Professional Nursing Practice Concepts Perspectives 7th Blais Hayes Test Bank

Professional Nursing Practice Concepts Perspectives 7th Blais Hayes Test Bank
Professional Nursing Practice Concepts

Perspectives 7th Blais Hayes Test Bank
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Blais/Hayes, Test Item File for Professional Nursing Practice: Concepts and
Perspectives, 7e
Chapter 9: The Nurse as Leader and Manager
Question 1
What is the definition of leadership?
1. Coordination and integration of resources.
2. Planning, organizing, directing, and controlling.
3. Process of influencing people to accomplish goals.
4. Accomplishing specific institutional goals and objectives.
Correct Answer: 3
Rationale: Leadership is defined as the “process of influencing people to accomplish
goals.” The remaining options are parts of the definition of management.
Cognitive Level: Understanding
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
QSEN Competencies: II.B.5. Assume role of team member or leader based on the
situation.
AACN Essential Competencies: II.1. Apply leadership concepts, skills, and decision
making in the provision of high quality nursing care, healthcare team coordination, and
the oversight and accountability for care delivery in a variety of settings.
NLN Competencies: Personal and Professional Development; Knowledge; Leadership
styles and strategies; Difference between leadership and management.
Nursing/Integrated Concepts: Assessment; Nursing Process
Learning Outcome: 1. Differentiate between leadership and management.
Page Number: p. 170
Question 2
What is the focus of leadership?
1. People
2. Systems
3. Structures
4. Other organizations
Correct Answer: 1
Rationale: Leaders focus on people, whereas managers focus on systems and structures.
Both leaders and managers have focus primarily within their own organization.
situation.
©2016 by Pearson Education, Inc. Blais/Hayes, Test Item File for Professional Nursing Practice:
Concepts and Perspectives, 7th Edition
Page Number: p. 170
Question 3
What is true of a manager?
1. Has an assigned position in the formal organization.
2. Does not have delegated authority.
3. Emphasizes interpersonal relationships.
4. Directs willing followers.
Correct Answer: 1
Rationale: Managers have an assigned position in the formal organization, whereas
leaders do not have delegated authority. The leader’s power derives from other means,
such as personal influence. The other options are true of a leader, not a manager.
situation.
Page Number: p. 171
Question 4
What are characteristics of successful leadership? (Select all that apply.)
1. Empowerment
2. Self-understanding
3. Intuition
4. Values incongruence
5. Emphasis on control
Correct Answer: 1, 2, 3
Rationale: Leaders are empowered and empower others. They understand themselves
and use intuition in leading others. Their values are congruent as evidenced by the ability
to understand and accept the mission and objectives of the organization. Managers
emphasize control, whereas leaders focus on group process.
situation.
Nursing/Integrated Concepts: Planning; Nursing Process
Page Number: p. 171
Question 5
Which of these statements is most accurate?
1. Managers are born; leaders must be educated.
2. Leaders are born; managers must be educated.
3. Managers have formal leadership titles in the organization; leaders are often informal
leaders.
4. Leaders have formal leadership titles in the organization; managers are informal
leaders.
Correct Answer: 3
Rationale: Managers are given formal leadership titles, but leaders may have no formal
title. Leaders may emerge from many levels of the organization. Although some
leadership and management traits may be inborn, these traits can also be learned and
assumed voluntarily.
Cognitive Level: Analyzing
situation.
Page Number: p. 171
Question 6
How does the term vision relate to being a leader?
1. Leaders imagine a different and better situation, and identify ways to achieve it.
2. Leaders are constantly imagining new and original goals.
3. Leaders see the way to meet their own needs.
4. Leaders use vision, rather than intuition, to make institutional changes.
Correct Answer: 1
Rationale: Leaders imagine a different and better situation, and identify ways to achieve
it. They do not constantly imagine new and original goals, but often see new ways to
achieve old goals. Leaders are not self-centered, and they use vision and intuition to solve
problems.
Cognitive Level: Applying
situation.
Nursing/Integrated Concepts: Implementation; Nursing Process
Page Number: p. 171
Question 7
The nurse-manager tends to make most unit decisions without consulting the nursing
staff. Which word best describes this style of leadership?
1. Authoritarian
2. Situational
3. Transformational
4. Laissez-faire
Correct Answer: 1
Rationale: In authoritarian leadership, the leader makes decisions for the group. In
situational leadership, levels of direction and support vary according to the level of
maturity of the employees or group. Transformational leadership focuses on preparing
people for change. Laissez-faire leadership is nondirectional, is characterized by
inactivity or passivity, and is permissive with few commands, questions, criticisms, or
suggestions.
situation.
Learning Outcome: 3. Compare and contrast the leadership styles: authoritarian,
democratic, laissez-faire, situational, charismatic, transactional, transformational, caring,
quantum, and servant leadership.
Page Number: p. 173
Question 8
The chair of a hospital committee acts as a facilitator and provides constructive criticism,
information, and suggestions. Which style of leadership does this represent?
1. Authoritarian
2. Transformational
3. Democratic
4. Laissez-faire
Correct Answer: 3
Rationale: In democratic, or participative, leadership, the leader seeks the participation
or consultation of subordinates in decision-making, actively guiding the group toward
achieving the group goals. This type of leaders provides constructive criticism, offers
information, makes suggestions, and asks questions. In authoritarian leadership, the
leader makes decisions for the group. Transformational leadership focuses on preparing
people for change. Laissez-faire leadership is nondirectional, is characterized by
suggestions.
situation.
Nursing/Integrated Concepts: Evaluation; Nursing Process
Page Number: p. 173
Question 9
The manager of an emergency department tries to involve staff in department decisions.
However, when a mass casualty situation arises, the nurse becomes very directive. What
style of leadership does this situation describe?
1. Authoritarian
2. Transformational
3. Laissez-faire
4. Situational
Correct Answer: 4
Rationale: In situational leadership, levels of direction and support vary according to the
level of maturity of the employee and group, and to the situation occurring. In
authoritarian leadership, the leader makes the decisions for the group. Transformational
leadership focuses on preparing people for change. Laissez-faire leadership is
nondirectional, is characterized by inactivity or passivity, and is permissive with few
commands, questions, criticisms, or suggestions.
situation.
Page Number: p. 174
Question 10
The staff members of a unit are inspired by their nurse-manager’s leadership and enjoy
working to create a positive nursing environment of the unit’s patients. What style of
leadership does this situation best describe?
1. Transformational
2. Authoritarian
3. Laissez-faire
4. Situational
Correct Answer: 1
Rationale: Transformational leadership “reconsiders the characteristics of the leader-
manager, reemphasizes the vision that the leader-manager shares with the group, and
stresses the importance of preparing people for change.” In situational leadership, levels
of direction and support vary according to the level of maturity of the employee and
group, and to the situation occurring. In authoritarian leadership, the leader makes the
decisions for the group. Laissez-faire leadership is nondirectional, is characterized by
suggestions.
situation.
Page Number: p. 175
Question 11
Which option characterizes the laissez-faire style of leadership?
1. The manager has a close relationship with the nurses on the unit and is an inspiration
for them to provide quality care.
2. The unit manager makes all of the decisions on the unit and rarely asks for input from
the group.
3. The nurse-manager serves as a facilitator to help the unit nurses provide the best
quality care that meets established expected outcomes.
4. The group leader is passive, allowing the group to work on goals independently.
Correct Answer: 4
Rationale: A passive leader exhibits the laissez-faire leadership style. The leader who
has an emotional relationship with the group members and inspires others exhibits the
charismatic leadership style. The leader who makes decisions for the group exhibits the
authoritarian leadership style. The leader who serves as the facilitator in guiding the
group toward achieving the group goals exhibits the democratic leadership style.
situation.
Page Number: pp. 173–174
Question 12
Which option characterizes the charismatic style of leadership?
1. The manager has a close relationship with the nurses on the unit and is an inspiration
for them to provide quality care.
2. The unit manager makes all of the decisions on the unit and rarely asks for input from
the group.
3. The nurse-manager serves as a facilitator to help the unit nurses provide the best
quality care that meets established expected outcomes.
4. The group leader is passive, allowing the group to work on goals independently.
Correct Answer: 1
Rationale: When there is an inspiring, emotional relationship between the leader and the
group members, the style is charismatic. The leader who makes decisions for the group
exhibits the authoritarian leadership style. The leader who serves as the facilitator in
guiding the group toward achieving the group goals exhibits the democratic leadership
style. A passive leader exhibits the laissez-faire leadership style.
situation.
Page Number: p. 174
Question 13
Which option characterizes the situational style of leadership?
1. The leader inspires through faith and belief.
2. The leader demonstrates affection and concern for group members.
3. The leader provides direction and support according to the level of the maturity of the
group members.
4. The leader negotiates an exchange based on incentives.
Correct Answer: 3
Rationale: In situational leadership, the leader provides direction and support according
to the level of the maturity of the group members. In charismatic leadership, the leader
inspires through faith and belief. The leader who demonstrates affection and concern for
group members is exhibiting caring leadership. The leader who negotiates an exchange
based on incentives is exhibiting transactional leadership.
situation.
Page Number: p. 174
Question 14
The nurse has been hired by the organization to direct the work of other nurses. What is
the term used to describe the type of power this nurse will hold?
1. Responsibility
2. Personal influence
3. Authority
4. Accountability
Correct Answer: 3
Rationale: Authority is the official power given by the organization to direct the work of
others. Accountability is the ability and willingness to assume responsibility. Personal
influence is a type of power that comes from within and is associated with leaders, not
managers.
situation.
Learning Outcome: 4. Describe the management concepts of authority, accountability,
planning, organizing, leading and delegating, and controlling.
Page Number: p. 179
Question 15
At the institutional level, accountability is reflected in which manner?
1. The nurse’s personal ethical integrity
2. Philosophy and objectives
3. Standards of practice
4. Nurse practice acts
Correct Answer: 2
Rationale: At the institutional level, accountability is reflected in the statement of
philosophy and objectives of the nursing department and nursing units. At the individual
or client level, accountability is reflected in the nurse’s ethical integrity. At the
professional level, accountability is reflected in standards of practice. At the societal
level, it is reflected in legislated nurse practice acts.
situation.
Page Number: p. 179
Question 16
How can planning help the nurse-manager? (Select all that apply.)
1. Identifying future opportunities
2. Quickly fixing current problems
3. Developing strategies
4. Avoiding future problems
5. Designing courses of action
Correct Answer: 1, 3, 5, 4
Rationale: Planning can help the nurse-manager (1) identify future opportunities, (2)
develop strategies and courses of action, and (3) anticipate and avoid future problems.
Situations that result in problems are sometimes the result of poor planning, and quick
fixes of those problems may cause future situations.
situation.
Page Number: p. 180
Question 17
What must the nurse consider when delegating responsibility to another? (Select all that
apply.)
1. The client’s needs
2. The skill level of the worker
3. The client’s goals
4. The worker’s gender
5. How long the worker has been at the facility
Correct Answer: 1, 2, 3
Rationale: To delegate effectively, the nurse must be aware of the needs and goals of the
client and family, the nursing activities that can help the client meet the goals, and the
skills and remembering of various nursing and support personnel. There is no indication
of need to consider the worker’s gender or how long the worker has been at the facility.
situation.
Page Number: p. 180
Question 18
The nurse is caring for a client who requires an intervention the nurse does not know how
to perform. Can the nurse delegate this intervention to another person?
1. No; the nurse should delegate only activities that he or she would be willing and able
to do.
2. No; the nurse must transfer the accountability and responsibility for this client to
another nurse who knows how to do the skill.
3. Yes; there is no requirement for the nurse to have personal knowledge or expertise in
the skill.
4. Yes, but the nurse must then learn to perform the skill within a “reasonable” period of
time.
Correct Answer: 3
Rationale: There is no requirement for the nurse to have personal knowledge or expertise
in a delegated skill, nor is there a requirement for the nurse to learn that skill. The nurse
also is not required to transfer total care of the client to another registered nurse.
Examples of such skills might be delegating food choice selection to a dietician.
situation.
Page Number: p. 180
Question 19
What is the best way for the nurse to ensure control on the nursing unit?
1. Create tightly written job descriptions
2. Write extensive rules
3. Make certain that procedures are strict
4. Support continuous quality improvement activities
Correct Answer: 4
Rationale: Formal, structured, bureaucratic controls, such as tightly written job
descriptions, extensive rules, and strict procedures elicit control by implying that not
following procedures will result in a negative outcome for the employee. Continuous
quality improvement activities are more flexible and are done with the employees.
Activities done with employees tend to produce better control and less staff resistance.
situation.
Page Number: p. 181
Question 20
The home health nurse visits the client three times a week, assesses for health changes,
sets up weekly medications for the client, and changes the client’s leg dressing. Which
type of nursing delivery model is this?
1. Team nursing
2. Case management
3. Total patient care
4. Functional care
Correct Answer: 3
Rationale: Total patient care is one of the earliest models of nursing care in which the
nurse assumes total responsibility for the comprehensive care of a client or a group of
clients. Functional care is task-oriented and is an approach in which personnel with less
preparation than the professional nurse perform less complex care tasks. Team nursing is
the delivery of individualized nursing care to clients by a nursing team led by a
professional nurse. Case management is a collaborative process in which several
disciplines are involved in meeting the individual’s health needs, and this care is
managed by one individual nurse.
situation.
Learning Outcome: 6. Compare and contrast the following nursing delivery models:
total patient care, the functional method, team nursing, and primary nursing.
Page Number: p. 182
Question 21
On this nursing unit, one nurse is assigned to administer medications to all the clients.
Another nurse provides all the treatments such as dressing changes. Another nurse
manages all invasive lines. What type of nursing delivery model is this?
1. Team nursing
2. Case management
4. Functional care
Correct Answer: 4
Rationale: Functional care is task-oriented and is an approach in which personnel with
less preparation than the professional nurse perform less complex care tasks. Total patient
care is one of the earliest models of nursing care and is when the nurse assumes total
responsibility for the comprehensive care of a client or a group of clients. Team nursing
is the delivery of individualized nursing care to clients by a nursing team led by a
professional nurse. Case management is a collaborative process in which several
disciplines are involved in meeting the individual’s health needs, and this care is
managed by one individual nurse.
situation.
Question 22
The nursing unit uses a method for nursing care delivery in which nursing assistants and
licensed practical nurses provide care to a group of clients on one section of the unit.
Another group of nursing assistants and licensed practical nurses provide care to a
different set of clients on a different section of the unit. Both these groups of staff provide
care under the supervision of a registered nurse. Which type of nursing care delivery is
this?
1. Team nursing
2. Case management
4. Functional care
Correct Answer: 1
Rationale: Team nursing is the delivery of individualized nursing care to clients by a
nursing team led by a professional nurse. Case management is a collaborative process in
which several disciplines are involved in meeting the individual’s health needs, and this
care is managed by one individual nurse. Total patient care is one of the earliest models
of nursing care, which is when the nurse assumes total responsibility for the
comprehensive care of a client or a group of clients. Functional care is task-oriented and
is an approach in which personnel with less preparation than the professional nurse
perform less complex care tasks.
situation.
Question 23
Which is true of primary nursing?
1. The nurse provides all care.
2. It is the same as primary care.
3. The nurse is responsible for total care of assigned clients.
4. The focus of the care is teaching the client about health and client advocacy.
Correct Answer: 3
Rationale: Primary nursing is a system in which one nurse is responsible for the total
care of assigned clients 24 hours a day, 7 days a week. Associates may provide some of
the care, but the primary nurse coordinates the care and communicates information to
those involved in the care. It is not the same as primary care, in which care is focused on
health promotion and illness/injury prevention. Primary nursing encompasses all aspects
of the professional role, including teaching, advocacy, decision making, and continuity of
care.
situation.
Page Number: p. 184
Question 24
Who were the first nurses to use the case management model?
1. Public health nurses
2. Oncology nurses
3. Emergency department nurses
4. Critical care nurses
Correct Answer: 1
Rationale: The first nurses to employ the case management model were public health
nurses and psychiatric/mental health nurses.
Cognitive Level: Remembering
situation.
Page Number: p. 185
Question 25
What is the primary reason for using shared governance in an organization?
1. It ensures high-quality care.
2. It improves nurses’ work environment, satisfaction, and retention.
3. Less time is spent in committee work.
4. It creates levels of middle management that increase the numbers of jobs for nurses
within the organization
Correct Answer: 2
Rationale: Shared governance is designed to give employees more opportunity to
participate in the decisions of the organization. It is thought to improve nurses’ work
environment, satisfaction, and retention. Although this model may improve the quality of
care, it does not ensure high-quality care. The nurse who participates in shared
governance will likely spend more time in committee work. There is no indication that
this management style creates more nursing middle-management jobs.
situation.
Learning Outcome: 9. Describe shared governance as a mechanism for nursing
involvement in organizational decision-making.
Page Number: p. 186
Question 26
Which option most closely demonstrates the concept of shared governance in a health
care organization?
1. The nurse makes the decision to increase the frequency of output measurement on a
postoperative client.
2. The nurse complains to a co-worker that there is not enough staff on duty for the
patient acuity this shift.
3. The nurse is asked to serve on one of the strategic planning committees of the hospital.
4. The nurse is asked to be chairperson of a fundraising committee.
Correct Answer: 3
Rationale: The focus of shared governance is to encourage nurses to participate in
decision-making at all levels of the organization. The clearest example of this is the nurse
being asked to serve on the strategic planning committee. Being chairperson of a
fundraising committee will not have the same impact on the decisions being made about
the future of the organization. The nurse who simply complains to a co-worker is not
being an effective change agent. Making client-centered care decisions is the role of the
nurse, but does not exemplify shared governance.
situation.
Learning Outcome: 9. Describe shared governance as a mechanism for nursing
involvement in organizational decision-making.
Page Number: p. 186
Question 27
The nurse is planning to apply for a position that has the following information in the
position description:
Primary Responsibilities: Supervises charge nurses; Supervises nurse managers;
Oversees the activities within designated client care areas; Reports to the Vice President
of Nursing Services.For which type of position is the nurse applying?
1. First-level manager
2. Middle-level manager
3. Top-level manager
4. Laissez-faire manager
Correct Answer: 2
Rationale: A middle-level manager supervises first-level managers within a specific
area, and is responsible for the personnel and work activities within those areas. The
middle-level manager usually functions as a liaison between first-level and top-level
managers. The first-level manager is responsible for supervising non-administrative
personnel in the conduct of day-to-day activities on specific work units. A top-level or
upper-level manager is primarily responsible for establishing the goals and strategic plans
for the entire nursing division. Middle-level managers generally report to the upper-level
manager. Various titles are given to upper-level nurse-managers. Examples are director
of nursing services, chief nursing officer, or vice president for nursing services. Laissez-
faire is not nursing position but rather an approach to management.
situation.
Learning Outcome: 2. Describe American Nurses Association and American
Organization of Nurse Executives competencies for nurses regarding leadership and
management.
Page Number: p. 179
Question 28
The nurse serving as a mentor documents the following information in a mentoring log:
Mentee: Sandra Martin, RN: During last shift Sandra questioned her ability to meet
goals negotiated several weeks ago. Discussed clarifying the goals strategies to achieve
them. Shared personal experiences with achieving goals and efforts taken to be
successful.
In which mentoring phase is the nurse when mentoring this new employee?
1. Preceptor phase
2. Invitational phase
3. Questioning phase
4. Transitional phase
Correct Answer: 3
Rationale: In the invitational phase the mentor must be willing to use time and energy to
nurture an individual (mentee) who is goal directed, willing to learn, and respectfully
trusting of the mentor. The nurse-mentor invites the mentee to share knowledge, skill,
and personal experiences of professional growth. In the questioning phase the nurse-
mentee experiences self-doubt and fear of being unable to meet the goals. The mentor
helps the mentee clarify goals and the strategies for achieving them, shares personal
experiences, and serves as a sounding board and a source of support during times of
doubt. In the transitional phase the mentor assists the mentee to become aware of the
mentee’s own strengths and uniqueness. The mentee now is able to mentor someone else.
Preceptor is not a phase of the mentoring process, but rather a role in which a nurse helps
to orient a new graduate or new employee to a care area.
situation.
Learning Outcome: 10. Differentiate between the roles and functions of mentors and
preceptors.
Page Number: p. 187
Question 29
The director of nursing is identifying roles and responsibilities of nurse practitioners
hired to provide community health care. In which order should the director review the
ANA standards of practice for these care providers?
1. Planning
Professional Nursing Practice Concepts Perspectives 7th Blais Hayes Test Bank
2. Diagnosis
3. Evaluation
4. Assessment
5. Consultation
6. Implementation
7. Coordination of care
8. Outcomes identification
9. Prescriptive authority and treatment
10. Health teaching and health promotion
Correct Answer: 4, 2, 8, 1, 6, 7, 10, 5, 9, 3
Rationale: The ANA standards of practice, which differentiate between the
competencies of the RN and the advanced practice nurse (APN), can be used to
determine roles and responsibilities. The ANA standards of practice include assessment,
diagnosis, outcomes identification, planning, implementation, coordination of care, health
teaching and health promotion, consultation (APN only), prescriptive authority and
treatment (APN only), and evaluation.
situation.
Page Number: p. 186
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