Leadership in Clinical Practice Pre-Test
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Course Introduction
Leadership in Clinical Practice explores the essential theories, skills, and strategies required for effective leadership in healthcare settings. This course examines the unique challenges faced by clinical leaders, emphasizing evidence-based decision-making, team dynamics, ethical considerations, and communication strategies. Students will analyze case studies and real-world scenarios to develop their ability to influence positive change, foster a culture of safety, and advocate for both patients and healthcare professionals. By integrating practical leadership tools with a deep understanding of clinical environments, participants will be prepared to confidently guide interdisciplinary teams and improve patient outcomes.
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) A nurse manager at Morgan Hill Community Hospital is known to be an excellent nursing manager by the personnel working on her nursing unit. The nurse manager exhibits which of the following behaviors? (Select all that apply.)
A) Knows the personnel and addresses them by name.
B) Intervenes when she receives complaints.
C) Has a consistent style that never varies.
D) Is visible on the nursing unit by all shifts on a frequent basis.
E) Evaluates a number of aspects of problems prior to making decisions.
F) Uses decision by consensus to resolve conflicts.
G) Fosters collaboration.
Answer: A, D, E, G
Q2) _____ are vital to good leaders because they are able to take the vision of the leader and achieve the determined goals.
A) Managers
B) Motivators
C) Visionaries
D) Followers
Answer: D
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Chapter 2: Change and Innovation
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Sample Questions
Q1) The first stage of planned change involves:
A) accepting the need for change.
B) cognitive redefinition.
C) integration and stabilization.
D) problem solving.
Answer: A
Q2) A small critical care unit forms a team of nurses to implement bedside rounds at shift change. The nurses have researched the efficacy of bedside rounds and have determined that this evidence-based practice will lead to improved communication of patient status. Which type of change does this demonstrate?
A) Transforming care at the bedside
B) Second-order change
C) Emergent change
D) Organizational change
Answer: A
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4
Chapter 3: Organizational Climate and Culture
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Q1) A nurse is interviewing for a position at a prominent hospital in her community. She notes a separate physicians' dining room, but all other professionals and visitors eat in the same dining area. The physicians have a separate parking area. Nurse practitioners and physician assistants are asked to park in the staff lot. What might these observations suggest?
A) The mission statement supports collaborative care.
B) The philosophy of the organization depicts inequality.
C) The values and actions may not be congruent.
D) The vision for nursing is defined clearly.
Answer: C
Q2) The nurse manager of a medical-surgical unit realized that there are differences in dealing with the varied generations of her nursing staff. How does the nurse manager communicate effectively with the Generation Y staff members (those born after 1980)?
A) Typewritten memos
B) Staff meetings held monthly for 2 hours
C) E-mails or text messages
D) Face-to-face interactions
Answer: C
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Chapter 4: Managerial Decision Making
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Q1) The nurse in a medical-surgical unit is working short-staffed due to a sick call. Which of these is an example of prioritization?
A) Charting by exception
B) Omitting personal hygiene in favor of timely medication administration
C) Timely medication administration without scanning the patient armband
D) Deploying a rapid response team when a patient condition changes
Q2) The decision support department has been asked to create balanced scorecards for each nursing unit. Nurse managers work with decision support on the data elements which will be useful in assessing financial, quality, and other measures in order to improve what?
A) Staff turnover
B) Organizational performance
C) Physician satisfaction
D) Reimbursement
Q3) Which of these concepts is key to refining clinical judgment capabilities?
A) Critical judgment
B) Reflection
C) Management experience
D) Nursing expertise
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Page 6
Chapter 5: Managing Time and Stress
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Sample Questions
Q1) The first critical step in creating an environment to prevent and address work-related stress is:
A) delegation.
B) motivation.
C) innovation.
D) intention.
Q2) Nurses who are successful at time management:
A) display an ability to set measurable goals and objectives. B) frequently volunteer for new and creative projects.
C) hesitate to delegate because of perfectionist characteristics. D) tend to accomplish specific activities within a time frame.
Q3) Jay, a nurse in the intensive care unit, has been caring for a patient with end-stage renal disease, congestive heart failure, and a stroke. The client has had four cardiac arrests in 4 days. Despite the grave prognosis, the client's family continues to want resuscitation at all cost. Jay knows that further medical care is futile. Jay is at risk for:
A) confrontational conflict.
B) resilience.
C) burnout.
D) moral distress.
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Page 7
Chapter 6: Legal and Ethical Issues
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Q1) The most common source of legal liability for nurse managers is a(n):
A) medical malpractice suit.
B) organizational nursing issue.
C) tort.
D) vicarious liability.
Q2) The nursing manager has assumed responsibility for ensuring that tasks within her department are delegated legally and are performed appropriately. In so doing, she has accepted which of the following nursing roles?
A) Ethical
B) Ombudsman
C) Paralegal
D) Supervisor
Q3) A new RN is observed breaking sterile technique by the perioperative nurse. This is an example of a violation of which ethical principle?
A) Autonomy
B) Justice
C) Nonmaleficence
D) Confidentiality
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Chapter 7: Communication Leadership
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Sample Questions
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) Which of the following is true about negotiation?
A) It commonly results in a win-lose situation.
B) It is aimed at solving problems, conflicts, or disputes.
C) It is used only in contract and labor union disputes.
D) It is the exchanging of favors or trading activity.
Q3) _____ communication patterns exist between colleagues and serve to contribute to a hostile work environment, high turnover, burnout, and job dissatisfaction.
A) Defensive
B) Disruptive
C) Negotiating
D) Humanizing
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Chapter 8: Team Building and Working With Effective Groups
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Sample Questions
Q1) Group as well as individual accountability exists within a: A) work group.
B) true team.
C) pseudoteam.
D) committee.
Q2) In nursing, the reason groups form is:
A) monetary rewards.
B) mandatory obligations.
C) physical needs.
D) professional socialization.
Q3) Group problem solving is known to be more effective over individual problem solving because of a larger knowledge and information base, increased acceptance of solutions, more approaches to a problem, lower economic costs, and the ability for:
A) group development.
B) individual expression.
C) hierarchical bonding.
D) organizational team building.
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Page 10
Chapter 9: Delegation in Nursing
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Q1) Delegating requires clear and skillful _____ to avoid liability.
A) negotiation
B) communication
C) corrective action
D) planning
Q2) 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
Q3) Which principles are important to consider when an RN delegates tasks to UAP?
(Select all that apply.)
A) Tasks are delegated that will challenge the UAP to use critical thinking.
B) Assess the condition and stability of the patient.
C) Delegate tasks that are within the expertise of the RN, particularly if the UAP is a student.
D) Evaluate the complexity of the task.
E) Determine the potential for harm to the patient.
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Page 11
Chapter 10: Power and Conflict
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Sample Questions
Q1) A nursing manager is leading a recruitment and retention committee. She manages in a laissez-faire style. Her co-leader is a staff nurse who is very detail oriented. The nurse manager usually leads the meetings. During the meeting, the staff nurse frequently needs to interject information that has not been presented. She also creates the agenda and communicates information with other team members. This scenario depicts which type of conflict?
A) Competitive
B) Disruptive
C) Organizational
D) Task
Q2) 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.
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Chapter 11: Workplace Diversity
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Sample Questions
Q1) 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
Q2) A nurse believes that she should provide optimal care to all clients, regardless of their cultural background. She is struggling with her emotions when caring for a client with a violent criminal background. What would be the best course of action for this nurse?
A) Avoiding the client as much as possible but providing care
B) Identifying her biases but providing care
C) Requesting another patient assignment
D) Taking sick days while the patient is hospitalized
Q3) What is the most modifiable factor in the provision of equitable health care?
A) Availability of services
B) Socioeconomic status
C) Care that is responsive to cultural needs
D) Education level
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Page 13
Chapter 12: Organizational Structure
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Sample Questions
Q1) The structure of authority in an organization is known as the:
A) authority.
B) centralization.
C) bureaucracy.
D) hierarchy.
Q2) The division of work by occupation or function is a form of:
A) specialization.
B) interdependence.
C) uncertainty.
D) technology.
Q3) Dividing work by occupation leads to a functional organization where services are arranged by the type of work performed. What are some benefits of the functional form within the health care organization? (Select all that apply.)
A) Professional silo
B) Fragmented care delivery
C) Cost reduction
D) Enhanced performance and quality
E) Promotion of professional development
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14
Chapter 13: Decentralization and Shared Governance
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Q1) Which of the following leadership styles is best suited for implementation of a shared governance structure?
A) Authoritarian
B) Autocratic
C) Participative
D) Laissez-faire
Q2) In organizations that practice shared governance, the nurse manager's role is to: (Select all that apply.)
A) hire new employees.
B) mentor the nursing staff.
C) train new nurses in patient care.
D) support the decisions of the nursing team.
E) enable the staff to become effective leaders.
Q3) In organizations that practice shared governance, staff, managers, and leaders are responsible for:
A) technology.
B) budgeting.
C) education.
D) innovation.
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Page 15
Chapter 14: Strategic Management
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Q1) The guiding framework that describes the organization's purpose and future direction is the:
A) futuristic guidelines.
B) mission and vision.
C) strategic plan.
D) core purpose.
Q2) Answering questions such as "What business are we in?" and "What business do we want to be in?" can lead the organization to define the:
A) mission.
B) objectives.
C) core purpose.
D) strategic plan.
Q3) A competitive move or business approach designed to produce a successful outcome is called _______.
Q4) Operational choices for action that are made to implement a strategy are called: A) tactics.
B) objectives.
C) core values.
D) strategic plans.
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Chapter 15: Professional Practice Models
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Sample Questions
Q1) The presence of a nurse professional practice model (PPM) is the nurse's: (Select all that apply.)
A) control over practice.
B) career focus.
C) job satisfaction.
D) psychological needs.
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) A(n) _____ is a written plan that identifies key, critical, or predictable incidents that must occur at set times to achieve client outcomes within an appropriate length of stay in a hospital setting.
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Page 17
Chapter 16: Case and Population Health Management
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Q1) A patient has a history of diabetes mellitus, myocardial infarctions, and hypertension. His HgbA?c level dropped from 7.8% to 6.2% 2 months after he began a walking exercise program. The nurse case manager had provided diabetic education and suggested ways to enhance his cardiac reserve. This is an example of:
A) nursing empowerment.
B) nursing knowledge.
C) patient expertise.
D) patient participation in care.
Q2) _____ has garnered considerable attention in health care in part because of the publication Crossing the Quality Chasm, a health care quality initiative of the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division).
A) Disease management
B) Development research groups
C) Case management
D) Diagnosis-related groups
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Chapter 17: Evidence-Based Practice: Strategies for Nursing Leaders
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Q1) A rigorous scientific process used to combine findings from research (usually randomized controlled trials) into a powerful and clinically useful report to guide practice is known as a systematic review. Standard components of a systematic review to consider are: (Select all that apply.)
A) process for initiating.
B) standard reporting format.
C) reliability and validity of data.
D) process for synthesizing the body of evidence.
E) process for finding and assessing individual studies.
Q2) 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
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Chapter 18: Quality and Safety
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Q1) Sentinel Event Alerts are published by TJC to do which of the following?
A) Allow facilities to learn from sentinel events that have occurred in other facilities and incorporate recommendations for prevention into their policies.
B) Notify hospitals that if a sentinel event occurs during an alert, the hospital will be subject to withdrawal of Medicare and Medicaid certification and reimbursement.
C) Prevent a near-miss from occurring.
D) Assist hospitals to find national standardized performance measures to benchmark themselves against other similar hospitals.
Q2) Hospitals must submit specific quality performance data regarding Medicare patients or risk:
A) an increase in federal tax.
B) decreased payments.
C) fewer physician referrals.
D) sanctions by The Joint Commission (TJC).
Q3) _____ is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
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Chapter 19: Measuring and Managing Outcomes
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Q1) 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
Q2) Outcomes measurement is complex because:
A) budgets are unable to allocate sufficient funds.
B) health care is multidimensional.
C) patients may not cooperate.
D) treatments are not always necessary.
Q3) A(n) _____ is the result or results obtained from the efforts to accomplish a goal.
Q4) Donabedian's aspects of quality include: (Select all that apply.)
A) goals.
B) process.
C) policies.
D) structure.
E) outcomes.
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Chapter 20: Prevention of Workplace Violence
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Q1) County Hospital has purchased a computerized reporting system for reporting incidents, including acts of violence. Violence reports are aggregated, trended, and used to mitigate future incidences of workplace violence. This type of management framework is _____ management.
A) risk
B) threat
C) total quality
D) human resources
Q2) 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.
Q3) An evaluation of a specific threat of violence and an evaluation of the person making the threat is conducted by ______.
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Chapter 21: Confronting the Nursing Shortage
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Q1) An important predictor of job satisfaction with new graduates is:
A) culture.
B) compensation.
C) benefit package.
D) staffing adequacy.
Q2) The process of identifying applicants for potential employment is called:
A) selection.
B) retention.
C) recruitment.
D) human resources.
Q3) A shortcoming that needs to be addressed related to the advertising of open nursing positions is:
A) inadequate use of Internet advertising.
B) insufficient funds allotted for advertising.
C) lack of follow-up with potential candidates.
D) short supply of advertising space in nursing journals.
Q4) Authentic respect for others requiring time, presence, engagement, and intention to seek common ground is called _____.
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Chapter 22: Staffing and Scheduling
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Q1) A forecasted workload and a recommended care standard determine the: A) staffing pattern.
B) skill mix of the unit.
C) nurse-to-patient ratios.
D) staffing management plan.
Q2) Key to effective staffing are protocols and processes for daily staffing decision support that are aligned with a budget-sensitive variable staffing plan. In a decentralized model, the responsibility of daily staffing allocation belongs to the: A) float pool.
B) staffing office.
C) department manager.
D) chief nursing officer.
Q3) 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.
Q4) When the needs and characteristics of the patient clinical unit, or system, are matched with a nurse's competencies, _____ results.
Q5) The amount of work performed by a unit is referred to as its _____.
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Page 24
Chapter 23: Budgeting, Productivity, and Costing Out Nursing
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Q1) The management team of a large hospital is attempting to identify the specific cost of providing nursing services. This process is known as:
A) costing out services.
B) fee-for-service care provision.
C) priority nursing management.
D) quality versus cost balance.
Q2) Janice is going to give her patient a bath. She has the option of using prepackaged bathing wipes or a bath basin and washcloths. She chooses the bath basin and washcloths because she knows their performance is the same but they are less expensive. Janice's choice is an example of:
A) rationing.
B) fiscal responsibility.
C) costing out services.
D) activity-based costing.
Q3) A(n) _____ is the difference between the budgeted and actual amounts.
A) expense
B) margin
C) revenue
D) variance
25
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Chapter 24: Performance Appraisal
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Q1) An experienced critical care nurse left a CCU staff nurse position to finish a master's degree. Periodically, he would return to work as a per diem nurse in the CCU. The staff was impressed with the nurse's performance; however, one staff member complained that he was unfamiliar with the new telemetry monitors when he first returned to work several months ago. This comment showed up in his evaluation, resulting in a poorer overall evaluation from the nurse manager compared with previous evaluations. This is an example of:
A) contrast bias.
B) a horn effect.
C) recent behavior bias.
D) similar-to-me effect.
Q2) The ability to perform a skill successfully is:
A) competency.
B) acuity.
C) aptitude.
D) motivation.
Q3) The process by which nurses systematically evaluate the quality of nursing care provided by peers as measured against professional standards is called _____.
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Chapter 25: Emergency Management and Preparedness
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Q1) An example of a cyber disaster is a catastrophic event caused by:
A) the use of military weapons.
B) an exposure to toxic materials.
C) an outbreak of a pathogen.
D) an attack initiated from one computer against another.
Q2) The hospital plays an important role in the community in the case of a disaster. What are some of the expected roles of the hospital? (Select all that apply.)
A) Stockpiling emergency equipment
B) Purchasing personal protective equipment (PPE)
C) Providing additional security for the community
D) Educating staff on all-hazards preparedness
E) Providing emergency shelter to community members
Q3) In a disaster, it is most important that the:
A) clients are sent home quickly.
B) medications and supplies are secure.
C) nurses and their families feel safe.
D) security department increases its workforce.
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Chapter 26: Data Management and Clinical Informatics
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Q1) Nursing outcome databases are critical because nurses must be able to:
A) assess the differences between an associate degree in nursing and a bachelor's of science degree in nursing.
B) compare interventional care strategies between physicians.
C) evaluate nurse's aide- and licensed practical/vocational nurse-sensitive outcomes.
D) measure how nurses influence patient outcomes.
Q2) Which of the following statements are true regarding health information technology (HIT) applications in nursing services? (Select all that apply.)
A) HIT involves nursing administration, clinical informatics, and effectiveness research.
B) Health information data allow nursing leaders to make informed decisions regarding patient care.
C) HIT is used primarily for financial decision making.
D) Clinical decision support utilizes tools for downloading, collecting, organizing, and analyzing data.
E) HIT is used by senior leaders only.
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Chapter 27: Marketing
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Sample Questions
Q1) The marketing mix of an organization is:
A) an individualized blend of tactics used to achieve goals.
B) guidelines that outline plans to market specific services.
C) patient education materials that also highlight services.
D) various television commercials used to advertise goods.
Q2) What unique challenges in the health care setting can be promoted through marketing? (Select all that apply.)
A) High-quality patient-centered care
B) Hospital mortality rates
C) Design of a healthy work environment
D) Hiring and retention of new graduate nurses
E) Practices aimed at patient satisfaction
Q3) A patient with pulmonary fibrosis is visiting a large metropolitan institution for treatment of her disease. An employee with a wheelchair and tank of oxygen greets her at the door and gives her instructions on how to find the pulmonology clinic. This is an example of:
A) client courtesy.
B) patient-centeredness.
C) patient advocacy.
D) strategic service.
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