Advanced Nursing Leadership Exam
Bank
Course Introduction
Advanced Nursing Leadership explores the complex roles and responsibilities of nurse leaders in todays evolving healthcare environment. This course focuses on theories and principles of leadership, management, and organizational behavior as they apply to advanced nursing practice. Students will examine strategies for effective team building, conflict resolution, decision-making, and ethical leadership. Emphasis is placed on navigating change, fostering innovation, and advocating for quality patient care within interdisciplinary teams. Through case studies and real-world applications, learners will develop skills essential for guiding healthcare teams, managing resources, and influencing policy to improve health outcomes.
Recommended Textbook
Leading and Managing in Canadian Nursing 1st Canadian Edition by Patricia S. Yoder - Copy
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30 Chapters
745 Verified Questions
745 Flashcards
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Chapter 1: Leading, Managing, and Following
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Sample Questions
Q1) According to complexity science,which of the following should be the focus of measurement?
A) Cost per hospital day
B) Bed utilization
C) Infection rates
D) Staff morale and budgets
Answer: D
Q2) Marie-Claire,the nursing unit manager,finds it difficult to work with Thomas,a new graduate.Thomas has many ideas,and his manner of presenting them irks Marie-Claire.After reflection and discussion with others,Marie-Claire recognizes that she also feels threatened by his behaviour.She comes to understand that Thomas is trying to establish his own role on the unit,is not trying to challenge her,and needs guidance,coaching,and affirmation.Marie-Claire is demonstrating
A) a positive self-concept.
B) deepening self-awareness.
C) leadership.
D) acquiescence.
Answer: B
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Chapter 2: Patient Focus
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Sample Questions
Q1) On the basis of a review of increased falls with injury and increased use of restraint during evening hours,you as the unit manager are most likely to
A) review daytime and evening staffing mixes.
B) schedule continuing education for all staff members.
C) review the safety of ambulation devices.
D) continue your current practices and procedures.
Answer: A
Q2) What is the primary purpose of nursing standards?
A) To inform performance appraisals at the unit level
B) To identify the desired level of performance
C) To inform the courts in relation to negligence and malpractice cases
D) To educate other health care professionals about the role of the nurse
Answer: B
Q3) Having access to information,evidence,and research is an important driver for quality and
A) nurse safety.
B) patient safety.
C) organizational policy development.
D) patient-centred care.
Answer: B
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Chapter 3: Developing the Role of Leader
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Q1) 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 exactly 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.
Answer: C
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Chapter 4: Developing the Role of Manager
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Sample Questions
Q1) A manager who is concerned with ensuring that patients on her surgical unit have the necessary information to make informed choices is
A) practicing legal nursing care.
B) demonstrating respect for patients' rights.
C) avoiding risks.
D) probably experiencing issues with informed consent.
Q2) A nurse manager has worked rapidly to persuade the staff to accept changes in the unit's mission,so that downsizing can be avoided,through innovative use of technology.This nurse manager is displaying
A) a focus on past concerns related to the mission.
B) how to teach staff members about self-management.
C) facilitation of goal accomplishment.
D) a requirement that all staff members need to review and reinforce their technologic skills.
Q3) The successful integration of informatics into health care settings is key to
A) quality decision-making and processes related to management of resources.
B) accessing current information about business practices.
C) leveraging ideas from other managers.
D) speeding up calculations and decisions in budget development.
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Page 6
Chapter 5: Legal Issues
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Sample Questions
Q1) The nurse manager organizes an orientation for new staff members.As part of the orientation,the nurse manager reviews the unit's policy and procedure manual,which is a part of which type of law?
A) Employment law
B) Common law
C) Written law
D) Legislated law
Q2) Which of the following is an unregulated health care worker?
A) Pharmacist
B) Occupational therapist
C) Practical nurse
D) Care aide
Q3) Which level of government is most responsible for hospitals and health care?
A) Local
B) Provincial
C) National
D) International
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Page 7
Chapter 6: Ethical Issues
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Sample Questions
Q1) Which of the following are core elements of relational ethics?
A) Mutual respect
B) Justice and beneficence
C) Informed consent
D) Interdependent environment
Q2) Which of the following is a key area of ethical nursing practice?
A) Nursing process
B) Therapeutic relationship
C) Decision-making model
D) Embodied knowledge
Q3) According to relational ethics,what is critical in the development and maintenance of the roles and actions of the nurse manager?
A) Time management skills
B) Professional relationships
C) Understanding of biomedical ethics
D) Comprehension of the Quebec Nurses Association's Code of Ethics for nursing
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Chapter 7: Making Decisions and Solving Problems
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Sample Questions
Q1) Several nurses on an adolescent psychiatric unit complain that the teenagers are becoming unmanageable on the shift from 2300 to 700 hours.To resolve this problem,the nurse manager decides that the staff should have a brainstorming session.The goal of brainstorming is to
A) evaluate problem solutions.
B) critique the ideas of other staff members.
C) generate as many solutions as possible.
D) identify only practical and realistic ideas.
Q2) Silvana,a nurse manager,has a staff nurse who has been absent a great deal for the past 3 months.A co-worker gives some information to Silvana indicating that the staff nurse will be resigning and returning to school.Because of this,Silvana decides to do which of the following?
A) Immediately fire the staff nurse.
B) Speak to the co-worker and elicit more information.
C) Speak to the staff nurse and ask her to resign.
D) Do nothing.
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Chapter 8: Health Care Organizations
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Sample Questions
Q1) Which three provinces/territories provide nurses with unrestricted access to seek work and enable nearly seamless nurse mobility between them?
A) Nova Scotia, New Brunswick, and Prince Edward Island
B) Northwest Territories, Yukon, and Nunavut
C) Ontario, Manitoba, and Saskatchewan
D) Alberta, British Columbia, and Saskatchewan
Q2) Which of the following is a characteristic of an open-systems organization?
A) A change in one component will not affect other components.
B) The internal environment consists of dependent, interactive components.
C) Inputs are acquired from the internal environment and are processed to be released as outputs.
D) Feedback about performance is used to influence subsequent selection of inputs.
Q3) An example of additional health care services is
A) dental cleaning and checkup.
B) annual Papanicolaou (Pap) smear.
C) childhood immunizations.
D) hospital room costs.
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Chapter 9: Understanding and Designing Organizational
Structures
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Q1) A hospital is working toward becoming a Magnet hospital.The chief nursing officer is aware that professional nursing departments of the future will
A) not be directed by nurses.
B) be virtual organizations.
C) be designed to maintain nursing standards of practice.
D) be entitled to have patient care departments.
Q2) In opening a new dialysis unit,the nurse manager has to develop a philosophy for the unit.This philosophy needs to
A) reflect the culture of the unit and its values.
B) be developed by the nursing manager on the unit.
C) identify the patients who will be served on the unit.
D) replicate the organization's philosophy.
Q3) A hospital and a nursing education program form a partnership to recruit more nurses to the region.This organizational structure is
A) being responsive to changes in the environment.
B) being bureaucratic.
C) creating permanent professional boundaries.
D) delineating structures for all decision-making.
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Chapter 10: Cultural Diversity in Health Care
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Q1) In caring for a patient from an East Indian culture,staff members express frustration that many friends and family members are in the room at any one time,which interferes with care.As the nurse manager,you provide leadership in understanding that this behaviour of the family and friend network reflects A) lack of understanding of the seriousness of the patient's illness. B) lack of communication between family members.
C) the social organization of friendships and family networks in East Indian culture. D) lack of caring about the hospital environment by the friends and family.
Q2) Recognizing that the Aboriginal candidate's lack of eye contact is different from her own,the non-Aboriginal nurse is exhibiting A) acculturation.
B) cultural sensitivity.
C) ethnocentrism.
D) transculturalism.
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Chapter 11: Power,Politics,and Influence
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Sample Questions
Q1) A nurse is participating in a baccalaureate course.One assignment is to attend the legislative session regarding the new role of physician assistants.Nurses should be involved in shaping public policy primarily because
A) involvement will enable nurses to take over the health care system at some point in the future.
B) other health care professions are less concerned about the essential needs of patients.
C) such activities are important career builders for nurses who seek top-level executive positions.
D) they are closest to the front line of health care and see how it affects patients and families.
Q2) Tomas,a new RN,is finding it difficult to practice because he is encountering,on a daily basis,differences between his learned ideals and what he is witnessing as nursing practice on the unit.This situation is an example of
A) the theory-to-practice gap.
B) transition shock.
C) an inadequately prepared nurse.
D) ethical distress.
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Chapter 12: Caring,Communicating and Managing With Technology
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Sample Questions
Q1) A nurse practitioner who manages his own practice offers his patients the option of contacting him via e-mail between visits.This allows his patients to request prescription renewals and educational materials and to ask nonemergency questions about their conditions.At times,this is convenient for both the patients and himself.What else he should tell his patients?
A) They can send urgent messages.
B) They should wait up to 24 hours for a response from him.
C) They should omit sending their names because they are in the e-mail addresses.
D) They can ask about sensitive topics because no one besides himself sees the e-mails.
Q2) As a nurse manager representative on a team to select a clinical information system,you would be particularly concerned if the favoured system has which of the following characteristics?
A) It involves screen displays that are best configured for nonclinical users.
B) It requires an upgrade to servers in the facility.
C) It requires staff orientation and training during implementation of the software.
D) It minimizes the amount of data entry necessary.
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Chapter 13: Managing Costs and Budgets
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Sample Questions
Q1) A nurse manager determines that RN 1 has 5 weeks of vacation time and 3 days of education and has averaged 3 sick days a year.RN 2 has 6 weeks of vacation time,has asked to attend a 3-day conference and a 2-day workshop,and has no history of sick time.RN 3 is new,and you anticipate 3 weeks of orientation,as well as 4 weeks of vacation time.RN 4 has 6 weeks of vacation and has an ongoing health condition,so you anticipate 2 weeks of sick time,as well as 3 days for education.RN 5 has 5 weeks of vacation,has no education plans,and averages 5 sick days per year.RN 6 has 6 weeks of vacation,has no education plans,and has been off ill for 4 weeks.How many hours of productive paid time can be anticipated for the budget?
A) 12,480
B) 11,200
C) 10,848
D) 10,688
Q2) The primary reason for calculating productive hours paid instead of simply calculating work paid per year is that productive hours enable the manager to A) anticipate total costs of patient care.
B) know how much time staff will probably be unavailable because of illness.
C) determine when orientation needs to occur for new staff.
D) determine the number of hours available for patient care.
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Page 15
Chapter 14: Care Delivery Strategies
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Sample Questions
Q1) In transitioning to a primary nursing model,it is important for a nurse manager who enjoys a high level of control over patient care to understand that his or her decision-making at the patient care level
A) is increased.
B) is decreased.
C) is relinquished.
D) remains the same.
Q2) During times of nursing shortage and increased nursing costs in health care,which of the following nursing care delivery models might come under greatest scrutiny?
A) Case method
B) Team nursing
C) Functional nursing
D) Nurse case management
Q3) Case-managed care may enhance profit in a for-profit health organization by
A) minimizing costs in areas of high resource consumption.
B) combining licensed and nonlicenced care providers in delivering patient care.
C) increasing reimbursement from third-party payers.
D) reducing the amount of technology used to support clinical decision-making.
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16
Chapter 15: Staffing and Scheduling
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Sample Questions
Q1) Scheduling is a function of implementing the staffing plan by assigning unit personnel to work specific hours and specific days of the week.To retain nursing staff,the nurse manager must schedule
A) all weekends off.
B) all holidays off.
C) a variety of scheduling options.
D) rotating shifts.
Q2) A nurse manager must also consider a number of internal variables that will affect staffing patterns.Which of the following is an internal variable to be considered?
A) Organizational staffing policies
B) Provincial/territorial licensing standards
C) Canadian Nurses Association guidelines
D) Consumer expectations
Q3) A strategy to increase RN staff retention at Valley Hospital includes A) better compensation and benefits.
B) clearer position descriptions.
C) layoffs of nursing assistants.
D) adequate staffing to care for increasing numbers of acutely ill patients.
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17
Chapter 16: Selecting, developing, and Evaluating Staff
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Sample Questions
Q1) The biggest challenge in the recruitment of staff is
A) finding well-qualified candidates who can function well within a particular work culture.
B) recruiting individuals with the appropriate qualifications and experience.
C) screening out candidates who are unable to function well within a team.
D) determining whether candidates have had previous negative experiences in a work environment.
Q2) Anecdotal notes
A) should be completed only when there are performance concerns.
B) can be used to support and justify fairness in termination discussions.
C) are unnecessary if the evaluation instrument is thorough.
D) need to be completed at the end of a performance period.
Q3) Which of the following is a strategy that clinical nurse educators can use to ensure understanding and retention of information in newly hired staff nurses?
A) Provide written information of all orientation topics.
B) Evaluate whether there is fit between learner and organizational values.
C) Develop a range of strategies that cover a variety of learning styles.
D) Organize group sessions for orientation to increase cost effectiveness.
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18
Chapter 17: Strategic Planning and Goal Setting
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Q1) After a year,staff members at Pacific Hospital are frustrated,and the implementation of evidence-informed practice has gone poorly.In responding to this situation,the strategic planning team at Pacific Hospital
A) recommends that the mission, objectives, and goals of the hospital be reassessed.
B) revises the goal statements in the strategic plan.
C) consults an external team on preparation of materials on evidence-informed practice.
D) holds focus groups with staff to determine what kinds of issues, challenges, and obstacles have occurred in implementation.
Q2) Northwestern Hospital has decided to implement peer review.As a clinical leader in the emergency department,you have overall responsibility for ensuring that this is in place by next month.The most important step in this process is to A) provide an educational session for staff on peer review.
B) revise the mission statement, objectives, and performance standards.
C) develop objectives and performance standards with employees.
D) implement objectives and performance standards.
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Chapter 18: Leading Change
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Q1) Ute has been vocal about her negative concerns related to a new charting system and frequently expresses the view that keeping the "old system" would have been just fine.In facilitating change,your best approach to Ute would be to
A) put her in the pilot planning group for the change.
B) determine whether she has considered retirement.
C) schedule her work assignment so that it coincides with those of two staff members who are confident with technology and the change.
D) avoid discussion of the change, and trust that with sufficient training and information, her attitude will change.
Q2) Which of the following would be the most effective response to Elizabeth?
A) "I understand how you feel, but you are going to have to change."
B) "It is unfortunate that you feel this way. Others seem quite excited about the new information."
C) "It is difficult sometimes to change what we know very well. Sometimes it can be frightening."
D) "Perhaps I can arrange some more information sessions for you, so you can see just how important this change is to patient safety."
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Page 20
Chapter 19: Building Teams Through Communication and Partnerships
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Sample Questions
Q1) What is not a key concept in a well-functioning team?
A) Absence of disagreement or conflict
B) Special work that is understood and supported by all
C) Willingness to work together respectfully
D) Dedication to a mission
Q2) Which of the following is a characteristic of a good team member?
A) Inflexibility
B) Cooperation
C) Enlarging
D) Playing politics
Q3) The Situation-Background-Assessment-Recommendation (SBAR)system of communications is one of the most widely used communication systems in health care because
A) it deals with all aspects of communications in patient care except communication with the physician.
B) the nurse is on the same communication level as administration.
C) it focuses on how information is provided and gleaned in an honourable way.
D) it honours an unstructured transfer of information.
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Chapter 20: Collective Nursing Advocacy
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Q1) On Unit 62,the nurses and the unit manager have been involved in shared decision-making about the model of nursing care delivery that the unit will adopt.All individuals have participated and been involved in decision-making and implementation of changes.When issues arise during implementation,it is expected that A) accountability resides entirely with the unit manager.
B) individual expertise will be used to provide solutions, but that responsibility for the change is shared.
C) no one really has any accountability or responsibility for the changes.
D) all of the staff will participate in the evaluation of the changes.
Q2) In an inner-city area,a group of nurses meet and develop a plan to negotiate with local businesses to support a breakfast program for young elementary school-age children.This is an example of A) community development.
B) collective bargaining.
C) collective action.
D) shared governance.
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22
Chapter 21: Managing Quality and Risk
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Q1) The nurse manager is performing a root-cause analysis related to medication administration errors with insulin.A root-cause analysis is very similar to the QI process except that a root-cause analysis is
A) retrospective.
B) prospective.
C) legislated for completion with all near-miss events.
D) conducted by only one person.
Q2) Hospital Magnet decides against creating a separate department to lead and monitor quality activities because
A) total organizational involvement is critical in QI.
B) data generated by a single, separate department are generally flawed.
C) monitoring and commitment to QI can come only from senior-level managers.
D) staff members resent suggestions for improvement that originate outside of their unit.
Q3) Patient perceptions are useful in
A) determining disciplinary actions in QI.
B) establishing the competitive advantage of QI decisions.
C) establishing priorities among possible changes to care identified in QI.
D) establishing blame for poor-quality care.
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Chapter 22: Translating Research Into Practice
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Q1) Which of the following has been identified as a significant factor in moving EBP into patient care?
A) Strong utilization models
B) Development of stronger opinion leaders
C) Technology
D) Support by other disciplines
Q2) Once evidence related to the use of prompted voiding in patients with cognitive impairment has been appraised and integrated with practice,it is important to A) consider whether patients' families see this as necessary for the well-being of family members.
B) search large databases such as the Cumulative Index to Nursing and Allied Health Literature (CINAHL) to amass further evidence.
C) clarify the clinical practice question.
D) solicit input regarding integration with practice.
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Chapter 23: Understanding and Resolving Conflict
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Q1) Lee,the head nurse in ER,has attempted to meet Jillian,one of her staff RNs,for several days to discuss concerns about Jillian's relationships with her team members.Lee hopes to offer Jillian coaching so that Jillian's relationships can be more satisfying for Jillian and her team members.Each time Lee and Jillian set a time to meet,Jillian phones in sick.In this situation,Lee and Jillian are demonstrating
A) similar conflict management strategies.
B) escalation of conflict.
C) avoidance and compromise strategies.
D) competing and compromise strategies.
Q2) In trying to achieve Magnet status for the hospital,the chief nursing officer establishes a shared governance model to help nurses experience job satisfaction.However,some nurses who have enjoyed working with less autonomy resist this change,which thus creates organizational conflict.Organizational conflict arises from which of the following?
A) Flat organizational structure
B) Clarity in role responsibilities
C) Increased autonomy through self-governance
D) Less participation in decision-making
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25
Chapter 24: Managing Personalpersonnel Problems
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Q1) When progressive discipline is used,the steps are followed progressively only for repeated infractions of the same rule.On some occasions,the breaking of rules is so serious that the employee is
A) transferred to another unit.
B) suspended indefinitely.
C) asked to attend a union grievance meeting.
D) terminated after the first infraction.
Q2) In which order should the strategies below occur in progressive discipline?
a. Suspending the staff member from work
b. Providing written admonishment that is discussed and placed in the employee's file
c. Providing verbal admonishment
d. Terminating the staff member
A)A,B,C,D
B)B,A,C,D
C)C,B,A,D
D)C,A,B,D
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Chapter 25: Workplace Violence and Incivility
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Q1) Canadian knowledge of the scale of workplace violence in health care remains incomplete because
A) collected data are inflated.
B) no consistent system of data collection for workplace violence exists.
C) data is collected only in relation to physical injuries.
D) the classification of workplace violence is unclear.
Q2) Aishwarya is involved in intervening when a patient attempts to harm herself on the unit.During the interaction,the patient slaps Aishwarya across the face.It is important that the head nurse
A) offer Aishwarya immediate education and training in self-defence.
B) assist with follow-up documentation and offer access to counselling.
C) provide access to a lawyer.
D) encourage Aishwarya to perceive the incident as a normal part of care.
Q3) A safety and security plan is important to a health care organization because it
A) specifies preventive measures in relation to violence.
B) provides direction as to changes in facilities that protect staff.
C) establishes expectations in relation to behaviour and tolerance of violence.
D) establishes policies and practices that guide prevention of violence and expectations in the workplace.
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Page 27
Chapter 26: Practising and Leading in Interdisciplinary Settings
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Q1) Sammi,a registered nurse,is part of an interdisciplinary team that provides care to patients with acute cardiac interferences.The team has not been functioning optimally.and Sammi is aware that this may cause a(n)
A) increase in the cohesiveness of the team.
B) escalation of turf protection.
C) increase in the quality of patient care.
D) decrease in workplace stress.
Q2) During a fire drill,the nurse manager becomes very assertive and directive in her communications with staff.This type of situational leadership depends on
A) supportive behaviour by the leader and immature followers.
B) the relationship with the followers and the type of behaviour of the leader.
C) well-trained followers, combined with a strong leader who acts quickly.
D) the leader's ability to evaluate personnel and communicate that evaluation.
Q3) A key advantage that a nurse manager has in terms of delegating is that A) patients receive less attention because too many staff members make it difficult to coordinate care.
B) nurses report less pressure to perform necessary tasks themselves.
C) administration can predict overtime more accurately.
D) team skills can be used more effectively.
Page 28
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Chapter 27: Role Transition
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Q1) As a nurse manager,you have hired two new graduates for your unit.To assist the new graduates in their role transition from student to practicing RN,you advocate for A) a journalling program.
B) hiring a nurse educator to work with these and other new graduates.
C) additional time off for nurses to practice RN skills.
D) additional staff while nurses are being orientated.
Q2) A strategy that may help Samia make the transition to her management role and to respond to relationships and situations in her new position is
A) avoiding discussion of her personal beliefs with staff until she is ready to do so.
B) finding a network of clinicians with similar interests to her own.
C) researching clinical literature to maintain her clinical assessment skills for the unit. D) recognizing her strong commitment to care in the management process through journalling.
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Chapter 28: Self-Management: Stress and Time
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Sample Questions
Q1) A hospice nurse has been feeling very stressed at work because of both the physical strain and the emotional drain of working with patients with acquired immune deficiency syndrome (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.Another 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.
Q2) Which of the following statements is true?
A) "Recent research has demonstrated 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 have the same effect on each individual."
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Chapter 29: Managing Your Career
Available Study Resources on Quizplus for this Chatper
26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/44774
Sample Questions
Q1) In preparing for a fair interview process as a hiring manager,you should
A) put water out for the candidates.
B) ensure that you know the names of all candidates.
C) dress comfortably and professionally.
D) prepare a schedule of questions to be asked of all candidates.
Q2) A nurse manager has been employed in the same facility for 20 years and has held the same position.This career style is known as A) linear.
B) spiral.
C) steady state.
D) entrepreneurial/transient.
Q3) A well-written letter of resignation is critical to
A) first announce your intent to resign.
B) formally signal discontent in your current position.
C) maintain a positive relationship with your former organization and colleagues.
D) fulfill your legal obligations as a departing employee.
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Chapter 30: Thriving for the Future
Available Study Resources on Quizplus for this Chatper
24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/44775
Sample Questions
Q1) Health care demographics,changing funding levels,and alternative approaches to care all interact with and influence one another.Nursing at individual,unit,and systems levels influences health care and society,and vice versa.The implication of this is that
A) funding levels will reduce the number of nursing positions.
B) the ethical influence of nursing on political decisions increases public trust in nursing.
C) negative publicity by politicians will negatively affect public perceptions of nursing.
D) the public has little effect on the organization of health care.
Q2) The phenomenon experienced by the staff in question 18 is termed A) eustress.
B) care process.
C) stereotypical thinking.
D) complexity compression.
Q3) Which of the following hampers the ability of nurses to be leaders?
A) A focus on the patient and not on the system
B) Lack of interest in leadership
C) Disillusionment with change
D) Funding disparities
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