Question 1

The nursing staff communicates that the new manager has a focus on the "bottom line," and little concern for the quality of care. What is likely true of this nurse manager?

Accepted Answer

1. This action would enable the manager to make a decision and not just evaluate the financial status of the environment.
2. If the manager is indeed focusing only on the "bottom line," the manager is not promoting a caring environment on the unit.
3. The organization may set great value on the "bottom line," but also must be concerned about quality of care. Problems with quality of care can impact the "bottom line." If the manager believes the financial status of the organization is the only organization value, a misunderstanding has probably occurred.
4. This manager has primary focus on the financial issues associated with provision of care. This will make the manager ineffective in the role.

Question 2

There have been several patient complaints that the staff members of the unit are disorganized and that "no one seems to know what to do or when to do it." The staff members concur that they don't have a real sense of direction and guidance from their leader. Which type of leadership is this unit experiencing?

Accepted Answer

1. Autocratic and authoritarian leaders make decisions for the group and assume people are incapable of making independent decisions. While this is not always a good leadership style, it is unlikely the complaints in this scenario would occur.
2. Bureaucratic leaders depend upon policy and rules. This is not always a good style of leadership, but it is unlikely the complaints in this scenario would occur.
3. This style of leadership can be so detached that there is no direction or real leadership. This will often be reflected in the work of the staff and the perceptions of the patients.
4. Autocratic and authoritarian leaders make decisions for the group and assume people are incapable of making independent decisions. While this is not always a good leadership style, it is likely the complaints in this scenario would occur.

Question 3

The nurse has just been promoted to unit manager. Which advice, offered by a senior unit manager, will help this nurse become inspirational and motivational in this new role?

Accepted Answer

1. Managers need to be honest and forthcoming with staff, which includes taking responsibility for one's own actions and errors. This also provides a positive role model for the staff.
2. When errors occur, the manager should use the opportunity for improvement, not punishment.
3. When staff feel some staff are given extra credit, they will feel uncomfortable with the manager and resentment will build.
4. Staff need to feel that they can share their feedback, positive or negative, and not feel threatened when they disagree with the manager.

Question 4

What statement, made in the morning shift report, would help an effective manager develop trust on the nursing unit?

Accepted Answer

1. To develop trust, managers who make promises to staff must keep the promise.
2. This statement implies that the staff nurse is not a team player. It also sets up one nurse against the remainder of the staff. Effective managers must be fair and supportive with all staff.
3. This manager is standing up for staff by not allowing another unit to take a nurse today.
4. This statement is belittling to the staff nurse. This attitude does not demonstrate trust that staff performances will be effective.

Question 5

A very young nurse has been promoted to nurse manager of an inpatient surgical unit. The nurse is concerned that older nurses may not respect the manager's authority because of the age difference. How can this nurse manager best exercise authority?

Accepted Answer

1. Critical thinking is important for every RN, not just a manager and will not distinguish the manager's authority.
2. Giving clear assignments is a characteristic of authority. The young nurse who takes staff expertise into consideration when making assignments is likely to be more successful in leading the group.
3. Nurse managers do work in complex healthcare environments, but must create an appropriate organizational environment as a way of exercising authority.
4. In autocratic leadership, one person has all of the power. This is not a good approach for a younger leader to adopt when working with a group of older, more experienced nurses.

Question 6

The nurse executive of a healthcare organization wishes to prepare and develop nurse managers for several new units that the organization will open next year. What should be the primary goal for this work?

Accepted Answer

1. This is an illustration of the "Peter Principle," which is promoting people to management positions just because they are doing a good job in their current position. Management level employees should be selected based upon the potential ability to manage and their desire to do so.
2. Nurse managers are directly responsible for maintaining standards of care, and managing fiscal resources and development of staff.
3. This is not the responsibility of most nurse managers. In this question, it is clear that managers of nursing units are being prepared and developed.
4. Interacting with hospital administration is a rare requirement for a unit nurse manager and, if it is required, it is not as important as maintaining standards of care.

Question 7

The nurse manager has asked that all staff nurses develop effective leadership competencies. How should the staff nurses interpret this request?

Accepted Answer

1. A nurse does not need to have a formal management position with a management title to be a leader; if nurses demonstrate leadership competencies, they are considered nurse leaders.
2. In today's healthcare environment, nurses must have knowledge of relevant leadership and management theories and styles. This knowledge helps nurses emerge as leaders. Nurses are also leaders of their own nursing practices.
3. Control, competition, and getting the job done are past theories and styles that are not as useful in today's environment.
4. Leadership is a skill that can be learned.

Question 8

Which behavior demonstrates the nurse's competency as an emotionally intelligent leader?

Accepted Answer

1. While technical skill is important for all nurses, it is not a hallmark of a competent leader.
2. Chaos theory states that solutions are not always clear and policies might not always be applied easily; other options might need to be considered.
3. In Emotional Intelligent theory, team members support each other and feel supported by the team leader.
4. This statement reflects the country club leadership style.

Question 9

Describe the primary focus of a manager in a knowledge work environment.

Accepted Answer

1. The most important focus of this manager is on developing and supporting effective teams, utilizing the knowledge of many.
2. Risk taking is a part of knowledge work, but is not the most important of this manager's tasks.
3. Knowledge work is a combination of routine and non-routine work, so the manager will have focus on the routine. This is not the manager's most important focus.
4. Understanding the history of the organization is important as it will help the manager work within the organization, but it is not the most important focus.

Question 10

Peter Drucker's view of management stimulated the shift toward the realization of the importance of participatory organizations. Which option provides a scenario that is an example of a participatory organization?

Accepted Answer

1. In participatory organizations, the control of the organization is decentralized and many decisions are made by those "on the front lines" of the organization.
2. The theory is that the staff should be nurtured to promote greater leadership competency.
3. According to Drucker, when staff participate in the core functions of management, the organization is more effective.
4. According to Drucker, when staff participate in the core functions of management such as planning and changes for their own units, the organization is more effective.

Question 11

Compare and contrast manager roles and leadership roles by choosing the options that are more aligned with the manager role. Select all that apply.

Accepted Answer

1. The manager accepts the status quo, while the leader challenges it.
2. The manager controls people, while the leader influences others.
3. The manager controls the environment, patient care, and the staff that deliver that care.
4. The leader focuses on people while the manager focuses on systems and structure.
5. Managers focus on efficiency, while leaders focus on effectiveness.

Question 12

The nurse executive wishes to be a transformational leader. What should this nurse focus on to become effective in this role? Select all that apply.

Accepted Answer

1. Transformational leadership requires interpersonal skills and having a vision for the future.
2. While formal education might increase the nurse's knowledge base for decision making, it is not a requirement for transformational leadership.
3. Having a mentor is not a requirement of transformational leadership.
4. This does not guarantee that the nurse will be a transformational leader.
5. Transformational leadership requires interpersonal skills and having a vision for the future.

Question 13

The nurse wishes to improve personal Emotional Intelligence (EI) in hopes of a promotion to nurse manager. Which skills are important for this nurse to improve? Select all that apply.

Accepted Answer

1. EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.
2. While this is an important aspect of professional nursing, it is not a competency of EI.
3. While this is an important aspect of professional nursing, it is not a competency of EI.
4. EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.
5. EI competencies are self-confidence, empathy, change catalyst, and visionary leadership.

Question 14

Which scenarios are examples of issues facing nursing in an age of healthcare change? Select all that apply.

Accepted Answer

1. An issue is the need for nurses to work as a team, despite differences in age, language, and culture.
2. There is a need to develop a culture of safety, which this hospital is doing already.
3. An issue is the need to be creative in doing more with less.
4. An issue is the increasing press coverage of recruitment and retention of nurses.
5. An issue is the increase in workplace violence.

Question 15

Compare and contrast transformational leaders and bureaucratic leaders by choosing the options that are examples of transformational leadership. Select all that apply.

Accepted Answer

1. This is a characteristic of a bureaucratic organization and leadership-stick to the structure and identified functions.
2. This is the transformational leader.
3. The IOM recommended transformational leadership in its report Leadership by Example (2003).
4. This is a quality of transformational leadership.
5. This is a quality of transformational leadership.

Question 16

Select the reason the transformational leadership sometimes fails in an organization.

Accepted Answer

1. Failure often results from a lack of urgency.
2. Failure often results from a lack of a guiding diverse coalition.
3. Failure often results from not applying influence, power, or empowerment.
4. This is a reason for failure of transformational leadership.

Question 17

The new chief operating officer (COO) of the healthcare facility states, "I believe that Fiedler had it right in his Contingency theory." The nurse executive understands that this COO will work to create which type of environment in the facility? Select all that apply.

Accepted Answer

1. Fiedler believed that the best type of situation occurs when there are positive leader-member relations.
2. Fiedler believed that high task structure resulted in the best situations.
3. Fielder believed that high position power resulted in the best situations.
4. This is not a static approach to leadership, but rather a situational approach.
5. In this theory, as the groups and situations change, leadership also changes.

Question 18

The rural hospital has experienced a very small patient census over the last two months. Salary costs for this period have been over budget, and the nurse manager announces that all nurses will be required to rotate taking unpaid furlough days until the census improves. Which type of leadership does this manager exemplify?

Accepted Answer

1. This style of leadership has limited interest in production or people.
2. This type of leader has an interest in people, but productivity is not a major focus.
3. This type of leadership focuses on efficiency and getting the job done and is not as concerned with staff members as people, but in this case this most likely is the only approach that the nurse manager can take.
4. This type of leader is very concerned about productivity and about staff, morale, and satisfaction.

Question 19

Typically, the nurse manager of a unit uses a participatory style of leadership. Today, a patient suffered a cardiac arrest. The manager took over the patient's care, issuing orders, and expecting staff to obey them immediately. Which type of leadership did this manager exhibit today? Select all that apply.

Accepted Answer

1. This style is focused on organizational rules and policies.
2. Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.
3. This is a "hands-off" approach.
4. Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.
5. Autocratic, directive, and authoritarian are all terms used to describe leadership in which the leader makes the decisions for the group, issues direct orders, and expects staff to immediately obey. This is an appropriate leadership style in emergencies such as a cardiac arrest.

Question 20

A key skill in today's healthcare environment is the ability to collaborate with others. A nurse identifies need to improve in this area. Which skills or traits would be essential for an effective nurse manager to develop to improve collaboration with others? Select all that apply.

Accepted Answer

1. In order to collaborate effectively, the nurse must be flexible, must be willing to listen to others and include them in his or her work, and work together toward the best solution to any problems that might arise.
2. In order to collaborate effectively, the nurse must be flexible, must be willing to listen to others and include them in his or her work, and must work together toward the best solution to any problems that might arise.
3. While a service orientation is common among nurses, it is not an essential trait for collaboration.
4. This is not an essential skill for ability to collaborate.
5. In order to collaborate effectively, the nurse must be flexible, must be willing to listen to others and include them in his or her work, and must work together toward the best solution to any problems that might arise.

Quiz 1: Conceptual Base for Leadership and Management