Sample Chapter

The New Leadership Challenge Creating the Future of Nursing 5th Edition By by Sheila C. Grossman -Test Bank
Sample  Questions


Chapter 1: The Phenomenon of Leadership: Classic/Historical and Contemporary Leadership Theories


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   Which leadership theory stresses the significance of the environment or circumstance, notes that the leader emerges but is not necessarily chosen, and gives little recognition to followers?

1. Trait theory
2. Modern theory
3. Situational theory
4. Great man theory



____    2.   A new nurse manager on the surgical unit is organizing a team. Which team member will be most beneficial to achieve a high level of creativity?

1. A scrub nurse
2. A medical nurse
3. A surgical nurse
4. A circulating nurse



____    3.   A nurse manager is using idealized influence to motivate staff. Which technique is the nurse manager using?

1. Increasing the staff’s confidence and trust
2. Teaching the staff to be goal-oriented and responsible
3. Encouraging creativity and new approaches to problems
4. Assisting staff to continue working hard and self-actualize



____    4.   A nurse is using the “4-D” cycle of appreciative inquiry. Which “D” should the nurse use?

1. Daring
2. Design
3. Decisive
4. Determined



____    5.   Which major factors in health care are creating the need for new leaders?

1. Chaos, uncertainty, unpredictability, and constant change
2. Health-care reform, politics, violence, and surplus resources
3. Inferior technology, mergers, acquisitions, and one’s legal scope of practice
4. Too many workers, not enough work, unprepared employees, and technology



____    6.   In the humanbecoming leading-following model proposed by Parse (2009), what are the three major components?

1. Goals, followers, and resources
2. Strategy, goals, and outcome evaluation
3. Vision, willingness to risk, and reverence for others
4. Trust, hierarchical power, and nonjudgmental attitude



____    7.   A theory of leadership proposed by Heifetz (2009) focuses on which component?

1. The extent to which leaders disturb the equilibrium
2. The extent to which leaders and followers are friends
3. The extent to which leaders’ traits and personalities are emphasized
4. The extent to which leaders can recruit followers to embrace their vision



____    8.   A nurse thinks that a turning schedule will be beneficial for a patient to prevent pressure ulcers. Before implementing the turning schedule, the nurse considers using a special mattress. Which technique did the nurse use?

1. Self-awareness
2. Relational transparency
3. Internalized moral perspective
4. Balanced information processing



____    9.   A nurse identifies a leader as one who is above average height and weight, has superior judgment, is decisive, and has self-confidence. Which theory did this nurse use to identify a leader?

1. Trait theory
2. Situational theory
3. Great man theory
4. Contemporary leadership theory



____  10.   According to Max Mckeown, what does innovation + strategy about shaping the future equal?

1. Leadership
2. Adaptability
3. Positive turbulence
4. Disturbing equilibrium



____  11.   A nurse is working in an agency that focuses on the six freedoms. In which type of environment is the nurse working?

1. Social model
2. Complexity theory
3. Appreciative inquiry
4. Eastern vs. Western leadership



____  12.   Which population group ranked higher on empowering?

1. Anglo leaders
2. European leaders
3. Middle Eastern leaders
4. Southeast Asian leaders



____  13.   According to The Future of Nursing: Leading Change, Advancing Health, which category of nurses should be prepared to lead?

1. All
2. Some
3. None
4. Just a few



____  14.   In Phase IV of the Quality and Safety Education for Nurses (QSEN), which degree should nurses obtain?

1. Vocational
2. Associate’s
3. Bachelor’s
4. Diploma



____  15.   Which important aspect of leadership is often overlooked?

1. Leaving early
2. Having alone time
3. Working with a team
4. Taking vacations with family



____  16.   A nurse on a busy unit goes to the park after work and thinks about the day at work before returning home. Which authentic leadership trait did the nurse display?

1. Integrity
2. Self-reflection
3. Relational transparency
4. Internalized moral perspective



____  17.   Which is necessary for a leader to be successful in health care’s volatile environment?

1. Being stagnate
2. Being inflexible
3. Enjoying the present
4. Always compromising



____  18.   Which nurse has an innovative leadership characteristic?

1. A nurse with a personal vision
2. A nurse with faith in the physicians
3. A nurse with a strong profit/cost focus
4. A nurse with fierce loyalty to the organization



____  19.   A nurse manager uses an assessment tool to identify eight practices, such as sensing and envisioning, and uses observations to identify personality characteristics to identify new nurses for leadership positions. Which two theories did the nurse manager blend?

1. Complexity theory and situational theory
2. Innovative leadership theory and trait theory
3. Appreciative inquiry theory and great man theory
4. Transformational leadership theory and ethical leadership theory



____  20.   Which information from a nurse indicates a correct understanding of leadership theories?

1. Successful leadership is authority.
2. There is a clear definition of leadership.
3. Leadership is multidimensional and multifaceted.
4. Effective leadership and ineffective leadership can be identified easily.



____  21.   A nurse is asked by a coworker how authentic leadership differs from ethical leadership. How should the nurse respond?

1. “A strong self-awareness is needed with ethical leadership.”
2. “High moral standards are needed solely for ethical leadership.”
3. “Good communication skills are needed with authentic leadership.”
4. “Disturbing the equilibrium is associated with authentic leadership.”



____  22.   According to the Institute of Medicine (IOM), which type of leadership should be used to increase patient safety and decrease health-care errors?

1. Trait
2. Great man
3. Situational
4. Transformational



____  23.   A nurse manager uses four processes, one of which includes individualized considerations, and enjoys the “messiness” of social processes to help new nurses “step up” to leadership positions. Which two theories did the nurse blend?

1. Transformational theory and complexity theory
2. Appreciative inquiry theory and authentic leadership
3. Trait theory and humanbecoming leading-following model
4. Contemporary leadership theory and classic leadership theory



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  24.   A manager is teaching the staff about contemporary leadership theories. Which topics will the nurse stress in the teaching session? Select all that apply.

1. Dyadic
2. Relational
3. Head-down approach
4. Complex social models
5. Individual leader qualities



____  25.   A nurse manager is using Denning and Dunham’s (2010) practices to innovatively lead the medical-surgical unit. Which practices will the nurse manager demonstrate? Select all that apply.

1. Sensing
2. Leading
3. Embodying
4. Dreaming
5. Following

Chapter 3: Disequilibrium and Chaos: Challenging, Invigorating, and Growth Producing


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   Which action indicates a nurse leader is following the chaos theory?

1. Rethinks the past and models self after previous nurse leaders
2. Develops specific short- and long-term plans with evaluation outcomes
3. Uses intuition and is comfortable with uncertainty
4. Works side by side with physician mentors



____    2.   Wheatley and Kellner-Rogers (1996) say that systems maintain themselves only when change is occurring. How should the nurse interpret this statement?

1. Disorder is a means to survival.
2. It is imperative to keep organizations in status quo.
3. An idea should have its own place and be labeled.
4. Change always produces positive growth.



____    3.   When should nurses start leading?

1. Whenever their preceptor says it is time
2. After working 3 years
3. When they are in management positions
4. As soon as they graduate



____    4.   The uncertainty of health care flows from the chaotic nature of the world over time. This perspective is most similar to which idea?

1. There are far more questions than there are answers.
2. Uncertainty breeds discontent.
3. Nurses should try to plan every step.
4. Life is an endless, thankless journey.



____    5.   Which most significant characteristic will assist nurses to grow in this chaotic health-care environment?

1. Rigidity
2. Efficiency
3. Steadfastness
4. Flexibility



____    6.   A nurse manager has a vision of providing holistic quality care to patients and families. Which action should the nurse manager take to strategically and successfully fulfill this vision?

1. Deemphasize empowerment of staff members.
2. Use the position’s leverage.
3. Partner with agencies outside the organization.
4. Create to-do lists for those involved in the change.



____    7.   When someone questions a procedure, a commonly heard statement by many nurses is, “We’ve always done it this way.” Which description best illustrates this attitude?

1. Limiting change
2. Desiring group cohesiveness
3. Honoring the past
4. Providing commitment



____    8.   Which action can increase a nurse manager’s power most dramatically?

1. Preserving the status quo
2. Maintaining sacred cows
3. Empowering staff members to make change
4. Unionizing with other administrators



____    9.   Unfreezing is a stage of Lewin’s theory of change. Which example in nursing depicts this stage?

1. Using a new acuity system
2. Having frequent staff meetings to discuss a possible change
3. Accepting the new documentation method
4. Evaluating the newly implemented procedure



____  10.   How can new leaders best participate fully in the decision-making processes of their health-care organizations to accomplish goals?

1. Collaborate with just other nurses to obtain new perspectives.
2. Compromise with other health-care workers so that nursing gets its share of resources.
3. Engage in continuous quality improvement.
4. Work in a silo by oneself.



____  11.   Which theory helps nurses realize all health-care systems work from the inside out?

1. Quantum theory
2. Adaptation theory
3. Developmental theory
4. Scientific theory



____  12.   Which action will help a nurse provide strategic leadership?

1. Focus on predictability.
2. Avoid the edge of chaos.
3. Expect few nurses to be leaders.
4. Work smarter.



____  13.   A nurse wants to make a change on the unit. Which principle should the nurse remember?

1. One’s past experience with change does not affect participation.
2. A change in one part of the system affects other parts of the system.
3. Conflict is a sign the change is not working.
4. People should be informed to change.



____  14.   One home care agency is being bought by a competing company that has a different type of patient assignment system for nurses. The director of the agency being purchased decides to share the new assignment system with the staff. The director encourages the staff to consider trying it now and compiling some feedback about how it works before the acquisition occurs. What is the rationale for the director’s actions?

1. It is better to choose to change and design one’s own approach to change than to have a change imposed by some external force.
2. The new company will most likely force the staff nurses to adopt this care delivery system on the first day after the merger.
3. Change should be quick so there is not enough time to complain about potential ramifications.
4. Change theory indicates the most beneficial changes are made spontaneously by only a few of the people who will be a part of the change process.



____  15.   A nurse has a conflict with a coworker and uses avoidance. Which outcome will most likely occur?

1. Generate a win-win situation.
2. Cause tension while negatively influencing care.
3. Result in compromise with both parties.
4. Will improve with time.



____  16.   The new nurse manager is using a Newtonian perspective to lead. Which action will this new nurse manager take?

1. Increase uncertainty.
2. Empower the group.
3. Build relationships.
4. Establish goals.



____  17.   Which behavior in a nurse leader exemplifies yin?

1. Takes positive action to deal with resistance to change
2. Uses courage to deal with resistance to change
3. Uses empathy to deal with resistance to change
4. Uses opposites to deal with resistance to change



____  18.   Which example illustrates the nurse manager’s strategies have decreased barriers to change?

1. Staff members refuse to attend orientation to electronic documentation on their own time even though lunch is provided at a nearby restaurant.
2. The division’s suggestion box reveals eight complaint messages about the nurse manager from nurses on the unit.
3. No one attends a mandatory orientation class on electronic documentation even though staffing would allow for half of the unit to participate.
4. Staff members are attending the manager’s summer party to kick-off a new initiative for the unit’s electronic documentation change.



____  19.   A nurse leader/manager wants to change a process in the emergency department. Which strategies are most important for successful change?

1. Effective communication, recognition of staff welfare, and staff empowerment
2. Tangible awards for participating staff, arguments against the change by key people, and target dates for implementation of the change process
3. Staff unawareness, outcomes for the change, and time off work to discuss the change with participating staff
4. Consequences for staff who will not participate, favoritism toward all participating staff, and an evaluation plan for the change



____  20.   How do Denhardt and Denhardt (2006) describe management?

1. “What determines a good leader from a poor leader”
2. “What energizes people”
3. “A way of working in a world of order”
4. “The dance and art of leadership”



____  21.   A patient care manager of the mobile intensive care unit (MICU) wants to make a change in the culture of the unit so that the more experienced nurses take on the less experienced nurses as mentees and not just as preceptees. What is an effective first step for the patient care manager to carry out with the staff according to Lewin’s theory for change?

1. Have all staff bring an article about the benefits and drawbacks of experienced staff nurses being mentors.
2. Announce that being a mentor is now required of any MICU nurse that has more than 5 years’ experience.
3. Meet with all of the experienced nurses and tell them the unit cannot survive without each one of them being responsible for a less experienced nurse.
4. Refine the job description of the mentor’s role to make it more acceptable to the experienced nurse.



____  22.   Which action by a nurse leader is paramount for making innovative changes in nursing?

1. Interconnecting solely with members of the nursing discipline
2. Seeing the health-care team as the focus of care
3. Incorporating a single perspective for improving care
4. Using diverse skill sets



____  23.   A patient has a 22 pack-year of cigarette smoking history and presents today at the medical clinic wanting to stop smoking. Part of the smoking cessation program should include a contract. It is imperative that which aspect be included in this contract?

1. A clause that protects the provider from any legal ramifications of the patient’s smoking cessation
2. Mutually developed (by the health-care provider and the patient) objectives
3. A clause describing the patient’s nicotine addiction
4. A nonspecific time frame for objectives to be accomplished so no added pressure will be put on the patient



____  24.   A new type of health-care insurance is being introduced that gives a reduction in premiums if an individual stops smoking, loses weight, or engages in some type of health promotion. When the individual first reads the policy and is in the process of considering a change in behavior, which stage of Lewin’s change model is in process?

1. Thinking
2. Moving
3. Unfreezing
4. Refreezing



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  25.   A nurse is comparing Kotter’s model of change to Lewin’s framework for assistance in initiating a goal for nursing. Which steps of Kotter’s model correlate to Lewin’s stage 2? Select all that apply.

1. Identify a need.
2. Encourage risk taking.
3. Gather the stakeholders.
4. Offer incentives for success of the goal.
5. Evaluate implications of the change as it takes hold.

Chapter 5: Followership and Empowerment


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   Chaleff asserts that followers do not orbit around a leader. Instead, followers and leaders both orbit around their:

1. Organization’s mission.
2. Mutual purpose.
3. Personal needs.
4. Shared history.



____    2.   Which statement made by a nurse suggests more instruction is needed about leaders and followers?

1. There can be no leaders without followers.
2. Followers are as important as leaders in shaping a preferred future.
3. Leaders and followers share many common qualities.
4. Followers are at their best when they seek permission from the leader.



____    3.   How should followership be described?

1. A well-defined science
2. Something that cannot be taught or cultivated
3. A role one chooses to accept
4. The least significant aspect of a leadership “event”



____    4.   Which action indicates the nurse is an effective follower?

1. Participates actively, rather than passively
2. Is more dependent than independent of the leader
3. Needs clear direction to accomplish each task
4. Goes along with, rather than challenges, the ideas of the leader



____    5.   A follower thinks critically about the leader’s suggestions but remains passive and perhaps even somewhat hostile. What type of follower is this?

1. Sheep
2. Alienated follower
3. “Yes” person
4. Contributor



____    6.   Using frameworks described by Kelley (1998) and Pittman, Rosenbach, and Potter (1998), which terms are most alike in their characteristics?

1. “Yes” people and contributors
2. Effective followers and politicians
3. Sheep and subordinates
4. Alienated followers and partners



____    7.   A follower assumes an active role because the leader has credibility. According to Kouzes and Posner (2011), which characteristics make leaders have credibility?

1. Competence, aggressiveness, and holding a position of authority
2. Honesty, ability to be inspiring, and forward-looking
3. Visionary, controlling, and powerful
4. Demanding, focused on maintaining the status quo, and open



____    8.   Which strategy can help a nurse develop as an effective or exemplary follower?

1. Find your passion in life and be passionate about what you do.
2. Be a “spectator” in your practice setting.
3. Wait to be told before taking action.
4. Keep your creative ideas to yourself until you are in the leader role.



____    9.   Which trait characterizes a follower more than it characterizes a leader?

1. Uses freedom responsibly
2. Creates new ideas
3. Takes risks
4. Makes decisions



____  10.   How can nurse leaders and nurse followers facilitate collaboration?

1. Follow the medical orders without question.
2. Empower one another.
3. Function more independently, rather than interdependently.
4. Assume a subordinate role on the health-care team.



____  11.   A nurse follower is high in performance initiative and high in relationship initiatives. What type of follower is this nurse?

1. Politician
2. Subordinate
3. Partner
4. Contributor



____  12.   A nurse follower is an active participant but is dependent on others and does not engage in critical thinking. What type of follower is this nurse?

1. Star follower
2. Alienated follower
3. Sheep
4. “Yes” person



____  13.   Which description best portrays an effective nurse follower?

1. Is visionary, dedicated to accomplishing the leader’s vision, and tentative with decision making
2. Is reflective, spontaneous, and focused on working as autonomously as possible
3. Is self-directing, looks at the “bigger picture,” and speaks truthfully
4. Blindly accepts the leader’s authority, abdicates responsibilities, and encourages others



____  14.   Which strategy is crucial for a nurse to “start a movement”?

1. Be the first follower.
2. Form a tipping point with new leaders.
3. Have new followers emulate the leader.
4. Let followers learn on their own.



____  15.   Several nurses on a unit consistently criticize new practice ideas that are generated and are rude to the new orientees and students. How should nurse leaders on this unit best help these nurses to become better followers?

1. Thank them for their critical perspectives.
2. Ask them to propose solutions to the practices they are criticizing.
3. Schedule them on shifts when students are not on the unit.
4. Assign them to all of the orientees.



____  16.   Which statement will identify a nurse as a star follower?

1. “I think I could do that.”
2. “I hope that can be done.”
3. “I can do that.”
4. “I might be able to complete that.”



____  17.   How should a nurse leader use power?

1. As an influence to direct the group and realize the vision
2. To control the group and select people for certain positions
3. To reward those who follow the wishes of the leader
4. As an influence to strengthen the leader’s power base



____  18.   A nurse has the title of Dean of the School of Nursing. Which type of power does this represent?

1. Coercive
2. Expert
3. Reward
4. Legitimate



____  19.   A nurse can start an IV solution when nobody else can. The staff go to this nurse anytime an IV cannot be started. What type of power does this nurse have?

1. Coercive
2. Reward
3. Expert
4. Referent



____  20.   A nurse leader sees the “big picture” of providing high-quality care and tells how each follower fits into this vision. Which characteristic has the nurse leader used to help followers?

1. Morality
2. Passivity
3. Competency
4. Forward looking



____  21.   Which technique used by a nurse leader is most likely to be effective in helping followers break routines and habits?

1. Affirm values.
2. Coerce.
3. Renew.
4. Serve as a symbol.



____  22.   Kellerman (2008) developed a continuum of followership that uses one metric. What does the metric represent?

1. Level of engagement
2. Knowledge of followership
3. Duration of time that the follower has known the leader
4. Extent to which leaders and followers “like” each other



____  23.   Parse (2009) reflects on the importance of power in her humanbecoming leading-following model. Parse acknowledges that power lies in one’s position but also emphasizes which other concept?

1. Expert power is not as strong as the power that comes from one’s position.
2. Power that lies within the person is most effective.
3. Authority is stronger than power.
4. Leaders are more important than followers.



____  24.   Which type of follower is highest on the metric continuum according to Kellerman (2008)?

1. Diehards
2. Activists
3. Participants
4. Bystanders



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  25.   How can a staff nurse be an effective follower? Select all that apply.

1. Become involved in professional organizations.
2. Be adversarial.
3. Complain and walk away.
4. Exercise a “courageous conscience.”
5. Contribute as an equal partner.

Chapter 7: Vision and Creativity


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   Which one is the most significant contribution a nurse leader can make to a group or organization?

1. Formulating a lockstep long-term plan for the organization
2. Mandating overtime for all registered nurses until goals are met
3. Defining and sharing a vision
4. Hiring only licensed professionals



____    2.   Martin Luther King, Jr.’s “I Have a Dream” speech is an excellent example of which concept?

1. A leader energizing people toward action
2. One person revolting against society
3. A leader propelling his own agenda
4. One person’s dream changing health-care policy



____    3.   How should a nurse best describe vision?

1. Organization’s short-term objectives
2. Summary of how an organization evolved to its current state
3. Image of where an organization wants to be in the future
4. Plan to reach organizational goals



____    4.   What is a successful leader able to do?

1. Accept the status quo if it is working.
2. Make a difference no matter what it takes.
3. Be reactive to change.
4. Focus entirely on work.



____    5.   A nurse leader creates many rules and regulations for the unit. What type of climate will this create?

1. One that produces change and growth
2. One that is proactive in making a difference
3. One that fosters the status quo
4. One that stimulates provocative discussions



____    6.   Which speech techniques can assist nurses in articulating their vision(s)?

1. Visual aids and background music
2. Role-playing and charades
3. Acting and singing
4. Repetition and rhythm



____    7.   What is the most likely outcome when a nurse leader uses creativity?

1. Thinks in a more focused manner
2. Repeats exactly, step-by-step, the plan
3. Uses strategies that have proved effective in the past
4. Reframes how work is perceived



____    8.   Which is the most effective method of increasing creativity in nurses?

1. Changing conditions in the work setting
2. Providing stress-reduction exercises to employees
3. Offering financial incentives to employees
4. Scheduling creativity workshops for greater attendance



____    9.   Which describes a nurse who has right-brain thinking?

1. Logical
2. Organized
3. Creative
4. Concrete



____  10.   Which is an important characteristic of a creative nurse?

1. Avoiding competitors
2. Being a risk taker
3. Following a specific plan
4. Being reactive to challenges



____  11.   A nurse develops both a personal vision and a professional vision. What are the primary reasons for these visions?

1. Have a purpose in life and accomplish work ideas.
2. Accrue wealth for personal gain and success in one’s profession.
3. Be successful at career and meet the organization’s mission.
4. Use one’s family values and education for own goals.



____  12.   Which activity indicates a nurse is using reflective techniques?

1. Thinking about an action in a single way
2. Rushing into a situation
3. Asking a peer for feedback
4. Basing a decision on one piece of data



____  13.   A nurse is using Tanner’s (2006) Clinical Judgment Model to determine the actual vision. Which stage is the nurse in according to the model?

1. Reflecting
2. Interpreting
3. Noticing
4. Responding



____  14.   A nurse is described as “thinking outside of the box.” Which characteristic does this nurse have?

1. Is a linear thinker
2. Follows directions effectively
3. Thinks there is a single right answer for each problem
4. Has the ability to envision an idea that is new and different



____  15.   How does mindful awareness enhance reflective practice for a nurse?

1. Increased neural circuits
2. Underdeveloped prefrontal cortex
3. Overdeveloped occipital area
4. Decreased neuroplasticity



____  16.   A successful nurse leader must be comfortable with disorder and chaos. How should the nurse interpret this statement?

1. Life should be predictable and part of a large planned schemata.
2. Change will occur no matter what we do to maintain the existing order.
3. Nurses are able to successfully prevent chaos in their workplaces.
4. People intuitively perform worse if an unexpected situation arises.



____  17.   A nursing unit in the midst of change experiences an unexpected event. How should the nurse leader interpret this event?

1. It can offer challenges for staff to build their problem-solving skills.
2. It can allow staff practice time with patients to manage their fears.
3. It can cause staff to make physicians fix the problems.
4. It can show staff that the change is a mistake.



____  18.   A nurse is using the Leadership Diamond Model developed by Koestenbaum (2002) to gain leadership skills. In which areas will the nurse focus?

1. Salesmanship, collaboration, vision, and empathy
2. Creativity, passion, determination, and sacrifice
3. Independence, hope, faith, and empowerment
4. Time, democracy, motivation, and teamwork



____  19.   A nurse leader is using Zaleznik’s (1989) principles to influence other nurses. Which action will the nurse take?

1. Help the staff realize how the proposed change will advance their interest.
2. Let administration tell staff about the changes.
3. Use a lockstep plan to engage logical thinking nurses to embrace the change.
4. Inspire staff to have passion rather than the nurse leader.



____  20.   Which information from a nurse demonstrates a creative outlook about work?

1. Work is an expression of thoughts.
2. Work comes from the inside out.
3. Work is repetitious.
4. Work is similar to each person.



____  21.   Zaleznik (1989) suggested that effective nurse leaders desiring to influence staff nurses should use which primary principle?

1. The staff can make a positive change that will improve conditions for a group/organization, not just for themselves.
2. The staff can make a profit that solely benefits the leader.
3. The staff can make a difference in their leadership style and widen the number of people they lead.
4. The staff can gain more notoriety and, possibly, worldly acclaim.



____  22.   A nurse is deliberately creating conflicts to spark new ideas. According to McCall (1989) which method is the nurse demonstrating?

1. Credibility
2. Crafty
3. Feisty
4. Flexibility



____  23.   Which technique should the nurse use to learn difficult concepts that will develop both the right and left brain?

1. Using formulas
2. Memorizing facts using flash cards
3. Mindmapping
4. Rewriting the terms involved with the concept repeatedly



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  24.   A nurse is using Cohen’s (2004) 10 essential principles to develop and carry out a vision. Which principles will the nurse use? Select all that apply.

1. Keep it complex.
2. Take the indirect route.
3. Exploit successes.
4. Commit fully to a goal.
5. Do the unexpected.



____  25.   A nurse is creative. Which characteristics does the nurse demonstrate? Select all that apply.

1. Thinks originally
2. Is closed to new ideas
3. Provides alternatives
4. Is willing to dream
5. Draws on the left brain

Chapter 9: Shaping a Preferred Future for Nursing


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   Which characteristics will help leaders shape a preferred future for nursing?

1. Credibility, knowledge base, and attractive appearance
2. Kindness, aggressiveness as a communicator, and fairness
3. Creativity, bridge builder, and ability to facilitate change
4. Critical thinking ability, confusion regarding vision, and sense of humor



____    2.   Nurses who wish to be a part of creating the future will need to take which action?

1. Use written documentation instead of electronic.
2. Be informed about issues and how they evolve.
3. Use prediction formulas.
4. Begin to stockpile resources to be used only if absolutely necessary.



____    3.   Which information from nurses best defines a preferred future of nursing?

1. What we would like to see happen
2. What can occur if some changes are made
3. What is likely to occur if efforts are made to accomplish goals
4. What is likely to occur if things continue as they are



____    4.   Which significant focus should a nurse leader take to prepare for future health-care systems?

1. Fee-for-service payments
2. Health promotion and maintenance
3. Inpatient care for acute and chronic episode of disease
4. Independent freestanding agencies



____    5.   Which issue will be most significant for nurses in the future?

1. Individualized plans of care
2. Outcomes of primary care
3. Patient safety
4. Nursing intervention documentation



____    6.   Which example best indicates a nurse is involved in developing health-care policy?

1. Becoming involved with a social media group
2. Aligning closely with a specific legislator interested in policy making
3. Spearheading a health curriculum change in public education
4. Volunteering to be on a community board where solutions for health-care issues are determined



____    7.   Which action by a nurse leader indicates more teaching is needed about shaping the future of health care?

1. Creates a workforce that is agile and diverse
2. Collaborates with other health-care professionals
3. Molds employees to the company culture
4. Develops a vision to align with new talent and new ideas



____    8.   Which philosophy will help a nurse leader create a preferred future?

1. Let’s keep this within nursing.
2. Stick to the plan.
3. Preserve sacred cows.
4. If it ain’t broke, break it.



____    9.   Which health-care trend should the nurse leader consider when planning for the future?

1. Narrowing the scope of mid-level providers
2. Using bundling to reduce costs
3. Focusing on individual goals
4. Merging a single health-care professional initiative



____  10.   A nurse leader brings out the best attributes in the group and allows those attributes to be shared. Which role did the nurse leader take?

1. Cross-fertilizer
2. Integrator
3. Diplomat
4. Emotionally intelligent thinker



____  11.   A nurse leader is implementing one of the components of the TeamSTEPPS Training Program for health-care professions. Which component will the nurse use?

1. Decision making from the top administrator
2. Vertical organizational structure
3. Shared governance
4. Fuzzy logic



____  12.   For a nurse leader to be most effective for the future, which action should the nurse leader take to maximize resources and conserve costs?

1. Identify a need for change.
2. Assist others to be a part of a vision.
3. Use more licensed professional staff.
4. Promote alternative practice models.



____  13.   Which behavior indicates the nurse is following the recommendations from the Institute of Medicine and the Robert Wood Johnson Foundation?

1. Pursuing an advanced nursing degree
2. Respecting physicians by being quiet during rounds
3. Practicing to the minimal extent of education level
4. Discussing redesigning ideas primarily with other nurses



____  14.   Which is an example of a “wild card” that would greatly affect staffing in an acute care institution?

1. Three ill staff members assigned to the same shift who call in sick
2. A patient who is diagnosed with Ebola virus
3. Absence of the nurse manager and assigned charge nurse on the same shift
4. A community disaster that sends 78 patients to the hospital for burns and other trauma injuries



____  15.   Which two conditions are more likely affecting patient care in acute care institutions today as a result of the chaotic health-care systems?

1. Ripple effect and smart machines
2. Uncertainty and unpredictability
3. Anxiety and mobile apps
4. 3D printers and creativity



____  16.   What is the best way to describe the plausible future?

1. What is likely to occur if things continue as they are and no changes are made
2. What can occur if some changes are made in the current state of affairs
3. What is likely to occur when specific efforts are made to accomplish goals
4. What we would like to see happen



____  17.   Senge (2006) recommends that leaders must act in three roles. Which behavior indicates the nurse is acting in the steward role?

1. Developing the vision to assist followers to remain in the group
2. Making sure each employee gains knowledge
3. Being responsible for distributing resources
4. Acting as a spokesperson for the group



____  18.   Each nurse needs to follow the recommendations of Bennis (2007), who suggests that exemplary leaders will have which competency?

1. Creating trust and optimism
2. Developing others to follow
3. Following the organization’s policies for each and every situation
4. Delineating each staff member’s role in detail so there is no repetition



____  19.   A nurse leader wants the agency to obtain Magnet status. Which component will the nurse develop?

1. Transactional leadership
2. New knowledge, innovation, and improvements
3. Exemplary nonprofessional practice
4. Patient-focused philosophy of care



____  20.   A nurse contacts the Nursing Workforce Center. What is the nurse trying to find?

1. Mandated policies regarding patient–health-care provider ratios
2. Self-care procedures that can be performed by patients and families
3. Health services research findings
4. Palliative care medication framework for dying patients with pain



____  21.   Which work environment described by Hesselbein and Goldsmith (2009) will the nurse leader create for long-lasting change and a positive future?

1. One that fosters pride and commitment
2. One that fosters a “think tank” and no leaders
3. One that fosters each department to work by itself
4. One that fosters empowerment and less spirit



____  22.   Which factor should the nurse leader keep in mind when projecting about the future of America’s health care?

1. Life expectancy is longer in the male population as compared to the female population.
2. The percentage of the younger population is increasing.
3. The number of retirees will increase.
4. The United States’ population is growing faster than normal.



____  23.   Which action should an effective nurse leader take to successfully shape the profession toward a preferred future?

1. Use a transformational leadership style.
2. Think small but try it.
3. Be a loner at the workplace.
4. Develop a formula-based staffing process.



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  24.   Which characteristics are needed for the nurse leader to be prepared to lead in the future? Select all that apply.

1. Dilemma flipping
2. Bio-sympathy
3. Constructive polarizing
4. Smart mob organizing
5. Quiet transparency



____  25.   Which activities can help maintain clinical competency and lifelong learning in professional nurses for the future? Select all that apply.

1. Mandatory continuing education
2. Ongoing certification in one’s area of practice
3. Institutional licensure
4. Inspirational music sessions
5. Attendance at in-house symposiums

Chapter 11: Leadership, Excellence, and Creating the Future of Nursing


Multiple Choice

Identify the choice that best completes the statement or answers the question.


____    1.   Which example characterizes excellence in nursing?

1. Setting and meeting high standards personally and for the group
2. Accepting mediocre or minimally adequate performance
3. Giving in to pressure from “above” to do only what is essential
4. Doing the best only when some authority figure pushes



____    2.   Professional nurses who strive for and expect excellence will most likely take which action in work situations where people seem to be satisfied with maintaining the status quo?

1. Question assumptions that underlie existing practices and report faulty ones to the person in charge.
2. Ask why things are done the way they are and offer thoughtful alternatives for doing things differently.
3. Be highly critical of the people in the setting and the procedures used.
4. Demand immediate change, regardless of the cost.



____    3.   According to Diers and Evans (1980), “excellent nurses are inflamed by nursing.” How should a nurse interpret the word inflamed?

1. Aggressively outspoken
2. Angry but active
3. Passionate about one’s work
4. Skilled and precise



____    4.   Which phrase best illustrates the idea that achieving excellence requires an enormous investment on the part of each individual, and not merely the creation of a supportive environment by those “at the top?”

1. “The cautious seldom err.” (Confucius)
2. “Every job is a self-portrait of the person who did it.” (Anonymous)
3. “Nothing endures but change.” (Heraclitus)
4. “Don’t judge a man until you have walked a mile in his shoes.” (Native American proverb)



____    5.   Which action will be considered challenging for a nurse who has been in nursing for less than 1 year?

1. Performing a highly complicated technical skill that the nurse has done a number of times before
2. Modifying the plan of care for a patient for whom the nurse has cared for during the past 4 days
3. Responding to a satisfaction survey sent by the school from which the nurse recently graduated
4. Accepting an invitation to speak at a regional professional meeting



____    6.   Which statement by a nurse best represents both excellence and leadership?

1. “Both can be achieved only by people in positions of authority.”
2. “Both require a degree of comfort with change.”
3. “Both are focused on the here and now.”
4. “Both thrive in an environment characterized by certainty and stability.”



____    7.   A nurse dreams of working in a setting where excellent care is given. The nurse observes, however, that more and more patients and families are complaining that no one is attending to their needs or answering their questions. Which action by the nurse demonstrates leadership and is likely to be most effective in moving toward a level of excellence?

1. Arrange for a meeting of nursing colleagues to discuss the problem and go to that meeting with a list of possible solutions to consider.
2. Tell the patients and families that the agency will not hire enough staff to spend more time with them so little can change.
3. Write a letter to the nurse executive and to the agency chief executive officer demanding that they do something to solve this problem.
4. Quit and find another job in another facility that fosters excellence.



____    8.   How can a nurse attain excellence?

1. Hold back when speaking up because it could get one in trouble.
2. Take safe risks.
3. Expect more than others think is possible.
4. Dream practical.



____    9.   A nurse leader strives for excellence. What will this accomplish?

1. Empower colleagues to be excellent.
2. Promote a narrow focus.
3. Decrease ambiguity.
4. Foster passivity.



____  10.   What is the most useful way for a nurse leader to build and sustain a culture of excellence?

1. Develop a mechanism to discipline staff not involved in seeking excellence.
2. Create a culture of critical reflection.
3. Attempt to improve the environment only in very small increments.
4. Allow for stabilization of growth for a minimum of 12 months.



____  11.   What type of relationship describes leadership for excellence?

1. One that follows “party lines”
2. One of authority
3. One of influence
4. One that is mandatory



____  12.   What do Mescon and Mescon (1984) say counts on the road to perfection?

1. The little things
2. The possible dream
3. The quantity
4. The organization



____  13.   Nurses interested in excellence want constructive feedback from their supervisor and peers. Frequently, however, the most helpful feedback is actually a result of which action?

1. Interviewing nurses from other agencies to obtain feedback about one’s care
2. Reviewing patient satisfaction of care results for one’s unit
3. Taking the “mirror test” to evaluate one’s own work
4. Asking patients about the care they received from the health-care team



____  14.   Besides excellence, which other focus should nurses have to create a preferred future?

1. Look to physicians to lead the health-care team.
2. Accomplish a list of tasks.
3. Achieve quality patient outcomes.
4. Create limited professional involvement.



____  15.   A nurse wants to become involved in a professional organization. Which organization was started by six nursing students who wanted to acknowledge nursing scholarship?

1. Sigma Theta Tau International
2. Phi Kappa Phi
3. American Nurses Association
4. National League for Nursing



____  16.   A staff nurse is striving for excellence by following the descriptions offered by Diers and Evans (1980). Which concept best describes the nurse’s ability to successfully balance competing demands?

1. Discipline
2. Skepticism
3. Responsibility
4. Choreography



____  17.   For nursing to achieve its preferred future, in which areas should each individual nurse take responsibility for providing leadership?

1. Selected professional and personal matters
2. Our lives, our institutions, and our society
3. Our communication with every individual we encounter
4. Certain parts of our lives



____  18.   Which term accurately describes a nurse leader striving for excellence?

1. Infallible
2. Genius
3. Risk taker
4. Perfectionist



____  19.   Deming (1986) is known for his statement that “quality is never an accident.” In light of this statement, what should a nurse do to reach success?

1. Work in a silo and be committed to perfection in every aspect of life.
2. Remain steadfast in one’s focus and never change one’s original ideas.
3. Be sincere about intentions and demonstrate intelligent direction and skillful execution.
4. Use multiple formative evaluations and financial incentives to improve productivity.



____  20.   A nurse leader has a commitment to pursue excellence to help shape a preferred future. Which idea should the nurse leader use?

1. Minimal training will be needed for this transformation.
2. People in top positions will accomplish the change.
3. Inspection will help achieve quality during this adjustment.
4. Individual investment will be required for this process.



____  21.   The Robert Wood Johnson Foundation and the Institute for Healthcare Improvement have a program that identifies five critical elements of a health-care organization’s success. Which element will the nurse leader use to help shape a preferred future for nursing in such organizations?

1. Improvement initiatives to actively engage staff in meaningful problem-solving
2. Integration of formal mentors to give formative and summative feedback regularly
3. Alignment to achieve inconsistency of goals to resource allocation
4. Leadership commitment to quantity



____  22.   Hesselbein (2002) expressed which statement about leadership for excellence?

1. Leadership is a matter of intelligence.
2. Leadership is a matter of how to do it.
3. Leadership is a matter of how to be.
4. Leadership is a matter of skill.



____  23.   Which trait is typical of a leader who wants to promote excellence?

1. Discourages conflict
2. Is unwilling to use intuition
3. Has limited vision
4. Acts as a change agent



Multiple Response

Identify one or more choices that best complete the statement or answer the question.


____  24.   Which actions by a nurse are components of excellence according to Diers and Evans (1980)? Select all that apply.

1. Acknowledges what is done well or poorly and blames no one
2. Strives to get by
3. Keeps an open mind to new ideas and perspectives
4. Allows several demands to go unmet so that another demand can be met successfully
5. Demonstrates a concern and a compassion for others



____  25.   A nurse striving for excellence joins a professional organization. What are the benefits of joining? Select all that apply.

1. It exposes the nurse to positive role models and potential mentors.
2. It offers opportunities for the nurse to develop new skills (e.g., advancing a health policy agenda).
3. It helps the nurse stay “connected” with significant issues facing nursing.
4. It helps the nurse learn less about excellence in nursing
5. It offers opportunities for the nurse to avoid working.