,2026/2027 Galen College of Nursing NUR282 Leadership and
Nursing Management Exam 3 | Questions, Answers & Detailed
Rationales.
A hospital reorganizes nursing services so that authority flows from the chief
nursing officer through several formal management levels. Which organizational
concept is being demonstrated?
A) Shared governance
B) Informal networking
C) Chain of command
D) Decentralized peer practice
Correct Answer: Chain of command
Rationale: The chain of command describes the formal line of authority and
communication within an organization. It clarifies who reports to whom and provides a
structured path for resolving concerns when issues cannot be addressed at the immediate
level.
2. Which characteristic is most consistent with a decentralized organization?
A) All decisions are made by executives.
B) Staff nurses have no input into practice decisions.
C) Decision-making authority is distributed closer to the point of care.
D) Unit managers must obtain executive approval for routine operational decisions.
Correct Answer: Decision-making authority is distributed closer to the point of care.
Rationale: Decentralization moves selected decision-making authority downward in the
organization. This can improve responsiveness, professional autonomy, and staff
engagement when appropriate accountability structures are maintained.
3. A nurse manager is responsible for 45 employees who all report directly to that
manager. Which management concept is most directly affected?
A) Unity of command
B) Shared governance
C) Organizational culture
D) Span of control
Correct Answer: Span of control
Rationale: Span of control refers to the number of employees or functions directly
supervised by one manager. A very broad span may limit the manager's ability to provide
effective communication, coaching, evaluation, and oversight.
, 4. Which statement best describes shared governance?
A) Executives independently establish all nursing policies.
B) Staff participate meaningfully in decisions affecting nursing practice.
C) Nurses work without managerial accountability.
D) Committees replace organizational leadership.
Correct Answer: Staff participate meaningfully in decisions affecting nursing practice.
Rationale: Shared governance promotes professional autonomy and collaboration by
involving nurses in decisions about standards, quality, practice, and the work environment.
5. A unit has several committees, but staff recommendations are routinely ignored.
What is the greatest concern?
A) Excessive decentralization
B) Participation may be symbolic rather than genuinely empowering.
C) The unit has too much shared governance.
D) Staff have excessive authority.
Correct Answer: Participation may be symbolic rather than genuinely empowering.
Rationale: Staff involvement improves engagement only when participation has meaningful
influence. Committees without real input can reduce trust and increase cynicism.
6. Which organizational structure groups employees according to areas such as
nursing, finance, pharmacy, and human resources?
A) Matrix structure
B) Service-line structure
C) Functional structure
D) Flat structure
Correct Answer: Functional structure
Rationale: Functional structures group employees by specialty or departmental expertise.
This can support technical specialization but may also create communication barriers
between departments.
7. In a matrix organization, a nurse may report to both a nursing manager and a
project leader. What potential problem can result?
A) Excessive patient autonomy
B) Role ambiguity from dual reporting relationships
C) Elimination of communication
D) Loss of all organizational accountability
Correct Answer: Role ambiguity from dual reporting relationships
Nursing Management Exam 3 | Questions, Answers & Detailed
Rationales.
A hospital reorganizes nursing services so that authority flows from the chief
nursing officer through several formal management levels. Which organizational
concept is being demonstrated?
A) Shared governance
B) Informal networking
C) Chain of command
D) Decentralized peer practice
Correct Answer: Chain of command
Rationale: The chain of command describes the formal line of authority and
communication within an organization. It clarifies who reports to whom and provides a
structured path for resolving concerns when issues cannot be addressed at the immediate
level.
2. Which characteristic is most consistent with a decentralized organization?
A) All decisions are made by executives.
B) Staff nurses have no input into practice decisions.
C) Decision-making authority is distributed closer to the point of care.
D) Unit managers must obtain executive approval for routine operational decisions.
Correct Answer: Decision-making authority is distributed closer to the point of care.
Rationale: Decentralization moves selected decision-making authority downward in the
organization. This can improve responsiveness, professional autonomy, and staff
engagement when appropriate accountability structures are maintained.
3. A nurse manager is responsible for 45 employees who all report directly to that
manager. Which management concept is most directly affected?
A) Unity of command
B) Shared governance
C) Organizational culture
D) Span of control
Correct Answer: Span of control
Rationale: Span of control refers to the number of employees or functions directly
supervised by one manager. A very broad span may limit the manager's ability to provide
effective communication, coaching, evaluation, and oversight.
, 4. Which statement best describes shared governance?
A) Executives independently establish all nursing policies.
B) Staff participate meaningfully in decisions affecting nursing practice.
C) Nurses work without managerial accountability.
D) Committees replace organizational leadership.
Correct Answer: Staff participate meaningfully in decisions affecting nursing practice.
Rationale: Shared governance promotes professional autonomy and collaboration by
involving nurses in decisions about standards, quality, practice, and the work environment.
5. A unit has several committees, but staff recommendations are routinely ignored.
What is the greatest concern?
A) Excessive decentralization
B) Participation may be symbolic rather than genuinely empowering.
C) The unit has too much shared governance.
D) Staff have excessive authority.
Correct Answer: Participation may be symbolic rather than genuinely empowering.
Rationale: Staff involvement improves engagement only when participation has meaningful
influence. Committees without real input can reduce trust and increase cynicism.
6. Which organizational structure groups employees according to areas such as
nursing, finance, pharmacy, and human resources?
A) Matrix structure
B) Service-line structure
C) Functional structure
D) Flat structure
Correct Answer: Functional structure
Rationale: Functional structures group employees by specialty or departmental expertise.
This can support technical specialization but may also create communication barriers
between departments.
7. In a matrix organization, a nurse may report to both a nursing manager and a
project leader. What potential problem can result?
A) Excessive patient autonomy
B) Role ambiguity from dual reporting relationships
C) Elimination of communication
D) Loss of all organizational accountability
Correct Answer: Role ambiguity from dual reporting relationships
