Leadership - NCLEX Questions and answers 2024

Which of the following definitions apply to management? (Select all that apply.) A. It is a process of inspiring people to accomplish goals through support and confidence building. B. It is the process of coordination and integration of resources to accomplish specific goals. C. It includes the activities of planning, organizing, coordinating, directing, and controlling. D. It is a process of planning and directing human effort to achieve established objectives. E. It is the directing of the organizations' money, facilities, and supplies to achieve results. Answers: B, C, D, and E Rationale: Management is defined as the process of coordination and integration of resources through planning, organizing, coordinating, directing, and controlling to accomplish specific goals. Management is a process of planning and directing human effort to achieve established objectives while ensuring that the organizations' money, facilities, and supplies are directed in a manner that achieves the best results. Which of the following traits describe a transactional leader? (Select all that apply.) A. Functions in a caregiver role. B. Surveys their followers' needs and sets goals for them. C. Uses charisma to produce greater effort in followers. D. Focuses on the maintenance and management of ongoing and routine work. E. Motivates followers to perform to their full potential. Answers: A, B, and D Rationale: A transactional leader is a leader or manager who functions in a caregiver role and is focused on day-to-day operations. Such leaders survey their followers' needs and set goals for them based on expectations. They are also leaders who are focused on maintenance and management of ongoing and routine work. Transformational leaders use charisma to produce greater effort and are able to motivate followers to perform to their full potential over time. Which of the following behaviors build trust between leaders and employees in an organization? (Select all that apply.) A. Sharing relevant information B. Encouraging competition via winners and losers C. Reducing controls D. Meeting expectations E. Avoiding discussion of sensitive issues Answers: A, C, and D Rationale: Leadership is founded on trust. Behaviors that build trust include sharing relevant information, reducing controls, and meeting expectations. Trust-destroying behaviors include being insensitive to beliefs and values, avoiding discussion of sensitive issues, and encouraging competition Which of the following is true of management activities: A. Inspiring a vision is a management function. B. Management is focused on task accomplishment. C. Management is more focused on human relationships. D. Management is more important than leadership. Answer: B Rationale: other options have more of leadership tasks The role of the _____ is to provide leadership and direction for all aspects of nursing services with a focus on integrating the system and building a culture. A. nurse manager B. care provider C. nurse executive D. senior leader Answer: C Rationale: The nurse executive's role and functions concentrate on long-term administration of an institution or program that delivers nursing services, focusing on integrating the system and building a culture A medical-surgical unit reports higher rates of patient satisfaction coupled with high rates of staff satisfaction and productivity. Which of the following is attributed to the data findings: A. Effective leadership B. Management involvement C. Mentoring D. Rewards and recognition Answer: A Rationale: Effective leadership is important in nursing because of the impact on nurses' work lives, it being a stabilizing influence during change, and for nurses' productivity and quality of care. A nurse is caring for an elderly patient who was admitted after sustaining a fall at home. When creating a care plan for the patient, she requests that the doctor order a home health visit to assess for home safety and medication compliance. In addition, the nurse is concerned about the nutrition of the patient and requests a dietitian evaluation. The nurse is demonstrating which of the following leadership skills: A. Care provider B. Business principles C. Care coordination D. Change management Answer: C Rationale: Care coordination is the delivery of nursing services that involves the organization and coordination of complex activities. The nurse uses managerial and leadership skills to facilitate delivery of quality care. During a staff meeting, a group of RNs has complained that medications are not arriving to the unit in a timely manner. The nurse manager suggests that the group resolve this issue through the development and work of a multidisciplinary team led by one of these RNs. This scenario demonstrates: A. adaptation. B. empowerment. C. flexibility. D. relationship management. Answer: B Rationale: Empowerment is the giving of authority, responsibility, and the freedom to act. In this situation, the manager has given authority, responsibility, and the freedom to act in the investigation and resolution of this issue. Leadership is best defined as: A. an interpersonal process of participating by encouraging fellowship. B. delegation of authority and responsibility and the coordination of activities. C. inspiring people to accomplish goals through support and confidence building. D. the integration of resources through planning, organizing, and directing Answer: C Rationale: Leadership is the process of influencing people to accomplish goals by inspiring confidence and support among followers. The postoperative patient with anterior cervical laminectomy is complaining of tightness in his throat. His voice is raspy. The staff nurse asks the unit secretary to page the healthcare provider stat. This is an example of _____ leadership. A. Authoritarian B. Democratic C. Laissez-faire D. Servant Answer: A Rationale: Authoritarian leadership uses directive and controlling behaviors in which the leader determines policies and makes decisions in isolation. The leader orders subordinates to carry out the tasks or work. This style is helpful in crisis situations. Subunit or __ power refers to relationships across departments. 1. Vertical 2. Organizational 3. Horizontal 4. Exertional Answer: 3 Rationale: Subunit or horizontal power pertains to relationships across departments. Which of the following statements accurately describe the varying mechanisms of power? (Select all that apply) 1. Connection power is based on the perception that the influencer has access to powerful people or groups. 2. Legitimate power is based on fear. 3. Expert power results from expertise, special skill, or knowledge. 4. Information power refers to skill in making rational appeals. 5. Referent power is based on admiration for a person. Answers: 1, 3, and 5 Rationale: Connection power is based on another's perception that the influencer has access to powerful people or groups. Expert power results from expertise, special skill, or knowledge. Referent power is based on admiration for a person. A hospital nurse manager is involved in conflict management between two staff members. The process of collaborating occurs when: 1. one person seeks to satisfy his/her own interests. 2. both sides strive to meet the interests of both parties. 3. a person chooses to withdraw from conflict. 4. one party seeks to appease the other. Answer: 2 Rationale: Collaborating ensues when the parties to conflict each desire to fully satisfy the concerns of all parties. The intention is to solve the problem by clarifying differences rather than by accommodating. What are the two major content dimensions of power? (Select all that apply) 1. Influence 2. Integrity 3. Authority 4. Dominance 5. Control Answers: 1 and 3 Empowerment for nurses may consist of three components. Which three of the following components may help nurses become empowered to use their power for better patient care? (Select all that apply) 1. A state in which a nurse has assumed control over his or her own practice 2. A social relationship between two or more people 3. A workplace that promotes opportunities for growth 4. A nurse’s sense of meaning as expressed in values and work role 5. Interdependence of personnel Answers: 1, 3, and 4 Rationale: Nurse empowerment was defined as a state in which an individual nurse has assumed control over his or her practice, enabling him or her to successfully fulfill professional nursing responsibilities within an organization. Organizational antecedents to nurse empowerment include the “opportunities for mobility and growth and access to resources, support, and information provided within the nurse’s work environment.” The organizational and individual antecedents lead to psychological empowerment, including a nurse’s sense of meaning as expressed in values and work role. A nursing manager is leading a recruitment and retention committee. She manages in a laissez-faire style. Her co-leader is a staff nurse who is very detail oriented. The nurse manager usually leads the meetings. During the meeting, the staff nurse frequently needs to interject information that has not been presented. She also creates the agenda and communicates information with other team members. This scenario depicts which type of conflict? 1. Competitive 2. Disruptive 3. Organizational 4. Task Answer: 4 Rationale: Task conflict is an awareness of differences in viewpoints and opinions pertaining to a group task. Negotiation is a form of conflict resolution. Which of the following terms are associated with negotiation? (Select all that apply) 1. Conciliation 2. Distributive bargaining 3. Arbitration 4. Mediation 5. Collective bargaining Answers: 1, 2, and 4 Rationale: Conflict resolution involves eliminating all forms of conflict. Negotiation, to establish more effective communications between the parties. mediation, and arbitration are often referred to in discussions of conflict resolution. These terms are also included under the umbrella of alternative dispute resolution (ADR). According to Knickle and colleagues (2012), the resolution continuum includes negotiation, mediation, arbitration, and litigation as a spectrum of third-party dispute resolution. A conciliator is like a third friend who might attempt to intercede in an argument between two other friends. Conciliators attempt to diffuse the negative emotions that are often involved in the conflict, and they strive Nurses derive much of their power from being: 1. authority figures in emergent situations. 2. central to the delivery of health care services. 3. organized through public associations. 4. the care coordinator of the health care team. Answer: 2 Rationale: Professional nurses have a high degree of centrality within health care organizations. They are critical to the operation of most health care organizations, and without nurses, many health care facilities would not be able to offer services. Nursing maintains power by being central to the actual delivery of health care services, which is the core business function. ______ is a personal quality that is admired in the person with referent power. 1. Problem solving 2. Authority 3. Knowledge 4. Coercive power Answer: 1 Rationale: Referent power comes from the affinity other people have for someone. They admire the personal qualities, the problem-solving ability, the style, or the dedication the person brings to the work. The nursing supervisor informs the staff that if they refuse to stay on the nursing unit and work an additional 8-hour shift, they will be reported to the state for patient abandonment. This type of power is known as: 1. coercive. 2. expert. 3. legitimate. 4. reward. Answer: 1 Rationale: French and Raven's five sources of power (1959) include reward, coercive, expert, referent, and legitimate. When coercive power is used, an individual reacts to the fear of the negative consequences that might occur for failure to comply. A common source of conflict in nursing occurs when the nurse wants to perform patient teaching or counseling, but there are competing priorities and the nurse has inadequate time to spend with the patient. This type of conflict is related to: 1. interpersonal conflict. 2. intergroup conflict. 3. intrapersonal conflict. 4. intragroup conflict. Answer: 3 Rationale: Intrapersonal conflict means discord, tension, or stress inside—or internal to—an individual that results from unmet needs, expectations, or goals. It often is manifested as a conflict over two competing roles. A nursing example occurs when the nurse determines that a patient needs teaching or counseling, but the organization's assignment system is set up in a way that does not provide an adequate amount of time. When other priorities compete, an internal or intrapersonal conflict of roles exists. Nurses must use which of these to facilitate change in health care organizations? (Select all that apply) 1. Actualization 2. Authorization 3. Influence 4. Ratification 5. Power Answer: 3, and 5 Rationale: As the largest health care profession, nursing must use power and influence as a legitimate tool to facilitate change in health care organizations and the health care system. A staff nurse is facing a dilemma between meeting clinical ethical standards and meeting organizational goals. The nurse manager understands that the best way to assist staff members in resolving ethical dilemmas effectively is to focus on: A. doing the right thing and taking the right action. B. meeting clinical standards before organizational goals. C. meeting organizational goals before clinical standards. D. referring indecisive staff members for additional training. Answer: A Rationale: Although the domain of clinical ethics is the care of clients, the domain of organizational ethics is a facility's business-related activities. Together, clinical and organizational ethics reflect a health care facility's concern that, whether related to the continuum of care or the continuum of services related to that care, ethical dilemmas should be resolved based on values-centered principles that focus on doing the right thing and taking the right action. On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations; it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. Because of the nurse's actions, the admitting hospital may be found to be: A. a judicial risk. B. an ostensible authority. C. indemnified. D. vicariously liable. Answer: D Rationale: If a nurse negligently injured a client during and within the scope of employment, not only would the nurse be directly liable for damages, but also the health care organization would be vicariously liable. The court has found that a registered nurse (RN) harmed a patient by violating his rights. The nurse is ordered to pay the patient a large sum of money. The court has determined that the nurse has committed a: A. civil act. B. criminal act. C. critical wrong. D. quality breach. Answer: A Rationale: By definition, civil acts are wrongs that violate the rights of individuals by tort or breach of contract. A staff nurse came in to work the 7 PM to 7 AM shift. She had met her friends for "happy hour" earlier in the evening. Her breath smells of alcohol. If this nurse is allowed to provide care for patients, she may be at risk for: A. maleficence. B. mélange. C. nonmaleficence. D. nonmanager. Answer: A Rationale: Maleficence is doing harm to the patient whether it is intentional or unintentional, such as an omission. If the nurse is intoxicated, she may fail to meet the standard of care. To establish legal liability on the grounds of malpractice, the injured party must prove which of the following? (Select all that apply) A. A duty of care was owed to the injured party. B. An agreement was made to assume another party's liability. C. There was a breach of duty. D. Causation was present. E. Actual harm or damages were suffered by the plaintiff. Answers: A, C, D, and E