NUR 4590 Exam 2| Professional Identity of the
Nurse Leader – Organizational Structure, Quality
Improvement and Nursing Informatics Questions
with Answers and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
NUR 4590 Exam 2. Topics include organizational structure and design, leadership theories,
professional identity, quality improvement, patient safety, and nursing informatics.
1. Which of the following factors influences the structure of an organization?
A. Age of the building
B. Brand of computer system
C. Number of employees
D. Square footage of the facility
Correct Answer: C — Number of employees
Rationale: Organizational structure is influenced by size, strategy, technology, and
environment. The number of employees determines span of control and
hierarchical layers. Larger organizations typically have more complex structures
with greater specialization .
,2. Within nursing practice, the use of advanced practice roles is an example of:
A. Cross-training
B. Departmentalization
C. Fragmentation
D. Specialization
Correct Answer: D — Specialization
Rationale: Specialization involves focusing expertise in a specific area of practice
(NP, CNS, CRNA, CNM). Advanced practice roles require graduate education and
specialized clinical knowledge. Specialization improves patient outcomes through
focused expertise .
3. The nursing chief executive officer (CEO) works in a major rehabilitation and
subacute facility network. Her span of control refers to the number of:
A. Miles in which the network resides
B. Ancillary staff accountable to her
C. Nurses and non-nurses reporting to her
D. Inpatients that the facilities service
Correct Answer: C — Nurses and non-nurses reporting to her
,Rationale: Span of control is the number of direct reports a manager supervises. It
includes all staff (professional and non-professional) reporting to the position.
Optimal span varies based on complexity and staff competency .
4. A nurse manager is responsible for a unit consisting of 40 nurses who report to
two clinical supervisors. In addition, there are 10 support staff who report to an
administrative supervisor. The subordinates reporting to this manager are known
as which dimension of organizational design?
A. Division of labor
B. Hierarchy
C. Span of control
D. Decentralization
Correct Answer: C — Span of control
Rationale: Span of control refers to the number of subordinates directly reporting
to a manager. Here the manager has two clinical supervisors and one
administrative supervisor reporting directly. Wide spans reduce management
layers; narrow spans provide closer supervision .
, 5. A staff nurse has been working in the neonatal critical care unit for 10 years.
She believes that a professional nurse is a lifelong learner. Many staff members
come to her for clinical problem solving and advice. This nurse has:
A. Decisional authority
B. Formal power
C. Informal power
D. Quantum authority
Correct Answer: C — Informal power
Rationale: Informal power is derived from personal characteristics, expertise,
relationships, and respect earned from colleagues rather than from a formal
position or title. This nurse has developed informal power through her clinical
experience, commitment to lifelong learning, and reputation as a clinical resource
.
6. An organizational chart with one line of management and one line of staff
reflects which of the following types of organizational structures?
A. Authoritarian structure
B. Flat structure
Nurse Leader – Organizational Structure, Quality
Improvement and Nursing Informatics Questions
with Answers and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on
NUR 4590 Exam 2. Topics include organizational structure and design, leadership theories,
professional identity, quality improvement, patient safety, and nursing informatics.
1. Which of the following factors influences the structure of an organization?
A. Age of the building
B. Brand of computer system
C. Number of employees
D. Square footage of the facility
Correct Answer: C — Number of employees
Rationale: Organizational structure is influenced by size, strategy, technology, and
environment. The number of employees determines span of control and
hierarchical layers. Larger organizations typically have more complex structures
with greater specialization .
,2. Within nursing practice, the use of advanced practice roles is an example of:
A. Cross-training
B. Departmentalization
C. Fragmentation
D. Specialization
Correct Answer: D — Specialization
Rationale: Specialization involves focusing expertise in a specific area of practice
(NP, CNS, CRNA, CNM). Advanced practice roles require graduate education and
specialized clinical knowledge. Specialization improves patient outcomes through
focused expertise .
3. The nursing chief executive officer (CEO) works in a major rehabilitation and
subacute facility network. Her span of control refers to the number of:
A. Miles in which the network resides
B. Ancillary staff accountable to her
C. Nurses and non-nurses reporting to her
D. Inpatients that the facilities service
Correct Answer: C — Nurses and non-nurses reporting to her
,Rationale: Span of control is the number of direct reports a manager supervises. It
includes all staff (professional and non-professional) reporting to the position.
Optimal span varies based on complexity and staff competency .
4. A nurse manager is responsible for a unit consisting of 40 nurses who report to
two clinical supervisors. In addition, there are 10 support staff who report to an
administrative supervisor. The subordinates reporting to this manager are known
as which dimension of organizational design?
A. Division of labor
B. Hierarchy
C. Span of control
D. Decentralization
Correct Answer: C — Span of control
Rationale: Span of control refers to the number of subordinates directly reporting
to a manager. Here the manager has two clinical supervisors and one
administrative supervisor reporting directly. Wide spans reduce management
layers; narrow spans provide closer supervision .
, 5. A staff nurse has been working in the neonatal critical care unit for 10 years.
She believes that a professional nurse is a lifelong learner. Many staff members
come to her for clinical problem solving and advice. This nurse has:
A. Decisional authority
B. Formal power
C. Informal power
D. Quantum authority
Correct Answer: C — Informal power
Rationale: Informal power is derived from personal characteristics, expertise,
relationships, and respect earned from colleagues rather than from a formal
position or title. This nurse has developed informal power through her clinical
experience, commitment to lifelong learning, and reputation as a clinical resource
.
6. An organizational chart with one line of management and one line of staff
reflects which of the following types of organizational structures?
A. Authoritarian structure
B. Flat structure
