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Contemporary Nursing Issues Trends 4th Edition Cherry Jacob Test Bank
| ISBN-13: 978-0323052177 | ISBN-13: 978-0323052177 |
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Cherry: Contemporary Nursing, 4th Edition
Test Bank
Chapter 15: Nursing Leadership and Management
MULTIPLE CHOICE
- In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees’ health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of planned change?
| A. | Unfreeze |
| B. | Move |
| C. | Refreeze |
| D. | Acceptance |
ANS: A
In alignment with Lewin’s stages of change (unfreezing, moving, and refreezing), education and involvement are keys to successful change. (A) is correct because the change agent promotes problem identification and encourages awareness of the need for change. People must believe that improvement is possible before they will be willing to consider change. (B) is incorrect because at this stage, the change agent clarifies the need to change, explores alternatives, defines goals and objectives, plans the change, and implements the change plan. (C) is incorrect because at this stage, the change is being integrated into the organization so that it becomes recognized as the status quo. The change agent must facilitate change monitoring adherence to the new requirements. (D) is incorrect because acceptance and integration represent the final aspect of any change.
DIF: Application REF: Pages 352-354
- In differentiating between a leader and a manager, it can be seen that
| A. | a leader has legitimate authority. |
| B. | a manager motivates and inspires others. |
| C. | a manager focuses on coordinating resources. |
| D. | a leader focuses on accomplishing goals of the organization. |
ANS: C
The terms leadership and management are used interchangeably, and it is difficult to discuss one without discussing the other. However, these roles have specific traits unique to themselves. (C) is correct because the manager is the coordinator of resources (time, people, and supplies) needed to achieve outcomes. (A) is incorrect because authority is the legitimate right to direct others that is given to a person the organization through assignment to an authorized position such as a nurse manager. (B) is incorrect because it is the nurse leader who has the ability to guide or influence, as well as to motivate and inspire, others on the team. (D) is incorrect because managers are assigned responsibility for accomplishing the goals of an organization.
DIF: Comprehension REF: Page 331
- The first step in the nursing process and in the problem-solving process is to
| A. | identify the problem. |
| B. | gather information. |
| C. | consider the consequences. |
| D. | implement interventions. |
ANS: B
The nursing process, which is familiar to nurses who address patient care needs, can be applied to all management activities that require decision making and problem solving. (B) is the correct answer because as in the nursing process and the problem-solving process, one must first gather information about the problem or situation. (A), (C), and (D) are the steps that follow in the nursing and problem-solving processes.
DIF: Comprehension REF: Page 350, Table-15-1 page 351
- An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation?
| A. | Autocratic |
| B. | Democratic |
| C. | Laissez-faire |
| D. | Situational |
ANS: D
(D) is correct because of the dynamics of the situation that the leader has to work within. Interaction between the leader, the worker, and the elements of the leadership situation involves several variables: organizational culture, values of the leader and values of the followers, influence of the leader/manager, complexities of the situation, work to be accomplished, and the environment. (A), (B), and (C) are incorrect because these are general leadership styles that are not related to specific situations.
DIF: Application REF: Page 333
- A registered nurse (RN) with excellent assessment and psychomotor skills would derive power on the basis of which source?
| A. | Rewards |
| B. | Coercion |
| C. | Expert |
| D. | Legitimate |
ANS: C
Seven (7) primary sources of power are known. For this question, response (C) is correct because Expert power is based on knowledge, skills, and information. (A) is incorrect because Rewards power comes from the ability to reward others for complying; it may include such rewards as money, desired assignments or recognition. (B) is incorrect because Coercive power is based on fear of punishment or failure to comply. (D) is incorrect because Legitimate power is based on holding an official position within the organization.
DIF: Application REF: Pages 331-332
- Managers who exhibit the authoritative behavioral style are most likely to use which source of power?
| A. | Informal |
| B. | Expert |
| C. | Coercive |
| D. | Reward |
ANS: C
Seven (7) primary sources of power are known. For this question, response (C) is correct because Coercive power is based on fear of punishment or failure to comply. Coercive power fits well into the authoritative behavioral style because authoritative managers dictate the work with much control, usually ignore the ideas or suggestions of subordinates, and provide little feedback or recognition for work accomplished. (A) is incorrect because Informal power is not one of the seven primary sources of power; however, informal leaders may distribute a considerable amount of power among the workers, can influence the attitude of the group, and significantly affects the efficiency and effectiveness associated with work flow, goal setting, and problem solving. (B) is incorrect because Expert power is based on knowledge, skills, and information. (D) is incorrect because Rewards power results from the ability to reward others for complying and may include such rewards as money, desired assignments or recognition.
DIF: Application REF: Pages 331-332, Box 15-3 page 336
- The illustration below identifies which type of chart?
| A. | Productivity |
| B. | Organizational |
| C. | Resource |
| D. | Staffing |
ANS: B
(B) is correct because an organizational chart is a visual picture of an organization that identifies lines of communication and authority. (A) is incorrect because productivity is the amount of output or work that is produced with a specific quantity of input or resources. (C) is incorrect because resources include personnel, time, and supplies needed to accomplish the goals of an organization. (D) is incorrect because staffing is the manpower needed to complete the work.
DIF: Comprehension REF: Page 341
- Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society’s perception of nursing). Those who depict her as a leader on the basis of these qualities are practicing which leadership theory?
| A. | Trait |
| B. | Chaos |
| C. | Bureaucracy |
| D. | Organizational |
ANS: A
(A) is correct because leadership trait theory describes intrinsic traits of leaders and is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery. (B) is incorrect because chaos is an organizational theory that attempts to account for complexity and randomness in organizations. (C) is incorrect because bureaucracy is part of the organizational theory that provides an understanding of authority within organizations. (D) is incorrect because organizational theory provides the framework for an understanding of leadership and management, and for an understanding of complex organizations.
DIF: Application REF: Pages 332-333
- A nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse?
| A. | Transactional |
| B. | Situational |
| C. | Transformational |
| D. | Contemporary |
ANS: A
(A) is correct because the transactional leader is concerned with the day-to-day operations of the facility. (C) is incorrect because the transformational leader is committed to organizational goals, has a vision, and is able to empower others with that vision. (B) and (D) are incorrect because situational and behavioral theories have attempted to integrate the dynamics of the interaction between the leader, the worker, and elements of the leadership situation, arguing that effective leadership depends on several variables. Theses two theories are subsumed under the theory of contemporary theories of leadership.
DIF: Application REF: Page 333, Box 15-1
- According to the unit’s policy for call-ins, a nurse is suspended for 3 days because of excessive call-ins that occur within 15 minutes of shift change. The nurse states, “You are unfair to me.” Which theory would disprove the nurse’s statement?
| A. | Bureaucracy |
| B. | Closed systems |
| C. | Open systems |
| D. | Trait |
ANS: A
(A) is correct because Weber’s concept of bureaucracy revolves around the assumption that authority confers the right to issue commands within an organization on the basis of impersonal rules and rights, virtue of the management position rather than any trait ascribed to the person who occupies that position. Other characteristics include the following: Impersonal rules govern the actions of superiors over subordinates, all personnel are chosen for their competence and are subject to strict rules that are applied impersonally and uniformly, and a system of procedures for dealing with work situations is in place. (B) and (C) are incorrect because they represent the systems theory of the organization. There are two views: open and closed. Closed systems theory views the system as being totally independent of outside influence, whereas open systems theory suggests that the organization is affected not only internal change but also external environmental changes that can have a direct or an indirect influence on the organization. (D) is incorrect because trait theory, which describes intrinsic traits of leaders, is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery.
DIF: Analysis REF: Pages 335-336
- A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which of the following actions would demonstrate positive reinforcement?
| A. | Every morning at shift change, thank each employee for an excellent job. |
| B. | Rotate a monthly “employee recognition award” among all employees on the unit. |
| C. | Wait until the annual performance review to recognize accomplishments. |
| D. | Give spur-of-the-moment recognition to an employee who has accomplished a goal. |
ANS: D
(D) is correct because to be effective, positive reinforcement should (1) be specific, with praise given for a particular task done well or a goal accomplished; (2) occur as close as possible to the time of the achievement; (3) be spontaneous and unpredictable (praise given routinely tends to lose value); and (4) be given for a genuine accomplishment. (A), (B), and (C) are incorrect because they lack spur-of-the moment, spontaneous recognition for a genuine accomplishment.
DIF: Application REF: Page 344
- A key management function is strategic planning. Which of the following represents this function?
| A. | Determining that all nurses on the unit understand the current organizational philosophy |
| B. | Evaluating the communication process between the pharmacy and the nursing departments |
| C. | Monitoring data from the quality management initiative related to the last three orientation programs |
| D. | Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units |
ANS: D
(D) is correct because a strategic plan is a written document that details organizational goals, allocates resources, assigns responsibilities, and determines time frames. The strategic plan generally looks 3 to 5 years into the future. (A), (B), and (C) are incorrect because they are all forms of current evaluation and analysis, and they do not look toward the future.
DIF: Comprehension REF: Pages 339-340
- A hospital’s policy requires that all nurse managers must have a minimum of a bachelor’s degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. A registered nurse who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to both physicians and staff that, “The new nurse manager has book sense but no leadership abilities.” What is the best approach that can be used the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?
| A. | Send memos to all staff except the upset nurse to invite them to a luncheon. |
| B. | Ask management to transfer the upset nurse to another unit. |
| C. | Assign the upset nurse to committees that do not directly affect that nursing unit. |
| D. | Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication. |
ANS: D
(D) is correct because the best way for the new nurse manager to communicate with this employee, who may be an informal leader, is to show respect for the individual’s clinical expertise and experience through clear and direct communication. The new nurse manager should attempt to identify the staff nurse’s power as an informal leader, should involve him and other staff members in decision making and change implementation processes, and should clearly communicate goals and work expectations to all staff members. (A) is not correct because the nurse manager would not gain the respect or trust of other nurses on the unit excluding one of their peers from an activity. (B) is not correct because the nurse manager must make a sincere attempt to work with the nurse, whose clinical experience is valuable to the unit. A transfer request would be the last option after all other efforts to develop a working relationship with the staff nurse have been exhausted. (C) is not correct because the best way to work with this employee and gain the respect of other nurses on the unit is through open and direct communication.
DIF: Analysis REF: Page 332
MULTIPLE RESPONSE
- Registered nurses who are entering the workforce will have expanded leadership responsibilities that include (Select all that apply.)
| A. | serving on interdisciplinary care teams. |
| B. | being competent to work in several areas independently when dictated patient census. |
| C. | attending a meeting to plan advanced training for unlicensed assistive personnel. |
| D. | evaluating outcomes of care that are reported to a standing committee. |
ANS: A, C, D
(A), (C), and (D) are correct because the new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. (B) is incorrect because for RNs who are entering the workforce, being competent to work in several areas independently is not a realistic expectation.
DIF: Application REF: Page 330
OTHER
- Place the following five major management functions into correct sequential order.
| A. | Staffing |
| B. | Directing |
| C. | Planning |
| D. | Controlling |
| E. | Organizing |
ANS:
C, E, A, B, D
Each of the management activities of planning, organizing, staffing, directing, and controlling come into play in the role of resource manager. The nurse must develop skills in the following ordered areas:
- Planning for the necessary resources (primarily staff and supplies) to manage the unit; planning serves as the basis for all other management functions; thus, it comes first in sequential order.
- Organizing resources to meet identified goals; organizing identifies the numbers and types of staff needed to meet goals, thus must occur prior to staffing.
- Staffing appropriately as determined patient needs and the budget plan; staff must be hired and in place prior to directing.
- Directing. After managers have planned what to do, organized how to do it, and staffed positions to do the work; they must direct personnel and activities to accomplish goals.
- Controlling is the final management function which managers, through staffing and directing, ensure that employees accomplish planned goals within the established organizational structure.
DIF: Analyzing REF: Page 338
