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Chapter 01: Leadership and Management
Motacki: Nursing Delegation and Management of Patient Care, 3rd Edition
MULTIPLE CHOICE
1. Nurses can be leaders without being managers. Which nursing actions demonstrate
leadership?
a. Assisting a new nurse with enteral tube feedings
b. Counseling a new nurse regarding attendance
c. Adjusting assignments after a staff member calls in sick
d. Calling a physician for new order clarification
ANS: A
Leaders act as role models and mentor new staff. The other options are incorrect because they
are management responsibilities and not leadership roles.
DIF: Cognitive Level: Application REF: page 6
2. Which nursing actions demonstrate the role of management in nursing?
a. Encouraging autonomous decision making
b. Observing the documentation of appropriate charges to patients
c. Assisting in a code
d. Asking the patient/family about advance directives
ANS: B
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Managers are responsible for the budget of their units. The other options are incorrect because
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DIF: Cognitive Level: Application REF: page 6
3. Much like a politician, a nurse manager must exhibit leadership that inspires and motivates. In
which instance is a nurse demonstrating leadership qualities?
a. A staff nurse becomes aware of increased infection rates following cardiac surgery.
The nurse takes it upon herself to research the possible causes and prevention
measures and to make suggestions to better protect patients.
b. A staff nurse acts quickly when a cardiac arrest is called on her patient.
c. A staff nurse notifies another staff member that she is being “pulled” today.
d. A new nurse volunteers to work when another staff member must leave work
because her child is ill.
ANS: A
Nurse leaders are interested in changing practice based on evidence. Options B and D are
incorrect because they are actions taken by nurses as part of the functional structure of the
unit. Option C is incorrect because it is an action taken by a manager.
DIF: Cognitive Level: Analysis REF: page 6
4. A nurse manager must exhibit qualities of efficiency and organization. Which nurse is
demonstrating the qualities necessary for a manager?
a. A nurse becomes aware of increased infection rates following cardiac surgery. The
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nurse takes it upon herself to research the possible causes and prevention measures
and to make suggestions to better protect patients.
b. A nurse acts quickly when a cardiac arrest is called on her patient.
c. A nurse notifies another staff member that she is being “pulled” today.
d. A nurse volunteers to work when another staff member must leave work because
her child is ill.
ANS: C
Determining who gets “pulled” is a management decision. Option A is incorrect because it is
a role taken by a nurse leader. Option B is incorrect because it is an action taken by staff as
part of the functional structure of the unit. Option D is incorrect because it is an action taken
by staff as part of the functional structure of the unit.
DIF: Cognitive Level: Analysis REF: page 6
5. A nurse has accepted a position on a nursing unit where the nurse manager promotes
autonomy and staff involvement in decision making. What would the nurse expect to observe
on this unit?
a. Nurse manager mandates changes.
b. Staff takes responsibility for assignments.
c. Staff participates on hospital committees.
d. Nurses are recognized for excellence in practice.
ANS: C
Work environments that promote autonomy and decision making encourage participation on
hospital committees so that staff may become involved in the decisions that are made. Option
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A is incorrect because this is not an environment in which staff are encouraged to participate
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in decision making. Option BNiU
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regardless of autonomy. Option D is incorrect because excellence in practice is not seen solely
in autonomous environments.
DIF: Cognitive Level: Analysis REF: page 6
6. The fundamental element of any patient care delivery combines work allocation with
a. patient acuity.
b. leadership.
c. clinical decision making.
d. delegation.
ANS: C
Work allocation is necessary in any patient care delivery system. The other options are
incorrect because it is not necessarily useful in determining the appropriate patient care
delivery systems needed.
DIF: Cognitive Level: Analysis REF: page 10
7. The student nurse, shadowing on a medical-surgical unit, observes the charge nurse. Which
action would the student identify as a leadership quality in the nurse’s actions?
a. Making patient care assignments distributed equally to staff
b. Sitting with a confused combative patient
c. Calling the nursing office for extra staff when an RN calls in sick
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d. Assisting in a code
ANS: B
Leaders act as role models and do what is right for the patient. The other options are incorrect
because these actions are expected as part of the functioning of the unit.
DIF: Cognitive Level: Analysis REF: page 5
8. Health care is seen and managed as a business today. Which skills are considered essential to
managing health care as a business?
a. Ability to pressure staff to do what you want
b. Resource utilization
c. Cutting corners to make money
d. Providing bonuses to staff members who help the organization to save money
ANS: B
The ability to manage a budget is essential to being a manager in health care today. The other
options are incorrect because they are only a perception of the public regarding successful
managers.
9. The novice nurse is speaking with the nurse manager about their roles within the hierarchy of
the institution. The nurse manager would most likely identify which role as having the most
internal conflict?
a. Coordinating institutional goals with the immediate demands of the clinical area
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b. Determining which of the staff members should get better raises than other
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c. Deciding which employees should be recommended for promotion
d. Determining which staff members get Christmas day off
ANS: A
Many times the goals of the institution conflict with the goals of the individual employees of a
particular clinical area and the nurse manager must implement institutional changes regardless
of the nurse’s personal opinion. The other options are incorrect because those roles should not
provoke as much conflict.
DIF: Cognitive Level: Application REF: pages 7-8
10. Nurse managers can best be described as people who
a. develop institutional goals based on staff suggestions.
b. develop institutional goals based on a personal theory.
c. motivate staff to meet institutional goals through positional power.
d. inspire staff to meet institutional goals through personal power.
ANS: C
Managers motivate staff to make changes. Options A and B are incorrect because nurse
managers usually do not make institutional goals. Option C is incorrect because leaders
inspire, not managers.
DIF: Cognitive Level: Application REF: page 6
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11. There are three levels of management in nursing. Which action by the nurse would indicate
the nurse is a first-line nurse manager?
a. Responding to a patient complaint
b. Deciding to incorporate walking rounds shift report hospitalwide
c. Reevaluating the nursing policy permitting IV push of certain medications by RNs
d. Designating assignment of new admissions
ANS: A
The first-line manager is the nurse manager and would be responsible for responding to
patient complaints. Option B is incorrect because middle-level managers set short- and
long-term goals. Option C is incorrect because reevaluating the nursing policy permitting IV
push of certain medications by RNs is a responsibility of upper-level management to forecast
trends in nursing. Option D is incorrect because designating assignment of new admissions
would be the responsibility of the charge nurse.
DIF: Cognitive Level: Analysis REF: page 7
12. The management process consists of six functions: planning, staffing, organizing, directing,
controlling, and decision making. What might be seen in the planning step of the process?
a. Identifying the problem of the lack of ICU beds
b. Organizing a meeting to address the problem
c. Establishing an alternate site within the hospital for these patients
d. Assigning experienced staff to implement care of these patients
ANS: A
Establishing objectives should be seen in the planning step following identification of the
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problem. Option B is the organizing step. Option C is the directing step. Option D is the
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controlling step.
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DIF: Cognitive Level: Application REF: page 7
13. The management process consists of six functions: planning, staffing, organizing, directing,
controlling, and decision making. What might be seen in the decision-making process?
a. Organizing a meeting to address the problem
b. Establishing an alternate site within the hospital for these patients
c. Assigning experienced staff to implement care of these patients
d. Establishing the new area as a step-down unit
ANS: D
Decision making is a result of the other steps. The other options are different steps in the
management process.
DIF: Cognitive Level: Application REF: page 7
14. First-level managers are responsible for the day-to-day activities of the unit. Which activity
would the nurse expect to see only from a first-level manager?
a. Making daily staffing assignments
b. Managing the unit’s budget
c. Maintaining currency in profession
d. Making daily patient rounds
ANS: B
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