Leadership in Nursing Practice Study Guide Questions
Course Introduction
Leadership in Nursing Practice explores the essential leadership theories, styles, and competencies required for effective nursing leadership in diverse healthcare settings. The course emphasizes the development of critical thinking, decision-making, communication, and conflict resolution skills, preparing students to manage teams, foster collaborative relationships, and guide change initiatives to improve patient care and organizational outcomes. Through case studies and practical applications, students gain insights into ethical considerations, advocacy, and strategies to promote a positive and inclusive work environment.
Recommended Textbook
Leading and Managing in Nursing 7th Edition by Yoder Wise
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Page 2
Chapter 1: Leading, Managing, and Following
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Q1) The nurse manager has been asked to implement an evidence-based approach to teach ostomy patients self-management skills postoperatively.The program is to be implemented across the entire facility.What illustrates effective leadership in this situation?
A) The training modules are left in the staff room for times when staff are available.
B) The current approach is continued because it is also evidence-based and is more familiar to staff.
C) You decide to implement the approach at a later date because of feedback from the RNs that the new approach takes too much time.
D) An RN who is already familiar with the new approach of volunteers to take the lead in mentoring and teaching others how to implement it.
Answer: D
Q2) According to the complexity theory,what would be the focus of measurement?
A) Cost per hospital day
B) Bed utilization
C) Infection rates
D) Staff morale and budgets
Answer: D
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3
Chapter 2: Clinical Safety: The Core of
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Q1) Pleasant Valley Hospital has amended its safety practices and policies.What has the hospital elected to emphasize accordance with changes by The Joint Commission (TJC)?
A) Safety goals specific to Pleasant Valley
B) Decision-making processes
C) Sufficient staffing for safe care
D) Increased numbers of baccalaureate-prepared RNs
Answer: A
Q2) To achieve Nurse-Sensitive Care Standards developed by the NQF,you advocate for which of the following in your health facility?
A) Evidence-based practice to reduce the prevalence of pressure sores
B) Implementation of informatics at the bedside
C) Staff-manager conferences to review reporting of adverse medical events
D) Patient councils to review food, recreation, and nurse-patient relations
Answer: A
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Chapter 3: Legal and Ethical Issues
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Q1) A nurse on your inpatient psychiatric unit is found to have made sexually explicit remarks toward a patient with a previous history of sexual abuse.The patient sues,claiming malpractice.What conditions do not apply in this situation and do not support malpractice?
A) Injury
B) Causation
C) Breach of duty
D) Breach of duty of care owed
Answer: A
Q2) As a charge nurse,you counsel your RN staff member that they have has their duty of care by notifying a child's physician regarding concerns about deterioration in the child's status at 0330 hours.The physician does not come in to assess the child and does not provide additional orders.The child dies at 0630 hours.As the charge nurse,you could be held liable for what?
A) Professional negligence
B) Assault
C) Avoidance
D) Murder
Answer: A
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Chapter 4: Cultural Diversity and Inclusion in Health Care
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Q1) Sarah,one of your RNs,tells you that she can't understand why Jim,an Aboriginal patient,wants to do a smudge.Sarah's response is based on her:
A) cultural marginality.
B) circle of familiarity.
C) cultural understanding.
D) acculturation.
Q2) A new graduate RN joins your unit.After a few weeks,she complains about some of her peers on the unit and compares their practices negatively to what she learned in her nursing program.She also is vocal about how she has learned so much here that she did not learn in her program.She is best described as:
A) having cultural sensitivity.
B) experiencing cultural diversity.
C) experiencing cultural marginality.
D) experiencing acculturation.
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Chapter 5: Gaining Personal Insight: The Beginning of Being a Leader
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Q1) The core of leadership is awareness.The text by Don Miguel,The Four Agreements,presents a set of agreements to enhance personal growth and awareness.What is not one of the four agreements?
A) Be impeccable with your word.
B) Take things personally.
C) Do not make assumptions.
D) Always do your best.
Q2) Which of the following is an example of a formal leadership position on a nursing unit?
A) Staff nurse
B) Unit secretary
C) Unit manager
D) Nursing assistant
Q3) A staff nurse is the person on the unit everyone seeks for input and asks questions.What type of leadership position is the staff nurse displaying?
A) Position leadership
B) Informal leadership
C) Personal leadership
D) Formal leadership
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Chapter 6: Being an Effective Follower
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Q1) As a new nurse manager,you are aware of leadership,management,and followership principles.The concept of followership is rather new as relating to leadership.What is the role of the follower in followership?
A) Leading the group in task
B) Submission position in organization
C) Person who may influence team
D) Negative meaning for worker
Q2) In nursing theory,one theorist developed the idea of new nurses progressing to experienced nurses and playing an important role in patient care in all stages.The new nurses follow their role and progress through stages to advanced nurse.Who was this theorist?
A) Dorothea Orem
B) Patricia Benner
C) Ida Jean Orlando
D) Robert E, Kelley
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8
Chapter 7: Managing Self: Stress and Time
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Q1) After several months of heavy patient loads in the Emergency Department and inability to secure sufficient and experienced staff,the department is especially taxed by a train accident that brings in many seriously injured individuals.You observe that Rama ignores the requests of several of the injured,even when time is available to care for them and is rude to two older adult patients.You are concerned that Rama is evidencing which state?
A) Hardiness
B) Depression
C) Role ambiguity
D) Depersonalization
Q2) The nurse manager is implementing a shared governance model to help with communication and decision making.Although staff members like the concept,change is difficult.Staff nurses feel:
A) more empowered.
B) more communicative.
C) less stressed.
D) more powerless and devalued.
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Chapter 8: Communication and Conflict
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Q1) Two nurses on a psychiatric unit come from different backgrounds and have graduated from different universities.They are given a set of new orders from the unit manager.Each nurse displays different emotions in response to the orders.Nurse A indicates that the new orders include too many changes; Nurse B disagrees and verbally indicates why.This step in the process is which of the following in Thomas' stages of conflict?
A) Frustration
B) Conceptualization
C) Action
D) Outcomes
Q2) Two staff nurses are arguing about whose turn it is to work on the upcoming holiday.In trying to resolve this conflict,the nurse manager understands that interpersonal conflict arises when:
A) risk taking seems to be unavoidable.
B) people see events differently.
C) personal and professional priorities do not match.
D) the ways in which people should act do not match the ways in which they do act.
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Chapter 9: Power,Politics,and Influence
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Q1) What interaction is MOST consistent with the idea of networking?
A) Meet with the same colleagues daily to have coffee and share concerns about the workplace and stories about colleagues.
B) Join an online workplace forum to gain ideas about how to handle workplace conflict.
C) Suggest that you and a new team member meet after work for coffee to review unit guidelines.
D) Join a nurse executive interest group to meet other executives for support and for sharing ideas of expertise.
Q2) During a unit meeting,you notice that Vivian listens attentively when Mary is speaking and offers support and advice when Mary presents ideas to the group.You are surprised because Vivian has often confided that she does not like Mary.Vivian's behavior is best described as:
A) insincere.
B) networking.
C) politically sophisticated.
D) collegial.
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11
Chapter 10: Healthcare Organizations
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Q1) A local hospital has formed a corporate partnership with a reputable HMO (health maintenance organization).The nurse manager has had to educate staff and personnel about the financial implications of this partnership.An HMO:
A) provides more expensive care than other types of insurance plans.
B) has a centralized administration that directs and compensates physician services. C) pays physicians on a fee-for-service basis.
D) does not pay as much for acute care as other practice plans.
Q2) A nurse manager at a home healthcare service has resigned to take a position at a local ambulatory care center.She has been hired because of her expertise in TJC accreditation.To initiate the changes,the nurse manager has to be knowledgeable about the differences between a home healthcare institution and an ambulatory care center,which is a primary care institution.Primary care institutions are facilities that provide:
A) rehabilitative or long-term care.
B) disease-restorative care.
C) first access to care.
D) only outpatient services.
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Page 12
Chapter 11: Organizational Structures
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Q1) In matrix organizational structures,a nurse manager understands that this type of structure:
A) is a simplified organizational structure.
B) has both a functional manager and a service or product-line manager.
C) arranges departments strictly according to function.
D) promotes harmony in organizational decision making.
Q2) A statement such as "We believe in the right of patients to make choices and to have care that is sensitive to their preferences and needs" is a _____ statement.
A) mission
B) goal
C) vision
D) philosophy
Q3) With revenue reductions and cost-saving measures,the number of managers has been reduced,this has increased the number of team leaders supervised by managers by as many as three.This change may result in:
A) decreased patient satisfaction.
B) increased efficiency in costs.
C) a more positive perception of managers.
D) little change to manager-staff relationships.
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Page 13
Chapter 12: Care Delivery Strategies
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Q1) You are the nurse manager of a nursing service organization that provides around-the-clock care to clients in their homes.To achieve maximum reimbursement for a client who is recovering from a hip replacement,the nursing staff most likely will follow the nursing care guidelines presented in the:
A) nursing care plan.
B) physician's orders.
C) critical pathway.
D) clinical practice guidelines.
Q2) In considering whether or not to accept a job offer as a nurse manager at a Magnet hospital,you look at an environment that you might encounter as a head nurse at the hospital.You determine that you could expect to:
A) find it difficult to recruit new staff.
B) see rapid turnover of staff on your unit.
C) find nurses who exemplify interest in quality care.
D) find limited interest in excellence in the nursing environment.
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14
Chapter 13: Staffing and Scheduling
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Q1) To project staffing needs and to avoid understaffing,it is important that nurse managers consider which of the following?
A) Maximum productive hours
B) Average non-productive hours
C) Minimum benefit hours
D) Maximum vacation time
Q2) 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 incorporate into the schedule plan:
A) all weekends off.
B) all holidays off.
C) a variety of scheduling options.
D) rotating shifts.
Q3) As the unit manager,you post the staffing plan and compliance reports.This initiative is aimed at:
A) maintaining unit morale.
B) complying with national requirements.
C) demonstrating patient outcomes.
D) inviting staff participation in decision making.
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Page 15
Chapter 14: Work Force Engagement Through Collective
Action and Governance
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Q1) You are hired as a new manager.When the offer of employment is made,you agree to at-will employment.Later,you become very concerned about the policies and practices of your organization and their impact on patient care.You speak with your supervisor several times about your concerns,but no action is taken.In considering your next steps,you:
A) consider your increased vulnerability under the terms of your employment.
B) recognize that your supervisor is more vulnerable than you are because of her more senior position.
C) are more likely as a leader to take action because you are well protected from repercussions by federal and state regulations.
D) contact your union to discuss your concerns and review your options.
Q2) The Emergency Department staff decides to use a collective bargaining model for negotiation rather than a traditional trade union model.A traditional trade union model is characterized by:
A) positional conflict.
B) management support of labor's initiatives.
C) a spirit of trust between management and labor.
D) an ability to resolve complaints.
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Chapter 15: Making Decisions and Solving Problems
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Q1) A clinic nurse has observed another nurse deviating from agency policy in performing wound care.The best approach for the clinic nurse to take is to:
A) stay out of it.
B) inform the nursing supervisor.
C) fill out a notification form (incident report).
D) assess the risk to the client and the agency before proceeding.
Q2) To solve a problem,the nurse manager understands that the most important problem-solving step is:
A) the implementation phase.
B) identification of numerous solutions.
C) accurate identification of the problem.
D) evaluation of the effectiveness of problem resolution.
Q3) An outpatient surgery manager is evaluating new infusion pumps for purchase to use in the operating room.The manager should:
A) select the least expensive brand.
B) use a decision-making tool to evaluate brands.
C) ask the nursing staff which brand they prefer.
D) select the vendor the institution usually buys from.
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Chapter 16: The Impact of Technology
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Q1) In an ICU,you order new devices to measure heart rhythm and rate,respiratory rate,oxygen levels,and intracranial pressure.These devices involve:
A) biomedical technology.
B) telecommunications.
C) retrieval of patient history information.
D) Internet.
Q2) At a newly built outpatient surgical center,an integrated information system has been purchased.The chief nursing officer creates a series of staff development classes to orient the staff to this new system.One of the advantages of an integrated information system is that client-care data from all sites can be stored in and retrieved from a:
A) nursing information system.
B) central data repository.
C) nurse expert system.
D) handheld device.
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18
Chapter 17: Delegating: Authority, Accountability,
Responsibility in Delegation Decisions
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Q1) The charge nurse is making patient assignments for the next shift on the unit.There is one critical patient on the unit,who is going to require more care than the other patients.Before delegating this patient in an assignment,what is the appropriate action by the charge nurse?
A) Delegate the admission assessment to the LPN.
B) Review the employee's performance assessment for the most recent period.
C) Assess the amount of guidance and support needed for the nursing care of the patient.
D) Create a task analysis of critical behaviors for the individual.
Q2) County Hospital has position descriptions for all staff,including RN Team Leaders.Sarah,a team leader on the rehab unit,assesses the needs of the patients in her area,assesses the skills and backgrounds of each of the individuals on her team,and then assigns and delegates the appropriate care provider to each patient and task.Sarah provides Colleen,her RN colleague with details regarding the patients to whom Colleen has been assigned on the day shift.This is an example of:
A) accountability.
B) responsibility.
C) assignment.
D) delegation.
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Chapter 18: Leading Change
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Q1) Elizabeth,an RN with approximately 15 years of service on your unit,walks away from one of the learning sessions on IV care and you overhear her telling a colleague that she thought the session was a waste of time because "the unit has been using heparin for years and there has never been any adverse effects." You follow up with Elizabeth and discover that she is really quite angry about the information sessions because she feels that you are implying that "what she has been doing all these years means that she is incompetent and doesn't care about her patients." 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 Effective Teams
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Q1) The nurse manager used a mediator to help resolve conflicts on the unit.During the mediation process,the nurse manager saw signs of potential team building.One key concept of an effective team is:
A) conflict.
B) task clarity.
C) commitment.
D) a designated leader.
Q2) The mediator noticed that tension was still evident between the nurse manager and staff members.He informed the chief nursing officer that to begin team building,it would be important that everyone:
A) work together in a respectful, civil manner.
B) use avoidance techniques when confronted with a conflict.
C) develop a personal friendship with each other.
D) socialize frequently outside of work.
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Chapter 20: Managing Costs and Budgets
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Q1) Which of the following are considered variable costs?
A) Salaries for the minimum number of staff
B) Utilities and rent
C) Managed care
D) Supplies
E) Medication and treatment supplies
Q2) A nurse manager approves two staff nurses to attend a national conference.When reviewing the budget,the nurse manager looks at which line item?
A) Cash budget
B) Capital budget
C) Operating budget
D) Supply and expense budget
Q3) 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 for patient care.
B) know how much time staff will likely 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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22
Chapter 21: Selecting, developing, and Evaluating Staff
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Q1) You have hired a new RN to replace a well-respected and experienced nurse in your outpatient department.The new RN recently graduated and is nervous about stepping into a role that was previously filled by someone who was so competent.You recognize anxiety and set up regular,frequent meetings during which you explore how she is dealing with her anxiety,provide feedback,and discuss strategies/ideas that will enhance her performance.What development approach are you using?
A) Performance appraisal
B) Counseling
C) Empowerment
D) Coaching
Q2) The final section of a performance appraisal is a rating scale.This scale is very detailed and relates to competency standards specific to surgical clients.The scale is a summary of performance directly observed or documentation reviewed and is specific to client care situations in which the employee has been involved.This type of evaluation is most commonly known as:
A) a traditional rating scale.
B) management by objectives/learning goals.
C) a forced distribution scale.
D) a behaviorally anchored rating scale.
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Chapter 22: Person-Centered Care
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Q1) As part of performance appraisal,the nurse manager designs strategies to acknowledge staff members.What practices by the nurse manager best acknowledge staff accountability and contribution?
A) Providing new and varied learning experiences for staff members
B) Fostering group cohesiveness through standardization of unit activities
C) Allowing professionals greater influence over their practices
D) Giving recognition for success and support for failure to staff members
Q2) In writing the patient satisfaction survey,the nurse manager is aware of the education levels of the families.What is the most critical element in the concept of health literacy?
A) Providing instructional materials at appropriate reading levels
B) Facilitating access to translators for persons with language barriers
C) Obtaining, processing, and understanding basic health information so appropriate decisions can be made
D) Knowing that most people have limited health literacy skills
Q3) The complexity of the healthcare environment for consumers is increased by:
A) falling levels of education among the public.
B) increased levels of poverty.
C) complex compensatory systems and a variety of delivery systems.
D) increased numbers of uninsured or underinsured.
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Chapter 23: Managing Quality and Risk
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Q1) A nursing-led classification system that has led to greater reliability and standardization in data utilized for QI processes is:
A) NANDA.
B) AHRQ.
C) NIOSH.
D) nursing process.
Q2) At Hospital Alpha,there has been a 20% increase in instruments and sponges being left in patients during surgery and surgeries on the wrong limbs.These are known as:
A) sentinel events.
B) medically sensitive events.
C) nurse-sensitive events.
D) Never Events.
Q3) A new graduate is asked to serve on the hospital's quality improvement (QI)committee.The nurse understands that the first step in quality improvement is to:
A) collect data to determine whether standards are being met.
B) implement a plan to correct the problem.
C) identify the standard.
D) determine whether the findings warrant correction.
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25
Chapter 24: Translating Research Into Practice
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Q1) A strategic goal for nursing in the facility developed by the chief nursing officer is to implement an evidence-based practice program.What is an appropriate strategy that can be used by a nurse manager who is beginning to implement an evidence-based practice program on the unit?
A) Conducting a review of adverse events and incident reports
B) Soliciting input from staff members
C) Reviewing specialty organization guidelines
D) Identifying patients with extended lengths of stay
Q2) Volunteers in a study are assigned randomly to groups.Some of the volunteers receive an herbal supplement that is reputed to control nausea,and some of the volunteers are assigned to a control group where a placebo is administered.This is an example of a(n):
A) longitudinal study.
B) RCT.
C) meta-analysis.
D) appraisal tool.
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Chapter 25: Managing Personal and Personnel Problems
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Q1) The nurse manager places a staff member on probation because of reports of chemical dependency.The nurse manager should be aware that which of the following statements is true regarding chemical dependency?
A) The chemically dependent employee usually hides any changes in behavior.
B) When confronted with the issue, the affected employee is usually relieved to have someone to talk to about the problem.
C) The chemically impaired nurse affects the entire healthcare organization.
D) Hospital policy, state laws, and nurse practice acts address procedures for the chemically dependent employee in the most general terms.
Q2) The unit manager on 4E is concerned about the performance of Jean,a staff nurse.She is not involved directly with Jean,so she has not been able to determine whether the problem is one of motivation,ability,or both.If Jean lacks ability,which of the following strategies might the head nurse use?
A) Dismiss or transfer Jean.
B) Document all problem areas and then discuss them with Jean.
C) Develop appropriate solutions and make recommendations to human resources.
D) Smooth over the problems if they are minor in nature.
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Chapter 26: Role Transition
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Q1) In addition to providing coaching,a nurse mentor may provide counseling to the mentee.For counseling to be successful,the mentor must:
A) provide a quiet environment away from the unit.
B) keep the focus on technical and management responsibilities.
C) assure confidentiality.
D) present assignments that stretch the intellectual and technical ability of the mentee.
Q2) John,a new nurse manager,complains to his colleague that he feels very uncomfortable with the conflict between what he thinks he should be doing as the manager and what his supervisor thinks he should be doing.According to Hardy's role theory,John is experiencing:
A) stress.
B) role stress.
C) role strain.
D) role exploration.
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28
Chapter 27: Managing Your Career
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Q1) A unit manager recently graduated as a clinical nurse specialist with a focus in gerontology.She applied to take a certification exam.Certification is designed to recognize:
A) basic knowledge in a specified area.
B) advanced practice in functional roles.
C) special knowledge beyond basic licensure.
D) continued competence as a registered nurse.
Q2) Before beginning her own nursing agency,a nurse worked with other temporary nursing agencies in nine states and multiple agencies.She had set a personal goal to start her own agency.What type of motivation does this exemplify in career success?
A) Linear
B) Spiral
C) External
D) Internal
Q3) Knowing your professional strengths is important to:
A) find your fit in positions and a career path.
B) maintain a professional status.
C) act in a manner that is legal and ethical.
D) understand the role expectations of a position.
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Page 29
Chapter 28: 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 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.
Q2) In working with Cheryl,her mentor suggests that it is really important for Cheryl to engage in self-appraisal and to know her strengths.This observation is based on an understanding that:
A) self-confidence comes automatically out of leading.
B) self-confidence requires constant self-affirmation of strengths.
C) there is little external motivation and affirmation in leadership.
D) supervisors of leaders rarely provide feedback.
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Chapter 29: Developing the Role of Manager
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Q1) The nurse manager,as the leader of the unit's "customer (client)first" initiative,has asked the staff nurses to develop and administer a survey to every client before discharge.In asking the staff nurses to accomplish this task,the nurse manager is demonstrating:
A) accountability.
B) shared leadership.
C) a common purpose.
D) independence in the nursing manager's role.
Q2) Electronic health records (EHRs)are being instituted at Pleasant Valley Hospital.Some of the staff on Unit 4 complain to the manager that acquiring the technologic skills required is too time consuming.They question its value in patient care.The manager responds that:
A) the use of technology is inevitable in our technologically oriented society.
B) the hospital is no longer able to find the space to accommodate paper record-keeping.
C) the initiative is being driven by decision makers higher up in the hierarchy and there is no choice.
D) EHRs will increase effectiveness of care by enhancing coordination and improving patient outcomes.
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Chapter 30: The Strategic Planning Process
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Source URL: https://quizplus.com/quiz/41491
Sample Questions
Q1) A community-based pain management program is being planned for your region.As a coordinator of a home care agency,you have been requested to develop a conceptual framework,mission statement,philosophy,and objectives for the program.In what order will you pursue this endeavor?
A) Objectives, philosophy, and mission statement
B) Philosophy, objectives, and mission statement
C) Philosophy, mission statement, and objectives
D) Mission statement, philosophy, and objectives
Q2) In assessing the internal environment,the strategic planning team at Pacific Hospital discovers that 90% of staff members have no idea what the current mission statement means.This is most likely related to:
A) the level of abstraction inherent in mission statements.
B) development of the statement by the administration team with no other staff involvement.
C) outdated goals and objectives contained in the mission statement.
D) failure to provide action statements within the mission statement.
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Chapter 31: Thriving for the Future
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Sample Questions
Q1) Which of the following strategies is most important in developing a strong vision?
A) Seeking out evidence to support trends and out-of-the-box thinking
B) Spending time with others with whom we discuss ideas
C) Setting up focus groups to provide information on current realities
D) Being honest and open about what we think for the future
Q2) In developing curricula that will address needs based on forecasts for the future,nursing educators need to contemplate:
A) prevention strategies.
B) leadership skills and knowledge.
C) violence de-escalation strategies.
D) strategies for job security.
Q3) Based on studies of workplace environments for nurses and future projections,the workplace of the future will be:
A) less intense because of more technology.
B) about the same as it is now.
C) more intense because of more technology.
D) fluctuating between intense periods and less intense periods.
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