Leadership Exam 1 questions with 100% correct and verified answers.

Leadership Exam 1 A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is asked to assess and adapt the unit to better meet the unique needs of the older adult patient. Using complexity principles, what would be the best approach to take for implementation of this change? a. Leverage the hierarchical management position to get unit staff involved in assessment and planning. b. Engage involved staff at all levels in the decision-making process. c. Focus the assessment on the unit and omit the hospital and community environment. d. Hire a geriatric specialist to oversee and control the project. - Correct answer b. Engage involved staff at all levels in the decision-making process." "A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow's need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients? a. Line up agency nurses who can be called in to work on short notice. b. Place the nurse on unpaid leave for the remainder of his wife's treatment. c. Sympathize with the nurse's dilemma and let the charge nurse know that this nurse may be calling in frequently in the future. d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife's treatments. - Correct answer d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife's treatments." "A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation session, the staff nurse repeatedly calls the unit manager's actions unfair, and the unit manager continues to reiterate the reasons for the actions. What would be the best course of action at this time? a. Send the two disputants away to reach their own resolution. b. Involve another staff nurse in the discussion for clarity issues. c. Ask each party to examine their own motives and issues in the conflict. d. Continue to listen as the parties repeat their thoughts and feelings about the conflict. - Correct answer c. Ask each party to examine their own motives and issues in the conflict." "At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. What is the appropriate next step? a. Arrange another meeting in a week's time so as to allow a cooling-off period. b. Elevate the next negation session to the next manager, one level above. c. Insist that participants continue to talk until a resolution has been reached. d. Back the unit manager's actions and end the dispute. - Correct answer b. Elevate the next negation session to the next manager, one level above." "The manager of a surgical area has a vision for the future that requires the addition of RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff have always practiced in a primary nursing-delivery system and are very resistant to this idea. What would be the best initial strategy for implementation of this change? a. Exploring the values and feelings of the RN group in relationship to this change b. Leaving the RNs alone for a time so they can think about the change before it is implemented c. Dropping the idea and trying for the change in a year or so when some of the present RNs have retired d. Hiring the assistants and allowing the RNs to see what good additions they are - Correct answer a. Exploring the values and feelings of the RN group in relationship to this change" "As the RN charge nurse on the night shift in a small long-term care facility, you've found that there is little turnover among your LPN and nursing assistant (NA) staff members, but they are not very motivated to go beyond their job descriptions in their work. Which of the following strategies might motivate the staff and lead to greater job satisfaction? a. Ask the director of nursing to offer higher wages and bonuses for extra work for the night LPNs and NAs. b. Allow the LPNs and NAs greater decision-making power within the scope of their positions in the institution. c. Hire additional staff so that there are more staff available for enhanced care, and individual workloads are lessened. d. Ask the director of nursing to increase job security for night staff by having them sign contracts that guarantee work. - Correct answer b. Allow the LPNs and NAs greater decision-making power within the scope of their positions in the institution." "The nurse manager wants to increase motivation by providing motivating factors for the nurse on the unit. What action would be appropriate to motivate the staff? a. Collaborate with the human resource/personnel department to develop on-site daycare services. b. Provide a hierarchical organizational structure. c. Implement a model of shared governance. d. Promote the development of a flexible benefits package. - Correct answer c. Implement a model of shared governance." "A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The family member leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner? a. Reflect to gain insight into how the situation could be handled differently in the future. b. Try to catch up with the angry family member to resolve the concern. c. Discuss the concern with the patient after the family member has left. d. Notify nursing administration of the situation. - Correct answer a. Reflect to gain insight into how the situation could be handled differently in the future." "The chief nursing officer has asked the staff development coordinator to facilitate the development of a clinical competency program for the facility. While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. What behavior by the staff development coordinator is most appropriate in this situation? a. Disregard staff concerns and continue with development of the program. b. Inform the nurses that this program is a requirement for JCAHO accreditation. c. Schedule a meeting with the chief nurse executive to apprise her of the situation. d. Facilitate a meeting so nurses can articulate their values and concerns about a competency program. - Correct answer d. Facilitate a meeting so nurses can articulate their values and concerns about a competency program." "The nurse manager has been asked to implement an evidence-based approach to teach ostomy patients self-management skills postoperatively. The program is to be implemented across the entire facility. What illustrates effective leadership in this situation? a. The training modules are left in the staff room for times when staff are available. b. The current approach is continued because it is also evidence-based and is more familiar to staff. c. You decide to implement the approach at a later date because of feedback from the RNs that the new approach takes too much time. d. An RN who is already familiar with the new approach of volunteers to take the lead in mentoring and teaching others how to implement it. - Correct answer d. An RN who is already familiar with the new approach of volunteers to take the lead in mentoring and teaching others how to implement it." "You overhear a new graduate RN telling a nurse colleague that leadership and management belong to the unit manager, not to her. As a nursing colleague, what do you know to be true in regard to the statement? a. The statement is correct. Leadership is not the role of the staff nurse. b. The new graduate would benefit from further understanding of her role as a professional, whose influence may affect the decision making of patients, colleagues, and other professionals. c. The new graduate has been influenced by nurse leaders and managers who leave for other positions. d. The general perception is that nurse leaders and managers are not satisfied in their jobs. - Correct answer b. The new graduate would benefit from further understanding of her role as a professional, whose influence may affect the decision making of patients, colleagues, and other professionals." "The charge nurse walks into Mr. Smith's room and finds him yelling at the LPN. He is obviously very upset. The charge nurse determines that he has not slept for three nights because of unrelieved pain levels. The LPN is very upset and calls Mr. Smith an "ugly, old man." The charge nurse acknowledges the LPN's feelings and concerns and then suggests that Mr. Smith's behavior was aggressive but was related to lack of sleep and to pain. The charge nurse asks, "Can you, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling his pain?" This situation is an example of what? a. Lack of empathy and understanding for Miss Jones b. Concern with placating Mr. Smith c. Leadership behavior d. Management behavior - Correct answer c. Leadership behavior" "After assessing an older adult patient in long-term care who has been slowly deteriorating for weeks, the nurse manager calls the family and asks them to come in, as the patient is dying. What is the most likely basis for the nurse manager's request? a. An established clinical pathway b. Confirmatory scientific evidence c. Unit protocol d. Experience - Correct answer d. Experience" "Chart audits have revealed significant omissions of data that could have legal and financial guideline ramifications. The unit manager meets with the staff to discuss audit findings and to find approaches that will address the gaps in charting and achieve desired goals. What is the manager demonstrating? a. Leadership b. Management c. Decision making d. Vision - Correct answer b. Management" "A family is keeping vigil at a critically ill patient's bedside. Distant family members call the unit continuously asking for updates and expressing concern. The nurse speaks with the distant family members and states she is referring them to the hospital social worker, whose role is to work with family in this situation. What role is the nurse assuming through this action? a. Manager b. Leader c. Follower d. Laissez-faire - Correct answer a. Manager" "A family is keeping vigil at a critically ill patient's bedside. The nurse approaches the unit manager with concern over the family dynamics for the patient concerned there are patient-family conflicts based on patient's wishes. The nurse suggests that the patient's provider may need to discuss the treatment plan with the family. The unit manager states he will arrange a discussion with the patient's provider and ask the nurse to support the provider's decisions. What is the role of the nurse in this situation? a. Leadership b. Management c. Follower d. Evidence-based - Correct answer c. Follower" "The manager calls the staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, the manager explains that the organization values patient-centered care and that evidence supports that acting as an advocate and a listener is helpful to families. The manager asks the staff for ideas and strategies that are effectively patient-centered in dealing with families in similar situations. What is the role of the nurse manager in this situation? a. Leadership b. Management c. Follower d. Visionary - Correct answer a. Leadership" "The manager of a unit is finding it difficult to work with a new graduate nurse. The new nurse has many ideas; however, his manner of presenting them irritates the manager. After reflection and discussion with others, the manager recognizes that she feels threatened by his behavior. She comes to understand that the new nurse is trying to establish his own role on the unit; is not trying to challenge her; and needs guidance, coaching, and affirmation. What is the nurse manager demonstrating in this situation? a. A positive self-concept b. Deepening self-awareness c. Leadership d. Acquiescence - Correct answer b. Deepening self-awareness" "As the head of a nursing program, you consistently invite the ideas of your team about innovations in teaching, community partnerships, and curriculum design and invite participation in decisions. Many of these ideas have been implemented successfully, and your staff members are keen to try on other ideas. What is the leadership you are employing? a. Situational b. Trait-based c. Contingency-based d. Transformational - Correct answer d. Transformational" "As a leader on a rehab unit, the manager encourages all staff members to see themselves as having a role in decision making and quality care. The manager sees their role as involving particular responsibilities in decision making but not as a hierarchal role. What is this view of the role consistent with in this situation? a. Trait theories b. Complexity theory c. Situated theory d. Emotional intelligence - Correct answer b. Complexity theory" "A staff nurse has been recently promoted to unit manager. During the time on the unit, the nurse formed a strong social network among staff, has promoted the development of relationships between staff and workers in other areas of the organization, and has formed relationships that generate ideas from patient organizations and the local nursing education program. According to complexity theory, what principle is being engaged? a. Empowerment b. Systematic thinking c. Development of networks d. Bottom-up interactions - Correct answer c. Development of networks" "According to the complexity theory, what would be the focus of measurement? a. Cost per hospital day b. Bed utilization c. Infection rates d. Staff morale and budgets - Correct answer d. Staff morale and budgets" "During a staff meeting held to discuss developing a mission statement for the unit, the idea of placing patient needs first is discussed. What is considered when the suggestion by the manager is for the unit mission to be derived from the organization mission? a. Empowering b. A leadership tag c. A symbol d. A management task - Correct answer b. A leadership tag" "A dispute arises between an RN and an LPN over a patient issue. The tension continues between the two and begins to affect other staff members, who are drawn into the conflict. Over time, the team becomes polarized toward either the RN or the LPN. How might this situation be prevented? a. Expediency in responding to the initial dispute, once it became apparent that it could not be resolved by the two parties themselves b. Asking other staff members what the real issues were in the dispute between the RN and the LPN c. Reassigning one of the parties to another unit when it became apparent that the two individuals could not resolve the dispute themselves d. Calling a staff meeting at the onset of the dispute to allow the team and the RN and LPN to discuss the initial dispute - Correct answer a. Expediency in responding to the initial dispute, once it became apparent that it could not be resolved by the two parties themselves" "The unit is shifting from primary nursing to a team model in an effort to contain costs. Staff members are upset about the change and ask for a meeting to discuss the new model. After hearing their concerns related to reduction in professional autonomy, what is the initial response by the manager to address the concerns? a. Acknowledge the loss. b. Explain the reasons for change, emphasizing the need to reduce costs. c. Repeat the information several times, giving detailed budget overviews. d. Adjourn the meeting and provide explanation through e-mail. - Correct answer a. Acknowledge the loss." "A new graduate nurse wonders about the directions that her preceptor has given her regarding management of incontinent, confused patients. The new nurse brings the preceptor evidence-based information she located regarding incontinence interventions for confused patients and asks to talk about the guidance that given after the preceptor reviews the information in the article. What is the new nurse demonstrating in this situation? (Select all that apply.) a. Assertiveness b. Followership c. Management d. Insubordination - Correct answer a. Assertiveness b. Followership" "As a new nurse manager, you are aware of leadership, management, and followership principles. What is the first step to becoming an effective leader? a. Being an effective follower b. Taking a class on leadership c. Taking a class on management d. Getting an advanced degree - Correct answer a. Being an effective follower" "As a nurse manager, you are a leader in health care and on the unit you manage. Looking at the larger picture of health care and patient environment on the unit, what is your primary role when evaluating the care provided on your nursing unit? a. Focus on cost outcomes. b. Assess staff for contentment on unit. c. Ensure quality patient care on unit. d. Provide education to the staff of the unit - Correct answer c. Ensure quality patient care on unit." "The chief nursing officer (CNO) is appointed for the local hospital in a rural area. The nursing committee agreed with the appointment of the new CNO offered the position. What is this type of leadership position considered? a. Formal leadership b. Informal leadership c. Director leadership d. Personal leadership - Correct answer a. Formal leadership" "The core of leadership is awareness. The text by Don Miguel, The Four Agreements, presents a set of agreements to enhance personal growth and awareness. What is not one of the four agreements? a. Be impeccable with your word. b. Take things personally. c. Do not make assumptions. d. Always do your best. - Correct answer b. Take things personally." "The core of nursing leadership incorporates integration of unique qualities to include us as individuals. Which is not considered part of leadership integration? a. Person b. Leader c. Nurse d. Position - Correct answer d. Position" "A new graduate nurse has accepted a position in an intensive care unit. The nurse is assigned a preceptor with several years of experience. The new nurse also notices the other staff seek this nurse out for answers to questions and as a resource to the unit. What does the new nurse consider the role of the mentor nurse? a. A formal leader b. A positional leader c. An official leader d. An informal leader - Correct answer d. An informal leader" "The manager of a nursing unit is having difficulty working with a new graduate nurse. The new graduate nurse is excited and full of ideas she wants to try. The manager decides to journal her feelings regarding the new nurse and her feelings. What is the nurse manager practicing in this situation? a. Leadership b. Reflection c. Knowledge d. Action - Correct answer b. Reflection" "A staff nurse is taking leadership classes in an advanced degree program as the nurse wants to become a manager. The instructor requires the students to create a journal and make notes of their feelings when they experience conflicts at work over the next few weeks. The assignment calls for the use of reflection. What is the purpose of this assignment? a. Log of conflicts which occur b. Reflection for self-awareness in conflict situations c. Assess the students conflict management skills d. Analysis of student lead conflicts - Correct answer b. Reflection for self-awareness in conflict situations" "The nurse manager is working with a group of new nurses. The new nurses ask questions about leadership and the role of a manager in leading nursing. The manager shares she has incorporated her core values and beliefs into her role and responsibilities as a nurse manager. What type of leadership has she described? a. Positional leadership b. Personal leadership c. Formal leadership d. Information leadership - Correct answer b. Personal leadership" "Excellent leaders need to have or develop the skills of empathy and expressiveness when dealing with others in the workplace. This is also known as understanding and managing own feelings and emotions as well as discerning the emotions of others. What is this an example of required by good leaders? a. Social awareness b. Self-awareness c. Emotional intelligence d. Intellectual ability - Correct answer c. Emotional intelligence" "A nurse manager when in the formal leadership position attempts to translate the picture or vision of her facility across for the staff nurses. The manager is faced with a staff who is resistant to the vision of the facility. What is the theory the manager needs to incorporate to be effective? a. Model the Way b. Inspire a Shared Vision c. Challenge the Process d. The Four Agreements - Correct answer b. Inspire a Shared Vision" "The manager is using self-reflection to gain insight into improving the leadership skills. By using self-awareness what does a leader develop? a. New knowledge b. Personal growth c. Improved self esteem d. Management skills - Correct answer a. New knowledge" "In developing leadership skills, one should focus on authentic leadership. The theory of authentic leadership focuses on various factors. What is the top priority in development of authentic leadership? a. Honest relationships b. Organizational task c. Accomplishment of goals d. Exploring others - Correct answer a. Honest relationships" "As a leader in nursing, one must seek new insights and establish personal tools to improve their lifelong learning. Which behavior by manager would be a concern for a chief nursing executive? a. Journaling for self-reflection b. Authentic relationships c. Complacent behavior d. Improved knowledge of staff - Correct answer c. Complacent behavior" "The charge nurse of a unit is asking the staff what patients they had the day before to make assignments for the day. A new nurse complains about having the same patients every day. The charge nurse considers the new nurse request at an assigned to different patient for today. What type of leadership is the charge nurse displaying? a. Informal leadership b. Formal leadership c. Favoritism d. No leadership displayed - Correct answer b. Formal leadership" "A staff nurse is the person on the unit everyone seeks for input and asks questions. What type of leadership position is the staff nurse displaying? a. Position leadership b. Informal leadership c. Personal leadership d. Formal leadership - Correct answer b. Informal leadership" "At the end of a shift, the charge nurse shares with the new nurse she had done an excellent job with a difficult patient that day. The new nurse was upset by the way the family of the patient had treated her. She shared her feeling with the charge nurse. The charge nurse offered to change the assignment the following day. What is the charge nurse displaying? a. Emotional intelligence b. Comportment c. Compassion d. Management of conflict - Correct answer a. Emotional intelligence" "Which of the following is an example of a formal leadership position on a nursing unit? a. Staff nurse b. Unit secretary c. Unit manager d. Nursing assistant - Correct answer c. Unit manager" "A new nurse leader wants to be the best leader she can. The nurse takes classes, finds and leadership mentor, seeks input from her unit, and employs other strategies for leadership development. What is another strategy for the leader to develop and improve leadership skills? a. Proactive learning b. Ignoring feedback c. Being in charge d. Authoritative position - Correct answer a. Proactive learning" "A staff nurse wants to become a charge nurse. What is one of the most effective methods for the staff nurse to incorporate to effectively transition to charge nurse? a. Read a book on charge position. b. Integrate prior experience to new role. c. Do things the way always done. d. Change units to be a charge on different unit. - Correct answer b. Integrate prior experience to new role." "As a nurse manager and the leader of the unit, you are aware of multiple avenues for learning leadership traits. Which avenues would you pursue for learning leadership traits? (Select all that apply.) a. Attending professional conferences b. Reading books on leadership c. Joining professional organizations d. Connecting with other leaders in the organization e. Experiences from new nurses - Correct answer a. Attending professional conferences b. Reading books on leadership c. Joining professional organizations d. Connecting with other leaders in the organization" "As a new nurse manager, you are aware of leadership, management, and followership principles. The concept of followership is rather new as relating to leadership. What is the role of the follower in followership? a. Leading the group in task b. Submission position in organization c. Person who may influence team d. Negative meaning for worker - Correct answer c. Person who may influence team" "As a nurse manager, you are a leader and a follower in health care and on the unit you manage. Looking at the larger picture of health care and patient environment on the unit, what is the primary role of the followers on the unit, as defined in nursing? a. Direct care provider b. Implements leader's policy unquestioned c. Passive role on unit d. Devalued staff member - Correct answer a. Direct care provider" "In nursing theory, one theorist developed the theory of self-care of patients. In the theory, the nursing action of providing care and educating the patients can be interpreted in the form of followership for the patient. Who was their theorist? a. Dorothea Orem b. Patricia Benner c. Ida Jean Orlando d. Robert E. Kelley - Correct answer a. Dorothea Orem" "In nursing theory, one theorist developed the idea of new nurses progressing to experienced nurses and playing an important role in patient care in all stages. The new nurses follow their role and progress through stages to advanced nurse. Who was this theorist? a. Dorothea Orem b. Patricia Benner c. Ida Jean Orlando d. Robert E. Kelley - Correct answer b. Patricia Benner" "The definition of leader refers to a person who has ability to guide people. In nursing, the leader does more. What is NOT a role of a leader in nursing? a. Active listening b. Open communication c. Accountability in decisions d. Tight control of decisions - Correct answer d. Tight control of decisions" "The definition of follower has historically referred to a person who is subservient and submissive. The new principles of followership offer a different perspective. What is NOT considered an attribute of followership in nursing? a. Independent decision making b. Critical thinking c. Patient advocate d. No influence over leaders - Correct answer d. No influence over leaders" "The manager of a nursing unit is having difficulty working with a new graduate nurse. The new graduate nurse is excited and full of ideas she wants to try keeps pushing the manager to make changes. The manager decides to provide the new nurse with an opportunity to present an idea to the staff at the next meeting. What is the manager providing the new nurse? a. Leadership opportunity b. Working to improve patient care c. Input to the unit d. All of the above - Correct answer d. All of the above" "A staff nurse is taking leadership classes in an advanced degree program with a goal to become a nurse manager. The nurse is studying the leader-follower relationship. What has the nurse discovered as accurate part of the leader-follower relationship? a. Leaders are also followers. b. Followers need to linear structures. c. Followers are submissive in nature. d. Leaders should dictate to the group. - Correct answer a. Leaders are also followers." "The nurse manager is working with a group of new nurses. The new nurses ask questions about leadership and the role of a manager in leading nursing. The manager shares the desire to have engaged staff nurses who participate in a team environment. What is the manager describing? a. Effective follower b. Effective leader c. Ineffective follower d. Ineffective leader - Correct answer a. Effective follower" "A new graduate nurse is working in an outpatient surgical center with the circulating nurse. The nurse is reviewing the patient's chart and orders. The patient has been in pre-op receiving eye drops in her right eye as preparation for cataract removal surgery. The pre-operative orders indicate a marking has been made above the right eyebrow by the pre-operative nurse for surgery. The pre-operative nurse has been instilling the medicated eye drops to dilate the right eye for surgery. Upon further review of surgical consent, the consent was for surgery on the left eye and the history and physical by the surgeon indicate the patient is supposed to have surgery on her left eye. What action by the new nurse is considered appropriate followership? (Select all that apply.) a. Alert the pre-operative nurse to the chart discrepancy. b. Ask the charge nurse to double check the chart together. c. Notify the surgeon to the issue - Correct answer a. Alert the pre-operative nurse to the chart discrepancy. b. Ask the charge nurse to double check the chart together. c. Notify the surgeon to the issue for further orders. d. Complete a hospital incident report." "As a nurse manager, you observe a staff nurse who over the past few weeks has become withdrawn and has had several absences due to minor ailments. Your best action would be to: a. ask the nurse if she is okay during report. b. refer the nurse to the employee assistance program. c. ask the nurse to meet with you for a few minutes before she leaves for the day. d. write a note to the nurse advising her that her work attendance must improve. - Correct answer c. ask the nurse to meet with you for a few minutes before she leaves for the day." "The nurse manager of a unit has lost many staff members, and the unit is now staffed with a large number of agency and traveling nurses. She knows that the agency and traveling nurses are all contracted to stay on the unit for the next 3 months. One way to improve morale and decrease stress in the unit would be to: a. plan a social event and include the agency and traveling nurse staff members. b. plan unit-based social events for your remaining permanent staff members. c. request hospital-based "floating" nurses to substitute for the temporary staff. d. implement team nursing. - Correct answer a. plan a social event and include the agency and traveling nurse staff members." "As a nurse manager, the one activity you should not overlook is: a. posting the yearly rotation schedule. b. reviewing vacation requests. c. scheduling staffing for holidays 6 months in advance. d. anticipating staff sick days. - Correct answer b. reviewing vacation requests." "A nurse manager has decided that she must institute some personal time-management steps to survive work and home life. Her first step should be to: a. determine what takes up so much of her time and energy. b. organize her personal and work spaces. c. purchase a handheld personal digital assistant to help remind her of important meetings. d. determine her personal and professional goals. - Correct answer d. determine her personal and professional goals." "A hospice nurse has been feeling very stressed at work because of both the physical strain and the emotional drain of working with clients with AIDS. She tries to walk 1 to 2 miles three times a week and to talk regularly with her husband about her work-related feelings. One reasonable stress-management strategy would be to: a. start taking yoga lessons. b. make an appointment to meet with a psychiatrist. c. start jogging 5 to 6 miles every day. d. plan to go out for a drink with fellow nurses after work every day. - Correct answer a. start taking yoga lessons." "The nurse manager is implementing a shared governance model to help with communication and decision making. Although staff members like the concept, change is difficult. Staff nurses feel: a. more empowered. b. more communicative. c. less stressed. d. more powerless and devalued. - Correct answer d. more powerless and devalued." "The chief nursing officer listens to nurse managers verbalize their feelings of internal stress. One common source of internal stress seems to be: a. the death of a loved one. b. perfectionism. c. getting married. d. losing a job. - Correct answer b. perfectionism." "The staff development educator presents a series of programs on stress management to the nurse managers. Research has indicated that an individual's ability to deal with stress is moderated by psychological hardiness. Psychological hardiness is a composite of: a. commitment, control, and challenge. b. commitment, powerlessness, and passivity. c. commitment, control, and passivity. d. decreased isolation, challenge, and passivity. - Correct answer a. commitment, control, and challenge." "The chief nursing officer understands that a nurse manager can exhibit stress that is related to trying to keep up with the number of electronic messages that arrive, as well as trying to remain accessible to staff. What is a strategy that would assist the manager to manage the information overload effectively? a. Ignore messages unless they are labeled as important. b. Determine who is most likely to send useful or important information or requests. c. Check e-mail messages once a day. d. Encourage face-to-face meetings rather than e-mail. - Correct answer b. Determine who is most likely to send useful or important information or requests." "In helping nurse managers to manage their time, the chief nursing officer suggests that they: a. maintain a perfectionistic attitude. b. set up a complaint list. c. have good negotiation skills. d. have good information literacy skills. - Correct answer d. have good information literacy skills." "Which of the following statements would best define stress? Stress is: a. the comfortable gap between how we like our life to be and how it actually is. b. everyday life, both the highs and the lows. c. a consequence or response to an event or stimulus that can be positive or negative. d. identical to distress. - Correct answer c. a consequence or response to an event or stimulus that can be positive or negative." "In a job interview for a nursing position, Marley can be assured that which of the following will occur? a. Both eustress and distress b. Only eustress c. Only distress d. Neither eustress nor distress - Correct answer a. Both eustress and distress" "Which one of the following statements has been proven to be true? a. Recent research has found that women do not have a unique physiologic response to stress. b. Both men and women interpret the same stressor in the same manner without regard to past experiences. c. Stress influences the immune system in one complex manner. d. Stressors that are identical do not necessarily have similar effects on each individual. - Correct answer d. Stressors that are identical do not necessarily have similar effects on each individual." "An example of role stress occurs when: a. the director of the ICU and the manager of the surgical unit wish to hire the same new employee. b. two part-time staff members are hired to work in a unit, but the job expectations for them are not clear, and the head nurse expresses disappointment in their performance. c. the nurse manager for the ICU wants to advocate for more staff and finds it difficult to find data to substantiate his proposal. d. line managers believe that support staff use their technical knowledge to intrude on their authority. - Correct answer b. two part-time staff members are hired to work in a unit, but the job expectations for them are not clear, and the head nurse expresses disappointment in their performance." "A staff nurse approaches the unit manager and indicates to her that because of her father's death in the previous month, she is now finding it very difficult to do her work effectively. This would be considered a(n) ________ stress. a. internal source b. familial c. burnout d. external - Correct answer d. external" "Sources of occupational stress in nursing include all except which of the following? a. Authoritarian leadership b. Concern about moral wrongdoing by colleagues c. Multiple changes in a short time d. Rotating shifts - Correct answer a. Authoritarian leadership" "Mr. T. Jones and Mr. R. Smith are both going to become residents in Sunny Haven Lodge. Mr. Jones views it as an opportunity to socialize and meet new friends. Mr. Smith views this as abandonment by his family and is worried that the care will be inadequate. Each senior perceives the situation differently. This is a good example of stress that is: a. both a positive stressor and a negative stressor. b. occurring only because of age. c. positive in both cases. d. harmful in both cases. - Correct answer a. both a positive stressor and a negative stressor." "Jeff, an RN in his 30s, has lost a parent, just purchased a new home, and is laid off with 6 months' severance pay. At the same time, Jerry, an RN in his 50s, is financially secure and is asked to take early retirement with a buyout. How will the two men react to the emotional and physical influences and the sequence of stress? a. The younger man will feel more stress. b. The two men may or may not feel the same amount of stress. c. The older man will feel more stress. d. Neither man will experience any stress. - Correct answer b. The two men may or may not feel the same amount of stress." "Social stressors are considered a major factor in the stress nurses experience in the healthcare system. Which of the following is not considered to be a social stressor? a. High amounts of stress in the nursing home environment b. Changes in the current healthcare system such as nursing strategies c. Disruptive behavior coming from physicians and other healthcare workers d. Stress triggers such as self-criticism and overanalyzing - Correct answer d. Stress triggers such as self-criticism and overanalyzing" "After several months of heavy patient loads in the Emergency Department and inability to secure sufficient and experienced staff, the department is especially taxed by a train accident that brings in many seriously injured individuals. You observe that Rama ignores the requests of several of the injured, even when time is available to care for them and is rude to two older adult patients. You are concerned that Rama is evidencing which state? a. Hardiness b. Depression c. Role ambiguity d. Depersonalization - Correct answer d. Depersonalization" ""Stress-buffering" behaviors can be elicited to reduce stress. All of the following behavioral coping responses can be used by nurse managers to reduce and manage stress except: a. distancing oneself from work. b. using cognitive reframing to change irrational thoughts. c. refusing a request to sit on a committee to evaluate scheduling software. d. exercising regularly. - Correct answer a. distancing oneself from work." "The education consultant at St. Joseph Hospital is giving a workshop on cognitive reframing. The consultant explains that cognitive reframing reduces stress by: a. aiding individuals in identifying positive stressors. b. helping people realize that negative thinking causes emotional distress. c. eliminating negative stressors. d. replacing positive self-statements with negative irrational beliefs. - Correct answer b. helping people realize that negative thinking causes emotional distress." "Time management is very essential for the nurse manager. Which of the following is not a good time-management technique? a. Decide what not to do. b. Learn to say "No." c. Learn to delegate. d. Break down your workload into smaller, manageable tasks. - Correct answer d. Break down your workload into smaller, manageable tasks." "As a unit manager, you chair the unit meetings. For each meeting, you consider and establish the purpose of the meeting. Second, you prepare an agenda. Arrange the following steps in an order that would make the meetings productive and successful. 1. Distribute an agenda. 2. Distribute minutes. 3. Select team members. 4. Start on time. 5. Keep the meeting focused and directed toward accomplishing the set objectives. Select the correct order from the following options: a. 1, 2, 4, 5, 3 b. 4, 1, 2, 5, 3 c. 3, 1, 4, 5, 2 d. 3, 4, 2, 1, 5 - Correct answer c. 3, 1, 4, 5, 2" "High levels of work-related stress affect all but which of the following? (Select all that apply.) a. Job satisfaction b. Absenteeism and turnover c. Nurses' health d. Client welfare - Correct answer a. Job satisfaction b. Absenteeism and turnover c. Nurses' health d. Client welfare" "As the clinical director of 24 employees, you have been asked to explain to staff members why they are not getting a raise this year, even though they have been working short-handed for many months and patient satisfaction scores have never been higher. Because you believe yourself to be a transformational leader, you will approach this problem by: a. telling the assistant clinical director and asking her to share the bad news with the other staff members. b. posting a note on the bulletin board that includes the phone number of the chief nursing officer, so anyone who has complaints may express them. c. showing staff members the budget and asking for input about how to cut costs so that raises will be possible in the future. d. meeting with a small group of seasoned staff members and asking them how to break the news. - Correct answer c. showing staff members the budget and asking for input about how to cut costs so that raises will be possible in the future." "After a newly hired director of nursing has reviewed the hospital's strategic plans, she develops a time line for achieving those plans. The new leader is: a. not expecting that novice leaders will have a vision. b. demonstrating mistrust of the abilities of her staff to implement the plans. c. instituting deadlines against which the performance of staff will be evaluated. d. translating a global document into realistic plans for nursing. - Correct answer d. translating a global document into realistic plans for nursing." "A nurse executive is hired to restore a unit's productivity, which has decreased as the result of low staff morale. The nurse executive utilizes which of the following leadership principles? a. The leader declares the intent and goals to enhance productivity and assumes that the unit also wishes to increase productivity, which allows nurses to feel in control of the environment. b. If staff members increase productivity, then they are given opportunity to engage in learning events such as workshops and conferences. If the staff members are not satisfied, they will insist on a different leader, who will get them what they want. c. Leaders at the national level who are seeking relief for nurses in the workplace are seen as the solution to the nursing shortage. d. Workplace satisfaction depends on staffing ratios, adequate pay, and tuition reimbursement, and these are things the leader can control. - Correct answer a. The leader declares the intent and goals to enhance productivity and assumes that the unit also wishes to increase productivity, which allows nurses to feel in control of the environment." "The director of nursing has been observing staff interactions in a 20-bed coronary care unit. Based on her observations, which of the following staff members is an obvious leader? a. The unit secretary who knows everyone's business b. The chief nursing officer who is in charge and is responsible for nursing services c. The chief cardiologist who admits the largest number of patients and brings in more revenue than any other physician d. The staff nurse who persuades other staff members to practice by making evidence-based decisions - Correct answer d. The staff nurse who persuades other staff members to practice by making evidence-based decisions" "After being interviewed for the unit manager position, the staff nurse reflects on the interview process. The staff nurse is aware that leadership begins: a. within. b. through a relationship with a mentor. c. with the job description. d. with the chief nursing officer of the organization. - Correct answer a. within." "The nurse manager in the Emergency Department needs to implement new staffing patterns. As a transformational leader, the nurse manager would: a. explain in detail how well the new idea will work. b. reinforce how this change will respond to the ideas and solutions generated by staff members. c. reason with staff members that the new idea will save money and allow more free time. d. imply that raises will be smaller than anticipated if the new idea is not accepted. - Correct answer b. reinforce how this change will respond to the ideas and solutions generated by staff members." "To retain supervisory staff members, the director of nursing develops a mentoring program. The best person to be a mentor for a new supervisor in a leadership position is someone who has: a. been in the same position and can relate to the new supervisor's problems. b. had vast leadership opportunities and likes to talk about his or her past experiences. c. leadership experience and time to spend communicating with the new supervisor about his or her experiences. d. people who can help the new supervisor get what he or she needs to make the organization grow quickly and prosper in the process. - Correct answer c. leadership experience and time to spend communicating with the new supervisor about his or her experiences." "Recruiting among the emerging work force (18 to 35 year olds) is a challenge for healthcare agencies. Marketing brochures should address the leadership and vision of the healthcare agency. Which of the following workplace environments will attract applicants in the emerging work force? a. A highly professional environment b. A nurturing and receptive environment c. An environment highlighted by lots of meetings, so staff members can have lots of input d. A totally online environment, so staff members will not have to interface with uncaring colleagues - Correct answer b. A nurturing and receptive environment" "A nurse executive who considers herself a Baby Boomer will have the challenge of convincing the emerging work force of the necessity of committee meetings. One of the primary reasons that the Baby Boom generation appears to have so many meetings in the work environment is that: a. they feel more comfortable in a group. b. they find that the journey to the solution is as important as the solution itself. c. they were deprived of collective action opportunities in the past and now feel that solutions are better when many people have input. d. Baby Boomers are aging and need the respite from work that meetings offer, so they can recuperate from the physical demands of the work environment. - Correct answer b. they find that the journey to the solution is as important as the solution itself." "The hospital administration is discussing the possibility of closing hospital beds in your unit because of a nursing shortage and the increased amount of overtime required to care for patients. As the leader on the unit, which of the following examples best demonstrates your transformational leadership style? a. Your entire staff walks out on strike. b. Your staff sends an ultimatum to the clinic director demanding higher pay. c. A group of your staff members goes to the administration to propose closing of a different unit. d. A group of your staff members goes to the administration to request that they be allowed to work the overtime hours. - Correct answer c. A group of your staff members goes to the administration to propose closing of a different unit." "John is interested in leadership positions within his nursing organization. Although he has been on the same unit for 10 years, he has attended two workshops during that time and has steadfastly refused opportunities to engage in leadership development opportunities or other learning offered as part of the hospital's succession planning strategy. He says that he is interested in a leadership role primarily because it will give him a more stable work schedule and will enable him to spend more time with his family. In coaching John, it would be important to: a. affirm that his years of service and stability on the unit are the most important attributes for assumption of a leadership role. b. reinforce that his concern with maintaining balance outside work would be a key factor in selecting him for a leadership position. c. encourage him to consider the financial rewards of the position, as well as the positive effect o - Correct answer d. encourage him to seek out new experiences and learning that will complement his existing strengths derived from experience and his interest in work-life balance." "Becky graduated 5 years ago and is keenly interested in pursuing leadership opportunities. She has been active in learning about leadership through workshops and Internet research and recently began a graduate degree program with a focus on nursing administration. She has excellent clinical skills and eagerly accepts responsibility for various projects on the unit. Her sarcastic and sometimes aggressive behavior tends to alienate other staff members on the unit. In coaching Becky, you: a. suggest that she reflect on situations in which she has had a positive influence and consider how her interactions contributed to the situation. b. suggest that she not consider leadership roles because her interaction skills are more suited to roles in which she has limited opportunities to work with others. c. ask staff members on the unit with whom she works to provide her feedback about ways in which her behavior irritates or tu - Correct answer a. suggest that she reflect on situations in which she has had a positive influence and consider how her interactions contributed to the situation." "The Sunny long-term care facility has experienced numerous difficulties with staff relationships, despite its success in maintaining financial viability and judicious use of resources. Staff members complain that the primary concerns of the facility include applying policy, saving money, and ensuring that lawsuits are avoided. There is little trust in, and involvement of, staff members. This facility may be: a. well managed and well led. b. overly managed and not well led. c. poorly managed and well led. d. overly led and overly managed. - Correct answer b. overly managed and not well led." "While explaining the importance of developing leadership skills among nurses to a group of first-year nursing students, Natalie, a nursing unit manager, emphasizes that: a. most nurses are not expected to assume leadership roles. b. the role of nurse leadership is only at the bedside, ensuring that patient care is performed according to established standards. c. only individuals in formal leadership roles are expected to be leaders. d. the public depends on nurses to assume leadership in moving consumer advocacy concerns forward. - Correct answer d. the public depends on nurses to assume leadership in moving consumer advocacy concerns forward." "Which of the following nurses is MOST likely to inspire others to do their best? a. Nancy, RN, is an individual who enjoys details and organization. She regularly leaves notes for the next shift about what has been done incorrectly or omitted. b. Jim, RN, has been involved in nursing for several years and is well liked by patients and families. He continually searches for new knowledge and skills, and his sense of humor and optimism are infectious. c. Clara has been the head nurse on Unit 3Y for years. She is quiet but enjoys patients and their families. She has not been to a conference in years because the unit is her entire life. d. Karen is a team leader. She is extraordinarily vigilant about ensuring that everyone is treated fairly in assignments. She is also very conscientious about care and regularly checks up on what everyone is doing to ensure that it is done correctly. - Correct answer b. Jim, RN, has been involved in nursing for several years and is well liked by patients and families. He continually searches for new knowledge and skills, and his sense of humor and optimism are infectious." "The new head nurse on G Unit has been the subject of a great deal of discussion and complaining during breaks. She is a competent nurse of tremendous integrity with approximately 30 years' experience. Her predominant method of problem solving and communication is through meetings, which can go over the allotted time. The staff may: a. be represented by a high number of Baby Boomers. b. be presenting different generational values and attitudes than the head nurse. c. be unresponsive to her transactional leadership style. d. want a leader rather than a manager. - Correct answer b. be presenting different generational values and attitudes than the head nurse." "The adage "leaders are born and not made" reflects which of the following ideas around leadership? a. Management can be taught; leadership depends on abilities. b. Mentorship is important in developing innate skills of leaders. c. Leadership is a natural skill that cannot be refined or developed. d. Succession planning and formal education related to leadership are ineffective. - Correct answer a. Management can be taught; leadership depends on abilities." "Kari, a head nurse on the dialysis unit, has been informed during budget planning meetings that budget cuts are likely. She discusses this at the next unit meeting and tells staff members that unless they do their jobs well, their positions may be terminated, and there will be no replacement. Kari is enacting which management style? a. Transformational b. Transactional c. Trusting d. Truthful - Correct answer b. Transactional" "Susan, a new graduate on the dialysis unit, appears to take Kari's remarks very seriously and works even harder, often volunteering for extra assignments. She also is often in Kari's office, advising of successes with her patients and of the extra effort that she is committing. This behavior suggests that Susan: a. is fearful of losing her job. b. lacks understanding of Kari's leadership style. c. is not intimidated by Kari's leadership style. d. knows how to "play the game." - Correct answer d. knows how to "play the game."" "The style of leadership that Kari is exhibiting is likely to: a. ensure that the organization is financially stable. b. stifle innovative thinking about ways to move out of financial jeopardy. c. lead to apathy and disinterest in the organizational goals. d. lead to decreased attrition of staff on her unit. - Correct answer b. stifle innovative thinking about ways to move out of financial jeopardy." "A group of managers is meeting to discuss ideas related to the successful implementation of evidence-based practice on their units. Susan has been asked by the director of care to assume leadership of these discussion groups. After two such sessions, Susan expresses disappointment to her mentor that the group seems disinterested in her ideas and that they are listening to Ken, who has much less experience with leadership. In discussing this with Susan, the mentor understands that leadership: a. is a designated role. b. must be earned. c. is more likely to be taken by someone who is more talkative. d. rarely is taken over by someone with less experience. - Correct answer b. must be earned." "The senior executive praises John for the positive patient evaluations that his unit has received. As an effective leader, John: a. thanks the senior executive for having confidence in him and celebrates by going out to a special restaurant. b. points out the impact that the changes he has initiated have had on the unit. c. advises the senior executive that the mission statement and goals are important to him. d. points out the contributions of his staff to the outcomes and shares the praise with his staff. - Correct answer d. points out the contributions of his staff to the outcomes and shares the praise with his staff." "During a discussion of concern about approaches used with aggressive patients in the Emergency Department, several staff members express concern for their safety. As a leader, the nurse manager should: a. look directly at speakers and acknowledge their comments. b. promise to implement each suggestion that is made. c. implement the idea that receives the most discussion. d. listen but implement the plan that she had in mind before the discussion began. - Correct answer a. look directly at speakers and acknowledge their comments." "In working with Cheryl, her mentor suggests that it is really important for Cheryl to engage in self-appraisal and to know her strengths. This observation is based on an understanding that: a. self-confidence comes automatically out of leading. b. self-confidence requires constant self-affirmation of strengths. c. there is little external motivation and affirmation in leadership. d. supervisors of leaders rarely provide feedback. - Correct answer c. there is little external motivation and affirmation in leadership." "As a senior executive, you are keen to develop your hospital as a learning organization. Part of your purpose in translating this vision into practice is to: (Select all that apply.) a. retain funding from third-party payers. b. develop leaders. c. maintain and/or improve quality of care. d. stay abreast of new knowledge and evidence. - Correct answer b. develop leaders. c. maintain and/or improve quality of care. d. stay abreast of new knowledge and evidence." "Role theory has its underpinnings in management theory. Management theories influence managers' leadership styles. Which of the following styles would a nurse manager be most likely to follow when redesigning the staffing schedule? a. Humanistic b. Authoritarian c. Flexibility d. Participative - Correct answer d. Participative" "A nurse manager has worked to bring the staff to participate in and then accept changes in the unit's mission, so that downsizing can be avoided. How is the nurse manager using change theory for this situation? a. Focusing on past concerns related to the mission b. Teaching staff members how to self-manage themselves c. Determining accurately the direction of change in the institution d. Requiring all staff members to review and reinforce their technological skills - Correct answer c. Determining accurately the direction of change in the institution" "The nurse manager, as the leader of the unit's "customer (client) first" initiative, has asked the staff nurses to develop and administer a survey to every client before discharge. In asking the staff nurses to accomplish this task, the nurse manager is demonstrating: a. accountability. b. shared leadership. c. a common purpose. d. independence in the nursing manager's role. - Correct answer b. shared leadership." "A nurse manager is experiencing considerable conflict among staff members because of weekend staffing coverage. During a called staff meeting, the nurse manager asks the disgruntled staff to meet as a group and determine the best staffing practices. In doing this, the nurse manager is using the concept of collaboration to: a. demonstrate interdependence. b. depict flexibility and broadmindedness. c. focus all energies of staff members on a best possible strategy. d. defuse the possibility that staff members will escalate their discontent when staffing the unit on weekends. - Correct answer c. focus all energies of staff members on a best possible strategy." "A nurse manager's responsibility for financial management involves making budgetary decisions. Budgets that allow the nurse manager to allocate resources at the unit level allow: a. minimal nurse manager input. b. limited rationale for budgetary requests. c. budgetary allocations at the executive nurse level. d. budgetary decision making at the point-of-service (POS). - Correct answer d. budgetary decision making at the point-of-service (POS)." "The nurse manager is anticipating changes on the unit because of managed care. It is up to the manager to "sell" the staff on this care concept. A goal of managed care that the staff must understand is that managed care is: a. grounded in business theory. b. useful for long-term patients only. c. designed to reduce unit resources and staff. d. not concerned with the best interests of clients. - Correct answer a. grounded in business theory." "The hospital administrator approves a case management position for a new rehabilitation unit to help reduce costs. In developing the job description, the nurse manager understands that a key element of case management is: a. managing of care by nurse managers. b. coordination of resources for effective outcomes. c. rapid discharge of clients to decrease costs. d. managing of care for outpatient clients only. - Correct answer b. coordination of resources for effective outcomes." "In planning a new wing, the nurse manager complies with the workplace safety requirements of the Occupational Safety & Health Administration (OSHA). Which of the following groups is considered to be at high risk for violence in the workplace? a. Pediatric staff b. Postsurgical unit staff c. Emergency Department staff d. Medical oncology unit staff - Correct answer c. Emergency Department staff" "Electronic health records (EHRs) are being instituted at Pleasant Valley Hospital. Some of the staff on Unit 4 complain to the manager that acquiring the technologic skills required is too time consuming. They question its value in patient care. The manager responds that: a. the use of technology is inevitable in our technologically oriented society. b. the hospital is no longer able to find the space to accommodate paper record-keeping. c. the initiative is being driven by decision makers higher up in the hierarchy and there is no choice. d. EHRs will increase effectiveness of care by enhancing coordination and improving patient outcomes. - Correct answer d. EHRs will increase effectiveness of care by enhancing coordination and improving patient outcomes." "Nurses in the CCU are unhappy and frustrated with their nurse manager. They complain that "nothing is ever good enough for him." These statements suggest that the nurse manager's goals may be: a. measurable. b. unrealistic. c. attainable. d. too low. - Correct answer b. unrealistic." "While interviewing for a nurse manager position, Ann is asked to give an example of a situation in which she demonstrated leadership. Which of the following examples exemplifies leadership? a. Through research and investigation of best practice and practice-based evidence, she proposed a change in the management of incontinence in older adult patients. b. She ensures that new policies related to parenteral infusions are implemented consistently within her team. c. When asked by her students about institutional policies, she readily and patiently interprets policies to facilita