducing the number of team members to minimize conflict
D. Assigning one discipline to document all decisions
Answer: B
Rationale: SBAR (Situation, Background, Assessment, Recommendation) standardizes
communication, reducing information loss and enhancing clarity. Hierarchical leadership or
reducing team size may not address underlying communication issues, and single-discipline
documentation can create silos.
Page 2
, 7. A nurse is reviewing a dashboard of clinical indicators for the unit. The data shows that
the average pain score for post-surgical patients decreased from 5/10 to 3/10, but the
documentation compliance for pain assessments dropped from 95% to 80%. What is the
most appropriate interpretation?
A. The pain improvement is likely accurate despite documentation lapses
B. The drop in documentation may bias the pain score data, requiring investigation
C. Documentation compliance is irrelevant if patient outcomes improve
D. The dashboard should prioritize the pain score over documentation metrics
Answer: B
Rationale: Low documentation compliance can lead to selective reporting, where missing data
may skew the average pain score (e.g., undocumented high pain cases omitted). Both metrics
must be examined together to ensure data integrity. Ignoring documentation risks inaccurate
conclusions.
8. A root cause analysis (RCA) is conducted after a patient received a double dose of an
anticoagulant. The investigation reveals that two nurses independently administered the
same medication due to an unclear discontinuation order and a lack of a barcode scanning
system. Which of the following is the most effective system-level recommendation?
A. Provide additional education on medication administration policies
B. Discipline both nurses involved in the error
C. Implement independent double-check protocols for high-alert medications
D. Install a computerized provider order entry (CPOE) system with decision support
Answer: D
Rationale: System-level solutions, such as CPOE with decision support, prevent errors by
removing reliance on memory and vigilance. Education and discipline do not address latent
conditions like unclear orders. Double-checks can help but are less robust than a system that
prevents the error.
9. A new provincial policy mandates that all healthcare organizations adopt a standardized
patient safety framework aligned with the Canadian Patient Safety Institute's domains.
Which of the following best reflects the intent of such a policy?
A. To reduce provincial government accountability for adverse events
B. To shift responsibility for safety solely to front-line staff
C. To create consistent measurement and improvement strategies across institutions
D. To limit the role of professional colleges in safety oversight
Answer: C
Rationale: Standardized frameworks enable benchmarking and sharing of best practices,
promoting system-wide improvement. Accountability remains shared, and front-line staff are not
solely responsible. Professional colleges continue their role in standard-setting.
Page 3
