nursing delegation and management of client care 3
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Nursing Delegation and Management of Client care 3rd Edition by
Motacki RN MSN, Kathleen, Burke RN PhD, Kathleen
,Chapter 01: Leadership and Management
Motacki: Nursing Delegation and Management of Client Care, 3rd Edition
MULTIPLE CHOICE
1. RNs can be leaders without being managers. Which nursing actions
demonstrate leadership?
a. Assisting a new RN with enteral tube feedings
b. Counseling a new RN regarding attendance
c. Adjusting assignments after a staff member calls in sick
d. Calling a physician for new order clarification
CORRECT ANS: A
Rationale: Leaders act as role models and mentor new staff. The other options are
incorrect becausethey 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 clients
c. Assisting in a code
d. Asking the client/family about advance directives
CORRECT ANS: B
Rationale: Managers are responsible for the budget of their units. The other options
are incorrect because those are leadership or mentoNriUngRrSolIesN.
DIF: Cognitive Level: Application REF: page 6
3. Much like a politician, a RN manager must exhibit leadership that inspires and motivates. In
which instance is a RN demonstrating leadership qualities?
a. A staff RN becomes aware of increased infection rates following cardiac
surgery. The RN takes it upon herself to research the possible causes and
prevention measures and to make suggestions to better protect clients.
b. A staff RN acts quickly when a cardiac arrest is called on her client.
c. A staff RN notifies another staff member that she is being “pulled” today.
d. A new RN volunteers to work when another staff member must leave
work because her child is ill.
CORRECT ANS: A
Rationale: RN leaders are interested in changing practice based on evidence. Options B
and D are incorrect because they are actions taken by RNs as part of the functional structure
of theunit. Option C is incorrect because it is an action taken by a manager.
DIF: Cognitive Level: Analysis REF: page 6
4. A RN manager must exhibit qualities of efficiency and organization. Which RN is
demonstrating the qualities necessary for a manager?
a. A RN becomes aware of increased infection rates following cardiac surgery. The
, RN takes it upon herself to research the possible causes and preventionmeasures
and to make suggestions to better protect clients.
b. A RN acts quickly when a cardiac arrest is called on her client.
c. A RN notifies another staff member that she is being “pulled” today.
d. A RN volunteers to work when another staff member must leave work
because her child is ill.
CORRECT ANS:C
Rationale: Determining who gets “pulled” is a management decision. Option A is
incorrect because it is a role taken by a RN leader. Option B is incorrect because it is an
action taken by staffas 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 RN has accepted a position on a nursing unit where the RN manager promotes
autonomy and staff involvement in decision making. What would the RN expect to
observe on this unit?
a. RN manager mandates changes.
b. Staff takes responsibility for assignments.
c. Staff participates on hospital committees.
d. RNs are recognized for excellence in practice.
CORRECT ANS:C
Rationale: Work environments that promote autonomy and decision making encourage
participation onhospital 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 BNiUs Rin S coIrr N ecGt be
TBca.uCse iO Mt should be seen inall
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 client care delivery combines work allocation with
a. client acuity.
b. leadership.
c. clinical decision making.
d. delegation.
CORRECT ANS:C
Rationale: Work allocation is necessary in any client care delivery system. The other
options are incorrect because it is not necessarily useful in determining the appropriate
client caredelivery systems needed.
DIF: Cognitive Level: Analysis REF: page 10
7. The learner RN, shadowing on a medical-surgical unit, observes the charge RN. Which
action would the learner identify as a leadership quality in the RN’s actions?
a. Making client care assignments distributed equally to staff
b. Sitting with a confused combative client
c. Calling the nursing office for extra staff when an RN calls in sick
, d. Assisting in a code
CORRECT ANS: B
Rationale: Leaders act as role models and do what is right for the client. 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
CORRECT ANS: B
Rationale: The ability to manage a budget is essential to being a manager in health
care today. Theother options are incorrect because they are only a perception of the
public regarding successful managers.
9. The novice RN is speaking with the RN manager about their roles within the hierarchyof
the institution. The RN 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
CORRECT ANS: A
Rationale: Many times the goals of the institution conflict with the goals of the individual
employees of a particular clinical area and the RN manager must implement institutional
changes regardlessof the RN’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. RN 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.
CORRECT ANS:C
Rationale: Managers motivate staff to make changes. Options A and B are incorrect
because RN 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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