Test Bank: The New Leadership Challenge ; Creating the
Future of Nursing 6th Edition by Grossman - Ch. 1-11,
9781719640411, with Rationales
1. According to the definition, which word best describes leadership?
A Allocate
B Influence
C Evaluate
D Control - ANSWER: B
Leadership is the ability to guide or influence others. The other words are more applicable to the
supervision of resources.
REF: p. 296-297
2. A nurse manager will likely have which of the following types of power?
A Referent
B Informal
C Legitimate
D Connection - ANSWER: C
Legitimate power is based on an official position in the organization. Through legitimate power, the
manager has the right to influence staff members, and staff members have an obligation to accept
that influence. Although a manager may have the other types of power, they are not a result of the
management position alone.
REF: p. 297
3. Which skill is most important for a nurse to possess when attempting to exercise or earn informal
power within an organization?
A Ability to persuade others
B Expert level nursing knowledge
C Understanding of management goals
D Willingness to compromise with everyone in the team - ANSWER: A
Informal leadership is exercised by the person who has no official or appointed authority to act, but is
able to persuade and influence others. The informal leader may have considerable power in the work
group and can influence the group's attitude and significantly affect the efficiency and effectiveness of
workflow, goal setting, and problem solving. The other options represent skills that either relates to
actual nursing care (expert nursing knowledge and cooperation) or management (goals).
REF: p. 297-298
4. Which activity demonstrates the organizational Chaos Theory?
A Preparing the yearly unit budget
B Planning for unexpected staffing shortages
C Preparing a rubric to guide staff performance reviews
D Setting unit goals related to quality control of client care - ANSWER: B
The Chaos Theory suggests that a degree of order can be attained by viewing complicated behaviors
and unpredictable situations as predictable by planning for them. The other options are not
considered unpredictable.
REF: pp. 301
,5. Which of the following activities engaged in by a nurse manager would be expected to have the
greatest impact on patient care?
A Role modeling effective communication between all levels of staff
B Conducting a survey to identify factors affecting staff job satisfaction
C Providing all nursing staff with opportunities to influence unit policies
D Providing all staff members with written copies of organizational policies - ANSWER: A
Positive role modeling is an effective tool the nurse can use to create a positive team spirit and
promote high-quality patient care. Positive role modeling simply means that the nurse performs the
job in such a way that he or she demonstrates ideal performance as a professional nurse; others
hopefully will follow the example. The other options are more related to the working climate and
control of staff performance.
REF: pp. 306-307
8. What interventions will a nurse manager implement when coaching a newly licensed nurse
regarding the way a patient's complaint was handled? (Select all that apply.)
A Asks, "What will you do differently the next time this situation occurs?"
B Begin the discussion with a personal interpretation of the situation
C Focus on how to achieve the "ideal situation"
D Approach the conversation in a nonjudgmental fashion
E Use close ended questions to help focus the conversation on the situation - ANSWER: A B D
Effective coaching includes discussing situations in a neutral way—avoid judgmental language that will
put the other person on the defensive, encouraging the other person to provide his or her perspective
about the situation and to reflect on his or her performance through open-ended questions. Being
realistic by focusing on what is actually achievable.
9. Which situations have been identified as positive factors in achieving job satisfaction among
nurses? (Select all that apply.)
A Having policy and practice decisions made by administration
B Managers taking care not to interfere when a patient focused crisis occurs
C Professional development opportunities made available at the facility
D Attention is paid to fostering excellent nurse-physician relationships
E Respect is given to and expected by all members of the health care team - ANSWER: C D E
Nursing job satisfaction depends on attention being paid to professional development and
advancement opportunities, support for good nurse-physician cooperation and a pleasant respectful
work environment. A lack of collaborative decision making and a management team uninvolved in the
daily function of the nursing units serve as negative factors.
REF: p. 305, Box 17-5
10. Which characteristics are expected to be represented in a health care facility's mission statement?
(Select all that apply.)
A Commitment to professional excellence
B Providing the most economic health care services
C Ethical treatment of all patients and staff
D Teamwork to deliver quality care
E Utilization of innovated service delivery methods - ANSWER: A C D E
Appropriate philosophies and values include commitment to professional and individual excellence,
with support for personal and professional growth, ethical and fair treatment for all through a
commitment to relationships based on fairness and trust with our patients and our employees.
Teamwork is consistently demonstrated as we work together to provide ever-improving quality care.
Compassion is our highest priority; we will always provide care and comfort to people in need with
,respectful and dignified treatment at all times. Innovation in service delivery is accomplished by
investing in the development of new and better ways to deliver health care.
REF: p. 303, Box 17-4
When considering the philosophy and values of a health care facility, _____________________ is the
highest priority. - ANSWER: COMPASSION
Compassion is the highest priority when providing care and comfort to people in need with respectful
and dignified treatment at all times. REF: p. 303, Box 17-4
The __________________ management style encourages staff involvement in the decision-making
process. - ANSWER: Democratic/Participative
The Democratic/Participative manager encourages staff participation in decision making. Involves
staff in planning and developing new ideas and programs while believing in the best in people. This
manager communicates effectively, and provides regular feedback and so builds responsibility in
people. Works well with competent, highly motivated people. REF: p. 300, Box 17-3
1. The most basic factor contributing to the effective supervision of unlicensed assistive personnel
(UAP) is the nurse's:
A ability to communicate effectively with others.
B confidence in his or her ability to delegate appropriately.
C experience managing other members of the health care team.
D ability to teach UAPs the necessary skills for their assigned tasks. - ANSWER: B
Because RNs are becoming increasingly responsible for delegation and supervision in today's health
care system, it is imperative that they have confidence in their delegation skills and understand the
legal responsibility that they assume when delegating to and supervising licensed personnel and UAP.
RNs must know what aspects of nursing and health care can be delegated. Although the other options
support their supervision of UAP, the basic component is appropriate delegation.
REF: p. 353-354
2. Which statement made by an unlicensed assistive personnel (UAP) would cause the registered
nurse team leader the most concern?
A "The nurse will follow up to make sure the client is well cared for."
B "I wonder who I can ask about how to use this new electronic thermometer."
C "I've only been working on this unit for a month and things are still new to me."
D "It's good to know that the nurse is really the one responsible for the client's care." - ANSWER: D
The UAP is responsible for his or her own actions. A belief that the nurse is fully responsible is a
concern and needs immediate attention by the nurse. It is true that the nurse will follow up and
evaluate the client's care. The statements concerning being new and asking for help are appropriate.
REF: p. 354
3. Which factor has the greatest impact on whether safe delegation of nursing tasks is possible?
A The level of competency displayed by the unlicensed assistive personnel (UAP)
B Whether the client is experiencing an acute or a chronic medical health issue
C Whether the client's physical condition is considered stable at the time
D The degree of trust shared between the nurse and the client - ANSWER: C
Generally the more stable the patient, the more likely delegation is to be safe. However, it is also
important to remember many tasks that can be delegated may also carry with them a nursing
responsibility. The other options are to be considered but they are not as impactful as is the physical
condition of the client at the time tasks are being delegated.
, REF: p. 355
4. After first having a strong understanding of the standards of practice that govern delegation, the
registered nurse must know the:
A patient care tasks that are being considered for delegation.
B expected outcomes of the care to be delegated.
C the condition and needs of the patient whose care is being delegated.
D skill and knowledge level of the staff member who is being delegated to. - ANSWER: C
The RN must then know the client whose care is being delegated. The client's condition and stability
must be determined before tasks and outcomes can be determined or consideration be given to the
skill level of the staff being delegated to.
REF: p. 358
5. When considering supervisory responsibilities, the registered nurse (RN) must recognize that:
A when two RNs work together to move a client, neither nurse is in a supervisory position.
B supervision is required only when staff is new to the unit, the patient, or the task.
C all supervision is done with the RN being immediately available to the staff.
D a charge nurse is actually supervising only the LPNs and UAPs on the unit. - ANSWER: A
One RN is working with another RN in a collegial relationship, and neither RN is in the position of
supervising the other. Each RN is responsible and accountable for his or her own practice. However,
the RN in a supervisory or management position (e.g., team leader, charge nurse, nurse manager), as
defined by the health care organization, will be in a position to supervise other RNs. Appropriate
supervision is a responsibility of any delegation of task, not just when the staff is unfamiliar with the
patient, the task, or the unit. Supervision may be categorized as on-site, in which the nurse is
physically present or immediately available while the activity is being performed, or off-site, in which
the nurse has the ability to provide direction through various means of written, verbal, and electronic
communication.
REF: pp. 361-362
6. The active process of directing, guiding, and influencing the outcome of an individual's performance
of an activity or task is referred to as _______________________. - ANSWER: supervision
Supervision is the active process of directing, guiding, and influencing the outcome of an individual's
performance of an activity or task. REF: p. 352
8. Which situations demonstrate effective delegation by the RN to the LPN? (Select all that apply.)
A RN asks the LPN, "Do you have any concerns about your assignment for today?"
B LPN asks, "Where will you be if I need help with the dressing I've been assigned?"
C RN adjusts the LPN's assignments when a patient's condition becomes unstable
D LPN states, "I'll do whatever is necessary to keep my patients free of pain."
E RN assumes responsibility for ambulating a patient when he reports, "I'm feeling dizzy." - ANSWER:
ABCE
The RN is responsible for communicating effectively with the LPN concerning responsibilities and
accountability regarding patient care. Asking the LPN if she/he has any concerns demonstrates
effective communication. Appropriate supervision is demonstrated by the LPN's when a question
about support is asked. Evaluation and reassessment is demonstrated by the RN adjusting
assignments and assuming a responsibility when the patients' conditions change. The LPN's statement
about doing whatever is necessary demonstrates a possible risk for actions outside the established
job description, competency, and standard of care on the part of the LPN.
REF: p. 360, Box 20-4
Future of Nursing 6th Edition by Grossman - Ch. 1-11,
9781719640411, with Rationales
1. According to the definition, which word best describes leadership?
A Allocate
B Influence
C Evaluate
D Control - ANSWER: B
Leadership is the ability to guide or influence others. The other words are more applicable to the
supervision of resources.
REF: p. 296-297
2. A nurse manager will likely have which of the following types of power?
A Referent
B Informal
C Legitimate
D Connection - ANSWER: C
Legitimate power is based on an official position in the organization. Through legitimate power, the
manager has the right to influence staff members, and staff members have an obligation to accept
that influence. Although a manager may have the other types of power, they are not a result of the
management position alone.
REF: p. 297
3. Which skill is most important for a nurse to possess when attempting to exercise or earn informal
power within an organization?
A Ability to persuade others
B Expert level nursing knowledge
C Understanding of management goals
D Willingness to compromise with everyone in the team - ANSWER: A
Informal leadership is exercised by the person who has no official or appointed authority to act, but is
able to persuade and influence others. The informal leader may have considerable power in the work
group and can influence the group's attitude and significantly affect the efficiency and effectiveness of
workflow, goal setting, and problem solving. The other options represent skills that either relates to
actual nursing care (expert nursing knowledge and cooperation) or management (goals).
REF: p. 297-298
4. Which activity demonstrates the organizational Chaos Theory?
A Preparing the yearly unit budget
B Planning for unexpected staffing shortages
C Preparing a rubric to guide staff performance reviews
D Setting unit goals related to quality control of client care - ANSWER: B
The Chaos Theory suggests that a degree of order can be attained by viewing complicated behaviors
and unpredictable situations as predictable by planning for them. The other options are not
considered unpredictable.
REF: pp. 301
,5. Which of the following activities engaged in by a nurse manager would be expected to have the
greatest impact on patient care?
A Role modeling effective communication between all levels of staff
B Conducting a survey to identify factors affecting staff job satisfaction
C Providing all nursing staff with opportunities to influence unit policies
D Providing all staff members with written copies of organizational policies - ANSWER: A
Positive role modeling is an effective tool the nurse can use to create a positive team spirit and
promote high-quality patient care. Positive role modeling simply means that the nurse performs the
job in such a way that he or she demonstrates ideal performance as a professional nurse; others
hopefully will follow the example. The other options are more related to the working climate and
control of staff performance.
REF: pp. 306-307
8. What interventions will a nurse manager implement when coaching a newly licensed nurse
regarding the way a patient's complaint was handled? (Select all that apply.)
A Asks, "What will you do differently the next time this situation occurs?"
B Begin the discussion with a personal interpretation of the situation
C Focus on how to achieve the "ideal situation"
D Approach the conversation in a nonjudgmental fashion
E Use close ended questions to help focus the conversation on the situation - ANSWER: A B D
Effective coaching includes discussing situations in a neutral way—avoid judgmental language that will
put the other person on the defensive, encouraging the other person to provide his or her perspective
about the situation and to reflect on his or her performance through open-ended questions. Being
realistic by focusing on what is actually achievable.
9. Which situations have been identified as positive factors in achieving job satisfaction among
nurses? (Select all that apply.)
A Having policy and practice decisions made by administration
B Managers taking care not to interfere when a patient focused crisis occurs
C Professional development opportunities made available at the facility
D Attention is paid to fostering excellent nurse-physician relationships
E Respect is given to and expected by all members of the health care team - ANSWER: C D E
Nursing job satisfaction depends on attention being paid to professional development and
advancement opportunities, support for good nurse-physician cooperation and a pleasant respectful
work environment. A lack of collaborative decision making and a management team uninvolved in the
daily function of the nursing units serve as negative factors.
REF: p. 305, Box 17-5
10. Which characteristics are expected to be represented in a health care facility's mission statement?
(Select all that apply.)
A Commitment to professional excellence
B Providing the most economic health care services
C Ethical treatment of all patients and staff
D Teamwork to deliver quality care
E Utilization of innovated service delivery methods - ANSWER: A C D E
Appropriate philosophies and values include commitment to professional and individual excellence,
with support for personal and professional growth, ethical and fair treatment for all through a
commitment to relationships based on fairness and trust with our patients and our employees.
Teamwork is consistently demonstrated as we work together to provide ever-improving quality care.
Compassion is our highest priority; we will always provide care and comfort to people in need with
,respectful and dignified treatment at all times. Innovation in service delivery is accomplished by
investing in the development of new and better ways to deliver health care.
REF: p. 303, Box 17-4
When considering the philosophy and values of a health care facility, _____________________ is the
highest priority. - ANSWER: COMPASSION
Compassion is the highest priority when providing care and comfort to people in need with respectful
and dignified treatment at all times. REF: p. 303, Box 17-4
The __________________ management style encourages staff involvement in the decision-making
process. - ANSWER: Democratic/Participative
The Democratic/Participative manager encourages staff participation in decision making. Involves
staff in planning and developing new ideas and programs while believing in the best in people. This
manager communicates effectively, and provides regular feedback and so builds responsibility in
people. Works well with competent, highly motivated people. REF: p. 300, Box 17-3
1. The most basic factor contributing to the effective supervision of unlicensed assistive personnel
(UAP) is the nurse's:
A ability to communicate effectively with others.
B confidence in his or her ability to delegate appropriately.
C experience managing other members of the health care team.
D ability to teach UAPs the necessary skills for their assigned tasks. - ANSWER: B
Because RNs are becoming increasingly responsible for delegation and supervision in today's health
care system, it is imperative that they have confidence in their delegation skills and understand the
legal responsibility that they assume when delegating to and supervising licensed personnel and UAP.
RNs must know what aspects of nursing and health care can be delegated. Although the other options
support their supervision of UAP, the basic component is appropriate delegation.
REF: p. 353-354
2. Which statement made by an unlicensed assistive personnel (UAP) would cause the registered
nurse team leader the most concern?
A "The nurse will follow up to make sure the client is well cared for."
B "I wonder who I can ask about how to use this new electronic thermometer."
C "I've only been working on this unit for a month and things are still new to me."
D "It's good to know that the nurse is really the one responsible for the client's care." - ANSWER: D
The UAP is responsible for his or her own actions. A belief that the nurse is fully responsible is a
concern and needs immediate attention by the nurse. It is true that the nurse will follow up and
evaluate the client's care. The statements concerning being new and asking for help are appropriate.
REF: p. 354
3. Which factor has the greatest impact on whether safe delegation of nursing tasks is possible?
A The level of competency displayed by the unlicensed assistive personnel (UAP)
B Whether the client is experiencing an acute or a chronic medical health issue
C Whether the client's physical condition is considered stable at the time
D The degree of trust shared between the nurse and the client - ANSWER: C
Generally the more stable the patient, the more likely delegation is to be safe. However, it is also
important to remember many tasks that can be delegated may also carry with them a nursing
responsibility. The other options are to be considered but they are not as impactful as is the physical
condition of the client at the time tasks are being delegated.
, REF: p. 355
4. After first having a strong understanding of the standards of practice that govern delegation, the
registered nurse must know the:
A patient care tasks that are being considered for delegation.
B expected outcomes of the care to be delegated.
C the condition and needs of the patient whose care is being delegated.
D skill and knowledge level of the staff member who is being delegated to. - ANSWER: C
The RN must then know the client whose care is being delegated. The client's condition and stability
must be determined before tasks and outcomes can be determined or consideration be given to the
skill level of the staff being delegated to.
REF: p. 358
5. When considering supervisory responsibilities, the registered nurse (RN) must recognize that:
A when two RNs work together to move a client, neither nurse is in a supervisory position.
B supervision is required only when staff is new to the unit, the patient, or the task.
C all supervision is done with the RN being immediately available to the staff.
D a charge nurse is actually supervising only the LPNs and UAPs on the unit. - ANSWER: A
One RN is working with another RN in a collegial relationship, and neither RN is in the position of
supervising the other. Each RN is responsible and accountable for his or her own practice. However,
the RN in a supervisory or management position (e.g., team leader, charge nurse, nurse manager), as
defined by the health care organization, will be in a position to supervise other RNs. Appropriate
supervision is a responsibility of any delegation of task, not just when the staff is unfamiliar with the
patient, the task, or the unit. Supervision may be categorized as on-site, in which the nurse is
physically present or immediately available while the activity is being performed, or off-site, in which
the nurse has the ability to provide direction through various means of written, verbal, and electronic
communication.
REF: pp. 361-362
6. The active process of directing, guiding, and influencing the outcome of an individual's performance
of an activity or task is referred to as _______________________. - ANSWER: supervision
Supervision is the active process of directing, guiding, and influencing the outcome of an individual's
performance of an activity or task. REF: p. 352
8. Which situations demonstrate effective delegation by the RN to the LPN? (Select all that apply.)
A RN asks the LPN, "Do you have any concerns about your assignment for today?"
B LPN asks, "Where will you be if I need help with the dressing I've been assigned?"
C RN adjusts the LPN's assignments when a patient's condition becomes unstable
D LPN states, "I'll do whatever is necessary to keep my patients free of pain."
E RN assumes responsibility for ambulating a patient when he reports, "I'm feeling dizzy." - ANSWER:
ABCE
The RN is responsible for communicating effectively with the LPN concerning responsibilities and
accountability regarding patient care. Asking the LPN if she/he has any concerns demonstrates
effective communication. Appropriate supervision is demonstrated by the LPN's when a question
about support is asked. Evaluation and reassessment is demonstrated by the RN adjusting
assignments and assuming a responsibility when the patients' conditions change. The LPN's statement
about doing whatever is necessary demonstrates a possible risk for actions outside the established
job description, competency, and standard of care on the part of the LPN.
REF: p. 360, Box 20-4
