Chapter 10: Challenges of Nursing
Management and Leadership Zerwekh
9th ED
1. What is the most consistent concern of the nurse as manager?
a. To develop long-range career goals
b. To coordinate patient care while meeting the agency goals
c. To maintain harmony within the agency
d. To organize the subordinates to meet agency goals
ANS: B
The role of the nurse as manager has evolved into a complex one that includes organizing
patient care, directing personnel to achieve agency goals, and allocating resources. The
most consistent concern of the nurse as manager is not to develop long-range career goals,
maintain harmony within the agency, or organize subordinates to meet agency goals.
Although having long-range career goals is a good idea for the nurse manager, it is not a
day-to-day concern. Organizing subordinates in not a role of the nurse manager, but instead
it is directing or supervising them to achieve patient care needs.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 208
OBJ: List characteristics of an effective manager and an influential leader.
TOP: Nursing definition
MSC: NCLEX®: Safe and effective care environment—management of care
2. What action would be an appropriate first step for the nurse to take toward becoming an
effective manager?
a. Learn how to effect and direct the change process.
b. Assess individuals' sources of power.
c. Develop communication and interpersonal skills.
d. Implement effective nursing care plans.
ANS: C
Effective managers have a balanced mix of management skills and leadership qualities.
There are generally four functions the manager performs: planning (what is to be done),
organizing (how it is to be done), directing (who is to do it), and controlling (when and how it
is done). To be effective in performing these functions, a manager must develop
communication and interpersonal skills.
PTS: 1 DIF: Cognitive Level: Application REF: p. 212
OBJ: List characteristics of an effective manager and an influential leader.
TOP: Nursing management
MSC: NCLEX®: Safe and effective care environment—management of care
, 3. What do the responsibilities of the nurse manager include?
a. Planning and organizing how nursing care can most effectively be delivered on the
nursing unit
b. Establishing the nursing care standards to be implemented on the unit
c. Developing educational programs to assist staff to meet licensure requirements
d. Assisting staff to adhere to organizational policies and procedures
ANS: A
Managers must be attentive to both dimensions of their job: the mission and goals of the
organization and planning with the staff to meet the nursing care goals of the unit within the
overall goals of the institution. Both levels must be addressed—the organization as well as
the needs of the individuals. Other options are not as comprehensive and could be included
within the first option.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 208-210
OBJ: List characteristics of an effective manager and an influential leader.
TOP: Nursing management
MSC: NCLEX®: Safe and effective care environment—management of care
4. The nursing staff on a busy unit enjoys autonomy and needs minimal direction for patient
care. Which leadership style would be most effective on this unit?
a. Democratic c. Laissez-faire
b. Authoritarian d. Bureaucratic
ANS: A
The democratic manager is people oriented and emphasizes effective group functioning.
The environment is open, communication is both ways, and staff members are encouraged
to participate in decision making. The manager is also willing to take responsibility to make
decisions when staff participation is not necessary. An authoritarian leader makes decisions
without the input of others. The laissez-faire manager maintains a permissive environment.
The bureaucratic leader follows a close set of standards to maintain order.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 212
OBJ: Describe various types of management. TOP: Nursing management
MSC: NCLEX®: Safe and effective care environment—management of care
5. Which statement best describes effective leadership by the nurse manager?
a. Directs a staff nurse to modify his or her communication skills
b. Fosters behavior changes in one staff member that have positive effects on the nurse
manager and his or her peers
c. Encourages behavior changes through the annual evaluation process
d. Uses the group process to determine what behavior is distressing to staff
ANS: B
Leadership in groups is democratic; the members feel positive about their participation and
the outcomes of the group process. The other options are not examples of effective
leadership. This person should be flexible enough to adapt to the changing roles of nursing
Management and Leadership Zerwekh
9th ED
1. What is the most consistent concern of the nurse as manager?
a. To develop long-range career goals
b. To coordinate patient care while meeting the agency goals
c. To maintain harmony within the agency
d. To organize the subordinates to meet agency goals
ANS: B
The role of the nurse as manager has evolved into a complex one that includes organizing
patient care, directing personnel to achieve agency goals, and allocating resources. The
most consistent concern of the nurse as manager is not to develop long-range career goals,
maintain harmony within the agency, or organize subordinates to meet agency goals.
Although having long-range career goals is a good idea for the nurse manager, it is not a
day-to-day concern. Organizing subordinates in not a role of the nurse manager, but instead
it is directing or supervising them to achieve patient care needs.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 208
OBJ: List characteristics of an effective manager and an influential leader.
TOP: Nursing definition
MSC: NCLEX®: Safe and effective care environment—management of care
2. What action would be an appropriate first step for the nurse to take toward becoming an
effective manager?
a. Learn how to effect and direct the change process.
b. Assess individuals' sources of power.
c. Develop communication and interpersonal skills.
d. Implement effective nursing care plans.
ANS: C
Effective managers have a balanced mix of management skills and leadership qualities.
There are generally four functions the manager performs: planning (what is to be done),
organizing (how it is to be done), directing (who is to do it), and controlling (when and how it
is done). To be effective in performing these functions, a manager must develop
communication and interpersonal skills.
PTS: 1 DIF: Cognitive Level: Application REF: p. 212
OBJ: List characteristics of an effective manager and an influential leader.
TOP: Nursing management
MSC: NCLEX®: Safe and effective care environment—management of care
, 3. What do the responsibilities of the nurse manager include?
a. Planning and organizing how nursing care can most effectively be delivered on the
nursing unit
b. Establishing the nursing care standards to be implemented on the unit
c. Developing educational programs to assist staff to meet licensure requirements
d. Assisting staff to adhere to organizational policies and procedures
ANS: A
Managers must be attentive to both dimensions of their job: the mission and goals of the
organization and planning with the staff to meet the nursing care goals of the unit within the
overall goals of the institution. Both levels must be addressed—the organization as well as
the needs of the individuals. Other options are not as comprehensive and could be included
within the first option.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 208-210
OBJ: List characteristics of an effective manager and an influential leader.
TOP: Nursing management
MSC: NCLEX®: Safe and effective care environment—management of care
4. The nursing staff on a busy unit enjoys autonomy and needs minimal direction for patient
care. Which leadership style would be most effective on this unit?
a. Democratic c. Laissez-faire
b. Authoritarian d. Bureaucratic
ANS: A
The democratic manager is people oriented and emphasizes effective group functioning.
The environment is open, communication is both ways, and staff members are encouraged
to participate in decision making. The manager is also willing to take responsibility to make
decisions when staff participation is not necessary. An authoritarian leader makes decisions
without the input of others. The laissez-faire manager maintains a permissive environment.
The bureaucratic leader follows a close set of standards to maintain order.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 212
OBJ: Describe various types of management. TOP: Nursing management
MSC: NCLEX®: Safe and effective care environment—management of care
5. Which statement best describes effective leadership by the nurse manager?
a. Directs a staff nurse to modify his or her communication skills
b. Fosters behavior changes in one staff member that have positive effects on the nurse
manager and his or her peers
c. Encourages behavior changes through the annual evaluation process
d. Uses the group process to determine what behavior is distressing to staff
ANS: B
Leadership in groups is democratic; the members feel positive about their participation and
the outcomes of the group process. The other options are not examples of effective
leadership. This person should be flexible enough to adapt to the changing roles of nursing
