Clinical Leadership in Nursing
Chapter Exam Questions
Course Introduction
Clinical Leadership in Nursing explores the essential theories, skills, and strategies required for effective leadership within clinical nursing environments. The course emphasizes the development of critical thinking, communication, decision-making, and ethical reasoning to navigate complex healthcare settings. Students will analyze case studies, engage in reflective practice, and examine roles and responsibilities of nurse leaders in promoting high-quality patient care, fostering collaborative teams, and driving change. The curriculum also addresses conflict resolution, evidence-based practice leadership, and the impact of health policy, preparing nurses to confidently lead initiatives that improve outcomes and advance the profession.
Recommended Textbook
Leadership and Nursing Care Management 6th Edition by Diane Huber
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Chapter 1: Leadership and Management Principles
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Q1) Nursing management is defined as:
A) delegation of authority and responsibility and the coordination of tasks.
B) the integration of resources through planning, organizing, and directing.
C) the process of influencing patients to accomplish goals.
D) the coordination and integration of nursing resources by applying the management process to accomplish nursing care and service goals and objectives.
Answer: D
Q2) A nurse is caring for an elderly patient who was admitted after sustaining a fall at home. When creating a care plan for the patient, she requests that the doctor order a home health visit to assess for home safety and medication compliance. In addition, the nurse is concerned about the nutrition of the patient and requests a dietitian evaluation. The nurse is demonstrating which of the following leadership skills?
A) Care provider
B) Business principles
C) Care coordination
D) Change management
Answer: C
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Chapter 2: Change and Innovation
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Q1) During periods of stress and change, which of the following strategies should managers use to provide emotional support to staff members? (Select all that apply.)
A) Reframe difficult questions.
B) Communicate facts through e-mail.
C) Provide active listening.
D) Promote action steps and solutions.
E) Keep staff informed of decisions.
F) Communicate with participation.
Answer: A, C, D, E, F
Q2) According to the ___________ people move through a series of states when modifying their behavior.
A) Organizational Change-Readiness Scale (OCRS)
B) Transtheoretical Stages of Change Model
C) Rapid Cycle Change
D) plan-do-study-act model
Answer: B
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4
Chapter 3: Organizational Climate and Culture
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Q1) Climate is best defined as the:
A) health and well-being of the structure of a facility.
B) perceptions that individuals have about an environment.
C) style in which individuals treat each other.
D) temperature in the nursing units of an institution.
Answer: B
Q2) The nursing manager of a telemetry unit has developed a policy in which all nurses automatically are scheduled to have a day off from work on their birthday unless they request to work on that day. He also gives a small gift to each nurse who becomes certified in his or her specialty area. This manager's actions are positively affecting the _____ of the unit.
A) climate
B) culture
C) interactions
D) operation
Answer: B
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Chapter 4: Managerial Decision Making
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Q1) Nurses working on the intermediate care unit have had many hours of overtime in the last 6 months. Before forming a team, the nurse manager gathers data about patient condition severity, staffing ratios, educational levels of staff, and personality mixes on each shift. What level of decision making is this process?
A) Establishment of solution evaluation criteria
B) Evaluation of the alternative solutions
C) Identification of a problem, issue, or situation
D) Search for alternative solutions or actions
Q2) .The nurse manager is dealing with a situation between two nurses who disagree on patient assignments. The nurse manager decides to allow the two nurses to work out their differences between themselves because the patient needs and the needs of the unit are being met. After the situation is resolved, the nurse manager praises the two nurses for making autonomous decisions about staffing. What will be the likely outcome of praising the nurses in this situation?
A) higher job satisfaction
B) Lower job satisfaction
C) Lower patient satisfaction
D) Increased staff turnover
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Chapter 5: Managing Time and Stress
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Q1) _____ is defined as the accomplishment of specified activities during the time available.
A) Stress
B) Mismanagement of resources
C) Time management
D) Self-management
Q2) There is evidence of a link between _____ employees with higher productivity and more satisfied customers.
A) stressed
B) empowered
C) financially focused
D) creative
Q3) A nurse manager has several complaints from her staff that she is inaccessible during the day. What is the best strategy the nurse manager takes to improve her staff satisfaction?
A) Notify staff when she will be out of the office.
B) Block time for daily rounds with staff.
C) Set realistic follow-up deadlines for staff issues, questions, and concerns.
D) Ask the staff to communicate with her through their supervisors.
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Page 7
Chapter 6: Legal and Ethical Issues
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Q1) A staff nurse is facing a dilemma between meeting clinical ethical standards and meeting organizational goals. The nurse manager understands that the best way to assist staff members in resolving ethical dilemmas effectively is to focus on:
A) doing the right thing and taking the right action.
B) meeting clinical standards before organizational goals.
C) meeting organizational goals before clinical standards.
D) referring indecisive staff members for additional training.
Q2) A Middle Eastern man has just been diagnosed with terminal cancer. The family has asked the medical and nursing staff to keep this information from the patient because in their culture they are fearful of delivering bad news as it may cause the patient to give up hope. Which ethical principles and dilemmas might be faced by nursing staff? (Select all that apply.)
A) Justice
B) Autonomy
C) Veracity
D) Confidentiality
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Chapter 7: Communication Leadership
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Q1) Over lunch in the cafeteria, student nurses are sharing educational information about the patients for whom they are caring. This is a(n):
A) breach of beneficence.
B) example of maleficence.
C) potential assault and battery charge.
D) violation of the Health Insurance Portability and Accountability Act (HIPAA).
Q2) E-mail is a great tool for communication. When should e-mail not be used? (Select all that apply.)
A) When you are mad.
B) When scheduling a meeting
C) When you are canceling or apologizing
D) If there is any chance your words could be misunderstood
E) When rebuking or criticizing
Q3) Which communication format was developed to address the communication arm of the TeamSTEPPS model?
A) NVC (nonviolent communication)
B) SBAR (situation, background, assessment, and recommendation)
C) VERA (validation, emotion, reassurance, activity)
D) MI (motivational interviewing)
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Page 9
Chapter 8: Team Building and Working With Effective Groups
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Q1) The critical care unit of a hospital utilizes team huddles at change of shift. This is an opportunity for the clinical supervisors to connect with team members and review the upcoming shift or any quick topics that need to be communicated. This is an example of a(n) _____ meeting.
A) information-sharing
B) opinion-seeking
C) problem-solving
D) strategy
Q2) What are some of the positive aspects of utilizing teams in a professional setting such as health care? (Select all that apply.)
A) Teams have the potential to perform at higher levels than individuals on their own.
B) Teams are a way to keep decision making at the management level.
C) Teams may contribute to constraints within the budget.
D) Teams can motivate individual members and provide encouragement, constructive criticism, and praise.
E) Teams can make individuals feel more connected to the larger organization.
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Chapter 9: Delegation in Nursing
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Q1) Which staff member should be assigned to a dying client who is experiencing symptoms of emotional distress?
A) UAP who can be spared to sit with the client
B) LPN/LVN who has grown attached to the family
C) RN who has experience as a hospice nurse
D) Newly graduated RN
Q2) If an error occurs as a result of delegation, the nurse is accountable for supervision, follow-up, intervention, and:
A) corrective action of the event.
B) documentation of the event.
C) evaluation of the process.
D) summation of the occurrence.
Q3) Delegating requires clear and skillful _____ to avoid liability.
A) negotiation
B) communication
C) corrective action
D) planning
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Chapter 10: Power and Conflict
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Q1) A staff nurse frequently is providing positive comments to get the manager in a good mood before asking about additional vacation time. This influence tactic is known as:
A) consultation.
B) ingratiation.
C) inspiration appeals.
D) rational persuasion.
Q2) Nurses derive much of their power from being:
A) authority figures in emergent situations.
B) central to the delivery of health care services.
C) organized through public associations.
D) the care coordinator of the health care team.
Q3) Negotiation is a form of conflict resolution. Which of the following terms are associated with negotiation? (Select all that apply.)
A) Conciliation
B) Distributive bargaining
C) Arbitration
D) Mediation
E) Collective bargaining
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Chapter 11: Workplace Diversity
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Q1) Recognizing one's own prejudices and learning about other people's differences is the first step toward:
A) cultural diversity.
B) multicultural competence.
C) social change.
D) valuing.
Q2) According to the National Healthcare Quality and Disparities Report, which group has worse access to health care in America, compared with Whites?
A) Hispanics
B) Asians
C) Blacks
D) American Indians
Q3) Equity is the absence of avoidable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically. Which group formulated this definition?
A) World Health Organization
B) Affordable Care Act
C) Centers for Disease Control
D) Agency for Healthcare Research and Quality
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Chapter 12: Organizational Structure
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Q1) Managers apply their leadership skills to their reporting relationships to release energy and talents of people in a manner that adds value to the work they perform. What are some examples of the effects of added value? (Select all that apply.)
A) Increased compensation
B) Improved productivity
C) Organizational commitment
D) Organizational citizenship behaviors
Q2) The patient is a 69-year-old woman who has a history of diabetes mellitus, peripheral vascular disease, and myocardial infarctions. She was admitted to the hospital with a stroke and is being transferred to a subacute facility and then to a rehabilitation facility. At every transfer she must review her entire history, provide telephone numbers of family members, list all 30 of her medications, and list all home care and medical supply companies. Which of these processes could improve the fragmentation in work flow?
A) Departmentalization
B) Standardization
C) Specialization
D) Subdivision
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Chapter 13: Decentralization and Shared Governance
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Q1) Shared governance is a vehicle for engaging organizations and creating the necessary forums and intersections that assure the decisions and actions remain dynamic and as close to the point of service as possible. Shared governance promotes: A) dependence.
B) non-punitive culture.
C) collaboration
D) executive decision making.
Q2) Decentralization occurs when:
A) equipment is being purchased from approved vendors.
B) hiring decisions are made at the executive level.
C) power is distributed to those closest to the work of caregiving.
D) supplies are distributed from one central supply area in the hospital.
Q3) In organizations that practice shared governance, the responsibility for unit outcomes rests with the:
A) nursing team.
B) nurse manager.
C) individual nurse.
D) chief nursing officer (CNO).
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15
Chapter 14: Strategic Management
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Q1) An action plan:
A) breaks a strategic plan into manageable parts.
B) details a futuristic view of the institution.
C) outlines the steps in performing a procedure.
D) provides a strategic plan for actualizing the mission.
Q2) Objectives are:
A) bylaws used to govern the organization.
B) financial minimums needed to operate.
C) performance-based criteria for accreditation.
D) targets that the organization wants to achieve.
Q3) The purpose of strategic management is to: (Select all that apply.)
A) ensure customer satisfaction.
B) establish a competitive position.
C) reach strategic objectives or goals.
D) develop the organizational mission.
E) provide a blueprint for operating a business.
Q4) A competitive move or business approach designed to produce a successful outcome is called _______.
Q5) A(n) _____ is a two- to three-page synopsis of the strategic plan, written in language understandable by all potential readers.
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Chapter 15: Professional Practice Models
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Q1) Which nursing care model was prominent before the Great Depression?
A) Functional nursing
B) Group nursing
C) Hospital staffing
D) Private duty nursing
Q2) A patient is admitted with congestive heart failure, diabetes mellitus, and dementia. He has a new dark spot on the top of his toes on his right foot. The nurse contacts the primary care physician, consults with the wound care specialist nurse, writes a nursing order for a referral to the diabetic educator, and contacts the discharge planner to facilitate future discharge plans. Which of the following care delivery models best describes how the nurse is providing care?
A) Case management
B) Group nursing
C) Functional nursing
D) Private duty nursing
Q3) Functional nursing:
A) divided and distributed nursing tasks.
B) enhanced client-oriented care.
C) provided a smooth care delivery system.
D) was expensive once implemented.
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Chapter 16: Case and Population Health Management
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Q1) Which of the following statements accurately describe disease management? (Select all that apply.)
A) Disease management is care coordination that is organized to achieve specific client outcomes, given fiscal and other resource constraints.
B) Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant.
C) Disease management relies on a structured system of interventions that focus on a specific condition.
D) Disease management program content and interventions are evidence and guideline based.
E) Disease management is the medical management of chronic disease.
Q2) The Collaborative Care Model of CM is best used for:
A) patients with co-occurring physical and mental health needs.
B) individuals and small systems.
C) hospital-based case management programs focusing on episodic care.
D) the transition of high-risk clients from acute care to community or long-term care settings.
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18
Chapter 17: Evidence-Based Practice: Strategies for Nursing Leaders
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Q1) The CNO at Mercy Hospital is implementing a new evidence-based practice for fall prevention. List the steps in order she should take to advance stakeholders (both people and systems) through the process of diffusion.
A) Integrating and sustaining use
B) Creating awareness and interest
C) Promoting action and adaptation
D) Building knowledge and commitment
Q2) Clinicians tend to buy into the need for practice change when: (Select all that apply.)
A) there is a strong evidence base.
B) the topic addresses an identified need.
C) the practice change offers a relative advantage.
D) the practice change is endorsed by organizational executive leadership.
E) data demonstrate an opportunity for practice improvement within the clinical area.
Q3) The role of the project director is to:
A) take meeting minutes.
B) maintain the action plan.
C) set the expectations for the unit.
D) report project progress to the governing body.
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Chapter 18: Quality and Safety
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Q1) A Healthcare Failure Modes and Effects Analysis (HFMEA) for a new bar-coding system is being conducted by an interdisciplinary team. List the steps of the HFMEA in the correct order.
A) Identifying prevention strategies
B) Endorsing action plans for implementation
C) Assessing risk points within the process steps
D) Flowcharting the steps of the process being studied
E) Designing out the most critical of the potential failures
F) Recommending process improvements for prevention of the failures
G) Ranking key risk points in terms of their impact on the potential failure of the system
H) Reporting action plans for implementing prevention strategies to the enterprise leaders
Q2) The degree to which health services for individuals and populations increases the likelihood of desired health outcomes that are consistent with current professional knowledge is known as the:
A) care delivery quotient.
B) excellence index.
C) quality of health care.
D) standard of care.
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Chapter 19: Measuring and Managing Outcomes
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Q1) The outcomes concept that emphasizes the multidisciplinary process of providing health care is known as outcomes:
A) maintenance.
B) management.
C) measurement.
D) monitoring.
Q2) Mary Lou is studying the 48-hour readmission rate of cardiac patients whose care was provided by nurses with associate degrees versus nurses with bachelor's degrees. The type of research Mary Lou is performing is called _____ research.
A) quality
B) patient outcomes
C) nursing outcomes
D) outcomes management
Q3) The results people care about most when seeking treatment is known as a(n):
A) achieved benefit.
B) benchmark.
C) expected response.
D) outcome.
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21
Chapter 20: Prevention of Workplace Violence
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Q1) Jeff, the manager of security at Methodist Hospital, has required that all of his security guards attend de-escalation training. The workplace violence prevention strategy Jeff is promoting is:
A) hazard prevention.
B) environmental designs.
C) behavior modification.
D) administrative control.
Q2) Employee assistance programs can be especially useful when mitigating which source of violence?
A) Patients
B) Current or former workers
C) Criminals with no connection to the employer
D) Someone who has a personal relationship with an employee
Q3) The agency that oversees the safety and health of health care workers is:
A) The Joint Commission (TJC).
B) the Department of Public Health (DPH).
C) OSHA.
D) CMS.
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22
Chapter 21: Confronting the Nursing Shortage
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Q1) A mechanism for giving feedback related to progress to employees new and experienced is called:
A) coaching.
B) mentoring.
C) counseling.
D) performance evaluation.
Q2) The total number of nurses who left a unit in 1 year divided by the total number of nurses employed on that unit is the _____ rate.
A) actualized
B) employable
C) turnover
D) vacancy
Q3) Using the targeted interview ensures that all candidates are interviewed based on the same criteria. The targeted selection process is built on: (Select all that apply)
A) organizational values.
B) analysis of work per job.
C) development of interview skills.
D) clear identification of competencies for key positions.
E) compliance with equal opportunity employer guidelines.
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Chapter 22: Staffing and Scheduling
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Q1) An approach for decreasing nursing RN skill mix was implemented in a one size fits all approach across organizations in the 1990s. These changes in skill mix led to:
A) decreases in RN workload.
B) increased nursing satisfaction.
C) decreased patient satisfaction.
D) decreased patient safety concerns.
Q2) Betty is calculating the total patient days on her unit. Her average daily census is 35 and her average length of stay is 2.4 days. In numerals, the total patient days on Betty's unit is _____ days.
Q3) A common element among nursing care delivery models is the:
A) ratio of nurses to patients.
B) manager is the frontline leader.
C) value of the nurse and patient/family relationship.
D) needs of the patients drive the competency of the nurse.
Q4) When the needs and characteristics of the patient clinical unit, or system, are matched with a nurse's competencies, _____ results.
Q5) The proportion of direct-care RNs to total direct-care nursing staff, expressed as a percentage of RNs to total nursing staff, is called _____.
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Chapter 23: Budgeting, Productivity, and Costing Out Nursing
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Q1) A(n) _____ is the difference between the budgeted and the actual amounts.
Q2) The key advantage of activity-based costing is:
A) workload is determined based on the required hours of nursing care.
B) it reflects what it costs to provide services and identifies why costs were incurred.
C) data can be used in constructing a personnel budget because it is linked to the volume indicator of patient days.
D) the judgment of an expert nurse clinician must override an empirical system and be based on patient's needs in real time.
Q3) Mary is the manager of the critical care unit. She would like to hire a wound care nurse for the unit. The type of organizational budget Mary would use to ensure she can hire the new nurse is called the _____ budget.
A) capital
B) personnel
C) operating
D) expense
Q4) A measure of the severity of illness of an individual patient or the aggregate patient population on a unit is called _____.
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Chapter 24: Performance Appraisal
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Q1) Carrie, the manager of the pediatric floor, is being evaluated by her director. Carrie set goals last year such as increasing patient satisfaction on her unit by 20% and decreasing staff turnover by 10%. Carrie's performance appraisal today is based on how well she achieved those goals. This type of performance appraisal measures: A) traits.
B) behaviors.
C) competencies.
D) results.
Q2) Jennifer is evaluating her own performance over the past year and comparing it to the standards set by the organization. Jennifer is performing a(n): A) peer review.
B) intervention.
C) self-evaluation.
D) performance appraisal.
Q3) _____ is a type of bias that occurs when individuals who are similar to the rater in some way are rated more favorably.
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Chapter 25: Emergency Management and Preparedness
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Q1) When working with the community, recognizable nomenclature is important for: A) response.
B) education.
C) reporting.
D) communication.
Q2) Which of the following questions should be considered in the hospital gap analysis survey of clinical operations readiness in the event of a disaster? (Select all that apply.)
A) Does the facility have procedures in place to maximize staff safety in a disaster?
B) Does the facility have procedures in place for use of PPE?
C) Can the facility track patients until discharge or death while maintaining confidentiality?
D) Does the facility have a lockdown plan in case of emergency?
E) Does the facility have a mechanism of tracking costs associated with the event?
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Chapter 26: Data Management and Clinical Informatics
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Q1) Successful implementation of a health information system requires a great deal of time, education, and support. The process will require which of the following expertise within the organization? (Select all that apply.)
A) Quality experts
B) Marketing specialists
C) Clinical nurse leaders
D) Nurse informaticians
E) Nurse managers
Q2) What are the primary purposes and benefits of EHRs? (Select all that apply.)
A) Single source of clinical, financial, and legal record
B) Electronic format supports the storage and exchange of continuity of care
C) Available within the health care facility to ensure confidentiality
D) Originate from a single place
E) Virtual record of retrospective, concurrent, and prospective information
Q3) The goals of meaningful use include: (Select all that apply.)
A) improve quality of care and safety.
B) engage patients and their families in care.
C) improve population health.
D) reduce costs associated with health care.
E) improve care coordination.
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Chapter 27: Marketing
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Q1) A center of excellence for geriatric care is put in place in a large retirement community. This is an example of which of the following marketing concepts?
A) Segmentation
B) Targeting
C) Product differentiation
D) Positioning
Q2) Which of the following marketing strategies are examples of niche marketing? (Select all that apply.)
A) Full-service community hospital
B) Children's hospital
C) Center for bariatric excellence
D) University hospital
E) Cancer specialty center
Q3) Which model of patient care is based on a strong philosophy of patient-centeredness?
A) TJC
B) Thomson Reuters
C) Beacon
D) Planetree
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