Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
Chapter 10: Understanding and Designing Organizational Structures
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Third Edition
MULTIPLE CHOICE
A hospital and a nursing education program form a partnership to recruit more nurses to
t he region. This organizational structure is:
Being responsive to changes in the environment.
Being bureaucratic.
Creating permanent professional boundaries.
Delineating structures for all decision making.
ANS: A
Shared decision making across organizations can lead to growth and responsiveness in
m eeting emerging needs.
DIF: Cognitive Level: Understand REF:
Page 195 TOP:
Nursing Process: Assessment
A hospital is working toward becoming a Magnet hospital. The chief nursing office
r is aware that professional nursing departments of the future will:
Not be directed by nurses.
Be virtual organizations.
Be designed to maintain nursing standards of practice.
Be entitled to have patient care departments. A
NS: C
NUR I G B.C M
S N T O
Professional nursing departments of the future will be focused on patient care outcomes and
nursing satisfaction.
DIF: Cognitive Level: Understand REF:
Page 207 TOP:
Nursing Process: Planning
The chief nursing officer and the dean of the school of nursing believe that by establishi
ng rules and regulations and controlling the environment, this partnership will:
Promote professional medical authority, autonomy, and responsibility.
Diminish quickly with no central figure.
Be essential for self-governance.
Provide for the establishment of medical committees.
ANS: B
Centralized decision-
making structures that emphasize high control, and rules and regulations that lay out ex
pectations, can be slow to respond to emerging trends. Organizations that are controlled
in a heavily centralized way can diminish quickly without the strong central figure.
DIF: Cognitive Level: Analyze REF:
Page 203 TOP:
Nursing Process: Assessment
NURSINGTB.COM
,Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
A nurse manager understands that a matrix organizational structure:
Is a simplified organizational structure.
Has both a functional manager and a service or product-line manager.
Arranges departments strictly according to function.
Promotes harmony in organizational decision making.
ANS: B
Matrix structures are complex, integrated organizational structures that involve both fun
ctional managers and service or product-
line managers. In this structure, team members or teams from various functional departm
ents may combine to complete a project or program, thereby becoming responsible to b
oth their functional department manager and their product-
line manager. Harmony or disharmony cannot be assumed.
DIF: Cognitive Level: Understand REF:
Page 203 TOP:
Nursing Process: Assessment
Collaborative partnerships between hospitals and schools of nursing are examples of hyb
r id organizational structures. A hybrid organizational structure:
Has many divisions of labour.
Best fits long-term care units.
Has a mixture of the characteristics of various organizational types.
Places the authority for decision making closest to the places where work
e rs perform.
ANS: C
Hybrid structures include characteristics of various organizational types and reflect the needs of the situat
ion and t Nhe eRn v i rIo n mGe n tB. .CM
USNT O
DIF: Cognitive Level: Understand REF:
Page 203 TOP:
Nursing Process: Assessment
In opening a new dialysis unit, the nurse manager has to develop a philosophy for the u
nit. This philosophy needs to:
Reflect the culture of the unit and its values.
Be developed by the nursing manager on the unit.
Identify the patients who will be served on the unit.
Replicate the organization‘s philosophy.
ANS: A
The philosophy needs to state what the nurse manager and staff believe is the vision for n
ursing management and practice, and sets the stage for establishing goals to make the vi s
ion a reality. It is complementary to the organizational philosophy, but reflects the values
of nursing. Shared governance enables staff and management to develop a vision and is c
ongruent with contemporary views of management. The identification of patients to be s e
rved reflects a mission statement.
DIF: Cognitive Level: Apply REF:
Page 204 TOP:
Nursing Process: Planning
NURSINGTB.COM
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
The hospital administration gives approval to the chief nursing officer to hire clinical nur
se specialists in staff positions rather than in administrative positions. A clinical specialist
who has staff authority but no line authority typically is able to:
Function through influence.
Take complete responsibility for the care of patients.
Interview and hire staff nurses for designated nursing units.
Be granted functional authority to determine standards of nursing care and enfo
r ce them.
ANS: A
Staff positions provide support to line positions but have no direct accountability for staff or
p atient outcomes and therefore function through influence.
DIF: Cognitive Level: Apply REF:
Page 200 TOP:
Nursing Process: Implementation
A new director of nursing in a small rural hospital wants to make changes from the trad
itional model of governance to a shared-
governance model. Of the following characteristics, which best describes the traditional
organizational structure in which a staff nurse is assigned to carry out nursing tasks for
patients but is not given the chance to provide input into forming the policies and proce
dures by which care is delivered or the standards by which care is evaluated?
Bureaucratic.
Decentralized.
Delegated authority and responsibility.
Delegated responsibility but no authority.
NURSINGTB.COM
ANS: D
In traditional structures, decision-making authority is held by a centralized decision-
making body; thus staff members have responsibility for certain functions but do not particip
ate in decisions related to those functions.
DIF: Cognitive Level: Analyze REF:
Page 197 TOP:
Nursing Process: Assessment
The chief nursing officer is given the task of reviewing and revising the organizatio
n ‘s mission, philosophy, and technology. In reviewing them, the chief nursing offic
er understands that they should be reflected in:
The organizational structure.
Line and staff responsibilities.
The policies and procedures.
Government regulations.
ANS: A
The mission statement is an important foundation for the organizational structure and def
i nes technology and human resources required for the organization.
DIF: Cognitive Level: Understand REF:
Page 192 TOP:
Nursing Process: Assessment
NURSINGTB.COM
Chapter 10: Understanding and Designing Organizational Structures
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Third Edition
MULTIPLE CHOICE
A hospital and a nursing education program form a partnership to recruit more nurses to
t he region. This organizational structure is:
Being responsive to changes in the environment.
Being bureaucratic.
Creating permanent professional boundaries.
Delineating structures for all decision making.
ANS: A
Shared decision making across organizations can lead to growth and responsiveness in
m eeting emerging needs.
DIF: Cognitive Level: Understand REF:
Page 195 TOP:
Nursing Process: Assessment
A hospital is working toward becoming a Magnet hospital. The chief nursing office
r is aware that professional nursing departments of the future will:
Not be directed by nurses.
Be virtual organizations.
Be designed to maintain nursing standards of practice.
Be entitled to have patient care departments. A
NS: C
NUR I G B.C M
S N T O
Professional nursing departments of the future will be focused on patient care outcomes and
nursing satisfaction.
DIF: Cognitive Level: Understand REF:
Page 207 TOP:
Nursing Process: Planning
The chief nursing officer and the dean of the school of nursing believe that by establishi
ng rules and regulations and controlling the environment, this partnership will:
Promote professional medical authority, autonomy, and responsibility.
Diminish quickly with no central figure.
Be essential for self-governance.
Provide for the establishment of medical committees.
ANS: B
Centralized decision-
making structures that emphasize high control, and rules and regulations that lay out ex
pectations, can be slow to respond to emerging trends. Organizations that are controlled
in a heavily centralized way can diminish quickly without the strong central figure.
DIF: Cognitive Level: Analyze REF:
Page 203 TOP:
Nursing Process: Assessment
NURSINGTB.COM
,Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
A nurse manager understands that a matrix organizational structure:
Is a simplified organizational structure.
Has both a functional manager and a service or product-line manager.
Arranges departments strictly according to function.
Promotes harmony in organizational decision making.
ANS: B
Matrix structures are complex, integrated organizational structures that involve both fun
ctional managers and service or product-
line managers. In this structure, team members or teams from various functional departm
ents may combine to complete a project or program, thereby becoming responsible to b
oth their functional department manager and their product-
line manager. Harmony or disharmony cannot be assumed.
DIF: Cognitive Level: Understand REF:
Page 203 TOP:
Nursing Process: Assessment
Collaborative partnerships between hospitals and schools of nursing are examples of hyb
r id organizational structures. A hybrid organizational structure:
Has many divisions of labour.
Best fits long-term care units.
Has a mixture of the characteristics of various organizational types.
Places the authority for decision making closest to the places where work
e rs perform.
ANS: C
Hybrid structures include characteristics of various organizational types and reflect the needs of the situat
ion and t Nhe eRn v i rIo n mGe n tB. .CM
USNT O
DIF: Cognitive Level: Understand REF:
Page 203 TOP:
Nursing Process: Assessment
In opening a new dialysis unit, the nurse manager has to develop a philosophy for the u
nit. This philosophy needs to:
Reflect the culture of the unit and its values.
Be developed by the nursing manager on the unit.
Identify the patients who will be served on the unit.
Replicate the organization‘s philosophy.
ANS: A
The philosophy needs to state what the nurse manager and staff believe is the vision for n
ursing management and practice, and sets the stage for establishing goals to make the vi s
ion a reality. It is complementary to the organizational philosophy, but reflects the values
of nursing. Shared governance enables staff and management to develop a vision and is c
ongruent with contemporary views of management. The identification of patients to be s e
rved reflects a mission statement.
DIF: Cognitive Level: Apply REF:
Page 204 TOP:
Nursing Process: Planning
NURSINGTB.COM
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
The hospital administration gives approval to the chief nursing officer to hire clinical nur
se specialists in staff positions rather than in administrative positions. A clinical specialist
who has staff authority but no line authority typically is able to:
Function through influence.
Take complete responsibility for the care of patients.
Interview and hire staff nurses for designated nursing units.
Be granted functional authority to determine standards of nursing care and enfo
r ce them.
ANS: A
Staff positions provide support to line positions but have no direct accountability for staff or
p atient outcomes and therefore function through influence.
DIF: Cognitive Level: Apply REF:
Page 200 TOP:
Nursing Process: Implementation
A new director of nursing in a small rural hospital wants to make changes from the trad
itional model of governance to a shared-
governance model. Of the following characteristics, which best describes the traditional
organizational structure in which a staff nurse is assigned to carry out nursing tasks for
patients but is not given the chance to provide input into forming the policies and proce
dures by which care is delivered or the standards by which care is evaluated?
Bureaucratic.
Decentralized.
Delegated authority and responsibility.
Delegated responsibility but no authority.
NURSINGTB.COM
ANS: D
In traditional structures, decision-making authority is held by a centralized decision-
making body; thus staff members have responsibility for certain functions but do not particip
ate in decisions related to those functions.
DIF: Cognitive Level: Analyze REF:
Page 197 TOP:
Nursing Process: Assessment
The chief nursing officer is given the task of reviewing and revising the organizatio
n ‘s mission, philosophy, and technology. In reviewing them, the chief nursing offic
er understands that they should be reflected in:
The organizational structure.
Line and staff responsibilities.
The policies and procedures.
Government regulations.
ANS: A
The mission statement is an important foundation for the organizational structure and def
i nes technology and human resources required for the organization.
DIF: Cognitive Level: Understand REF:
Page 192 TOP:
Nursing Process: Assessment
NURSINGTB.COM
