Nursing Leadership & Management

1. Ms. Caputo is newly-promoted to a patient care manager position. She

updates her knowledge on the theories in management and leadership in order
to become effective in her new role. She learns that some managers have low
concern for services and high concern for staff. Which style of management
refers to this?

A. Organization Man
B. Impoverished Management
C. Country Club Management
D. Team Management

2. Her former manager demonstrated passion for serving her staff rather than
being served. She takes time to listen, prefers to be a teacher first before
being a leader, which is characteristic of

A. Transformational leader
B. Transactional leader
C. Servant leader
D. Charismatic leader

3. On the other hand, Ms. Caputo notices that the Chief Nurse Executive has
charismatic leadership style. Which of the following behaviors best describes
this style?

A. Possesses inspirational quality that makes followers gets attracted of him and
regards him with reverence
B. Acts as he does because he expects that his behavior will yield positive results
C. Uses visioning as the core of his leadership
D. Matches his leadership style to the situation at hand.

4. Which of the following conclusions of Ms. Caputo about leadership

characteristics is TRUE?

A. There is a high correlation between the communication skills of a leader and the
ability to get the job done.
B. A manager is effective when he has the ability to plan well.
C. Assessment of personal traits is a reliable tool for predicting a manager’s
potential.
D. There is good evidence that certain personal qualities favor success in
managerial role.

5. She reads about Path Goal theory. Which of the following behaviors is
manifested by the leader who uses this theory?

A. Recognizes staff for going beyond expectations by giving them citations

B. Challenges the staff to take individual accountability for their own practice
C. Admonishes staff for being laggards.
D. Reminds staff about the sanctions for non performance.

6. One leadership theory states that “leaders are born and not made,” which
refers to which of the following theories?

A. Trait
B. Charismatic
C. Great Man
D. Situational

7. She came across a theory which states that the leadership style is effective
dependent on the situation. Which of the following styles best fits a situation
when the followers are self-directed, experts and are matured individuals?

A. Democratic
B. Authoritarian
C. Laissez faire
D. Bureaucratic

8. She surfs the internet for more information about leadership styles. She
reads about shared leadership as a practice in some magnet hospitals. Which
of the following describes this style of leadership?

A. Leadership behavior is generally determined by the relationship between the

leader’s personality and the specific situation
B. Leaders believe that people are basically good and need not be closely controlled
C. Leaders rely heavily on visioning and inspire members to achieve results
D. Leadership is shared at the point of care.

9. Ms. Caputo learns that some leaders are transactional leaders. Which of the
following does NOT characterize a transactional leader?

A. Focuses on management tasks

B. Is a caretaker
C. Uses trade-offs to meet goals
D. Inspires others with vision

10. She finds out that some managers have benevolent-authoritative style of
management. Which of the following behaviors will she exhibit most likely?

A. Have condescending trust and confidence in their subordinates

B. Gives economic or ego awards
C. Communicates downward to the staff
D. Allows decision making among subordinates

11. Henry is a Unit Manager I the Medical Unit. He is not satisfied with the way
things are going in his unit. Patient satisfaction rate is 60% for two
consecutive months and staff morale is at its lowest. He decides to plan and
initiate changes that will push for a turnaround in the condition of the unit.
Which of the following actions is a priority for Henry?

A. Call for a staff meeting and take this up in the agenda.

B. Seek help from her manager.
C. Develop a strategic action on how to deal with these concerns.
D. Ignore the issues since these will be resolved naturally.

12. He knows that there are external forces that influence changes in his unit.
Which of the following is NOT an external force?

A. Memo from the CEO to cut down on electrical consumption

B. Demands of the labor sector to increase wages
C. Low morale of staff in his unit
D. Exacting regulatory and accreditation standards

13. After discussing the possible effects of the low patient satisfaction rate,
the staff started to list down possible strategies to solve the problems head-
on. Should they decide to vote on the best change strategy, which of the
following strategies is referred to this?

A. Collaboration
B. Majority rule
C. Dominance
D. Compromise

14. One staff suggests that they review the pattern of nursing care that they
are using, which is described as a:
A. job description
B. system used to deliver care
C. manual of procedure
D. rules to be followed

15. Which of the following is TRUE about functional nursing?

A. Concentrates on tasks and activities

B. Emphasizes use of group collaboration
C. One-to-one nurse-patient ratio
D. Provides continuous, coordinated and comprehensive nursing services

16. Functional nursing has some advantages, which one is an EXCEPTION?

A. Psychological and sociological needs are emphasized.

B. Great control of work activities.
C. Most economical way of delivering nursing services.
D. Workers feel secure in dependent role

17. He raised the issue on giving priority to patient needs. Which of the
following offers the best way for setting priority?

A. Assessing nursing needs and problems

B. Giving instructions on how nursing care needs are to be met
C. Controlling and evaluating the delivery of nursing care
D. Assigning safe nurse: patient ratio

18. Which of the following is the best guarantee that the patient’s priority
needs are met?

A. Checking with the relative of the patient

B. Preparing a nursing care plan in collaboration with the patient
C. Consulting with the physician
D. Coordinating with other members of the team

19. When Henry uses team nursing as a care delivery system, he and his team
need to assess the priority of care for a group of patients, which of the
following should be a priority?

A. Each patient as listed on the worksheet

B. Patients who needs least care
C. Medications and treatments required for all patients
D. Patients who need the most care
20. He is hopeful that his unit will make a big turnaround in the succeeding
months. Which of the following actions of Henry demonstrates that he has
reached the third stage of change?

A. Wonders why things are not what it used to be

B. Finds solutions to the problems
C. Integrate the solutions to his day-to-day activities
D. Selects the best change strategy

21. Joey is a newly-appointed nurse manager of The Holy Spirit Medical

Center, a tertiary hospital located within the heart of the metropolis. He thinks
of scheduling planning workshop with his staff in order to ensure an effective
and efficient management of the department. Should he decide to conduct a
strategic planning workshop, which of the following is NOT a characteristic of
this activity?

A. Long-term goal-setting
B. Extends to 3-5 years in the future
C. Focuses on routine tasks
D. Determines directions of the organization

22. Which of the following statements refer to the vision of the hospital?

A. The Holy Spirit Medical Center is a trendsetter in tertiary health care in the next
five year
B. The officers and staff of The Holy Spirit Medical Center believe in the unique
nature of the human person
C. All the nurses shall undergo continuing competency training program.
D. The Holy Spirit Medical Center aims to provide a patient-centered care in a total
healing environment.

23. The statement, “The Holy Spirit Medical Center aims to provide patient-
centered care in a total healing environment” refers to which of the following?

A. Vision
B. Goal
C. Philosophy
D. Mission

24. Joey plans to revisit the organizational chart of the department. He plans to
create a new position of a Patient Educator who has a coordinating
relationship with the head nurse in the unit. Which of the following will likely
depict this organizational relationship?
A. Box
B. Solid line
C. Broken line
D. Dotted line

25. He likewise stresses the need for all the employees to follow orders and
instructions from him and not from anyone else. Which of the following
principles does he refer to?

A. Scalar chain
B. Discipline
C. Unity of command
D. Order

26. Joey orients his staff on the patterns of reporting relationship throughout
the organization. Which of the following principles refer to this?

A. Span of control
B. Hierarchy
C. Esprit d’ corps
D. Unity of direction

27. He emphasizes to the team that they need to put their efforts together
towards the attainment of the goals of the program. Which of the following
principles refers to this?

A. Span of control
B. Unity of direction
C. Unity of command
D. Command responsibility

28. Joey stresses the importance of promoting ‘esprit d corps’ among the
members of the unit. Which of the following remarks of the staff indicates that
they understand what he pointed out?

A. “Let’s work together in harmony; we need to be supportive of one another”

B. “In order that we achieve the same results; we must all follow the directives of
Julius and not from other managers.”
C. “We will ensure that all the resources we need are available when needed.”
D. “We need to put our efforts together in order to raise the bar of excellence in the
care we provide to all our patients.”

29. He discusses the goal of the department. Which of the following

statements is a goal?
A. Increase the patient satisfaction rate
B. Eliminate the incidence of delayed administration of medications
C. Establish rapport with patients.
D. Reduce response time to two minutes.

30. He wants to influence the customary way of thinking and behaving that is
shared by the members of the department. Which of the following terms refer
to this?

A. Organizational chart
B. Cultural network
C. Organizational structure
D. Organizational culture

31. He asserts the importance of promoting a positive organizational culture in

their unit. Which of the following behaviors indicate that this is attained by the
group?

A. Proactive and caring with one another

B. Competitive and perfectionist
C. Powerful and oppositional
D. Obedient and uncomplaining

32. Stephanie is a new Staff Educator of a private tertiary hospital. She

conducts orientation among new staff nurses in her department. Joseph, one
of the new staff nurses, wants to understand the channel of communication,
span of control and lines of communication. Which of the following will
provide this information?

A. Organizational structure
B. Policy
C. Job description
D. Manual of procedures

33. Stephanie is often seen interacting with the medical intern during coffee
breaks and after duty hours. What type of organizational structure is this?

A. Formal
B. Informal
C. Staff
D. Line

34. She takes pride in saying that the hospital has a decentralized structure.
Which of the following is NOT compatible with this type of model?
A. Flat organization
B. Participatory approach
C. Shared governance
D. Tall organization

35. Centralized organizations have some advantages. Which of the following

statements are TRUE?

1. Highly cost-effective
2. Makes management easier
3. Reflects the interest of the worker
4. Allows quick decisions or actions.

A. 1 & 2
B. 2 & 4
C. 2, 3& 4
D. 1, 2, & 4

36. Stephanie delegates effectively if she has authority to act, which is BEST
defined as:

A. having responsibility to direct others

B. being accountable to the organization
C. having legitimate right to act
D. telling others what to do

37. Regardless of the size of a work group, enough staff must be available at
all times to accomplish certain purposes. Which of these purposes is NOT
included?

A. Meet the needs of patients

B. Provide a pair of hands to other units as needed
C. Cover all time periods adequately.
D. Allow for growth and development of nursing staff.

38. Which of the following guidelines should be least considered in

formulating objectives for nursing care?

A. Written nursing care plan

B. Holistic approach
C. Prescribed standards
D. Staff preferences
39. Stephanie considers shifting to transformational leadership. Which of the
following statements best describes this type of leadership?

A. Uses visioning as the essence of leadership.

B. Serves the followers rather than being served.
C. Maintains full trust and confidence in the subordinates
D. Possesses innate charisma that makes others feel good in his presence.

40. As a manager, she focuses her energy on both the quality of services
rendered to the patients as well as the welfare of the staff of her unit. Which of
the following management styles does she adopt?

A. Country club management

B. Organization man management
C. Team management
D. Authority-obedience management

Answers and Rationale

Answers and rationale are given below for this exam. Check your correct answers
and read the rationales for additional learning. Tell us your scores on the comments
section.

1. Answer: A. Country Club Management

Country club management style puts concern for the staff as number one priority at
the expense of the delivery of services. He/she runs the department just like a
country club where everyone is happy including the manager.

2. Answer: C. Servant leader

Servant leaders are open-minded, listen deeply, try to fully understand others and
not being judgmental

3. Answer: A. Possesses inspirational quality that makes followers gets

attracted of him and regards him with reverence

Charismatic leaders make the followers feel at ease in their presence. They feel that
they are in good hands whenever the leader is around.

4. Answer: C. Assessment of personal traits is a reliable tool for predicting a

manager’s potential.
It is not conclusive that certain qualities of a person would make him become a good
manager. It can only predict a manager’s potential of becoming a good one.

5. Answer: A. Recognizes staff for going beyond expectations by giving them

citations

Path Goal theory according to House and associates rewards good performance so
that others would do the same

6. Answer: C. Great Man

Leaders become leaders because of their birth right. This is also called Genetic
theory or the Aristotelian theory

7. Answer: C. Laissez faire

Laissez faire leadership is preferred when the followers know what to do and are
experts in the field. This leadership style is relationship-oriented rather than task-
centered.

8. Answer: D. Leadership is shared at the point of care.

Shared governance allows the staff nurses to have the authority, responsibility and
accountability for their own practice.

9. Answer: D. Inspires others with vision

Inspires others with a vision is characteristic of a transformational leader. He is

focused more on the day-to-day operations of the department/unit.

10. Answer: A. Have condescending trust and confidence in their

subordinates

Benevolent-authoritative managers pretentiously show their trust and confidence to

their followers

11. Answer: A. Call for a staff meeting and take this up in the agenda.

This will allow for the participation of every staff in the unit. If they contribute to the
solutions of the problem, they will own the solutions; hence the chance for
compliance would be greater.

12. Answer: C. Low morale of staff in his unit

Low morale of staff is an internal factor that affects only the unit. All the rest of the
options emanate from the top executive or from outside the institution.

13. Answer: B. Majority rule

Majority rule involves dividing the house and the highest vote wins. 1/2 + 1 is a
majority.

14. Answer: B. system used to deliver care

A system used to deliver care. In the 70’s it was termed as methods of patient
assignment; in the early 80’s it was called modalities of patient care then patterns of
nursing care in the 90’s until recently authors called it nursing care systems.

15. Answer: A. Concentrates on tasks and activities

Functional nursing is focused on tasks and activities and not on the holistic care of
the patients

16. Answer: A. Psychological and sociological needs are emphasized.

When the functional method is used, the psychological and sociological needs of the
patients are neglected; the patients are regarded as ‘tasks to be done ‘

17. Answer: A. Assessing nursing needs and problems

This option follows the framework of the nursing process at the same time applies
the management process of planning, organizing, directing and controlling

18. Answer: B. Preparing a nursing care plan in collaboration with the patient

The best source of information about the priority needs of the patient is the patient
himself. Hence using a nursing care plan based on his expressed priority needs
would ensure meeting his needs effectively.

19. Answer: D. Patients who need the most care

In setting priorities for a group of patients, those who need the most care should be
number-one priority to ensure that their critical needs are met adequately. The needs
of other patients who need less care ca be attended to later or even delegated to
assistive personnel according to rules on delegation.

20. Answer: C. Integrate the solutions to his day-to-day activities

Integrate the solutions to his day-to-day activities is expected to happen during the
third stage of change when the change agent incorporate the selected solutions to
his system and begins to create a change.

21. Answer: C. Focuses on routine tasks

Strategic planning involves options A, B and D except C which is attributed to

operational planning

22. Answer: A. The Holy Spirit Medical Center is a trendsetter in tertiary health
care in the next five years

A vision refers to what the institution wants to become within a particular period of
time.

23. Answer: B. Goal

24. Answer: C. Broken line

This is a staff relationship hence it is depicted by a broken line in the organizational

structure

25. Answer: C. Unity of command

The principle of unity of command means that employees should receive orders
coming from only one manager and not from two managers. This averts the
possibility of sowing confusion among the members of the organization

26. Answer: B. Hierarchy

Hierarchy refers to the pattern of reporting or the formal line of authority in an

organizational structure.

27. Answer: B. Unity of direction

Unity of direction means having one goal or one objective for the team to pursue;
hence all members of the organization should put their efforts together towards the
attainment of their common goal or objective.

28. Answer: A. “Let’s work together in harmony; we need to be supportive of

one another”

The principle of ‘esprit d’ corps’ refers to promoting harmony in the workplace, which
is essential in maintaining a climate conducive to work.
29. Answer: A. Increase the patient satisfaction rate

Goal is a desired result towards which efforts are directed.

30. Answer: D. Organizational culture

An organizational culture refers to the way the members of the organization think
together and do things around them together. It’s their way of life in that organization

31. Answer: A. Proactive and caring with one another

32. Answer: A. Organizational structure

Organizational structure provides information on the channel of authority, (i.e., who

reports to whom and with what authority) the number of people who directly reports
to the various levels of hierarchy and the lines of communication whether line or
staff.

33. Answer: B. Informal

This is usually not published and oftentimes concealed.

34. Answer: D. Tall organization

Tall organizations are highly centralized organizations where decision making is

centered on one authority level.

35. Answer: A. 1 & 2

Centralized organizations are needs only a few managers hence they are less
expensive and easier to manage

36. Answer: C. having legitimate right to act

Authority is a legitimate or official right to give command. This is an officially

sanctioned responsibility

37. Answer: B. Provide a pair of hands to other units as needed

Providing a pair of hands for other units is not a purpose in doing an effective staffing
process. This is a function of a staffing coordinator at a centralized model.

38. Answer: D. Staff preferences

Staff preferences should be the least priority in formulating objectives of nursing
care. Individual preferences should be subordinate to the interest of the patients.

39. Answer: A. Uses visioning as the essence of leadership.

Transformational leadership relies heavily on visioning as the core of leadership.

40. Answer: C. Team management

Team management has a high concern for services and high concern for staff.