RNSG 2221 Professional Nursing Leadership and Management
Exam 3 Outline
-100 question comprehensive final exam
-You may be tested on information found in assigned chapters and Power Points, Homework
assignments, and websites.
-There may be alternate-format questions.
Information for Exam III will come from the following areas: Chapters 11, 13, 15-22, and questions
from Unit 1 and Unit 2. Please review Unit 1 and Unit 2 blueprint also.
1. Apply the key terms in each chapter to meet the identified learning outcomes.
Look these up
2. Why is it necessary for nurses to be prepared for an emergency, especially a terrorist
attack?
A nurse needs to be able to respond quickly and decisively should an act of terrorism occur.
Not only do you need to provide quality care for the victims and ensure your own safety but,
as a key player in an emergency, you’re expected to take a leadership role during a public
health crisis.
3. Emergency preparedness. Mass casualty incidents. PG 274
Mass Casualty Incident- a disaster situation that results in a large number of victims who need
the response of multiple organizations. In the high numbers of mass casualties a nurse shifts
to paradigm (change priorities into doing the greatest good for the greatest number of people.
The care is given to those patients who have the greatest chance of survival.
4. What is the #1 priority in any emergency situation (natural disaster, terrorist attack,
etc.)? 275
5. What are the routes of exposure?
Biologic, chemical, nuclear, explosive, or radiologic exposure
6. There are 4 levels of PPE (personal protective equipment). Name them & differentiate
between them and when each should be used.
Level A- provides a totally encapsulated chemical resistant suit, including supplied air. As a
result, maximum respiratory and skin protection is provided. In addition, this level of
equipment is used to provide protection against liquid splashes or in situations in which agents
are still unidentified.
Level B- provides a chemical splash-resistant suit with hood and self-contained breathing
apparatus (SCBA). It provides maximum respiratory protection but less skin protection than
level A.
Level C- chemical-resistant clothing with a hood and an air-purifying respirator. The
respirator can remove all anticipated contaminants and concentrations of chemical materials,
thus providing adequate protection against airborne biologic agents and radiologic materials.
Level D- protection may consist of a uniform or scrubs and is appropriate when it has been
determined that no respiratory or skin hazard is present.
7. Read chapter overview: leadership and management skills expected of the nurse by the
health care organization. Whose primary responsibility is leadership and management
activities? Will your activities as an RN be more about managing the delivery of care, or
providing that care? What are the roles of a nurse manager? Understand the nursing
leader role in coaching and performance appraisals. Roles of the nurse manager are:
responsible for performing administration tasks such as planning staffing, performing
employee performance reviews, controlling use of supplies and time, and meeting budget and
productivity. Formal line of authority and accountability to ensure that safe and effective
, patient care is delivered in a manner that meets the organization’s foals and standards.
Function of a leader is to guide people and groups to accomplish a common goal.
The primary responsibility of leadership and management falls upon the RN.
8. Define and compare/contrast leadership and management.
Leadership is the ability to guide or influence others, whereas management is the coordination
of resources (time, people, supplies) to achieve outcomes. People are led, whereas activities
and things are managed. Leaders are able to motivate and inspire others, whereas managers
have assigned responsibility for accomplishing the goals of an organization.
9. Discuss power and authority; formal and informal leadership. Be able to give examples.
pp. 288-289
Power- is the ability to motivate people to get things done with or without the legitimate right
granted by organization. The following are types of power
Reward- ability to reward others for complying and may include such rewards as
money, desired assignments, or acknowledgment of accomplishments.
Coercive- based on fear of punishment for failure to comply. Sources include
withheld pay increases, undesired assignments, verbal and written warnings, and termination.
Legitimate- based on an official position in the organization. The manager has
the right to influence staff members, and staff members have an obligation to accept that
influence.
Referent- comes from the followers’ identification with the leader. The admired
and respected nurse is able to influence other nurses because of their desire to emulate her.
Expert- based on knowledge, skills, and information. Ex: nurses who have
expertise in areas such as physical assessment or technical skills, or who keep up with current
information on important topics will gain respect from others
Information- based on a person’s possession of information that is needed by
others
Connection- based on a person’s relationship or affiliation with other people
who are perceived as being powerful.
Authority- the legitimate right to direct others and is given to a person by the organization
through an authorized position, such as nurse manager.
Formal- is practiced by the nurse who is appointed to an approved position (e.g. nurse
manager, supervisor, director) and given the authority to act by the organization.
Informal- exercised by a person who has no official or appointed authority to act, but is able
to persuade and influence others.
Ex: the informal leader of a patient care group may be highly supportive of a new nursing care
delivery model being implemented on the unit, and as a result, the other team members will be
more willing to accept the change
10. Compare/contrast Weber’s, Systems, and Chaos Theory.
Weber’s Theory- argued that the great benefit of bureaucracy was in its ability to apply
general rules to specific cases, making the actions of management fair and predictable. The
bases for his concepts was that bureaucracy revolves around explaining authority around
organizations. Authority- the right to issue commands within an organization- is based on
impersonal rules and rights granted by virtue of the management position rather than r/t the
person who occupies that position. Emphasized rules instead of individuals and competency
instead of favoritism. His work failed to recognize the complexity of human behavior and the
constantly changing work environments.
Systems theory (trickle down theory)- views organization as a set of interdependent parts
that together form a whole. Suggest that anything that affects the functioning of one aspect of
the organization will affect the other parts of the organization. Open systems theory suggests
that its not only affected by internal changes but external environment as well. Closed system-
, views the system as being totally independent of outside influences, which is an unrealistic
view for health care organizations.
Chaos Theory- a degree of order can be attained by viewing complicated behaviors and
situations as predictable. It states variation is a normal part of managing health care systems.
11. Give examples of how the different Management Styles are exhibited. pp. 291 box 16-3
Look at the box
12. Discuss management functions – what is involved in planning, controlling, organizing,
directing and staffing? pp. 293-300
• Functions are interrelated, different phases occur simultaneously, processes should be
circular
• Manager always working toward improving quality, patient safety, and staff & customer
satisfaction
Planning- all management functions are based on planning
• w/o effective planning, the management process will fail
• requires nurse manager to understand the organization’s mission, philosophy, strategic
plan (long range)/operational planning (short-range), goals & objectives
• defining goals & objectives, developing policies & procedures, determining resource
allocation & developing evaluation methods
• involves several steps:
1. Identify goals & objectives to be achieved
2. Identify resources needed (people, supplies, equipment)-
3. Determine action steps
4. Establish a timeline for the actions steps & goal achievement
Organizing-identifying management structure to accomplish work, determining
communication processes & coordinating people, time & work
• Defines lines of authority, communication & decision making
• Involves developing policies & procedures to outline how work will be done &
establishing position qualifications & job descriptions
• Involves:
1. Using resources (staff, supplies, time) wisely
2. Assigning duties & responsibilities appropriately
3. Coordinating activities with other departments
4. Effectively communicating with subordinates & superiors to ensure smooth workflow
Staffing-includes activities required to have qualified people accomplish work, such as
recruiting, hiring, training, scheduling & ongoing staff development
• Involves:
1. Determine number & type of staff needed based on goals & budget requirements
2. Recruit, interview, select & assign personnel based on job description requirements &
performance standards
3. Get new employees off to good start by offering orientation, training & socialization
programs
4. Implement ongoing staff development program to enhance knowledge & skills and
develop personal & professional opportunities
5. Implement creative & flexible scheduling based on patient care needs, employee needs &
organization productivity requirements
Directing-encourages employees to accomplish goals & objectives and involves
communicating, delegating, motivating & managing conflict
• Requires nurse manager to:
1. Communicate performance expectations
2. Create motivating climate & team spirit
3. Model expected behaviors
