Nursing Leadership and Management Exam Questions
Course Introduction
Nursing Leadership and Management explores the principles, theories, and practical skills required to effectively lead and manage within healthcare environments. The course covers topics such as leadership styles, communication, team building, conflict resolution, ethical decision-making, and strategic planning. Emphasis is placed on the nurses role in resource management, quality improvement, patient safety, and interprofessional collaboration. Through case studies, discussions, and project work, students gain a comprehensive understanding of how to lead diverse teams, implement change, and navigate the complex organizational dynamics of contemporary healthcare settings.
Recommended Textbook
Leading and Managing in Nursing Revised Reprint 5th Edition by Patricia S. Yoder
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758 Verified Questions
758 Flashcards
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Chapter 1: Leading, Managing, and Following
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Sample Questions
Q1) Sarah wonders about the direction that you have given regarding management of incontinent,confused patients.She brings you evidence that she has found regarding incontinence interventions and asks you if she and you could talk about the guidance that you have given after you have had an opportunity to read the articles she has given you.This is an example of
A) Assertiveness.
B) Followership.
C) Management.
D) Insubordination.
Answer: A,B
Q2) Chart audits have revealed significant omissions of data that could have legal and funding guidelines.As the unit manager,you meet with the staff to discuss audit findings and to find approaches that will address the gaps in charting and achieve desired goals.This is an example of:
A) Leadership.
B) Management.
C) Decision making.
D) Vision.
Answer: B
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3
Chapter 2: Patient Safety
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Sample Questions
Q1) You notice that Sally,a student on your unit,is giving information to an anxious young teen,who seems very uncertain about preparation for an upper GI series.After Sally leaves the room,you ask her how she thought her conversation went and:
A) Encourage her to ask the patient if he has questions or concerns about the procedure.
B) Advise her to consider providing the patient with more information.
C) Suggest that she leave some brochures on the procedure with the patient.
D) Suggest that she also provide teaching to the adolescent's parents.
Answer: A
Q2) Traditional approaches to ensuring patient safety have focused on:
A) Assigning blame.
B) Finding solutions to systems issues.
C) Instituting best practices in response to errors.
D) Hiding errors from potential litigation.
Answer: A
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4
Chapter 3: Developing the Role of Leader
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Sample Questions
Q1) The director of nursing has been observing staff interactions in a 20-bed coronary care unit.Based on her observations,which of the following staff members is an obvious leader?
A) The unit secretary who knows everyone's business
B) The chief nursing officer who is in charge and is responsible for nursing services
C) The chief cardiologist who admits the largest number of patients and brings in more revenue than any other physician
D) The staff nurse who persuades other staff members to practice by making evidence-based decisions
Answer: D
Q2) The style of leadership that Kari is exhibiting is likely to:
A) Ensure that the organization is financially stable.
B) Stifle innovative thinking about ways to move out of financial jeopardy.
C) Lead to apathy and disinterest in the organizational goals.
D) Lead to decreased attrition of staff on her unit.
Answer: B
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Chapter 4: Developing the Role of Manager
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Sample Questions
Q1) The nurse manager plays a unique role in institutional management in that the nurse manager:
A) Encourages shared decision making.
B) Models professional nursing behavior.
C) Interprets healthcare trends and their impact on revenues.
D) Coordinates care and allocates resources.
Q2) In developing an orientation program,the hospital educator breaks essential organizational information down into chunks,which she develops as online modules.This is an application of which of Drucker's functions of management?
A) Establishment of goals and objectives
B) Motivation and communication
C) Analysis and interpretation of performance
D) Organization of activities into manageable tasks
Q3) 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 patient rights.
C) Avoiding risks.
D) Likely experiencing issues with informed consent.
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Chapter 5: Legal and Ethical Issues
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Sample Questions
Q1) The parents of a toddler who dies after being brought to the ER launch a lawsuit,claiming that the failure of nurses to pursue concerns related to their son's deteriorating condition contributed to his death.The senior nurse executive is named in the suit:
A) As a global respondent.
B) Under the doctrine of respondeat superior.
C) As a frivolous action.
D) Under the element of causation.
Q2) To reduce the incidence of falls in a skilled nursing unit,the nurse manager contacts the risk manager.Risk management is a process that attempts to identify potential hazards and:
A) Compensate for previous injuries.
B) Eliminate these risks before anyone else is harmed.
C) Supersede the need for staff members to file incident reports.
D) Discipline staff members who have been involved in previous incident reports.
Q3) Which ethical principle is primarily involved in informed consent?
A) Veracity
B) Autonomy
C) Beneficence
D) Nonmaleficence
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Chapter 6: Making Decisions and Solving Problems
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Sample Questions
Q1) After the nurses who work on an adolescent psychiatric unit have had a brainstorming session,they are ready to resolve the problem of teenagers who are unmanageable.To maximize group effectiveness in decision making and problem solving,the nurse manager has:
A) Prevented conflict.
B) Formed highly cohesive groups.
C) Used majority rule to arrive at decisions.
D) Encouraged equal participation among members.
Q2) Justin is a nurse manager in a rehabilitation unit in a small urban center.There is a high turnover rate among rehab-assistants because of the heavy work assignments.Justin decides to hire new staff in the order that applications are received until all vacant positions are filled.Which of the following decision-making models did Justin use in making his decision?
A) Subjective model
B) Objective model
C) Optimizing model
D) Satisficing model
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8
Chapter 7: Health Care Organizations
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Sample Questions
Q1) Which of the following would be the most appropriate focus in developing a business plan for a nurse-owned home healthcare service?
A) Programs to educate the community on preparing healthy meals for a limited cost
B) Reduction of injuries from alcohol-related accidents
C) Pain management for patients with low back pain
D) Reduction of falls among seniors
Q2) You are a nurse manager in a facility that is part of a national system of specialized hospitals that provide services to children and that is funded and managed through a religious charity organization. This system emphasizes compassionate,faith-based care.What level of consolidated system is represented in this example?
A) First level
B) Second level
C) Fourth level
D) Fifth level
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Chapter 8: Understanding and Designing Organizational
Structures
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Sample Questions
Q1) 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 clients that will be served on the unit.
D) Replicate the organization's philosophy.
Q2) Sarah is a clinical nurse educator in the dialysis unit at Pines Health Center and provides education,consultation,and training support.Sarah has:
A) Direct responsibility for patient care.
B) Direct accountability for patient outcomes.
C) An authority relationship to staff.
D) An influence over patient outcomes.
Q3) 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 client care departments.
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Chapter 9: Cultural Diversity in Health Care
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Sample Questions
Q1) A 66-year-old native Chinese patient,hospitalized for a myocardial infarction,asks the nurse manager about seeing his "acupuncture doctor" for treatment of his migraine headache.The best response to this patient would be:
A) "How long have you been using acupuncture treatment?"
B) "Do you think acupuncture relieves your pain satisfactorily?"
C) "What have you told your heart specialist about your migraines and treatment?"
D) "Have you tried nonprescription pain medication or been given a prescription drug for your headaches?"
Q2) Mary joins 5W nursing unit.Mary is a new graduate who is anxious to fit in.She soon learns that some of her "book learning" is being criticized by her colleagues,so she adapts her practice to what others on the unit are doing.She is demonstrating:
A) Cultural awareness.
B) Cultural sensitivity.
C) Acculturation.
D) Cultural marginality.
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11
Chapter 10: Power, Politics, and Influence
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Sample Questions
Q1) A nurse is participating in a baccalaureate course.For the class,she has to attend the legislative session regarding the new role of medication assistants.Nurses should be involved in shaping public policy primarily because:
A) Involvement will enable nurses to take over the healthcare system at some point in the future.
B) Other healthcare professions are less concerned about the essential needs of clients.
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 clients and families.
Q2) Politics is usually:
A) Confined to legislatures.
B) Seen in dysfunctional workplaces.
C) Found in all social organizations.
D) A representation of self-interest.
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Chapter 11: Caring,Communicating,and Managing With Technology
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Sample Questions
Q1) As a nurse manager in a multisite facility,you are comparing the effectiveness of prompted voiding training programs for staff by examining the impact of prompted voiding on the frequency of incontinence in patients.To do this,you access an NMDS,which allows you to:
A) Retrieve standardized information regarding patient care and trends.
B) Access medical diagnoses and pharmacologic interventions.
C) Learn sociodemographic and population-based trends.
D) Find information on public funding and private health insurance revenues.
Q2) A home health nurse has been assigned to cover a 300-square-mile area of remote Montana.Mrs.Baker has just been discharged home and will need daily contacts for the next week.Because it is not possible to visit Mrs.Baker in person every day and see all of the other clients,the nurse gives her a laptop computer with net meeting software installed.Each morning,both dial in at an agreed-upon time and discuss her progress.The home health nurse assesses whether or not the client needs to be seen that day.This type of technology is called:
A) Distance learning.
B) Knowledge software.
C) Telecommunications.
D) Biomedical technology.
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Chapter 12: Managing Costs and Budgets
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Sample Questions
Q1) After reviewing her monthly budget report,the nurse manager sees that she has a negative variance,which prompts her to change the staffing schedule.A negative or unfavorable variance in a monthly expense report may result from:
A) Overestimation of inflation.
B) Higher than expected client acuity.
C) Net revenue exceeding net expenses.
D) Not replacing staff who called in sick.
Q2) During the budgeting process,nurse managers are typically responsible for which of the following ?
A) Calculating workload
B) Developing unit operation objectives
C) Justifying capital equipment requests
D) Predicting cash flow
E) Calculating patient load
Q3) Which of the following factors is not implicated in rising healthcare costs?
A) Rising expectations of consumers for cure and care
B) Unintentional injuries
C) Socioeconomic conditions
D) Rising Medicare costs
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Page 14
Chapter 13: Care Delivery Strategies
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Sample Questions
Q1) The chief nursing officer implements the team nursing model on the acute care units.Expectations of the team leader include which of the following ?
A) Being attentive to the needs of the organization
B) Being newly graduated with a baccalaureate degree
C) Having several years of clinical nursing practice
D) Being attentive to the needs of the patient
E) Being attentive to the needs of the staff
Q2) The nurse case manager is working with a client admitted for end-stage renal disease.The case manager's major goal during this hospitalization is to:
A) Implement the care MAP on admission.
B) Provide direct nursing care throughout the hospitalization.
C) Supervise the nursing staff members who implement the care MAP.
D) Prevent additional hospitalizations resulting from complications of the client's disease.
Q3) The model outlined in Question 12 might be particularly effective in:
A) Promoting communication among diverse team members.
B) Facilitating multiple perspectives on the total care of a patient.
C) Avoiding patient-provider conflict.
D) Developing competence and confidence in unskilled workers.
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Page 15
Chapter 14: Staffing and Scheduling
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Sample Questions
Q1) In Question 10,the classification system that is used:
A) Utilizes financial data to determine number of staff to patient ratios.
B) Utilizes DRGs to determine acuity on a unit.
C) Combines interventions and time required for interventions to determine levels of care required.
D) Combines financial resources and nursing interventions to determine patient contact hours.
Q2) In reviewing the job description of a nurse manager,the staff becomes aware that a nurse manager's role is complex.Which of the following duties are required of a nurse manager ?
A) Responsibility for nursing benchmarks
B) No responsibility for knowledge of staffing benchmarks
C) Responsibility for planning staffing of UNPs only
D) Preparing a unit budget
E) Changing staffing plans based on service needs
Q3) The difference between staffing and scheduling is that staffing:
A) Puts the right person in the right position.
B) Puts the right person in the right time and place.
C) Refers to the number of nursing hours per patient per day.
D) Looks after interpretation of benefits and compensation.
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Chapter 15: Selecting, Developing, and Evaluating Staff
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Sample Questions
Q1) John's performance was satisfactory during the first month,but after that time,he was found to be very inconsistent in the provision of nursing care.One month before the end of the rating period,he cared for a very wealthy and influential client,who is best friends with the clinical manager.This client donated new furniture for the staff lounge in John's name to show appreciation for his care.John's subsequent performance appraisal resulted in outstanding ratings in all areas.This is an example of:
A) A performance rating based on justifiable evidence.
B) A bias related to recent events.
C) The impact of personality on the appraisal of performance.
D) The effective use of a behavior-anchored scale.
Q2) John,a new graduate,reviews the employee evaluation for his new position.The first section requires that he list his own specific objectives to be accomplished.This is an example of:
A) The traditional rating scale.
B) Learning goals, or management by objectives.
C) A forced distribution scale.
D) A behavior-anchored rating scale.
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Page 17
Chapter 16: Strategic Planning, Goal-Setting, and Marketing
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Sample Questions
Q1) To meet the social and human needs of a target market,it is critical to:
A) Assess the needs and priorities of the target market.
B) Revise the organization's mission statement to reflect external needs.
C) Assess the internal culture and needs.
D) Develop highly sophisticated media.
Q2) As a nursing leadership student,you have had the opportunity to develop a palliative care manual that will be utilized by the palliative care network (PCN)in your region for teaching healthcare professionals.The PCN has requested that you provide a prioritized plan of action for marketing the manual on a regional and state basis.What is the first priority?
A) Motivate the target market.
B) Research the target market.
C) Communicate benefits to the target group.
D) Package the product.
Q3) Nurses are valuable partners in marketing strategies because they:
A) Are more likely than other members of the organization to use marketing tools.
B) Have a strong background in using evidence to support decisions.
C) Have close involvement with patients, who are the target group for marketing.
D) Constitute the largest staff group in most healthcare organizations.
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Page 18
Chapter 17: Leading Change
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Sample Questions
Q1) In Question 12,staff nurses who gain information on current IV therapy practices are engaging in which phase of Rogers' decision-making process?
A) Persuasion
B) Knowledge
C) Confirmation
D) Decision
Q2) To engage your staff in awareness of their current practice and how it is affirmed or not by evidence,you plan a short series of learning presentations on evidence and use of heparin and saline to maintain IV patency.You meet with the educator to plan out the goals for each session with the overall purpose of increasing knowledge and awareness of staff in readiness to consider questions related to the IV practice.This learning approach is an example of which change management approach?
A) Linear
B) Nonlinear
C) Facilitative
D) Integrative
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19
Chapter 18: Building Teams Through Communication and Partnerships
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Sample Questions
Q1) 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.
Q2) A mediator suggested that the nurse manager and staff members decide on a method to resolve conflicts.It is important to have agreements about how team members will work together because:
A) If there are no agreements, each member will make up his or her own procedures without consensus.
B) People are naturally difficult and will not work well together without such agreements.
C) People will naturally ask for agreements about how to be together.
D) A way to eliminate nonproductive team members must be available.
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20
Chapter 19: Collective Action
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Sample Questions
Q1) While making rounds,a night supervisor finds a unit with a low census and too many staff members.The night supervisor is performing as a statutory supervisor when he or she:
A) Assigns nurses to care for specific clients.
B) Develops a protocol for unlicensed personnel.
C) Recommends transferring a nurse to another service.
D) Teaches a nurse to use a new piece of equipment.
Q2) The chief nursing officer utilizes the hospital's Workplace Advocacy to help the overwhelmed emergency department staff.Workplace Advocacy is designed to assist nurses by:
A) Creating professional practice climates in their institutions.
B) Equipping them to practice in a rapidly changing environment.
C) Negotiating employment contracts.
D) Representing them in labor-management disputes.
Q3) The emergency department nurses' decision to organize for the purpose of collective bargaining is being driven by a desire to:
A) Establish the staffing pattern that will be used.
B) Determine the hours that one is willing to work.
C) Create a professional practice environment.
D) Protect against arbitrary discipline and termination.
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Chapter 20: Managing Quality and Risk
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Sample Questions
Q1) Healthcare organization X is committed to improving patient outcomes and,as part of the QI process,examines its executive structure and organizational design.This approach recognizes which model of QI?
A) Donabedian
B) Continuous quality improvement
C) Employee involvement
D) QSEN
Q2) A method commonly used in Quality Assurance to monitor adherence to established standards is:
A) A Pareto chart.
B) Brainstorming.
C) Patient interviews.
D) Chart audit.
Q3) Patient perceptions are useful in:
A) Determining disciplinary actions in QI.
B) Establishing the competitive advantage of QI decisions.
C) Assisting to establish priorities among possible changes to care identified in QI.
D) Establishing blame for poor-quality care.
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Chapter 21: Translating Research Into Practice
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Q1) The chief nursing officer at a local hospital seeking Magnet status creates staff development classes concerning research utilization.What best describes research utilization?
A) Conducting an integrative review of the literature
B) Searching the literature for a systematic review
C) Providing the results of research studies to practitioners
D) Applying the results of a research study to practice
Q2) Which of the following would be considered research?
A) Evaluation of the effectiveness of implementation of evidence-based guidelines for prompted voiding
B) Comparison of patient outcomes after implementation of practice guidelines against baseline (pre-implementation) outcome data
C) Audit of adverse events after implementation of evidence-based guidelines for pressure ulcers
D) Interviews with terminally ill cancer patients regarding their experience of being terminally ill
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Chapter 22: Consumer Relationships
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Q1) An example of a factor that would impede a patient's learning would include:
A) Poverty.
B) Recent diagnosis of chronicity.
C) Being an older adult.
D) Heavy sedation.
Q2) In designing a Web-based program for seniors with Parkinson's disease,it is important to understand that:
A) The program will not be used by half of the target population.
B) Parkinson's disease affects younger patients as well.
C) The program should include graphics as well as text.
D) Seniors find it difficult to read computer screens.
Q3) The chief nursing officer decides to establish a client advocacy position in an oncology unit.Advocacy is best represented by:
A) Establishing private and professional networking systems.
B) Asking social services to handle clients' concerns.
C) Identifying community support groups.
D) Empowering others by promoting self-determination.
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Chapter 23: Conflict: the Cutting Edge of Change
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Q1) Factors that influence the ease with which conflict is resolved include all except which of the following?
A) Level of interdependence of the parties
B) Importance of the outcome
C) Perceived fairness of the process of resolution
D) Experience and education level of those in conflict
Q2) In trying to achieve Magnet status,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,thus creating 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) In keeping with guidelines of the organization,the nurse manager documents staff problems.Documentation of disciplinary problems should:
A) Include a plan to correct them and to prevent future occurrences.
B) State a detailed history of past problems that are related to the current one.
C) Be written at the convenience of the manager.
D) Accumulate until the evaluation period begins.
Q2) A nurse manager understands that the typical first step in handling an employee with a disciplinary problem is a:
A) Verbal reprimand.
B) Written reprimand.
C) Reminder of employment standards.
D) Day off without pay.
Q3) A nurse manager must be familiar with the agency's policies regarding termination.Termination procedures include which of the following?
A) Following specific procedures from other organizations
B) Having an attorney present at the termination meeting
C) Having adequate written documentation to support the action
D) Having a friend present during the termination meeting
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Chapter 25: Workplace Violence and Incivility
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Q1) In Question 19,which of the four is most likely to be a perpetrator of violence?
A) Becky
B) Sarah
C) Sharon
D) Donna
Q2) In addressing the staff turnover rate in Question 13,you are:
A) Confirming the high correlation between managerial incompetence and violence.
B) Demonstrating awareness that workplace violence, if present, has significant costs.
C) Aware that staff and manager experiences contribute to high turnover.
D) Aware that violence is a rare but present factor in the workplace.
Q3) Linda,a staff nurse on nights,yells at Ali,another RN,and tells Ali that she is stupid and can't get anything right.In responding to this situation as head nurse,it is critical that you:
A) Require that Linda attend anger management classes.
B) Investigate to see if Ali did anything to aggravate Linda.
C) Call both immediately into the office in the morning to discuss the situation.
D) Respond to Linda in a way that is consistent with organizational processes and with similar situations.
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Chapter 26: Delegation: An Art of Professional Practice
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Q1) In delegating to a UNP in a home health setting,which of the following represents the most appropriate delegation communication?
A) "You will be taking care of Mrs. S. Mrs. S. needs assistance with her bath."
B) "You will need to help Mrs. S. get into and out of her shower. Ensure that you check the condition of her feet, and let me know if you have any concerns when you check in."
C) "I am not sure that you know how to do this, but I am giving you Mrs. S. She is quite obese and needs skin care."
D) "Mrs. S. needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness."
Q2) With delegation,responsibility and accountability remain with the:
A) Physician.
B) Professional who delegates.
C) Individual who receives the delegation.
D) Individual who previously performed the task.
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28
Chapter 27: Role Transition
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Sample Questions
Q1) After beginning her new position,Sarah (Question 11)finds that she spends a great deal of time in direct patient care.Her staff begins to complain that they are never able to find her when they need her,and that some aspects of her responsibilities fall behind,such as scheduling.Sarah is most likely:
A) Lacking an understanding of the nurse management role.
B) Attempting to prove her clinical skills to the nursing staff.
C) Experiencing difficulty in unlearning old roles.
D) Lacking enjoyment in her new role.
Q2) A nurse is interviewing for a manager's position.Which of the following actions is considered a role preview?
A) Formal commitment of the employment contract
B) Improving role performance
C) Touring the unit
D) Disillusionment about the expectations of the job
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Chapter 28: Self-Management: Stress and Time
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Sample Questions
Q1) Which one of the following statements has been proven to be true?
A) Recent research has found 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.
Q2) As a nurse manager,the one activity you should not overlook is:
A) Posting the yearly rotation schedule.
B) Reviewing vacation requests.
C) Scheduling staffing for holidays 6 months in advance.
D) Anticipating staff sick days.
Q3) Sources of occupational stress in nursing include all except which of the following?
A) Authoritarian leadership
B) Concern about moral wrongdoing by colleagues
C) Multiple changes in a short time
D) Job insecurity
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Chapter 29: Managing Your Career
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Sample Questions
Q1) During an interview for a manager's position,you find the supervisor and staff unfriendly.Responses to questions are met with vague responses.After the interview,you decide not to pursue the position.What follow-up,if any,is most appropriate?
A) There is no need for you to do anything further. You likely will not be offered the position anyway.
B) You should file a complaint with Human Resources about the supervisor's lack of interviewing skills.
C) You should send a thank you note to the interviewer, indicating appreciation for her time.
D) You should call and leave a voicemail, indicating your disinterest in the position.
Q2) Knowing your professional strengths is important to:
A) Finding 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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Chapter 30: Thriving for the Future
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Sample Questions
Q1) To move beyond stereotypical thinking and toward thinking about the future,which of the following would be most helpful?
A) Listing everything that we know about our current situation
B) Defining which practices will remain unchanged and which will change
C) Asking someone with a great deal of experience to share ideas about best practice
D) Challenging current and future practices with questions of "what if?"
Q2) Which of the following hampers the ability of nurses to be leaders?
A) Focus on the patient and not on the system
B) Lack of interest in leadership
C) Disillusionment with change
D) Funding disparities
Q3) A necessary leadership strength for nurses of the future is:
A) The ability to involve stakeholders in common interests to achieve outcomes that meet their needs.
B) Enhanced skills and knowledge in advanced clinical techniques.
C) Understanding of the nuances of fundraising to make up funding shortfalls.
D) The ability to manage a workforce that lacks loyalty to one organization.
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