TEST BANK
Leadership Roles and Management Functions in Nursing:
Theory and Application
Carol J. Huston MSN MPA DPA
11th Edition
,Table of Contents
Chapter 01 Decision Making Problem Solving Critical Thinking and Clinical Reasoning:
Requisites for Successful Leadership and Management 1
Chapter 02 Classical Views of Leadership and Management 15
Chapter 03 Twenty-First Century Thinking About Leadership and Management 29
Chapter 04 Ethical Issues 43
Chapter 05 Legal and Legislative Issues 57
Chapter 06 Patient Subordinate Workplace and Professional Advocacy 72
Chapter 07 Organizational Planning 86
Chapter 08 Planned Change 100
Chapter 09 Time Management 113
Chapter 10 Fiscal Planning and Health Care Reimbursement 127
Chapter 11 Career Planning and Development in Nursing 140
Chapter 12 Organizational Structure 154
Chapter 13 Organizational Political and Personal Power 168
Chapter 14 Organizing Patient Care 182
Chapter 15 Employee Recruitment Selection Placement and Onboarding 196
Chapter 16 Educating and Socializing Staff in a Learning Organization 210
Chapter 17 Staffing Needs and Scheduling Policies 224
Chapter 18 Creating a Motivating Climate 238
Chapter 19 Organizational Interpersonal and Group Communication in Team Building 251
Chapter 20 Delegation 265
Chapter 21 Conflict Workplace Violence and Negotiation 279
Chapter 22 Collective Bargaining Unionization and Employment Laws 293
Chapter 23 Quality Control in Creating a Culture of Patient Safety 307
Chapter 24 Performance Appraisal 320
Chapter 25 Problem Employees: Rule Breakers Marginal Employees and Those with
Substance Use Disorder 334
,Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
Chapter 1, Decision Making, Problem Solving, Critical Thinking, and Clinical
Reasoning: Requisites for Successful Leadership and Management
1. A nurse is applying a decision-making process to a clinical challenge. When applying this process,
the nurse must:
a. analyze the root causes of a situation.
b. begin by solving the underlying problem.
c. choose between different courses of action.
d. prioritize the maximum good for the maximum number of people.
ANS: C
Feedback: Decision making is a complex, cognitive process often defined as choosing a particular
course of action. Problem solving is part of decision making and is a systematic process that
focuses on analyzing a difficult situation. It is not always realistic for the nurse to solve each of the
problems contributing to a larger challenge, especially at the beginning of the decision-making
process. The nurse often lacks the time, information, or resources to analyze the root causes of a
situation. Many times, the nurse makes a decision that benefits the largest number of people, but
this is not always feasible or desirable.
PTS: 1 DIF: Moderate
REF: Page and Header: 3, Decision Making, Problem Solving, Critical Thinking, Clinical
Reasoning, and Elastic Thinking OBJ: 1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Clinical Decision Making, Leadership & Management TOP: Chapter:
1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
2. A nurse is applying the traditional problem-solving model when mediating a conflict between two
colleagues. When applying this model, the nurse should prioritize what task?
a. Identifying the root cause of the conflict
b. Implementing a solution as quickly as possible
c. Eliciting input from other nurses
d. Encouraging each nurse to reflect on their actions
ANS: A
Feedback: The traditional problem-solving model attempts to identify the root problem in
situations, a task that requires much time and energy. Efficiency is desirable, but trying to
implement a solution as quickly as possible can result in a hasty and incorrect solution.
Outside input may or may not be necessary; this varies with each individual problem.
Reflective thinking is always beneficial, but this is not a specific component of the traditional
problem-solving model.
PTS: 1 DIF: Moderate
REF: Page and Header: 3, Decision Making, Problem Solving, Critical Thinking, Clinical
Reasoning, and Elastic Thinking OBJ: 1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Clinical Decision Making, Collaboration
TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM:
Cognitive Level: Analyze NOT: Multiple Choice
1|Pag e
,Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
3. Which statement is true regarding decision making?
a. Scientific methods provide identical decisions by different individuals for the same
problems.
b. Decisions are greatly influenced by each person’s value system.
c. Personal beliefs can be adjusted for when the scientific approach to problem
solving is used.
d. Past experience has little to do with the quality of the decision.
ANS: B
Feedback: Values, life experience, individual preference, and individual ways of thinking will
influence a person’s decision making. No matter how objective the criteria will be, value judgments
will always play a part in a person’s decision making, either consciously orsubconsciously. It is not
possible for a nurse to fully “set aside” personal beliefs when making a decision, even if the nurse
applies the principles of self-reflection.
PTS: 1 DIF: Moderate
REF: Page and Header: 16, Choose and Act Decisively OBJ: 3 NAT:
Client Needs: Safe and Effective Care Environment: Management of Care
LOC: Nursing Concepts: Leadership & Management TOP: Chapter: 1
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
4. The nurse-manager of a short-staffed unit needs to make a decision about a nurse’s request for an
unpaid leave of absence. In order to increase the chance of making a good decision, the manager
should:
a. involve as many people in the decision-making process as possible.
b. begin the decision-making process by presuming the statusquo to be the bestoption.
c. generate as many different alternatives as possible.
d. prioritize the option that is most innovative.
ANS: C
Feedback: The greater the number of alternatives that can be generated by the decision maker, the
better the final decision will be. Generating multiple alternatives may require involving more
people in the decision-making process, but the process can easily become unwieldy if too many
people are involved. The manager should always consider the statusquo as a possible option, but
this is not always considered to be the default option.
Innovation is often a desirable characteristic, but it would be inappropriate to choose an option
solely because it is innovative; many other values must be considered.
PTS: 1 DIF: Moderate
REF: Page and Header: 14, Generate Numerous Alternatives OBJ: 4 NAT:
Client Needs: Safe and Effective Care Environment: Management of CareLOC: Nursing
Concepts: Clinical Decision Making, Leadership & Management TOP:Chapter: 1
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
5. An experienced nurse-manager has been described as being a “right-brained thinker.” Which
is an example of this manager’s decision-making process?
2|Pag e
,Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
a. Uses data sets to generate solutions
b. Uses thinking that is outside the normal standards to find a solution
c. Has the ability to ask all those involved in the decision making
d. Focuses on the intended process to reach a solution or goal
ANS: B
Feedback: Right-brained thinkers have traditionally been characterized as creative and intuitive,
and thinking outside of normal standards to find a solution. Linear analysis, such as the ability to
generate solutions based on data sets, is more closely aligned with
left-brained thinking. Transparency, such as getting all those involved, and efficiency, which
focuses on the process to reach a goal, are desirable qualities that are not particularly aligned with
either of these two paradigms.
PTS: 1 DIF: Easy
REF: Page and Header: 18, Brain Hemisphere Dominance and Thinking Styles OBJ:
3|4
NAT: Client Needs: Safe and Effective Care Environment: Management of CareLOC:
Nursing Concepts: Human Development, Leadership & Management TOP: Chapter:
1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
6. A nurse-manager is applying an evidence-based approach to a clinical question around client
mobilization. When using a PICO (patient or population, intervention, comparison, and outcome)
format to search for evidence, the nurse should identify what?
a. The role of intuition in the decision-making process
b. The preferences of clients and their families
c. The clients for whom the intervention would be relevant
d. Costs associated with a potential change in practice
ANS: C
Feedback: The PICO format is used in evidence-based practice to guide the search for thecurrent
best evidence to address a problem. Client and family preferences and cost are included in evidence-
based practice but are not explicit components of the PICO format. Intuition is a component of
decision making but is not specifically included in the PICO format.
PTS: 1 DIF: Moderate
REF: Page and Header: 13, Use an Evidence-Based Approach OBJ: 5 | 6
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Clinical Decision Making, Leadership & Management, Evidence-
Based Practice TOP: Chapter: 1
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
7. A nurse-manager is applying the decision-making process when addressing a nurse’s high rate of
absenteeism. This process should result in:
a. an outcome that is desired by all.
b. a chosen course of action.
c. an action that guarantees success.
d. a new understanding of the problem.
3|Pag e
,Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
ANS: B
Feedback: A decision is made when a course of action has been chosen. A decision may not always
be pleasing to everyone involved in the situation, and success can never be fully guaranteed. The
manager should seek to fully understand the problem, but this is a phase in decision making, not the
result of the process.
PTS: 1 DIF: Easy
REF: Page and Header: 3, Decision Making, Problem Solving, Critical Thinking, Clinical
Reasoning, and Elastic Thinking OBJ: 1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Clinical Decision Making, Leadership & Management TOP: Chapter:
1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
8. A nurse-manager is faced with a difficult decision in a situation that involves the manager’s values.
What is the manager’s best action?
a. Try to base a decision on intuition rather than values.
b. Set aside their own values and make a rationale decision.
c. Defer the decision to a colleague with different values.
d. Identify and reflect on their own values.
ANS: D
Feedback: Every person has a value system, and this cannot simply be “set aside.” Awareness and
reflection are necessary to make good decisions in the context of one’s own values. Intuition and
values are not counterpoints, and prioritizing intuition does not negate the importance of values.
Values influence every decision to varying degrees, and it is impractical to defer every value-laden
decision to someone else.
PTS: 1 DIF: Moderate REF: Page and Header: 17, ValuesOBJ: 8
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Ethics, Leadership & Management TOP: Chapter: 1
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
9. Which statement concerning critical thinking is true?
a. It is a simple approach to decision making.
b. It is narrower in scope than decision making.
c. It requires reasoning and creative analysis.
d. It is a synonym for the problem-solving process.
ANS: C
Feedback: Critical thinking has a broader scope and is more complex than decision making and
problem solving. It is sometimes referred to as reflective thinking. Critical thinking also involves
reflecting on the meaning of statements, examining the offered evidence and reasoning, and
forming judgments about facts.
PTS: 1 DIF: Moderate
REF: Page and Header: 4, Decision Making, Problem Solving, Critical Thinking, Clinical
4|Pag e
,Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
Reasoning, and Elastic Thinking OBJ: 1
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Critical Thinking TOP: Chapter: 1
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
10. A nurse-manager has realized that the data gathering process before a recent decision may have
been influenced by confirmation bias. How can the manager best prevent this in the future?
a. Delegate data gathering to a trusted colleague who has different values.
b. Make sure not to prioritize information that supports their own beliefs.
c. Consider all of the implications of an alternative before making a decision.
d. Collect only the minimum quantity of data before making a decision.
ANS: B
Feedback: Confirmation bias refers to our tendency to search for and favor information that confirms
our beliefs while simultaneously ignoring or devaluing information that contradictsour beliefs. Self-
awareness and reflection can reduce this tendency. Delegating the
data-gathering process may be beneficial in some situations, but every person is prone to
confirmation bias, although in differing ways. Considering the implications of a decision is an
important part of decision making but does not address the issue of confirmation bias. Minimizing
data collection may reduce confirmation bias but could compromise the quality of a decision.
PTS: 1 DIF: Difficult
REF: Page and Header: 12, Gather Data Carefully OBJ: 8 | 9 | 10
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Clinical Decision Making, Ethics TOP: Chapter: 1
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
11. A nurse-manager has made a decision and is now preparing to evaluate that decision. Whatquestion
should best guide the nurse’s evaluation process?
a. Is evaluation necessary when using a good decision-making model?
b. Can evaluation be eliminated if the problem is resolved?
c. Is every party happy with the outcomes of the decision?
d. Did the outcomes align with the original objectives?
ANS: D
Feedback: The evaluation phase is necessary to find out more about one’s ability as a decision
maker and to find out where the decision making was faulty. This step cannot be eliminated from
the decision-making process because it provides the means for determiningwhether a good decision
was made. Happiness is not the criterion by which decisions are usually evaluated. Rather,
evaluation is done by comparing actual outcomes to desired outcomes.
PTS: 1 DIF: Moderate
REF: Page and Header: 8, Managerial Decision-Making ModelsOBJ:
7|9
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
5|Pag e
,Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
LOC: Nursing Concepts: Leadership & Management, Critical ThinkingTOP:
Chapter: 1 KEY: Integrated Process: Nursing Process BLM:
Cognitive Level: ApplyNOT: Multiple Choice
12. Which statement concerning the role of the most powerful individuals in organizational
decision making is true?
a. They exert less influence on decisions than was previously thought.
b. They often make decisions that are in congruence with their own values.
c. They tend to delegate decision making rather than making decisions themselves.
d. They usually make important decisions with consideration of the effect on others.
ANS: B
Feedback: Not only does the preference of the powerful influence decisions of others in an
organization but the powerful are also able to inhibit the preferences of the less powerful. Powerful
people in organizations are more likely to have decisions made that are congruent with their own
preferences and values. Powerful people tend to make decisions on their own rather than delegating
them. Often, the effect on others is not prioritized as highly as it should be.
PTS: 1 DIF: Easy
REF: Page and Header: 20, Effect of Organizational Power OBJ: 12
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
LOC: Nursing Concepts: Health Care Organizations TOP: Chapter: 1
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
13. One of the nurses on the unit said, “My Vietnamese client won’t look me in the eye, but I know
that Asian clients avoid making eye contact as a way of showing respect.” This nurse is
demonstrating what type of illogical thinking?
a. Affirming the consequences
b. Arguing from analogy
c. Deductive reasoning
d. Overgeneralizing
ANS: D
Feedback: This type of flawed thinking occurs when one believes that because one person has a
particular characteristic, every other person in the same category also has the same characteristic. It
is an overgeneralization to assign one meaning for an action to every personfrom dozens of countries.
This kind of oversimplified deduction is exemplified when stereotypical statements are used to justify
arguments and decisions. When affirming the consequences, the nurse thinks that if B is good, but
someone is doing A, then A must not be good. When arguing from analogy, the nurse applies a
component that is present in two separate concepts and then states that because A is present in B,
then A and B are alike in allrespects.
PTS: 1 DIF: Moderate REF: Page and Header: 15, Think Logically
OBJ: 10
NAT: Client Needs: Safe and Effective Care Environment: Management of CareLOC:
Nursing Concepts: Critical Thinking, Patient-Centered Care, Diversity TOP:Chapter:
1 KEY: Integrated Process: Nursing Process
6|Pag e
,Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
BLM: Cognitive Level: Analyze NOT: Multiple Choice
14. A nurse has accepted a job in a workplace where organizational power has a pronounced effect.
This characteristic may have what effect on the nurse and the workplace?
a. Many decisions will be delegated to the nurse by supervisors.
b. There will be high levels of mistrust and suspicion at the workplace.
c. Communication will be compromised at the workplace.
d. The nurse may have to accept decisions contrary to their own values.
ANS: D
Feedback: The ability of the powerful to influence individual decision making in an organization
often requires adopting a private personality and an organizational personality. The nurse will often
have to accept decisions that solely reflect the values of more powerful individuals. This may lead to
a feeling of powerlessness but not necessarily mistrust and lack of communication. Delegation of
decision making is likely to be rare, not common, because it is concentrated with those in power.
PTS: 1 DIF: Moderate
REF: Page and Header: 20, Effect of Organizational Power OBJ: 12
NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC:
Nursing Concepts: Health Care Organizations, Leadership & Management TOP:
Chapter: 1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze NOT: Multiple Choice
15. A unit manager has created a decision grid in order to assist with a difficult staffing decisionthat will
affect many nurses. The decision grid will allow the manager to:
a. examine alternatives visually and compare each against the same criteria.
b. ensure that the decision is made objectively rather than subjectively.
c. plot the outcomes of a decision over time and evaluate the decision -making
process.
d. predict when events must take place to complete a project on time.
ANS: A
Feedback: A decision grid allows one to visually examine the alternatives and compare each against
the same criteria. This assists with the decision-making process, but it cannot guarantee that the
decision will be completely objective. A decision grid is not a tool for tracking the outcomes of a
decision. Decision grids are not synonymous with project planning tables.
PTS: 1 DIF: Moderate REF: Page and Header: 22, Decision Grids
OBJ: 7
NAT: Client Needs: Safe and Effective Care Environment: Management of CareLOC:
Nursing Concepts: Clinical Decision Making, Health Care Organizations TOP:Chapter:
1 KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand NOT: Multiple Choice
16. A nurse-manager is planning to apply a decision-making model to a clinical challenge.When
using a decision-making tool, what should the manager do?
a. Be aware that the tool cannot eliminate the risk of human error.
b. Have an impartial colleague apply the tool, if possible.
7|Pag e
, Test Bank - Leadership Roles and Management Functions in Nursing: Theory and Application, 11th Edition (Huston, 2024)
c. Apply the tool as quickly as possible.
d. Recognize that the tool will negate the effect of the manager’s values.
ANS: A
Feedback: Management decision-making aids are subject to human error and do not
removethe effects of individual values, which always affect decision making. There is no
particularreason that a tool would have to be applied by another person.
Making the correct decision can take time; moving too quickly can compromise the quality
of the process.
PTS: 1 DIF: Difficult
REF: Page and Header: 21, Decision-Making Tools OBJ: 14 NAT: Client Ne
LOC: Nursing Concepts: Clinical Decision Making TOP:
Chapter:
1KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply NOT: Multiple Choice
17. A nurse-manager had to intervene in a conflict between a client and a staff member.
The manager chose to make a decision “in the moment” rather than applying a
methodical or deliberate decision-making tool. How should this manager’s actions be
best interpreted?
a. The manager applied heuristics to a problem that required a quick solution.
b. The manager should have used a decision-making tool before responding.
c. The manager’s decision was likely made on the basis of emotion.
d. The manager demonstrated an autocratic leadership style.
ANS: A
Feedback: Most individuals rely on discrete, often unconscious processes known as
heuristics, which allows them to solve problems more quickly and to build on
experiencesthey have gained in their lives. This manager’s prompt decision making
exemplifies this rapid approach. This does not necessarily lead to worse outcomes than a
slower, more methodical approach. Heuristics can be based on experience and
knowledge and are not simply expressions of emotion. Heuristics and rapid decision
making are not synonymouswith an autocratic leadership style that downplays input
from others.
PTS: 1 DIF: Moderate
REF: Page and Header: 7, Theoretical Approaches to Problem Solving and
DecisionMaking OBJ: 3
NAT: Client Needs: Safe and Effective Care Environment: Management of Care
LOC: Nursing Concepts: Leadership & Management TOP:
Chapter:
1KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze NOT: Multiple Choice
18. Which statement is true regarding an “economic man” style manager?
a. The manager may lack complete knowledge and generate few alternatives.
b. The manager makes decisions that may not be ideal but result in
solutions thathave an adequate outcome.
c. The manager is primarily motivated by their own financial gain.
d. The manager gathers as much information as possible and
8|Pag e
