LEADERSHIP ROLES AND MANAGEMENT
FUNCTIONS IN NURSING
THEORY AND APPLICATION
11TH EDITION
• AUTHOR(S)CAROL J. HUSTON
TEST BANK
Q1
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: A charge nurse on a busy med-surg unit notices two post-
op patients experiencing unexpected hypotension. The charge
nurse must decide which patient to assess first while also
delegating duties to available staff. Which action best reflects
sound clinical reasoning and management?
A. Assess the older patient first because age increases risk.
B. Assign a licensed practical nurse (LPN) to assess both patients
,sequentially while the charge nurse finishes documentation.
C. Prioritize the patient with recent blood loss for immediate
assessment and assign the other to a stable RN for ongoing
monitoring.
D. Call the hospitalist immediately and wait for orders before
assessing either patient.
Correct Answer: C
Rationales — Correct: Prioritizing the patient with recent blood
loss aligns with risk-based triage and physiologic urgency; it
uses clinical data to guide action. The charge nurse both
assesses and delegates appropriately to ensure timely care and
maintains accountability. This approach reflects analysis and
decisive action consistent with Huston’s emphasis on evidence-
based, time-sensitive decision making.
Rationales — Incorrect:
A. Age alone is not the best single triage criterion; physiologic
instability and bleeding take priority.
B. Delegating both assessments to an LPN may exceed scope
and delay RN assessment for unstable patients.
D. Waiting for physician orders before assessment delays
necessary immediate interventions.
Teaching Point: Triage by physiologic risk; delegate but keep
accountability.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
,Q2
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: A nurse manager must choose between two staffing
options for a unit with rising acuity: hire one experienced RN
per shift or two novice RNs per shift. Which decision-making
approach best supports ethical, evidence-based staffing?
A. Choose two novices to save costs and increase headcount.
B. Hire one experienced RN to maximize patient safety and
mentorship capacity.
C. Alternate between one experienced RN and two novices each
week.
D. Request staff volunteers and post a sign-up sheet.
Correct Answer: B
Rationales — Correct: Selecting an experienced RN prioritizes
patient safety, skill mix, and on-shift clinical judgment, aligning
with ethical duty and evidence that experience reduces errors.
An experienced RN can mentor novices and support clinical
reasoning across the team. Huston emphasizes matching
staffing decisions to patient acuity and organizational
responsibility for safety.
Rationales — Incorrect:
A. Cost savings alone neglects safety and skill mix
considerations.
C. Alternating weekly creates inconsistent skill mix and
jeopardizes continuous safe care.
D. Volunteer systems may not ensure appropriate competency
, or equitable distribution.
Teaching Point: Prioritize skill mix and patient safety over
headcount.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
Q3
Reference: Ch. 1 — Vicarious Learning to Increase Problem-
Solving and Decision-Making Skills
Stem: A nurse educator plans simulation sessions to improve
new nurses’ decision making. Which simulation design best
fosters vicarious learning and critical thinking?
A. One high-fidelity simulation with no debriefing to replicate
real pressure.
B. Multiple low-stakes simulations with guided debriefing and
reflection.
C. Observe a recorded code without participant involvement.
D. A written test after watching an expert demonstrate
procedures.
Correct Answer: B
Rationales — Correct: Multiple low-stakes simulations with
structured debriefing promote vicarious learning, reflection,
feedback, and transfer of skills—key elements Huston
advocates. Guided debriefs enhance metacognition and clinical
reasoning in novices. This scaffolding aligns with adult learning
theory and reduces cognitive overload.
FUNCTIONS IN NURSING
THEORY AND APPLICATION
11TH EDITION
• AUTHOR(S)CAROL J. HUSTON
TEST BANK
Q1
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: A charge nurse on a busy med-surg unit notices two post-
op patients experiencing unexpected hypotension. The charge
nurse must decide which patient to assess first while also
delegating duties to available staff. Which action best reflects
sound clinical reasoning and management?
A. Assess the older patient first because age increases risk.
B. Assign a licensed practical nurse (LPN) to assess both patients
,sequentially while the charge nurse finishes documentation.
C. Prioritize the patient with recent blood loss for immediate
assessment and assign the other to a stable RN for ongoing
monitoring.
D. Call the hospitalist immediately and wait for orders before
assessing either patient.
Correct Answer: C
Rationales — Correct: Prioritizing the patient with recent blood
loss aligns with risk-based triage and physiologic urgency; it
uses clinical data to guide action. The charge nurse both
assesses and delegates appropriately to ensure timely care and
maintains accountability. This approach reflects analysis and
decisive action consistent with Huston’s emphasis on evidence-
based, time-sensitive decision making.
Rationales — Incorrect:
A. Age alone is not the best single triage criterion; physiologic
instability and bleeding take priority.
B. Delegating both assessments to an LPN may exceed scope
and delay RN assessment for unstable patients.
D. Waiting for physician orders before assessment delays
necessary immediate interventions.
Teaching Point: Triage by physiologic risk; delegate but keep
accountability.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
,Q2
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: A nurse manager must choose between two staffing
options for a unit with rising acuity: hire one experienced RN
per shift or two novice RNs per shift. Which decision-making
approach best supports ethical, evidence-based staffing?
A. Choose two novices to save costs and increase headcount.
B. Hire one experienced RN to maximize patient safety and
mentorship capacity.
C. Alternate between one experienced RN and two novices each
week.
D. Request staff volunteers and post a sign-up sheet.
Correct Answer: B
Rationales — Correct: Selecting an experienced RN prioritizes
patient safety, skill mix, and on-shift clinical judgment, aligning
with ethical duty and evidence that experience reduces errors.
An experienced RN can mentor novices and support clinical
reasoning across the team. Huston emphasizes matching
staffing decisions to patient acuity and organizational
responsibility for safety.
Rationales — Incorrect:
A. Cost savings alone neglects safety and skill mix
considerations.
C. Alternating weekly creates inconsistent skill mix and
jeopardizes continuous safe care.
D. Volunteer systems may not ensure appropriate competency
, or equitable distribution.
Teaching Point: Prioritize skill mix and patient safety over
headcount.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
Q3
Reference: Ch. 1 — Vicarious Learning to Increase Problem-
Solving and Decision-Making Skills
Stem: A nurse educator plans simulation sessions to improve
new nurses’ decision making. Which simulation design best
fosters vicarious learning and critical thinking?
A. One high-fidelity simulation with no debriefing to replicate
real pressure.
B. Multiple low-stakes simulations with guided debriefing and
reflection.
C. Observe a recorded code without participant involvement.
D. A written test after watching an expert demonstrate
procedures.
Correct Answer: B
Rationales — Correct: Multiple low-stakes simulations with
structured debriefing promote vicarious learning, reflection,
feedback, and transfer of skills—key elements Huston
advocates. Guided debriefs enhance metacognition and clinical
reasoning in novices. This scaffolding aligns with adult learning
theory and reduces cognitive overload.
