Nursing Leadership and Management
Final Exam Questions
Course Introduction
Nursing Leadership and Management explores the principles, theories, and skills essential for effective leadership and management within the nursing profession. This course examines the roles and responsibilities of nurse leaders and managers in diverse healthcare settings, focusing on topics such as decision-making, team building, conflict resolution, communication, strategic planning, and quality improvement. Students will analyze leadership styles, ethical and legal responsibilities, resource management, and strategies to facilitate change. Through case studies and real-world scenarios, the course prepares students to guide teams, foster a positive work environment, and ensure safe, high-quality patient care.
Recommended Textbook
Leading and Managing in Nursing 7th Edition by Patricia S. Yoder
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Chapter 1: Leading, Managing, and Following
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Q1) The manager of a surgical area has a vision for the future that requires the addition of RN assistants or unlicensed persons to feed, bathe, and ambulate patients.The RNs on the staff have always practiced in a primary nursing-delivery system and are very resistant to this idea.What would be the best initial strategy for implementation of this change?
A)Exploring the values and feelings of the RN group in relationship to this change
B)Leaving the RNs alone for a time so they can think about the change before it is implemented
C)Dropping the idea and trying for the change in a year or so when some of the present RNs have retired
D)Hiring the assistants and allowing the RNs to see what good additions they are
Answer: A
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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Chapter 2: Clinical Safety: The Core of Leading, Managing, and Following
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Q1) What did the IOM Health Professions Education report highlight as a concern for patient safety?
A)A normal risk in professional practice
B)A result of disciplinary silos
C)A reflection of frontline staff
D)Related to systems errors
Answer: B
Q2) As a manager in a new nursing home, where might you consult for guidance and evidence to support the development of safe patient practices?
A)Hospitals
B)Business
C)Industry
D)Outpatient clinics
Answer: A
Q3) What does the SBAR approach to patient safety encourage?
A)Consistency in assessment and practices
B)Continuing education
C)Multidisciplinary approaches
D)Patient feedback
Answer: A
Page 4
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Chapter 3: Legal and Ethical Issues
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Q1) One means of ensuring that the nurses floated to other patient care areas in healthcare organizations are qualified to work in the areas they are floated is:
A)employing additional staff to assist with orientation processes.
B)cross-educating staff members to other areas of the institution.
C)transferring patients to units where the staffing pattern is optimal.
D)orienting staff members to all patient care areas as part of their general orientation to the institution.
Answer: B
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.
Answer: B
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Chapter 4: Cultural Diversity and Inclusion in Health Care
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Q1) In designing programs through your institution to address the health needs of Hispanics in your community, you most likely would develop programs related to: A)diabetes.
B)cardiovascular disease.
C)cancer.
D)asthma.
Q2) During performance appraisal, you praise Xia for her attention and care to nursing details.You suggest that her care would be further enhanced by greater acknowledgment of patients' feelings.Xia bursts into tears and leaves the office.Later, you learn that criticism is perceived as akin to failure in Xia's culture.You reflect on how you could modify your approach in the future to acknowledge different cultural interpretations of feedback.Your response is indicative of: A)bias.
B)cultural awareness.
C)cultural diversity.
D)ethnocentricity.
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Chapter 5: Gaining Personal Insight: The Beginning of Being a Leader
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Q1) In developing leadership skills, one should focus on authentic leadership.The theory of authentic leadership focuses on various factors.What is the top priority in development of authentic leadership?
A)Honest relationships
B)Organizational task
C)Accomplishment of goals
D)Exploring others
Q2) A nurse manager when in the formal leadership position attempts to translate the picture or vision of her facility across for the staff nurses.The manager is faced with a staff who is resistant to the vision of the facility.What is the theory the manger needs to incorporate to be effective?
A)Model the Way
B)Inspire a Shared Vision
C)Challenge the Process
D)The Four Agreements
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Page 7
Chapter 6: Being an Effective Follower
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Q1) The definition of leader refers to a person who has ability to guide people.In nursing, the leader does more.What is NOT a role of a leader in nursing?
A)Active listening
B)Open communication
C)Accountability in decisions
D)Tight control of decisions
Q2) The nurse manager is working with a group of new nurses.The new nurses ask questions about leadership and the role of a manager in leading nursing.The manager shares the desire to have engaged staff nurses who participate in a team environment.What is the manager describing?
A)Effective follower
B)Effective leader
C)Ineffective follower
D)Ineffective leader
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Chapter 7: Managing Self: Stress and Time
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Q1) Keep the meeting focused and directed toward accomplishing the set objectives.Select the correct order from the following options:
A)1, 2, 4, 5, 3
B)4, 1, 2, 5, 3
C)3, 1, 4, 5, 2
D)3, 4, 2, 1, 5
Q2) An example of role stress occurs when:
A)the director of the ICU and the manager of the surgical unit wish to hire the same new employee.
B)two part-time staff members are hired to work in a unit, but the job expectations for them are not clear, and the head nurse expresses disappointment in their performance.
C)the nurse manager for the ICU wants to advocate for more staff and finds it difficult to find data to substantiate his proposal.
D)line managers believe that support staff use their technical knowledge to intrude on their authority.
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Chapter 8: Communication and Conflict
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Q1) Lee, the head nurse in ER, has attempted to meet Jillian, one of her staff RNs, for several days to discuss concerns about Jillian's relationships with her team members.Lee hopes to offer Jillian coaching so that Jillian's relationships can be more satisfying for Jillian and her team members.Each time Lee and Jillian set a time to meet, Jillian phones in sick.In this situation, Lee and Jillian are demonstrating:
A)similar conflict management strategies.
B)escalation of conflict.
C)avoidance and compromise strategies.
D)competing and compromise strategies.
Q2) Jill is the head nurse on a unit in a large hospital.Two of the staff nurses are constantly arguing and blaming each other, and a resolution has not occurred in months.To solve the existing conflict, which is the most creative conflict resolution?
A)Avoiding
B)Competing
C)Compromising
D)Collaborating
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Chapter 9: Power, Politics, and Influence
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Q1) A nurse manager recognizes the need to expand her professional network as she begins a job search for a middle-management position.What action is least likely to expand her job-searching network?
A)Reviewing her address book or card file for names and phone numbers of former colleagues who are now in middle-management positions
B)Making an appointment to meet with a former instructor from her graduate program in nursing administration
C)Making a long overdue return call to a former colleague who is now a chief nurse executive
D)Attending a state-level conferences for nurse managers and executives and volunteering to help with professional organizations' informal luncheons and receptions
Q2) What has the literature on oppression in nursing demonstrated?
A)Verified the presence of behaviors associated with oppression within nursing.
B)Suggested that oppression leads to bullying but has little or no effect on patient outcomes.
C)Failed to establish that oppression is present in nursing groups.
D)Indicated that nurses use oppression negatively.
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Chapter 10: Health Care Organizations
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Q1) The local health department nurse manager has developed and implemented a disaster readiness plan as part of a community service.Community services:
A)care for the specific needs of individual families in the community.
B)focus on the treatment of community-wide problems rather than on individual health problems.
C)do not include services provided by public health departments.
D)provide personal health follow-up for all acute care hospitalizations.
Q2) Tracy is an RN case manager who interfaces between the Centers for Medicare & Medicaid.Tracy's responsibilities most likely would include:
A)managing physician-led research.
B)monitoring physician documentation of the need for medical care.
C)determining which services are designated fee-for-service.
D)identifying errors in physician diagnoses.
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Chapter 11: Organizational Structures
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Q1) 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
Q2) Taylor Hospital has well-defined organizational units that provide maintenance, financial services, care for cardiac patients, care for surgical patients, and so on.The organizational chart indicates that surgical units report to a surgical manager and all nursing units report to a vice president of nursing; financial services to an accountant and then to a business executive; and so on.The primary disadvantage of this organizational structure is:
A)breakdown in function and communication across specialties.
B)lack of congruence in culture and organizational values.
C)highly centralized decision making and authority.
D)wide span of control.
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Chapter 12: Care Delivery Strategies
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Q1) When interviewing an applicant for an RN position, the nurse manager describes the unit's care delivery system as one in which the nursing assistants are cross-trained to perform specific tasks and the RNs complete all treatment, medication administration, and discharge teaching.The nurse applicant knows this nursing care delivery strategy to be:
A)the case method.
B)functional nursing.
C)primary nursing.
D)nurse case management.
Q2) The relief charge nurse has assigned a newly licensed baccalaureate-prepared nurse to be one of the team leaders for the 3-11 shift.In making this decision, the charge nurse has overlooked this nurse's:
A)clinical expertise.
B)leadership ability.
C)communication style.
D)conflict-resolution skills.
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Chapter 13: Staffing and Scheduling
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Q1) A nurse manager uses many sources of data when planning the unit's workload for the year.Which of the following data must be considered in the planning?
A)Hours of operation of the unit
B)Trends in acuity on the unit
C)Maximum work stretch for each employee
D)Weekend requirements
Q2) A nurse manager must consider a number of external variables when preparing the personnel budget and projecting the unit's staffing needs.An external variable to be considered is:
A)organizational staffing policies.
B)staffing models.
C)changes in services that will be offered.
D)department of Health licensing standards.
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 14: Work Force Engagement Through Collective
Action and Governance
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Q1) Nursing labor-management partnerships:
A)engage nurses at all levels in problem solving for better patient care.
B)require unions and management to negotiate in good faith regarding hours of work and wages.
C)have been shown to have negligible effects on nurse turnover and patient outcomes.
D)have typically resulted in increased polarization of nurses and management, leading to formation of collective bargaining units.
Q2) In a nurse managers' meeting, strategies for ways to help retain staff are discussed.One strategy for assisting nurses in developing collective action skills is:
A)accepting the practice of "going along to get along."
B)attending as many workshops as practical.
C)spending as much time as possible in clinical settings.
D)taking the opportunity to work with a mentor.
Q3) Collective action is effective in:
A)ensuring that needs of nurses are placed ahead of other disciplines.
B)defining nursing as a profession.
C)advising patients of the needs of nurses.
D)amplifying the influence of individuals.
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Chapter 15: Making Decisions and Solving Problems
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Q1) In a busy rehabilitation unit, the team manager decided that the best way to reward the staff was to give them a monetary bonus rather than time off.The staff was very concerned about the decision and went to the administration with a number of complaints.Critical thinking is a process that entails a number of steps.What steps did the manager omit? She should have: (Select all that apply.)
A)identified what assumptions were underpinning the issues.
B)considered why it was important to make this change or the context for the change.
C)considered how this change might affect staff relationships.
D)attained a majority consensus of all staff.
Q2) John Smith, one of three managers at BSG Labs, drafted a policy that would allow his department to do more testing in his lab.This policy included the times for regular collection as well as a new process for emergency laboratory testing.The policy and procedures were never followed.The reason was that:
A)the policy was too lengthy and inundated readers with too much detail.
B)the policy made decisions for other departments in the company.
C)the staff did not believe that the new policy would be effective.
D)testing should not be done in the lab.
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Chapter 16: The Impact of Technology
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Q1) Despite the implementation of bar-code medication administration (BCMA) on your busy medical unit, you notice that the number of medication errors has not significantly decreased.Which of the following reasons might explain the lack of change in errors?
A)A number of new medications have been introduced into the hospital pharmacy that are not yet recognized in the CDS.
B)There have been an unusually high number of patients on the unit who have been unable to confirm their identity at the time of medication administration.
C)Lack of staff understanding and support for BCMA has led to overrides or failures to scan bar codes during busy times.
D)Clinical data that have been entered into the system to guide administration of the medications are outdated.
Q2) A necessary, basic condition for successful integration of clinical information systems is:
A)software.
B)standard medical nomenclature.
C)confirmatory evidence from nursing-led studies.
D)strong interdisciplinary cultures.
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Chapter 17: Delegating: Authority, Accountability,
Responsibility in Delegation Decisions
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Q1) 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's activity in the example described is termed:
A)passive delegation.
B)passive accountability.
C)active delegation.
D)active responsibility.
Q2) During a fire drill, the nurse manager becomes very assertive and directive in her communications with staff.This type of situational leadership depends on:
A)supportive behavior by the leader and immature followers.
B)the development level of the followers and the behavior based on the situation.
C)well-developed followers combined with a strong leader who acts quickly.
D)the leader's ability to evaluate personnel and communicate that evaluation.
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Chapter 18: Leading Change
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Questions
Q1) When goals/outcomes are somewhat unclear in early preparation for a complex change, the manager and the change management team develop several acceptable goals/outcomes.This change in management approach is termed:
A)unfreezing.
B)nonlinear.
C)cybernetic.
D)linear.
Q2) Elizabeth is an example of a(n):
A)early adopter.
B)late majority.
C)laggard.
D)resister.
Q3) The oncology clinical manager and the educational coordinator asked nursing staff to complete a brief written survey to assess their attitudes and knowledge related to having used the new infusion equipment for 6 weeks.The stage of change in this situation is:
A)developing awareness.
B)experiencing the change.
C)integrating the change.
D)perceiving awareness.
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Chapter 19: Building Effective Teams
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Q1) Trust is an important aspect of helping relationships, therapeutic communications, and the positive communications model.Which statement does not involve or define trust? Trust:
A)involves decisions to manipulate situations to gain advantage over another.
B)is the basis by which leaders facilitate the activities and progress of a team.
C)is low among members and leaders in poorly performing teams.
D)involves what we say and not necessarily what we do.
Q2) The staff development educator developed strategies to help nurse managers actively listen.Guidelines for active listening include which of the following?
A)Speed up your internal processes so that you can process more data.
B)Realize that the first words of the sender are the most important.
C)Be prepared to make an effective judgment of the communication sender.
D)Cultivate a desire to learn about the other person.
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Chapter 20: Managing Costs and Budgets
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Q1) In preparing a budget, the nurse manager needs to anticipate the cost of benefits (e.g., health, life insurance, pension, and retirement plans).Based on the usual cost of benefits, how much should a nurse manager include for a total full-time salary cost of $312,000?
A)$78,000 to $93,600
B)$62,400 to $78,000
C)$46,800 to -$93,600
D)$31,200 to $46,800
Q2) A staff nurse regularly works two 12-hour shifts each week and one 8-hour shift every other week.How many FTEs is this position?
A)0.6
B)0.7
C)0.8
D)1
Q3) Which of the following factors is not implicated in rising healthcare costs?
A)Rising expectations of consumers for cure and care
B)Marketing of drugs to consumers
C)Large administrative staffs to process medical billings
D)Rising Medicare costs
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Page 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) An outpatient clinic advertised for RN positions.Before authorizing an open position, the nurse manager should:
A)review the position description and performance expectations for the opening.
B)place an ad in the local newspaper and on the telephone job line.
C)review all current applications on file.
D)look for employees within the system who might best fill the position.
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Chapter 22: Person-Centered Care
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Q1) 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.
Q2) A nurse is admitted to a psychiatric unit.The staff expresses frustration with her because they have explained her medication regimen several times, and yet, when she leaves the unit with a pass, she fails to follow it.The staff believe that, as a nurse, she should be able to understand what is expected.The nurse's failure to follow the regimen indicates:
A)early cognitive impairment.
B)lack of motivation.
C)lack of health literacy.
D)worsening health state.
Q3) An example of a factor that would impede a patient's learning is:
A)poverty.
B)limited health insurance.
C)being an older adult.
D)heavy sedation.
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Page 24
Chapter 23: Managing Quality and Risk
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Q1) The nurse educator of the pediatric unit determines that vital signs are frequently not being documented when children return from surgery.According to quality improvement (QI), to correct the problem, the educator, in consultation with the patient care manager, would initially do which of the following?
A)Talk to the staff individually to determine why this is occurring.
B)Call a meeting of all staff to discuss this issue.
C)Have a group of staff nurses review the established standards of care for postoperative patients.
D)Document which staff members are not recording vital signs and write them up.
Q2) 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:
A)the importance of decentralized structure in QA.
B)that structure influences nurse burnout and participation in quality improvement initiatives.
C)the need to ensure sufficient supervisory staff to respond in a corrective manner when mistakes occur.
D)that a narrow hierarchy ensures accountability for errors and outcomes.
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Chapter 24: Translating Research Into Practice
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Q1) Which of the following is most accurate regarding evidence-based practice?
A)Evidence-based practice replaces continuous quality improvement.
B)Evidence-based practice began with medicine and assists in determining which medical models can be applied in nursing practice.
C)Effective and efficient care can already be demonstrated, which means that EBP will soon become redundant.
D)EBP is generally recognized across disciplines and by policymakers as state-of-the-art clinical practice.
Q2) Which of the following would be most effective in implementing the findings of a new clinical treatment for problems associated with bowel motility for the staff nurses?
A)Lecture by a nurse practitioner
B)Workshop for surgical nurses that involves discussion of case studies and application of evidence
C)Discussion of the findings on the bulletin boards at the workstation
D)Education of unit opinion leaders regarding the evidence presented in the studies
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Chapter 25: Managing Personal and Personnel Problems
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Q1) 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.
Q2) When progressive discipline is used, the steps are followed progressively only for repeated infractions of the same rule.On some occasions, rules that are broken are so serious that the employee is:
A)transferred to another unit.
B)suspended indefinitely.
C)asked to attend a union grievance meeting.
D)terminated after the first infraction.
Q3) During unit staff meetings, you observe that Marg rolls her eyes and snorts whenever Julia makes a comment.Your first response as a unit manager is to:
A)discuss what you have observed with Marg.
B)file immediate documentation in Marg's personnel file.
C)ask Julie to monitor Marg's behavior during meetings.
D)ignore the behavior, as Marg is one of your strongest nurses.
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Page 27
Chapter 26: Role Transition
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Q1) The nurse manager of a unit was demoted to staff nurse 6 months ago.Because of being near retirement, the former nurse manager wanted to be employed at the hospital and was offered a position on the same unit.The former nurse manager complains often about how infrequently the current nurse manager is available on the unit and argues with physicians and co-workers.Clients have complained about the attitude of the nurse.The behavior of the former nurse manager can be best explained as being caused by:
A)overwork in the staff nurse position.
B)inadequate mentoring in the new role.
C)anger as a stage of the grieving process.
D)demotion as a threat to personal identity.
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 27: Managing Your Career
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Q1) A functional résumé focuses on:
A)experience and skills gained in positions.
B)positions held and specific roles in the positions.
C)academic qualifications and achievements.
D)relating skills and experience to qualifications in a specific position.
Q2) A new graduate is seeking a new position in nursing and wants to "sell" herself effectively.The best strategy is to:
A)create a résumé.
B)practice interviewing.
C)call the personnel offices.
D)create a curriculum vitae.
Q3) A well-written letter of resignation is critical to:
A)first announce your intent to resign.
B)formally signal discontent in your current position.
C)maintain a positive relationship with your former organization and colleagues.
D)fulfill your legal obligations as a departing employee.
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Chapter 28: Developing the Role of Leader
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Q1) Kari, a head nurse on the dialysis unit, has been informed during budget planning meetings that budget cuts are likely.She discusses this at the next unit meeting and tells staff members that unless they do their jobs well, their positions may be terminated, and there will be no replacement.Kari is enacting which management style?
A)Transformational
B)Transactional
C)Trusting
D)Truthful
Q2) After being interviewed for the unit manager position, the staff nurse reflects on the interview process.The staff nurse is aware that leadership begins:
A)within.
B)through a relationship with a mentor.
C)with the job description.
D)with the chief nursing officer of the organization.
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Chapter 29: Developing the Role of Manager
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Sample Questions
Q1) While interviewing for a nurse manager position, Ann is asked to give an example of a situation in which she demonstrated leadership.Which of the following examples exemplifies leadership?
A)Through research and investigation of best practice and practice-based evidence, she proposed a change in the management of incontinence in older adult patients.
B)She ensures that new policies related to parenteral infusions are implemented consistently within her team.
C)When asked by her students about institutional policies, she readily and patiently interprets policies to facilitate quality care.
D)She organizes the team and delegates responsibilities effectively in providing nursing care.
Q2) Budgeting and protection of revenues is a function of:
A)leadership.
B)management.
C)team leadership.
D)followers.
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Chapter 30: The Strategic Planning Process
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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) The reasons cited by nursing administrators for not planning in a systematic manner include:
A)lack of understanding of the planning process.
B)lack of knowledge regarding the internal and external operations of the organization.
C)not enough hours in the day for both day-to-day operations and planning.
D)delegation of the task to subordinates.
Q3) 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.
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Chapter 31: Thriving for the Future
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Sample Questions
Q1) A stroke unit experiences numerous changes related to implementation of new technology, a changed nursing care delivery model, and staff turnover within a period of 6 months.Staff members begin to show signs of reluctance to implement any more changes.This exemplifies:
A)a poor relationship between leaders and staff.
B)lack of knowledge regarding the importance of changes.
C)striving to achieve stability during great disequilibrium.
D)the importance of chaos in promoting adherence with established practices.
Q2) Which of the following will require greater attention in the future?
A)Chronic disorders
B)Obstetrical outcomes
C)Prevention of hospital-based errors
D)Team conflict resolution strategies
Q3) As a nurse manager, it is important to become a "future thinker." Which is an example of a "future thinker"?
A)Keeping traditional practices
B)Moving toward evidence-based practices
C)Finding less need for more knowledge
D)Believing that macromarketing will be a necessity
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