LEADERSHIP ROLES AND MANAGEMENT
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 — Defining Objectives &
Gathering Data
Stem: As charge nurse on a 28-bed medical-surgical unit you
receive conflicting reports about a patient’s deteriorating
oxygen saturation. Resources are limited and the unit is short-
staffed. What should you do first to ensure safe decision
making?
Options:
A. Immediately call the rapid response team and transfer the
,patient to ICU.
B. Gather objective data (vital signs, recent ABGs, current
oxygen device, medication list) and reassess the patient at
bedside.
C. Delegate monitoring to the most junior nurse while you
continue assigning tasks to other staff.
D. Document the reported saturation values in the chart and
wait to see if values improve.
Correct Answer: B
Rationale — Correct: Gathering objective, current clinical data
aligns with Huston’s emphasis on defining objectives and
careful data collection before making critical decisions.
Immediate bedside reassessment clarifies the problem and
informs appropriate next steps.
Rationale — Incorrect:
A. Calling rapid response may be necessary but is premature
without current assessment; unnecessary activation wastes
resources.
C. Delegating monitoring without you reassessing risks delayed
recognition and undermines clinical judgment.
D. Waiting is unsafe when deterioration is reported; passive
documentation delays action.
Teaching Point: Always gather current objective clinical data
before decisive interventions.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
, 2.
Reference: Ch. 1 — Decision Making Models — Traditional &
Managerial Decision Making
Stem: A nurse manager must choose between two staffing
models for a unit: one maximizes continuity of care but
increases overtime costs, the other reduces overtime but
requires more float staff. How should the manager decide which
model to implement?
Options:
A. Choose the model that minimizes immediate payroll
expense.
B. Use a decision grid to weigh objectives (safety, staff
satisfaction, cost, continuity) and quantify trade-offs.
C. Ask senior leadership to select the model to avoid
responsibility.
D. Implement the continuity model because patient satisfaction
is a visible metric.
Correct Answer: B
Rationale — Correct: Using a structured decision tool (decision
grid) reflects managerial decision-making and evidence-based
weighing of multiple objectives, as Huston recommends. It
supports transparent, defensible choices.
Rationale — Incorrect:
A. Focusing solely on cost ignores quality and staff well-being.
C. Abdicating responsibility undermines managerial
accountability and erodes trust.
D. Choosing based only on patient satisfaction ignores other
, critical system outcomes and trade-offs.
Teaching Point: Use structured decision tools to weigh
competing objectives and trade-offs.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
3.
Reference: Ch. 1 — Integrated Ethical Problem-Solving Model
— Use of Values in Decisions
Stem: Two experienced nurses disagree about whether to
withhold a PRN sedative for an agitated postoperative patient
because family demands additional medication. As nurse
manager, what ethical approach best resolves this?
Options:
A. Side with the more senior nurse to preserve hierarchy and
order.
B. Apply an integrated ethical problem-solving model: clarify
values, gather clinical data, consult policy, and negotiate a
patient-centered plan.
C. Immediately administer the sedative to satisfy the family and
avoid complaints.
D. Suspend both nurses pending investigation to avoid further
conflict.
Correct Answer: B
Rationale — Correct: Huston’s integrated ethical problem-
solving promotes clarifying values, gathering facts, and applying
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 — Defining Objectives &
Gathering Data
Stem: As charge nurse on a 28-bed medical-surgical unit you
receive conflicting reports about a patient’s deteriorating
oxygen saturation. Resources are limited and the unit is short-
staffed. What should you do first to ensure safe decision
making?
Options:
A. Immediately call the rapid response team and transfer the
,patient to ICU.
B. Gather objective data (vital signs, recent ABGs, current
oxygen device, medication list) and reassess the patient at
bedside.
C. Delegate monitoring to the most junior nurse while you
continue assigning tasks to other staff.
D. Document the reported saturation values in the chart and
wait to see if values improve.
Correct Answer: B
Rationale — Correct: Gathering objective, current clinical data
aligns with Huston’s emphasis on defining objectives and
careful data collection before making critical decisions.
Immediate bedside reassessment clarifies the problem and
informs appropriate next steps.
Rationale — Incorrect:
A. Calling rapid response may be necessary but is premature
without current assessment; unnecessary activation wastes
resources.
C. Delegating monitoring without you reassessing risks delayed
recognition and undermines clinical judgment.
D. Waiting is unsafe when deterioration is reported; passive
documentation delays action.
Teaching Point: Always gather current objective clinical data
before decisive interventions.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
, 2.
Reference: Ch. 1 — Decision Making Models — Traditional &
Managerial Decision Making
Stem: A nurse manager must choose between two staffing
models for a unit: one maximizes continuity of care but
increases overtime costs, the other reduces overtime but
requires more float staff. How should the manager decide which
model to implement?
Options:
A. Choose the model that minimizes immediate payroll
expense.
B. Use a decision grid to weigh objectives (safety, staff
satisfaction, cost, continuity) and quantify trade-offs.
C. Ask senior leadership to select the model to avoid
responsibility.
D. Implement the continuity model because patient satisfaction
is a visible metric.
Correct Answer: B
Rationale — Correct: Using a structured decision tool (decision
grid) reflects managerial decision-making and evidence-based
weighing of multiple objectives, as Huston recommends. It
supports transparent, defensible choices.
Rationale — Incorrect:
A. Focusing solely on cost ignores quality and staff well-being.
C. Abdicating responsibility undermines managerial
accountability and erodes trust.
D. Choosing based only on patient satisfaction ignores other
, critical system outcomes and trade-offs.
Teaching Point: Use structured decision tools to weigh
competing objectives and trade-offs.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
3.
Reference: Ch. 1 — Integrated Ethical Problem-Solving Model
— Use of Values in Decisions
Stem: Two experienced nurses disagree about whether to
withhold a PRN sedative for an agitated postoperative patient
because family demands additional medication. As nurse
manager, what ethical approach best resolves this?
Options:
A. Side with the more senior nurse to preserve hierarchy and
order.
B. Apply an integrated ethical problem-solving model: clarify
values, gather clinical data, consult policy, and negotiate a
patient-centered plan.
C. Immediately administer the sedative to satisfy the family and
avoid complaints.
D. Suspend both nurses pending investigation to avoid further
conflict.
Correct Answer: B
Rationale — Correct: Huston’s integrated ethical problem-
solving promotes clarifying values, gathering facts, and applying
