Organizational Leadership in Nursing Review Questions
Course Introduction
Organizational Leadership in Nursing explores the essential principles and practices of effective leadership within healthcare organizations, focusing on the unique role of nurses as leaders and change agents. The course covers foundational leadership theories, ethical decision-making, communication strategies, team building, and conflict management. Emphasis is placed on the development of visionary leadership skills, fostering a culture of safety and quality in patient care, and navigating complex organizational structures. Students will examine case studies and evidence-based practices to understand how nurse leaders influence policy development, interdisciplinary collaboration, and organizational outcomes to improve healthcare delivery. Recommended Textbook
Leadership and Nursing Care Management 6th Edition by Diane Huber
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Page 2
Chapter 1: Leadership and Management Principles
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Q1) A medical-surgical unit reports higher rates of patient satisfaction coupled with high rates of staff satisfaction and productivity. Which of the following is attributed to the data findings?
A) Effective leadership
B) Management involvement
C) Mentoring
D) Rewards and recognition
Answer: A
Q2) The role of the _____ is to provide leadership and direction for all aspects of nursing services with a focus on integrating the system and building a culture.
A) nurse manager
B) care provider
C) nurse executive
D) senior leader
Answer: C
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Page 3
Chapter 2: Change and Innovation
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Q1) How is the refreezing stage of change similar to the nursing process?
A) Refreezing is similar to the assessment phase of the nursing process.
B) Refreezing is similar to the problem identification phase of the nursing process.
C) Refreezing is like the planning and implementation phase of the nursing process.
D) Refreezing is like evaluation in the nursing process.
Answer: D
Q2) Which of the following factors is used to describe the degree to which successful planned change is thought to be better than the status quo?
A) Complexity
B) Compatibility
C) Trialability
D) Relative advantage
Answer: D
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Chapter 3: Organizational Climate and Culture
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Q1) Researchers study organizational climate in order to examine how the work environment influences behaviors. Which of the following characteristics are utilized to study climate? (Select all that apply.)
A) Supervisor support
B) Unit staffing and its effect on incident reporting
C) Autonomy
D) Peer cohesion
E) Rewards and recognition
Answer: A, C, D, E
Q2) Culture is best defined as (the):
A) deviation from the majority.
B) differences in likes and dislikes.
C) shared beliefs and values.
D) similar views and opinions.
Answer: C
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Chapter 4: Managerial Decision Making
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Q1) How is decision making at the staff nurse level exemplified?
A) The staff nurse adapts to a challenging patient assignment.
B) The staff nurse refers issues to the performance improvement committee.
C) The staff nurse accepts the status quo.
D) The staff nurse questions current practice and refers to unit leadership for change.
Q2) Nurses working on the intermediate care unit have had many hours of overtime in the last 6 months. Before forming a team, the nurse manager gathers data about patient condition severity, staffing ratios, educational levels of staff, and personality mixes on each shift. What level of decision making is this process?
A) Establishment of solution evaluation criteria
B) Evaluation of the alternative solutions
C) Identification of a problem, issue, or situation
D) Search for alternative solutions or actions
Q3) Which of these concepts is key to refining clinical judgment capabilities?
A) Critical judgment
B) Reflection
C) Management experience
D) Nursing expertise
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Chapter 5: Managing Time and Stress
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Q1) A new nurse manager is provided with a smartphone in order to efficiently manage her time. What is the most effective method of managing stress related to e-mail?
A) Create an auditory cue that alerts the manager to incoming messages so they can be processed immediately.
B) Set aside time during meetings to read and respond to messages.
C) Schedule blocks of time to tackle e-mail.
D) Delete e-mails that require a lengthier response.
Q2) Nurses on the midnight shift are experiencing difficulty with receiving materials from the central supply department. Last night a patient was admitted to the unit from the emergency department with a heart dysrhythmia. The nurse requested that a temporary pacemaker kit be placed in the unit as a standby in case the patient required its use. The central supply unit did not comply until the patient required its emergent use. The nurse was stressed. This is an example of which type of stress?
A) Job stress
B) Overload of role
C) Moral distress
D) Role conflict
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Page 7
Chapter 6: Legal and Ethical Issues
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Q1) A staff nurse is facing a dilemma between meeting clinical ethical standards and meeting organizational goals. The nurse manager understands that the best way to assist staff members in resolving ethical dilemmas effectively is to focus on:
A) doing the right thing and taking the right action.
B) meeting clinical standards before organizational goals.
C) meeting organizational goals before clinical standards.
D) referring indecisive staff members for additional training.
Q2) A patient who is not fully informed about his or her health status is an example of a violation of which ethical principle?
A) Autonomy
B) Justice
C) Utilitarianism
D) Confidentiality
Q3) "To do good for others" is an example of which ethical principle?
A) Nonmaleficence
B) Fidelity
C) Beneficence
D) Confidentiality
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8
Chapter 7: Communication Leadership
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Q1) _____ communication patterns exist between colleagues and serve to contribute to a hostile work environment, high turnover, burnout, and job dissatisfaction.
A) Defensive
B) Disruptive
C) Negotiating
D) Humanizing
Q2) Group readiness levels can be assessed in four stages. Which of the following statements is accurate regarding group readiness? (Select all that apply.)
A) Members are organized and secure about their roles in the forming stage.
B) At the forming stage, the group needs direction in defining goals.
C) During the storming period, there is more willingness to accept the group goals.
D) The group becomes self-managing during the norming period.
E) During the performing period, the members willingly perform the task.
Q3) The number one cause of preventable medical errors is:
A) hostile work environments.
B) poor communication.
C) ineffective leadership.
D) staff competency.
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Chapter 8: Team Building and Working With Effective Groups
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Q1) Why is an interdisciplinary, team-based approach essential in health care? (Select all that apply.)
A) Reimbursement protocols and government regulations require them.
B) Diverse team's enhanced ability to adapt to continuous or sudden change.
C) A collective pool of thinking styles allows for greater exchange of information, ideas, and problem solving.
D) Rapid information dissemination is most efficient with multidisciplinary teams.
E) Engaging teams in this process allows for diverse points of view, creativity, and innovation.
Q2) When teams are assigned, but not designed, dysfunction can occur. What are some characteristics of a dysfunctional team? (Select all that apply.)
A) Confusion over the purpose of the team
B) Lacks real authority
C) Effective interpersonal communication patterns
D) Team needs placed above individual needs
E) Lack of evaluation criteria
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10
Chapter 9: Delegation in Nursing
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Q1) Which of the following colleagues would a nurse typically delegate to in the health care setting? (Select all that apply.)
A) Nurse apprentices
B) Personal care attendants
C) Family members at bedside
D) Physicians
E) Nursing assistants
Q2) The nurse manager determines that communication style is contributing to problems with delegation on her unit. What tool is used to teach principles of communication, leadership, situation monitoring, and mutual support?
A) American Nurses Association (ANA)
B) Agency for Healthcare Quality and Research (AHRQ)
C) Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)
D) Institute for Healthcare Improvement (IHI)
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11
Chapter 10: Power and Conflict
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Q1) Negotiation is a form of conflict resolution. Which of the following terms are associated with negotiation? (Select all that apply.)
A) Conciliation
B) Distributive bargaining
C) Arbitration
D) Mediation
E) Collective bargaining
Q2) A common source of conflict in nursing occurs when the nurse wants to perform patient teaching or counseling, but there are competing priorities and the nurse has inadequate time to spend with the patient. This type of conflict is related to:
A) interpersonal conflict.
B) intergroup conflict.
C) intrapersonal conflict.
D) intragroup conflict.
Q3) _____ is a personal quality that is admired in the person with referent power.
A) Problem solving
B) Authority
C) Knowledge
D) Coercive power
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Page 12
Chapter 11: Workplace Diversity
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Q1) A client of Vietnamese background is admitted to the unit after a hysterectomy. She has an order for clear liquids. When her tray is brought to her, she refuses the lime Jell-O. Which response by the nurse is most appropriate?
A) "I don't blame you. I don't like lime Jell-O either."
B) "Tell me about your cultural beliefs to best help you."
C) "Why don't you want to eat the lime Jell-O?"
D) "It is important for you to eat so that you will heal."
Q2) What is the most modifiable factor in the provision of equitable health care?
A) Availability of services
B) Socioeconomic status
C) Care that is responsive to cultural needs
D) Education level
Q3) A patient from the Philippines has been admitted to the ICU after a motor vehicle accident. The patient has a very large group of family and friends wanting to visit, hold vigils, and provide meals to the visitors and staff. This is an example of:
A) inflexible attitude
B) ambiguity
C) ethnocentrism
D) collectivism
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Page 13
Chapter 12: Organizational Structure
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Q1) According to the _____ organizational approach, organizations are logical and predictable with identifiable and scientifically measurable characteristics that can be predicted, observed, or manipulated.
A) objective
B) subjective
C) postmodern
D) realistic
Q2) Dividing work by occupation leads to a functional organization where services are arranged by the type of work performed. What are some benefits of the functional form within the health care organization? (Select all that apply.)
A) Professional silo
B) Fragmented care delivery
C) Cost reduction
D) Enhanced performance and quality
E) Promotion of professional development
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14
Chapter 13: Decentralization and Shared Governance
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Q1) Nurses' involvement in shared governance is an important component of:
A) practice models.
B) Magnet recognition.
C) increased reimbursement.
D) physician satisfaction.
Q2) The local hospital has a new specialty unit for women and children. The nursing staff has created a family advisory council to assist in reviewing educational materials used at discharge. This shared governance structure is an example of:
A) interprofessional education.
B) whole-system integration.
C) engagement.
D) collaboration.
Q3) In organizations that practice shared governance, staff, managers, and leaders are responsible for:
A) technology.
B) budgeting.
C) education.
D) innovation.
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Chapter 14: Strategic Management
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Q1) An action plan:
A) breaks a strategic plan into manageable parts.
B) details a futuristic view of the institution.
C) outlines the steps in performing a procedure.
D) provides a strategic plan for actualizing the mission.
Q2) Most strategic plans result in a written document. Strategic plan documents generally contain which of the following sections? (Select all that apply.)
A) Forward
B) Glossary
C) Goals and strategies
D) Executive summary
E) Mission, vision, and values
Q3) A nurse manager enjoys implementing new programs and beginning new projects. She is beginning to find herself overwhelmed and needs to decrease her workload. Which of the following ideas might best help decrease her workload?
A) Comparing her vision with that of the institution
B) Following the strategic objectives and mission of the hospital
C) Reviewing the action plan and vision of the hospital system
D) Using her intuition to determine which project should continue
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Page 16
Chapter 15: Professional Practice Models
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Q1) Which of the following is true about team nursing?
A) It includes only registered nurses (RNs) and licensed practical/vocational nurses (LPN/LVNs).
B) Each team member has his or her own patient assignments.
C) Team members must have dual degrees.
D) The nurse with a bachelor's of science in nursing degree is the leader of the team.
Q2) A professional practice model is a:
A) conceptual framework and philosophy of nursing within an organization.
B) staffing grid that outlines nursing unit work schedules.
C) mechanism by which care is actually provided to patients and families.
D) blueprint for developing specific measurable objectives and actions.
Q3) Stakeholders are informed of an organization's key goals through its:
A) vision.
B) values statement.
C) mission statement.
D) organizational philosophy.
Q4) A(n) _____ is a written plan that identifies key, critical, or predictable incidents that must occur at set times to achieve client outcomes within an appropriate length of stay in a hospital setting.
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Chapter 16: Case and Population Health Management
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Q1) _____ has garnered considerable attention in health care in part because of the publication Crossing the Quality Chasm, a health care quality initiative of the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division).
A) Disease management
B) Development research groups
C) Case management
D) Diagnosis-related groups
Q2) A concept involving a system that guides and tracks patients over time through a comprehensive array of health services to span all levels of intensity of care is known as:
A) transition of care.
B) continuum of care.
C) rounds.
D) disease management strategies.
Q3) A health care management continuum:
A) deals strictly with health promotion.
B) controls problems at the population level.
C) is a linkage of health services across settings.
D) provides another health care option for the homeless.
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Page 18
Chapter 17: Evidence-Based Practice: Strategies for Nursing Leaders
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Q1) When articulating the business case for evidence-based practice to governing boards, key messages to share with board members include: (Select all that apply.)
A) reporting of patient safety events.
B) reporting of anticipated outcomes.
C) reporting only projects that have cost savings.
D) functional responsibility of committees within the organizational and nursing infrastructure.
E) reporting the linkages between evidence-based practice and the organization's mission, values, and strategic plan.
Q2) The cardiac care unit is putting together a shared governance committee. To develop expertise in evidence-based practice processes, the members of the committee should have skills that include the ability to: (Select all that apply.)
A) report results.
B) perform research.
C) critique and synthesize evidence.
D) statistically analyze quality improvement.
E) develop an implementation and evaluation plan.
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Chapter 18: Quality and Safety
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Q1) Which of the following are never events? (Select all that apply.)
A) A minor medication error
B) A foreign object left in the body during surgery
C) Surgery on the wrong body part
D) A mismatched blood transfusion
E) Hip fracture acquired in the hospital
F) Pressure ulcer acquired in the home
G) Catheter-associated urinary tract infection
H) Surgical site infection
Q2) A framework for understanding health care improvement has been proposed by the IOM Committee on Quality of Health Care in America. The aims for health care quality improvement propose that health care systems ensure that care is: (Select all that apply.)
A) safe.
B) timely.
C) efficient.
D) cost-controlled.
E) patient-centered.
Q3) _____ is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
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Chapter 19: Measuring and Managing Outcomes
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Q1) The specific tools used to make quality visible to stakeholders in health care are called:
A) indicators.
B) outcomes.
C) variable selections.
D) quality measures.
Q2) _____ involves accounting for patient factors, the intrinsic risks that a patient brings to the health care encounter in the form of clinical and/or demographic factors, before drawing conclusions about the meaning of different values for indicators.
Q3) The results people care about most when seeking treatment is known as a(n):
A) achieved benefit.
B) benchmark.
C) expected response. D) outcome.
Q4) A(n) _____ is the result or results obtained from the efforts to accomplish a goal.
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21
Chapter 20: Prevention of Workplace Violence
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Q1) The agency that oversees the safety and health of health care workers is:
A) The Joint Commission (TJC).
B) the Department of Public Health (DPH).
C) OSHA.
D) CMS.
Q2) Administrative controls that may affect workplace violence include: (Select all that apply.)
A) adequate staffing levels.
B) controlled access.
C) development of systems to alert security personnel to threats of violence.
D) conflict resolution.
E) architectural modifications.
Q3) Staff nurses may be able to avoid bullying behavior through:
A) increasing time spent with patients at the bedside.
B) ignoring the assaults.
C) filing a grievance.
D) cognitive rehearsal training.
Q4) An evaluation of a specific threat of violence and an evaluation of the person making the threat is conducted by ______.
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Chapter 21: Confronting the Nursing Shortage
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Q1) The failure to retain an employee who is performing at or above a satisfactory level is:
A) selection.
B) transfer.
C) voluntary turnover.
D) termination.
Q2) A shortcoming that needs to be addressed related to the advertising of open nursing positions is:
A) inadequate use of Internet advertising.
B) insufficient funds allotted for advertising.
C) lack of follow-up with potential candidates.
D) short supply of advertising space in nursing journals.
Q3) According to McHugh et al. (2008), a major barrier to the recruitment of IENs has been related to:
A) limited visas.
B) language barriers.
C) cultural differences.
D) the inability of IENs to pass state board exams.
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23
Chapter 22: Staffing and Scheduling
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Q1) The new nursing care model, developed by the American Association of Critical-Care Nurses (2016), focuses on the needs of the patient and the competencies of the nurse. It is known as the:
A) Synergy Model for Patient Care.
B) Case Management Model.
C) Primary Nursing Model.
D) Clinical Nurse Leader Model.
Q2) Relationship-based care (RBC) is a common model used in care delivery. Person (2004) articulated that _____ is/are central nursing care delivery models.
A) continuity of care
B) case management
C) coordination of care
D) the needs or characteristics of the patients
Q3) The process of providing and measuring the correct full-time equivalent (FTE), or complement, to adequately staff a given area is known as:
A) scheduling.
B) position control.
C) forecasted workload.
D) demand management.
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Chapter 23: Budgeting, Productivity, and Costing Out Nursing
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Q1) The management team of a large hospital is attempting to identify the specific cost of providing nursing services. This process is known as:
A) costing out services.
B) fee-for-service care provision.
C) priority nursing management.
D) quality versus cost balance.
Q2) A budget functions as a:
A) capital constraint.
B) employee management tool.
C) human resource tool.
D) planning instrument.
Q3) The operating budget covers a specific period, called a _____ year.
A) fiscal
B) budget
C) calendar
D) federal government
Q4) A(n) _____ is the difference between the budgeted and the actual amounts.
Q5) A(n) _____ is a written financial plan aimed at controlling the allocation of resources.
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Chapter 24: Performance Appraisal
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Q1) An experienced critical care nurse left a CCU staff nurse position to finish a master's degree. Periodically, he would return to work as a per diem nurse in the CCU. The staff was impressed with the nurse's performance; however, one staff member complained that he was unfamiliar with the new telemetry monitors when he first returned to work several months ago. This comment showed up in his evaluation, resulting in a poorer overall evaluation from the nurse manager compared with previous evaluations. This is an example of:
A) contrast bias.
B) a horn effect.
C) recent behavior bias.
D) similar-to-me effect.
Q2) Jennifer is evaluating her own performance over the past year and comparing it to the standards set by the organization. Jennifer is performing a(n):
A) peer review.
B) intervention.
C) self-evaluation.
D) performance appraisal.
Q3) _____ is a type of bias that occurs when individuals who are similar to the rater in some way are rated more favorably.
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Page 26
Chapter 25: Emergency Management and Preparedness
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Q1) What are the major roles of nursing leadership in disaster planning? (Select all that apply.)
A) Providing clearly defined roles for staff nurses in a disaster situation
B) Ensuring the synchronization of department plans
C) Encouraging staff to stay at home in the event of a disaster to decrease confusion
D) Ensuring that the community is synchronizing internal department plans in the event of a disaster
E) Developing or refining the hospital's emergency operations plan.
Q2) The nursing leadership role once the all-hazards preparedness plan is completed is to:
A) confirm that resources are allocated appropriately.
B) ensure that every facility department understands their role is a disaster situation.
C) establish goals for all-hazards preparedness.
D) provide rewards for the committee's accomplishments.
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Chapter 26: Data Management and Clinical Informatics
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Q1) The formal process of using patient data for providing evidence for the design of care protocols is termed:
A) evidence-based practice.
B) practice-based evidence.
C) data analysis.
D) effectiveness research.
Q2) In the provider domain, what are some of the variables that are used to measure variability in nursing? (Select all that apply.)
A) Certification
B) Hours of work
C) Education level
D) Years of experience
E) Attitudes and beliefs
Q3) The first person to analyze patient outcomes associated with nursing care delivery was:
A) Clara Barton.
B) Dorothea Dix.
C) Florence Nightingale.
D) Luther Christman.
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Page 28
Chapter 27: Marketing
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Q1) How is the business of health care different from the practice of health care? (Select all that apply.)
A) The practice of health care is an exchange relationship.
B) The business of health care is transactional.
C) The business of health care is based on mutual caring and support.
D) The practice of health care is based on trade for mutual benefit.
E) The practice of health care is like a communal relationship.
Q2) Which of the following marketing strategies are examples of niche marketing? (Select all that apply.)
A) Full-service community hospital
B) Children's hospital
C) Center for bariatric excellence
D) University hospital
E) Cancer specialty center
Q3) The primary hospital _____ is the care that is delivered by nursing staff.
A) product
B) price
C) place
D) promotion
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