LEADING AND MANAGING IN NURSING,
8TH EDITION CHAPTERS 1-25 VERIFIED
ANSWERS & DETAILED RATIONALES
(2025/2026)
Chapter 1: Leading, Managing, and Following
1. A nurse manager is known for empowering staff, encouraging shared governance, and focusing on a
collective vision. Which leadership style does this manager exemplify?
a) Autocratic
b) Transactional
c) Transformational
d) Laissez-faire
Correct Answer: c) Transformational
Rationale: Transformational leaders inspire staff to exceed expectations by focusing on a shared vision,
empowerment, and innovation. Autocratic leaders make unilateral decisions, transactional leaders focus
on rewards and punishments, and laissez-faire leaders provide minimal direction.
2. A new graduate nurse consistently seeks feedback from preceptors and adapts practice accordingly.
This behavior is characteristic of:
a) Managing
b) Following
c) Delegating
d) Directing
Correct Answer: b) Following
Rationale: Effective followership involves being accountable, actively participating, and seeking
feedback to improve performance. Managing involves resources and processes; delegating involves
assigning tasks; directing involves giving instructions.
,Chapter 2: Clinical Safety: The Core of Leading, Managing, and Following
3. A nurse identifies a near-miss medication error. According to a Just Culture framework, the
appropriate response is to:
a) Terminate the nurse immediately to ensure safety.
b) Focus on the systems that contributed to the error.
c) Report the nurse to the Board of Nursing.
d) Ignore the incident since no harm occurred.
Correct Answer: b) Focus on the systems that contributed to the error.
Rationale: Just Culture distinguishes between human error, at-risk behavior, and reckless behavior. It
focuses on system redesign rather than punitive measures for unintentional errors.
4. Which of the following is a primary characteristic of a High-Reliability Organization (HRO) in
healthcare?
a) Siloed communication between departments
b) Preoccupation with failure
c) Blame-oriented culture
d) Reluctance to standardize processes
Correct Answer: b) Preoccupation with failure
Rationale: HROs are characterized by five principles: preoccupation with failure, reluctance to simplify,
sensitivity to operations, commitment to resilience, and deference to expertise.
Chapter 3: Legal and Ethical Issues
5. A nurse is served with a summons for a malpractice lawsuit related to an incident that occurred 2.5
years ago. The statute of limitations in the state is 2 years. What is the most likely outcome?
a) The case will proceed to trial.
b) The case will likely be dismissed due to the statute of limitations.
c) The nurse will automatically lose their license.
d) The hospital will pay the settlement regardless.
Correct Answer: b) The case will likely be dismissed due to the statute of limitations.
Rationale: The statute of limitations sets a time limit for filing a lawsuit. If the time limit has expired, the
court typically dismisses the case unless a specific exception applies (e.g., foreign object left in patient).
6. A patient refuses a blood transfusion based on religious beliefs. The nurse understands that
respecting this refusal is adhering to the ethical principle of:
a) Beneficence
, b) Nonmaleficence
c) Autonomy
d) Justice
Correct Answer: c) Autonomy
Rationale: Autonomy respects the right of a patient to make their own healthcare decisions.
Beneficence is doing good, nonmaleficence is avoiding harm, and justice is fairness in distribution of
resources.
Chapter 4: Cultural Diversity and Inclusion in Health Care
7. To provide culturally competent care, the nurse should first:
a) Learn the language of every culture served.
b) Assess personal biases and cultural beliefs.
c) Treat every patient exactly the same.
d) Refer all minority patients to specialists.
Correct Answer: b) Assess personal biases and cultural beliefs.
Rationale: Cultural competence begins with self-awareness. Recognizing one’s own biases is essential
before attempting to understand the cultural context of others.
8. A nurse manager is implementing strategies to improve health equity on a unit. Which action is
most effective?
a) Hiring staff that all share the same cultural background to reduce conflict.
b) Collecting patient data on race, ethnicity, and language preference to identify disparities.
c) Assuming all patients have the same health literacy level.
d) Avoiding the use of interpreters to save time.
Correct Answer: b) Collecting patient data on race, ethnicity, and language preference to identify
disparities.
Rationale: Identifying disparities requires data collection. Using trained interpreters and understanding
diverse backgrounds are key to equity.
Chapter 5: Gaining Personal Insight: The Beginning of Being a Leader
9. A nurse manager uses the Myers-Briggs Type Indicator (MBTI) to understand the team. A staff
member who prefers "Judging" (J) over "Perceiving" (P) likely:
a) Prefers spontaneous actions and flexibility.
b) Likes structure, schedules, and decisiveness.
8TH EDITION CHAPTERS 1-25 VERIFIED
ANSWERS & DETAILED RATIONALES
(2025/2026)
Chapter 1: Leading, Managing, and Following
1. A nurse manager is known for empowering staff, encouraging shared governance, and focusing on a
collective vision. Which leadership style does this manager exemplify?
a) Autocratic
b) Transactional
c) Transformational
d) Laissez-faire
Correct Answer: c) Transformational
Rationale: Transformational leaders inspire staff to exceed expectations by focusing on a shared vision,
empowerment, and innovation. Autocratic leaders make unilateral decisions, transactional leaders focus
on rewards and punishments, and laissez-faire leaders provide minimal direction.
2. A new graduate nurse consistently seeks feedback from preceptors and adapts practice accordingly.
This behavior is characteristic of:
a) Managing
b) Following
c) Delegating
d) Directing
Correct Answer: b) Following
Rationale: Effective followership involves being accountable, actively participating, and seeking
feedback to improve performance. Managing involves resources and processes; delegating involves
assigning tasks; directing involves giving instructions.
,Chapter 2: Clinical Safety: The Core of Leading, Managing, and Following
3. A nurse identifies a near-miss medication error. According to a Just Culture framework, the
appropriate response is to:
a) Terminate the nurse immediately to ensure safety.
b) Focus on the systems that contributed to the error.
c) Report the nurse to the Board of Nursing.
d) Ignore the incident since no harm occurred.
Correct Answer: b) Focus on the systems that contributed to the error.
Rationale: Just Culture distinguishes between human error, at-risk behavior, and reckless behavior. It
focuses on system redesign rather than punitive measures for unintentional errors.
4. Which of the following is a primary characteristic of a High-Reliability Organization (HRO) in
healthcare?
a) Siloed communication between departments
b) Preoccupation with failure
c) Blame-oriented culture
d) Reluctance to standardize processes
Correct Answer: b) Preoccupation with failure
Rationale: HROs are characterized by five principles: preoccupation with failure, reluctance to simplify,
sensitivity to operations, commitment to resilience, and deference to expertise.
Chapter 3: Legal and Ethical Issues
5. A nurse is served with a summons for a malpractice lawsuit related to an incident that occurred 2.5
years ago. The statute of limitations in the state is 2 years. What is the most likely outcome?
a) The case will proceed to trial.
b) The case will likely be dismissed due to the statute of limitations.
c) The nurse will automatically lose their license.
d) The hospital will pay the settlement regardless.
Correct Answer: b) The case will likely be dismissed due to the statute of limitations.
Rationale: The statute of limitations sets a time limit for filing a lawsuit. If the time limit has expired, the
court typically dismisses the case unless a specific exception applies (e.g., foreign object left in patient).
6. A patient refuses a blood transfusion based on religious beliefs. The nurse understands that
respecting this refusal is adhering to the ethical principle of:
a) Beneficence
, b) Nonmaleficence
c) Autonomy
d) Justice
Correct Answer: c) Autonomy
Rationale: Autonomy respects the right of a patient to make their own healthcare decisions.
Beneficence is doing good, nonmaleficence is avoiding harm, and justice is fairness in distribution of
resources.
Chapter 4: Cultural Diversity and Inclusion in Health Care
7. To provide culturally competent care, the nurse should first:
a) Learn the language of every culture served.
b) Assess personal biases and cultural beliefs.
c) Treat every patient exactly the same.
d) Refer all minority patients to specialists.
Correct Answer: b) Assess personal biases and cultural beliefs.
Rationale: Cultural competence begins with self-awareness. Recognizing one’s own biases is essential
before attempting to understand the cultural context of others.
8. A nurse manager is implementing strategies to improve health equity on a unit. Which action is
most effective?
a) Hiring staff that all share the same cultural background to reduce conflict.
b) Collecting patient data on race, ethnicity, and language preference to identify disparities.
c) Assuming all patients have the same health literacy level.
d) Avoiding the use of interpreters to save time.
Correct Answer: b) Collecting patient data on race, ethnicity, and language preference to identify
disparities.
Rationale: Identifying disparities requires data collection. Using trained interpreters and understanding
diverse backgrounds are key to equity.
Chapter 5: Gaining Personal Insight: The Beginning of Being a Leader
9. A nurse manager uses the Myers-Briggs Type Indicator (MBTI) to understand the team. A staff
member who prefers "Judging" (J) over "Perceiving" (P) likely:
a) Prefers spontaneous actions and flexibility.
b) Likes structure, schedules, and decisiveness.
