LEADERSHIP ROLES AND MANAGEMENT
FUNCTIONS IN NURSING
THEORY AND APPLICATION
11TH EDITION
• AUTHOR(S)CAROL J. HUSTON
TEST BANK
1
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning — Defining Objectives &
Gathering Data
Stem: As the charge nurse, you notice a sudden rise in call-light
volume on a medical–surgical unit after the evening med pass.
You review recent medication timing, staffing, and patient
acuity. Which next step most effectively follows Huston’s
emphasis on defining objectives and gathering data?
,A. Immediately add another nurse to the med pass without
further analysis.
B. Conduct a quick audit of medication administration times
and patient pain scores for the past 12 hours.
C. Blame the evening nurse and schedule a performance review.
D. Move patients with higher acuity to another unit.
Correct Answer: B
Rationale — Correct: Conducting a targeted audit aligns with
Huston’s principle to gather data carefully and define objectives
before acting, enabling problem identification. This evidence-
based step helps isolate causes (timing, analgesia, staffing)
before resource allocation.
Rationale — A: Adding staff prematurely may waste resources
and fails to use data to target the real problem.
Rationale — C: Blame is punitive and ignores the need for
systematic data collection and objective analysis.
Rationale — D: Transferring patients without cause disrupts
care and doesn't address the root problem.
Teaching Point: Gather targeted data before allocating
resources or assigning blame.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
2
Reference: Ch. 1 — Decision Making Models — Traditional vs.
Managerial Models
,Stem: A nurse manager must choose between two staffing
models during a census surge: stick to the unit’s traditional
fixed-ratio staffing or adopt a flexible, acuity-based model
recommended by administration. Which decision approach best
reflects managerial decision-making as described by Huston?
A. Use the traditional fixed-ratio model because it has worked
historically.
B. Choose the acuity-based model after comparing measured
patient care needs and available skill mix.
C. Alternate models every shift randomly to test both.
D. Ask the most senior staff nurse to pick the model for the
week.
Correct Answer: B
Rationale — Correct: Huston’s managerial decision-making
emphasizes using data (acuity, skill mix) and administrative
guidance to select practical, context-appropriate models;
evaluation of measurable needs supports this.
Rationale — A: Tradition alone ignores current evidence and
may not meet patient needs.
Rationale — C: Random alternation lacks logic, consistency, and
accountability.
Rationale — D: Leaving such decisions to a single staff member
can create bias and bypass structured decision processes.
Teaching Point: Use data and practical constraints to choose
staffing models.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
, 3
Reference: Ch. 1 — Critical Thinking Models — Marquis–Huston
Model Application
Stem: During rounds, a staff nurse presents conflicting
assessment findings for a postoperative patient. As the clinical
leader, how do you apply the Marquis–Huston critical-thinking
teaching model to assist the nurse?
A. Tell the nurse to follow gut instinct next time.
B. Guide the nurse through structured questioning about cues,
assumptions, and alternate explanations.
C. Document the discrepancy and ignore it if patient appears
stable.
D. Reassign the patient to another nurse immediately.
Correct Answer: B
Rationale — Correct: The Marquis–Huston model promotes
structured reflection (identify cues, clarify assumptions,
generate alternatives), which builds clinical reasoning and
reduces future errors.
Rationale — A: Encouraging intuition without structure
discourages analytical skills development.
Rationale — C: Ignoring discrepancies risks missing
deterioration and misses a teaching opportunity.
Rationale — D: Reassignment avoids addressing the nurse’s
reasoning gap and reduces learning.
Teaching Point: Use structured questioning to develop clinical
FUNCTIONS IN NURSING
THEORY AND APPLICATION
11TH EDITION
• AUTHOR(S)CAROL J. HUSTON
TEST BANK
1
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning — Defining Objectives &
Gathering Data
Stem: As the charge nurse, you notice a sudden rise in call-light
volume on a medical–surgical unit after the evening med pass.
You review recent medication timing, staffing, and patient
acuity. Which next step most effectively follows Huston’s
emphasis on defining objectives and gathering data?
,A. Immediately add another nurse to the med pass without
further analysis.
B. Conduct a quick audit of medication administration times
and patient pain scores for the past 12 hours.
C. Blame the evening nurse and schedule a performance review.
D. Move patients with higher acuity to another unit.
Correct Answer: B
Rationale — Correct: Conducting a targeted audit aligns with
Huston’s principle to gather data carefully and define objectives
before acting, enabling problem identification. This evidence-
based step helps isolate causes (timing, analgesia, staffing)
before resource allocation.
Rationale — A: Adding staff prematurely may waste resources
and fails to use data to target the real problem.
Rationale — C: Blame is punitive and ignores the need for
systematic data collection and objective analysis.
Rationale — D: Transferring patients without cause disrupts
care and doesn't address the root problem.
Teaching Point: Gather targeted data before allocating
resources or assigning blame.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
2
Reference: Ch. 1 — Decision Making Models — Traditional vs.
Managerial Models
,Stem: A nurse manager must choose between two staffing
models during a census surge: stick to the unit’s traditional
fixed-ratio staffing or adopt a flexible, acuity-based model
recommended by administration. Which decision approach best
reflects managerial decision-making as described by Huston?
A. Use the traditional fixed-ratio model because it has worked
historically.
B. Choose the acuity-based model after comparing measured
patient care needs and available skill mix.
C. Alternate models every shift randomly to test both.
D. Ask the most senior staff nurse to pick the model for the
week.
Correct Answer: B
Rationale — Correct: Huston’s managerial decision-making
emphasizes using data (acuity, skill mix) and administrative
guidance to select practical, context-appropriate models;
evaluation of measurable needs supports this.
Rationale — A: Tradition alone ignores current evidence and
may not meet patient needs.
Rationale — C: Random alternation lacks logic, consistency, and
accountability.
Rationale — D: Leaving such decisions to a single staff member
can create bias and bypass structured decision processes.
Teaching Point: Use data and practical constraints to choose
staffing models.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
, 3
Reference: Ch. 1 — Critical Thinking Models — Marquis–Huston
Model Application
Stem: During rounds, a staff nurse presents conflicting
assessment findings for a postoperative patient. As the clinical
leader, how do you apply the Marquis–Huston critical-thinking
teaching model to assist the nurse?
A. Tell the nurse to follow gut instinct next time.
B. Guide the nurse through structured questioning about cues,
assumptions, and alternate explanations.
C. Document the discrepancy and ignore it if patient appears
stable.
D. Reassign the patient to another nurse immediately.
Correct Answer: B
Rationale — Correct: The Marquis–Huston model promotes
structured reflection (identify cues, clarify assumptions,
generate alternatives), which builds clinical reasoning and
reduces future errors.
Rationale — A: Encouraging intuition without structure
discourages analytical skills development.
Rationale — C: Ignoring discrepancies risks missing
deterioration and misses a teaching opportunity.
Rationale — D: Reassignment avoids addressing the nurse’s
reasoning gap and reduces learning.
Teaching Point: Use structured questioning to develop clinical
