Test Bank NURS 2900 Leadership Roles and Management Functions,100% CORRECT

Test Bank NURS 2900 Leadership Roles and Management Functions 1. Which of the following roles of a nurse is an example of legitimate power? A) Director of nursing B) Team leader making assignments C) Head nurse scheduling vacations D) Shift supervisor Ans: A Feedback: Legitimate power is power by virtue of the management position. Director of nursing is an example of legitimate power. Team leader making assignments is an example of reward power. Head nurse scheduling vacations is an example of coercive power. Shift supervisor is an example of referent power. 2. Which of the following is the perceived advantage of autocratic leadership styles? A) Staff members are invested in management's goals. B) Decisions are made without any input from staff. C) Communication is limited to memos. D) Decisions may not occur on time. Ans: B Feedback: In autocratic leadership style, the lines of authority and policies are clear, and communication is directive and flows downward. In addition, decisions are made quickly, and staff members are not invested in management's goals. 3.A licensed practical nurse (LPN) has delegated a task to unlicensed assistive personnel (UAP). Who is accountable for evaluating the results of the tasks? A) Physician B) Shift supervisor C) UAP D) LPN Ans: D Feedback: An LPN or licensed vocational nurse (LVN) who delegates tasks to a UAP is accountable for evaluating the results of the tasks. The UAP is responsible for performing the actual task. The physician or shift supervisor is not accountable for evaluating the results of the tasks. 4.According to Ellis and Hartley (2011), which type of leadership involves the least amount of structure and control? A) Autocratic B) Laissez-faire C) Democratic D) Multicratic Ans: B Feedback: Laissez-faire leadership involves the least structure and control. Autocratic leadership entails strong control by the manager over the work group. Democratic leadership involves more participation in decision making by the work group. Multicratic leadership allows a leader to determine which approach is best for a particular circumstance. 5.A nurse manager who denies vacation time to an employee who failed to meet expectations is exhibiting what type of power? A) Legitimate B) Coercive C) Reward D) Referent Ans: B Feedback: Coercive power is the ability to threaten or punish someone who fails to meet expectations. Legitimate power is obtained through a designated position. Reward power occurs when a person attains power through the ability to grant favors or rewards. Referent power is the power a person has because of his or her association with other who are powerful. 6.A nurse manager typically exhibits which type of power when using education and work experience? A) Referent B) Legitimate C) Coercive D) Expert Ans: D Feedback: Expert power results from knowledge, expertise, or experience in a particular area. Referent power concerns the power a person has because of his or her association with other who are powerful. Legitimate power is obtained through a designated position. Coercive power is the ability to threaten or punish someone who fails to meet expectations. 7. Which of the following is an advantage of democratic leadership? A) Tasks are accomplished without staff input. B) Leaders see themselves as coworkers. C) Quick decision making occurs. D) Managers provide support and freedom for employees. Ans: B Feedback: Democratic leadership involves more participation in decision making by the work group. Leaders with this style often see themselves as coworkers. Autocratic leadership allows little input from staff for decisions. In laissez-faire leadership, the manager leaves the work group to set goals, make decisions, and take responsibility for their own management. 8. Which of the following would not be considered one of the five rights of delegation? A) Educational level B) Task C) Circumstances D) Person Ans: A Feedback: The NCSBN (1997) identified the five rights of delegation: right task, right circumstances, right person, right direction/communication, and right supervision/evaluation. 9. Which of the following would be considered an indirect activity that may be delegated to unlicensed assistive personnel? A) Delivering meal trays B) Obtaining vital signs C) Ambulation D) Specimen collection Ans: A Feedback: Indirect activities are focused on environmental tasks, such as cleaning equipment, emptying trash or soiled linen receptacles, and delivering meal trays. Direct activities are those that help clients meet basic needs, including vital signs, weights, specimen collection, and ambulation. 10. The leader is making all the decisions for the group. Which type of leadership is being exhibited? A) Autocratic B) Democratic C) Laissez-faire D) Multicratic Ans: A Feedback: Autocratic leadership entails strong control by the manager over the work group. Democratic leadership involves more participation in decision making by the work group. Laissez-faire leadership involves the least structure and control. Multicratic leadership allows a leader to determine which approach is best for a particular circumstance. 11. The nurse at a long-term care facility is receiving an admission to a skilled medical unit with a full census. Which nursing situation is the best example of a nurse demonstrating appropriate management skills in the care of the client? A) The nurse is arranging the room to best accommodate the client's medical equipment. B) The nurse is obtaining the needed paperwork to begin the admission process. C) The nurse is delegating patient orientation to the room while obtaining contact information from the family. D) The nurse is obtaining a urinary collection hat for the toilet. Ans: C Feedback: Management of clients, especially on a busy unit, is best accomplished by delegation of appropriate tasks. A manager must use resources in an efficient and effective manner to accomplish a goal. The manager sees the big picture and determines appropriate actions. 12. Which of the following statements best demonstrates a combination of leadership and management skills when teaching a client with uncontrolled diabetes? A) “While you have agreed to check your blood sugar every morning, it is also important to recognize the overall effect on your body system.” B) “Once you have the lancet in the device, hold it against the finger and press the button.” You are doing a good job. C) “Because Thanksgiving is next week, evaluate the amount of simple sugars in the desserts and eat those in moderation.” D) “I will notify your physician of your blood glucose reading and request a referral for a dietician to improve your knowledge of calorie controlled diets.” Ans: A Feedback: In many ways, leadership and management skills are interrelated. Option A uses management skills of instructing on obtaining blood sugars every morning and leadership skills of looking at the overall picture of the disease process within the system. Option B provides instruction on a procedure. Option C instructs on managing dietary habits. Option D does not include using management and leadership in teaching a client. 13. The nurse is caring for pediatric clients on an oncology unit. The unit is experiencing a renovation, and the nurse manager is requesting suggestions for placement of the nurse's station with the goal of close pediatric client access. Which type of leadership style is the nurse manager employing? A) Political leadership style B) Democratic leadership style C) Laissez-faire leadership style D) Authoritarian leadership style Ans: B Feedback: When a manager uses the democratic leadership style, the manager welcomes participation in decision making with a goal of consensus and teamwork. Option A and D are not leadership styles. Option C is a leadership style that involves little structure and guidance. 14. During which client–nurse interaction would the nurse most appropriately use the autocratic leadership style? A) The nurse is assisting the client to the bathroom when wound dehiscence occurs. B) The nurse is presenting meal options to a resistant diabetic client. C) The nurse is instructing on how to obtain blood glucose readings. D) The nurse is preparing discharge instructions per physician's order. Ans: A Feedback: During an emergency, such as when a wound dehiscence occurs, an autocratic leadership style with one person in tight control of the situation is best. At this time, the focus is on accomplishing the tasks of patient safety, wound care, and physician notification. All of the other interactions would best be managed with a therapeutic nurse patient interaction. 15.A mother of a 10-year-old newly diagnosed diabetic client expresses concern that her child will not follow through with the diabetic regimen. The nurse suggests developing a calendar of daily requirements with a weekly prize for completing. The mother is exerting which type of power to obtain the desired result? A) Coercive power B) Expert power C) Parental power D) Reward power Ans: D Feedback: Reward power is using rewards and favors to obtain a particular action. In this case, the mother rewards the child when the child completes the prescribed diabetic regimen. Coercive power is used when using a threat or punishment to meet expectations. Expert power results from the respected knowledge in a particular situation. Parental power many times falls under expert power. 16. The manager of the surgical unit is presenting the benefits of a new computer documentation system on reducing the nurse's time documenting, thus increasing the time to care for clients at the bedside. Increasing nurse excitement in the changes within the system is a form of which type of power? A) Referent power B) Motivational power C) Legitimate power D) Authoritarian power Ans: B Feedback: Motivational power refers to the ability to create enthusiasm for a collaborative project or achievement of a common goal. Referent power relates to being in or associating with someone who is in the position of power. Legitimate power is afforded to the management position but is not the best answer for this question scenario. Option D relates to leadership styles. 17. The LPN is caring for a full nursing assignment and delegates specific duties to the certified nursing assistant (CNA). Which nursing action is best to assess the competency of the CNA to complete the assignment? A) Ask the client if the assignments were completed B) View the paperwork related to the assignments for completion C) Ask the CNA exactly how the assignments were completed D) Observe the CNA during completion of the assignments Ans: D Feedback: Observing the CNA, especially during the first time that the CNA is independent, is the best way to ensure the knowledge and competency of the CNA (a component of supervision). If the CNA performs the assignment correctly, the task can be routinely delegated with usual follow-up. Asking clients, viewing paperwork, and asking the CNA provides information on the task but is not the best choice for assessing. 18. The LPN is assigning clients on a rehabilitation unit. Which of the following nursing actions should the LPN complete prior to assigning any delegated task? A) Complete nursing report B) Review physician notes C) Assess the clients D) Obtain feedback from the CNA Ans: C Feedback: Assessing the client prior to delegation assures the right person, task, and circumstance. The licensed nurse should assess the appropriateness of assignment to meet the skills of the person being delegated to. Completing nursing report provides information about the client, which the assessment phase confirms. Reviewing physician notes provides updated information regarding medical orders. Obtaining feedback on the assignment from CNA provides information on skill level. 19. The registered nurse (RN) delegates management of the client vital signs to the LPN while the client is receiving blood products. Which of the following RN actions is essential in completing the “right circumstance” right of delegation? A) The RN initiates the transfusion and remains with the client during initial vital signs. B) The RN supervises the LPN obtaining vital signs and discusses signs of a transfusion reaction. C) The RN obtains the LPN scope of practice and determines the ability to manage client. D) The RN discusses the specific tasks to delegate and asks for any questions. Ans: A Feedback: To complete the “right circumstance” right, the RN must determine that the client is not having any transfusion reaction and that the client's vitals are stable. Option B and C represents “right tasks” because the RN validates the scope of practice and supervises the competent completion of tasks. Option D represents right communication. 20. Staff is assembling for shift assignments. Which of the following nursing actions identifies the manager's responsibility on the clinical unit? A) The manager assesses the clients on the clinical unit and updates the physician. B) The manager assures that adequate care is given by the staff and assesses the flow of activities on the clinical unit. C) The manager removes the physician orders from the chart and notes completion. D) The manager attends facility meetings and plans the goals of the healthcare facility. Ans: B, D Feedback: The key feature of the manager's position is the individual responsibility and accountability for the accomplishment of tasks on the clinical unit. Option B accounts for the care of the clients and flow of the clinical unit. Options A and C are task oriented, and, although the manager may assist staff, it is not the focus of the manager's responsibility. Option D identifies manager (attending meetings) and leadership (goals of the facility) duties. 21. The LPN on the clinical unit is discussing client medication administration. The medication nurse states, “I crushed the medication because the nurse on the prior shift told me to do it.” This statement indicates a lack of which? A) Responsibility B) Management C) Accountability D) Leadership Ans: C Feedback: Accountability means being answerable for one's actions. Following another's actions and using that as a rationale is not being accountable for the action taken. Responsibility is the duty or assignment to a specific task. Management entails assigning functions to meet particular objectives. Leadership provides guidance to achieve common goals. 22. The nurse is planning care for the day for a client with multiple diagnoses. Which of the following criteria should the nurse consider first when setting priorities for the care of the client? A) Consider the priority of maintaining vital signs. B) Consider the priority of symptom management. C) Consider the priority of management of pain. D) Consider the priority of preventing spread of disease. Ans: A Feedback: All options are a priority when providing care to a client. When prioritizing, vital signs provide data on maintaining life and are considered first. All other options come after. 23. Which nursing management duties would the LPN identify as the primary goal of directing nursing care in the role of the team leader on a nursing unit? A) To maintain the efficient flow of client care on the nursing unit B) To ensure the personal care for all residents is completed C) To assess vital signs on a client with changing hemodynamic status D) To coordinate physician orders between the physician and nursing staff Ans: A Feedback: The key words are “primary goal,” which is broad in nature. The best choice is to maintain the efficient flow of the nursing unit. Individual staff also has the responsibility to complete the nursing task of personal care and vital sign assessment. Coordinating physician orders is a combined duty between the physician and nursing staff and falls under the goal of maintaining efficient flow of client care. 24.A nurse is caring for clients on a surgical unit. Which nursing actions positively impact the goal of healthcare cost containment? Select all that apply. A) Completing a nursing assessment and setting up a breakfast tray in an isolation client's room B) Teaching and encouraging the use of an incentive spirometer C) Delegating the ambulation of a client three times daily in the hall D) Completing client wound dressing change prior to physician rounds E) Checking the completion of foley catheter care with the nursing assistant F) Initiating a turning protocol for a bedbound client Ans: A, B, C, E, F Feedback: Cost-consciousness measures include prudent use of expensive supplies, careful monitoring of clients to reduce potential complications and lengths of stay, and reduction of waste of limited resources. Options A, B, C, E, and F are examples of these. 25.A nurse is caring for a client with stage IV colon cancer and multiple-stage two wounds on the coccyx area. The client confides feeling very weak and wanting to discontinue further aggressive treatment. Which nursing action best demonstrates the nurse in the role of the patient advocate? A) The nurse relays the message to the physician and requests an antidepressant. B) The nurse asks the client how might his or her family feel with this decision. C) The nurse sits with the client and suggests that the client reconsider. D) The nurse offers to be present to support the client at a family meeting. Ans: D Feedback: Advocacy meaning promoting the cause of another person. The nurse functions as a patient advocate by supporting the client and the client's decisions. Offering to support the client as the client expresses healthcare decisions is the best example of a client advocate. Relaying the message to the physician and asking for an antidepressant does not demonstrate supporting the client. Opening conversation related to family response is appropriate for discussion but is not the best choice to support the client. The nurse would not ask the client to reconsider because this is a block to communication. 26. The nurse manager is discussing financial penalties for readmissions to the hospital. Which nursing action, when caring for a client, is most helpful in decreasing hospital readmission? A) Emphasize client teaching B) Fully explain discharge instructions C) Sanitize hands upon entering a client room D) Disinfect the client environment at discharge Ans: C Feedback: All options help to reduce the potential for readmission but the key words are “most helpful”. Handwashing is the best way to reduce hospital acquired infections, which could lead to readmissions. Handwashing also maintains standards of care. Client education during hospitalization and with discharge instructions empowers the client in care of themselves. Disinfecting the client's room reduces cross contamination. 27. The LPN is supervising the nursing unit staff when a nonlethal breach in client standards of care occurs. Which situation demonstrates the limitations of supervising client care in the role of the LPN? A) The LPN supervisor is unable to write the incident report outlining the breach in care standard. B) The LPN supervisor reports the breach in care standard to the RN only. C) The LPN supervisor oversees the staff but has no disciplinary responsibility. D) The LPN supervisor is responsible for personal care and not all nursing functions. Ans: C Feedback: The role of the LPN supervisor does not include hiring/firing or disciplinary actions of employees. When a breach in the standards of care occurs, the LPN is responsible for documenting the event and reporting the event to the proper individuals, such as RN supervisor, administrator in charge, physician, family representative, etc. The supervisor oversees client care. 28. The LPN supervisor is assigning LPNs to clients on a skilled nursing unit at a long term care facility. In which situation would the LPN reduce the assignment due to client acuity? A) A client who desaturates with minimal exertion B) A client with dementia who is combative during medication administration C) A client who needs to be ambulated in the hall with the assistance of two for restorative therapy D) A client requires several intravenous antibiotics to treat a septic infection Ans: A Feedback: Acuity refers to the severity of the illness and the potential rapid change in the client. A client that desaturates with minimal exertion is at risk for respiratory compromise and respiratory arrest. Careful and repeated nursing assessment is needed limiting the time for other client interactions. Dementia is a chronic condition making daily activities such as medication administration challenging. A restorative care client focuses on improving activities of daily living. A client with multiple intravenous antibiotics should improve as treatment progresses. 29.A nurse in the physician's office must multitask assignments according to client needs. Arrange the clients in order of which should be assessed/assisted from first to last? A) A client in an examining room on an ill office call who reports flulike symptoms B) A client in the office reception area who appears unannounced due to chest heaviness C) A client calling on the phone who is inquiring about doubling the morning dose of medication because of forgetting the last day's dose D) A client who needs to be called by the nurse to advice of a medication dosage change E) A client who stopped into the office to pick up sample medications Ans: A, B, C, D, E Feedback: All nurses must manage multiple client needs in a timely manner. Nurses must prioritize to determine the proper order of response. Maslow's Hierarchy of Needs can be helpful to make that determination in certain circumstances. A client with chest heaviness potentially could be having a life-threatening condition needing attention immediately. Next, the client in the exam room needs vital signs and a history of present illness before the physician enters. To maintain the flow of the office, this client is a priority. Next, the nurse would answer the question of the client on the phone who may otherwise incorrectly ingest a double dose of medication. Next, a client needs to be called with medication dosage change. Lastly, the client in the office who has come to obtain sample medication needs medication instruction on dosage and side effects. 30.A new client charting system is in the education phase at a healthcare facility. Much discussion has been prompted regarding the new system. With which statement does the nurse best exhibit the integrated leader/manager traits? A) “Let's look at the daily benefits of using the new technology on the clinical unit.” B) “I am not used to the new technology, but if it better serves the client and enables easy sharing of client authorized records, I see a benefit.” C) “New technology may be costly up front but will serve us well in the future.” D) “I do not believe that this technology will be helpful in caring for a client because it often is down during peak use times and is difficult to train for.” Ans: B Feedback: The traits of an integrated leader/manager combine understanding the daily operations on a clinical unit while seeing the big picture and thinking in the long term. Better serving the client and sharing records as needed demonstrates the willingness to think positively and take risks on improvement for the future. Option A and C only look at one aspect of leadership/management. Option D is a negative statement.