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NURSING DELEGATION AND MANAGEMENT OF PATIENT CARE
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Harvard University
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Nursing Delegation and Management of Patient Care
TEST BANK For Nursing Delegation and Management of Patient Care, 3rd Edition by Motacki | Verified Chapters 1 - 21 | Complete Newest Version
TEST BANK For Nursing Delegation and Management of Patient Care, 3rd Edition by Motacki | Verified Chapters 1 - 21 | Complete Newest Version
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Test Bank for Nursing Delegation and Management of Patient Care,
3rd Edition by Motacki
| Verified Chapter's 1 - 21 | Complete Newest Version
,Test Bank for Nursing Delegation and Management of Patient Care, 3rd Edition by Motacki
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
Managers are responsible for the budget of their units. The other options are incorrect because
those are leadership or mentoNriU
ngRrS
oI
lesN. GTB.COM
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
, 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
A is incorrect because this is not an environment in which staff are encouraged to participate
in decision making. Option BNiU sR coI
inS ecG
rrN tTbeB
ca.uC
seOiM
t should be seen in all environments
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
, 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
b. Determining which of the staff members should get better raises than other
members .
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
,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
problem. Option B is the organizing step. Option C is the directing step. Option D is the
controlling step. .
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
, Managing the unit budget is the sole responsibility of the nurse manager and first-level
manager. The other activities are not specific to first-level managers.
DIF: Cognitive Level: Application REF: page 7
15. Middle-level managers are responsible for planning for changes of the unit. What activity
would the nurse expect to see only from a middle-level manager?
a. Maintaining currency in profession
b. Planning for changes within the service line in the organization
c. Being responsible for activities on the unit 24/7
d. Supervising patient care delivery
ANS: B
The middle-level manager is solely responsible for planning changes and presenting them to
upper-level managers. The other activities are not the exclusive responsibility of the
middle-level manager.
DIF: Cognitive Level: Application REF: pages 8-9
16. Upper-level managers are responsible for the management of the nursing organization of the
institution. What activity would the nurse expect to see only from an upper-level manager?
a. Supervising patient care delivery
b. Establishing strategic goals for nursing
c. Maintaining currency in profession
d. Being responsible for activities on the unit 24/7
ANS: B
Upper-level managers are resN ponR
SIe N
U sibl
responsibilities shared by all levels.
foG
r foB
Trm.iC
ng sM
Otrategic plans. The other activities are
DIF: Cognitive Level: Application REF: page 9
17. The nurses are complaining about how busy they are this shift. The charge nurse must do
which of the following to ensure the safety of the patients and staff for this and future shifts?
a. Take responsibility for a team of patients.
b. Delegate care to the UAPs.
c. Assist the RNs to prioritize their patients and their responsibilities.
d. Call the supervisor for more staff.
ANS: C
As a leader, the charge nurse should assist the RNs to prioritize their patient care
responsibilities to allow for safer care to be provided. The other actions may correct the
immediate problem that day but will not change the care provided over a length of time if RNs
are lacking prioritization skills.
DIF: Cognitive Level: Application REF: page 9
MULTIPLE RESPONSE
1. To become a leader, one must develop certain personal aspects. Which of the following can be
identified as competencies expected in creating leadership in oneself? (Select all that apply.)
, a. Asking for overtime
b. Asking for certain patient assignments
c. Personal and professional accountability
d. Acquiring advanced degrees
e. Personal discipline
ANS: C, D, E
Options C, D, and E are competencies identified in the text for developing leadership in
oneself. Although they may be associated with a good work ethic, the other options do not
apply to the development of leadership competencies.
DIF: Cognitive Level: Analysis REF: page 11
2. The patient care delivery system used by an institution should be based on which fundamental
elements? (Select all that apply.)
a. Work allocation
b. Accountability
c. Allocation of resources
d. Mission statement
e. Leadership style
f. Cultural diversity of patients
ANS: A, B, D
Options A, B, and D are correct because the text lists these as fundamental elements of any
patient care delivery system. Options C, E, and F are not fundamental elements of a patient
care delivery system.
DIF: Cognitive Level: ApplicN URSINGRTEB
ation F:.C geM7
paO
3. A nurse manager encourages the nursing staff using a transformational leadership
environment. The nurse manager interprets that a successful transformational environment is
one in which (Select all that apply.)
a. a staff nurse provides advice and guidance to new nurses.
b. a clinical ladder is used for advancement.
c. a staff nurse researches an increase in surgical wound infections and makes
recommendations to prevent them.
d. annual performance appraisals are provided with competitive raises.
e. decisions are made from the top down.
ANS: A, B, C
Options A, B, and C are correct because a transformational leadership environment
encourages consultation and collaboration, empowering and motivating staff. The other
options are examples of transactional leadership.
DIF: Cognitive Level: Analysis REF: page 5
4. A nurse leader, according to the American Organization of Nurse Executives (AONE), is
competent in the areas of (Select all that apply.)
a. knowledge of the health care environment.
b. communication.
c. business management.
, d. demanding participation by the staff.
e. providing a financial incentive.
ANS: A, B, C
Options A, B, and C are identified by AOEN as a competencies of nurse leaders. The other
options are not competencies recommended by the AOEN.
DIF: Cognitive Level: Analysis REF: pages 8-9
5. The organizational hierarchy is used in which of the following situations? (Select all that
apply.)
a. A staff member is observed taking money from a patient’s bedside table.
b. A staff member is found to be drinking alcohol while at work.
c. A nurse refuses to care for a patient receiving peritoneal dialysis because he has
not been trained on this procedure.
d. A nurse refuses to be floated to the ICU while still in orientation.
e. A nurse fails to respond to repeated requests by the UAP to check on the condition
of a patient.
ANS: A, B, E
Options A, B, and E are correct because inappropriate actions by staff are managed by the
hierarchy of any organization. Options C and D are incorrect because they are scenarios
requiring actions not relegated to the hierarchy of the organization.
DIF: Cognitive Level: Analysis REF: page 5
.
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Chapter 02: Organizational Structure of Health Care
Motacki: Nursing Delegation and Management of Patient Care, 3rd Edition
MULTIPLE CHOICE
1. In interviewing for a new position, a nurse may want to inquire about the institution’s views
on autonomy in the workplace for nurses. The nurse concludes that autonomy is valued when
told that the unit has
a. infrequent “floating.”
b. self-scheduling.
c. cover of another nurse’s assignment while she or he is on break.
d. hourly pay differential for the night shift.
ANS: B
In a self-governance working environment, staff are encouraged to be autonomous, which
includes self-scheduling. Option A is incorrect because it does not address autonomy. Option
C is incorrect because they are decisions made by the organization and are practiced
throughout the organization. Option D is incorrect because they are decisions made by the
organization and practiced throughout the organization.
DIF: Cognitive Level: Application REF: page 16
2. The student nurse learns about the advantages and disadvantages of various patient care
delivery models. The student understands that besides an historical perspective of nursing
practice, a patient delivery care model may need to be instituted to adapt to
a. alterations in available staff due to weather emergencies.
b. the financial environmentNoU R e IpaNtien
f thS
GTt B.C
populO
M
ation.
c. a wide range of ages among the staff.
d. a limited number of unlicensed staff on the unit.
ANS: A
Patient delivery models are instituted based on various elements including clinical
decision-making and work allocation; thus, changes may need to be made in an emergency
based on availability of staff. The other options do not describe a fundamental element used in
the decision-making process for delivery mode.
DIF: Cognitive Level: Application REF: page 19
3. An agency nurse is assigned to work on a unit that uses the team nursing model of health care
delivery. Which of the following would the nurse expect to experience in this environment?
a. UAP taking vital signs and giving baths
b. RN taking vital signs and giving baths
c. RN delegating patient care delivery to a group of patients
d. Charge nurse delegating care delivery
ANS: C
In a team nursing environment, an RN delegates patient care to a group of patients. Option A
is incorrect because it is practiced in a functional model environment. Option B is incorrect
because it is seen in primary nursing. Option D is incorrect because it may be seen in all types
of health care delivery models.
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DIF: Cognitive Level: Application REF: page 20
4. In which health care delivery model would the nurse expect to see “point-of-care” decision
making occur?
a. Primary care nursing
b. Team nursing
c. Functional nursing
d. Modular nursing
ANS: A
Primary nursing allows the nurse to practice autonomously and make most bedside decisions.
The other options are incorrect because they may not allow for the autonomy required for
“point-of-care” decisions.
DIF: Cognitive Level: Application REF: page 21
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 sNtaffRmayIbeGcomBe.inCvolM
ved in the decisions that are made. Option
U S N T O
A is incorrect because this is not an environment in which staff are encouraged to participate
in decision making. Option B is incorrect because it should be seen in all environments
regardless of autonomy. Option D is incorrect because it is not seen solely in autonomous
environments.
DIF: Cognitive Level: Analysis REF: page 16
6. Leadership structures in health care can be centralized or decentralized. The nurse understands
that she is working in a centralized structured environment when which of the following
occurs?
a. All organizational decisions must be approved by the CEO.
b. Changes can be made rapidly based on immediate needs.
c. Nurses must work under a dual-authority structure.
d. Decisions can be made at the “point of care.”
ANS: A
In a centralized leadership structured environment, all decisions are made from the top down,
usually without input from staff. The other options are examples of a decentralized
environment in which decisions can be made more quickly as needed.
DIF: Cognitive Level: Application REF: page 16
7. What should the nurse expect when working in a product-line leadership structured
environment?
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