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
Stem: As charge nurse on a 28-bed med-surg unit, you receive
conflicting reports about a patient’s falling risk: nursing
assistant says patient is repeatedly unsteady; tech reports
patient refused assist twice. You must decide immediate action
and plan to prevent recurrence. Which approach best balances
rapid safety and evidence-based decision making?
,A. Place a sitter immediately and document staff reports.
B. Conduct an immediate focused assessment, implement fall
precautions, and notify the interprofessional team.
C. Instruct staff to increase hourly rounding and reassess in 8
hours.
D. Transfer the patient to a higher-acuity observation area.
Correct answer: B
Rationale — Correct: A focused assessment gathers objective
data (vitals, neurologic status, medication review), while
immediate fall precautions and team notification align with
evidence-based safety and decisive action. This integrates
clinical reasoning and the “gather data” and “choose and act
decisively” elements of Huston’s decision-making framework.
Rationale — A: A sitter alone may protect safety short-term but
omits clinical assessment and team coordination.
Rationale — C: Increased rounding is valuable but waiting 8
hours risks harm and delays decisive action.
Rationale — D: Transfer may be unnecessary without
assessment and wastes resources.
Teaching point: Assess first, act to protect safety, then
coordinate the team.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
2.
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
,Stem: A nurse manager must choose between two staffing
models after fiscal review: (1) hire experienced RNs at higher
cost, (2) increase use of new graduate RNs with precepting.
Which decision-making model best fits this organizational-level
choice?
A. Traditional problem-solving process with single-solution
selection.
B. Managerial decision-making model using cost-benefit
analysis and stakeholder input.
C. Intuitive decision-making relying on past hiring instincts.
D. Randomized trial assigning staff and observing results.
Correct answer: B
Rationale — Correct: Managerial decision-making uses
systematic analysis (costs, outcomes, staff competencies) and
stakeholder engagement, aligning with organizational power
and evidence-based approaches Huston describes. It balances
fiscal responsibility and patient safety.
Rationale — A: Traditional one-solution focus risks ignoring
alternatives and stakeholder effects.
Rationale — C: Intuition alone lacks systematic evaluation and
accountability for financial decisions.
Rationale — D: A randomized trial is impractical and ethically
complex for staffing choices.
Teaching point: Use managerial models for organizational
resource decisions.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
, 3.
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: During a simulation debrief, a nurse identifies their
thinking style as “fast, gut-based.” They ask how to reduce bias
when making rapid decisions. Which strategy should the
educator recommend?
A. Rely on intuition more to save time.
B. Use a brief decision checklist and verbalize rationale during
action.
C. Always defer to the most senior clinician.
D. Avoid rapid decisions and always transfer care to higher
units.
Correct answer: B
Rationale — Correct: A brief checklist preserves speed while
requiring explicit data capture and reasoning, reducing
cognitive bias as suggested by Marquis–Huston and Huston’s
recommendations to use structured tools during rapid
decisions.
Rationale — A: Increasing reliance on intuition risks unchecked
bias.
Rationale — C: Deferring to senior staff can delay care and
disempower competent clinicians.
Rationale — D: Not feasible—delaying or transferring
undermines timely care.
Teaching point: Checklists reduce bias in fast-paced decisions.
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
Stem: As charge nurse on a 28-bed med-surg unit, you receive
conflicting reports about a patient’s falling risk: nursing
assistant says patient is repeatedly unsteady; tech reports
patient refused assist twice. You must decide immediate action
and plan to prevent recurrence. Which approach best balances
rapid safety and evidence-based decision making?
,A. Place a sitter immediately and document staff reports.
B. Conduct an immediate focused assessment, implement fall
precautions, and notify the interprofessional team.
C. Instruct staff to increase hourly rounding and reassess in 8
hours.
D. Transfer the patient to a higher-acuity observation area.
Correct answer: B
Rationale — Correct: A focused assessment gathers objective
data (vitals, neurologic status, medication review), while
immediate fall precautions and team notification align with
evidence-based safety and decisive action. This integrates
clinical reasoning and the “gather data” and “choose and act
decisively” elements of Huston’s decision-making framework.
Rationale — A: A sitter alone may protect safety short-term but
omits clinical assessment and team coordination.
Rationale — C: Increased rounding is valuable but waiting 8
hours risks harm and delays decisive action.
Rationale — D: Transfer may be unnecessary without
assessment and wastes resources.
Teaching point: Assess first, act to protect safety, then
coordinate the team.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
2.
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
,Stem: A nurse manager must choose between two staffing
models after fiscal review: (1) hire experienced RNs at higher
cost, (2) increase use of new graduate RNs with precepting.
Which decision-making model best fits this organizational-level
choice?
A. Traditional problem-solving process with single-solution
selection.
B. Managerial decision-making model using cost-benefit
analysis and stakeholder input.
C. Intuitive decision-making relying on past hiring instincts.
D. Randomized trial assigning staff and observing results.
Correct answer: B
Rationale — Correct: Managerial decision-making uses
systematic analysis (costs, outcomes, staff competencies) and
stakeholder engagement, aligning with organizational power
and evidence-based approaches Huston describes. It balances
fiscal responsibility and patient safety.
Rationale — A: Traditional one-solution focus risks ignoring
alternatives and stakeholder effects.
Rationale — C: Intuition alone lacks systematic evaluation and
accountability for financial decisions.
Rationale — D: A randomized trial is impractical and ethically
complex for staffing choices.
Teaching point: Use managerial models for organizational
resource decisions.
Citation: Huston, C. J. (2024). Leadership Roles and
Management Functions in Nursing (11th ed.). Ch. 1.
, 3.
Reference: Ch. 1 — Decision Making, Problem Solving, Critical
Thinking, and Clinical Reasoning
Stem: During a simulation debrief, a nurse identifies their
thinking style as “fast, gut-based.” They ask how to reduce bias
when making rapid decisions. Which strategy should the
educator recommend?
A. Rely on intuition more to save time.
B. Use a brief decision checklist and verbalize rationale during
action.
C. Always defer to the most senior clinician.
D. Avoid rapid decisions and always transfer care to higher
units.
Correct answer: B
Rationale — Correct: A brief checklist preserves speed while
requiring explicit data capture and reasoning, reducing
cognitive bias as suggested by Marquis–Huston and Huston’s
recommendations to use structured tools during rapid
decisions.
Rationale — A: Increasing reliance on intuition risks unchecked
bias.
Rationale — C: Deferring to senior staff can delay care and
disempower competent clinicians.
Rationale — D: Not feasible—delaying or transferring
undermines timely care.
Teaching point: Checklists reduce bias in fast-paced decisions.
