In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees’ health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin’s planned change?

a. Unfreeze
b. Move
c. Refreeze
d. Acceptance

A

One difference between a leader and a manager is that a:

1. leader has legitimate authority.
2. manager motivates and inspires others.
3. manager focuses on coordinating resources.
4. leader focuses on accomplishing goals of the organization.

C

The first step in the nursing process and in the problem-solving process is to:

1. identify the problem.
2. gather information.
3. consider the consequences.
4. implement interventions.

B

An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation?

a. Autocratic
b. Democratic
c. Laissez-faire
d. Referent

A

An RN with excellent assessment and psychomotor skills would derive power on the basis of which source?

a. Rewards

b. Coercion

c. Expert
d. Legitimate

C

Managers who exhibit an authoritative behavioral style are most likely to use which source of power?

a. Informal

b. Expert
c. Coercive

d. Reward

C

Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society’s perception of nursing). Those who depict her as a leader on the basis of these qualities are practicing which leadership theory?

a. Trait
b. Chaos
c. Bureaucracy

d. Organizational

A

A nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse?
a. Transactional

b. Situational
c. Transformational

d. Contemporary

A

According to the unit’s policy for call-ins, a nurse is suspended for 3 days because of excessive call-ins that occur within 15 minutes of shift change. The nurse states, “You are unfair to me.” Which theory would disprove the nurse’s statement?

1. Authoritative
2. Closed systems
3. Open systems
4. Trait

A

A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which action would demonstrate positive reinforcement?

1. Every morning at shift change, thank each employee for an excellent job.
2. Rotate a monthly “employee recognition award” among all employees on the unit.
3. Wait until the annual performance review to recognize accomplishments.
4. Give spur-of-the-moment recognition to an employee who has accomplished a goal.

D

Which action represents the key management function of strategic planning?

1. Determining that all nurses on the unit understand the current organizational philosophy
2. Evaluating the communication process between the pharmacy and the nursing departments
3. Monitoring data from the quality management initiative related to the last three orientation programs
4. Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units

D

A hospital’s policy requires that all nurse managers must have a minimum of a bachelor’s degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, “The new nurse manager has book sense but no leadership abilities.” What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?

1. Send memos to all staff except the upset nurse to invite them to a luncheon.
2. Ask management to transfer the upset nurse to another unit.
3. Assign the upset nurse to committees that do not directly affect that nursing unit.
4. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.

D

A clinical nurse leader (CNL) enters the workforce and hopes to use her interdisciplinary skills to participate on a quality improvement committee. The coordinator of the quality group invites the CNL to join the group. Which type of power is demonstrated by the coordinator of the group?

a. Coercive
b. Transformational

c. Laissez-fair
d. Legitimate

D

A director of nursing (DON) asks the staff to list how their nursing unit can help the organization meet its goal to “provide quality patient care with attention to compassion and excellence.” An ad hoc committee is formed to develop a timeline of identified actions. The DON coaches the committee to reach desired outcomes. This DON is demonstrating which other role of leadership and management?

1. Transactional
2. Clinical consultant
3. Corporate supporter
4. Autocratic

C

A staff nurse provides care based on intuition and always seems to be in control of her personal and professional life—serving on the board of the state nurses association, serving as the nursing unit’s representative on the ethics committee, and coaching her daughter’s soft ball team. Many of the staff observes how she manages time and provides care. This nurse’s power comes from which type of power?
a. Referent
b. Legitimate
c. Information
d. Connection

A

A staff nurse states, “I really enjoyed having dinner with the Chief of Medical Staff and the President of the hospital. We hope to meet again soon.” Which source of power does this nurse possess?
a. Expert

b. Legitimate

c. Connection

d. Reward

C

A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager’s approach to improve their own units. This nurse is which type of leader?

a. Transformational

b. Transactional
c. Laissez-faire
d. Authoritative

A

A hospital recently learned that their scorecard did not meet the national benchmark for patient satisfaction and brought in a professional change agent to determine what their issues were and how they could improve their score. The agent collected data and recommended that nurses participate in interdisciplinary walking rounds and allow the patient and family to be participants. Nurses now round every shift and perform “huddles to update the team” as needed throughout the shift as part of best practices. Random visits are made to nursing units to ensure all nurses are participating and patients are interviewed for their involvement. This stage of Lewin’s change is:
a. unfreeze.
b. moving.
c. refreeze.
d. resistance.

C

A manager just finished the last annual performance review of the staff, reviews the unexpected expenditures for the month due to use of agency nurses, and shares the latest quality indicators with the staff nurses. This manager is performing which management function?

a. Directing

b. Planning
c. Organizing

d. Controlling

D

Registered nurses who are entering the workforce will have expanded leadership responsibilities that include: (select all that apply)

1. serving on interdisciplinary care teams.
2. being competent to work in several areas independently when dictated by patient census.
3. attending a meeting to plan advanced training for unlicensed assistive personnel.
4. evaluating outcomes of care that are reported to a standing committee.
5. managing units with higher acuity, shorter length of stay, and more diverse patients and staff.

A, C, D, E

A nurse asks, “What is meant by ‘internal’ customers?” The correct response is: (select all that apply)

1. insurance companies
2. accreditors such as The Joint Commission
3. X-ray technicians
4. clinical pharmacist
5. chief financial officer

C, D, E