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Leadership and Management 4th Edition Grohar-Murray DiCroce Test Bank

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Leadership and Management 4th Edition Grohar-Murray DiCroce Test Bank

ISBN-13: 978-0135138670

ISBN-10: 0135138671

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Leadership and Management 4th Edition Grohar-Murray DiCroce Test Bank

ISBN-13: 978-0135138670

ISBN-10: 0135138671

 

 

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Free Nursing Test Questions:

 

Grohar-Murray TIF

Chapter 8: Delegation: The Manager’s Tool

Learning Objective 1:

 

Describe how delegation facilitates the efficient use of resources.

 

  1. Which statement indicates that successful learning has taken place at a “how to” course on successful delegation?

 

  1. “Delegation has no benefit on our unit, since our clients are frequently admitted and then discharged so quickly.”
  2. “I never knew I could actually save time for myself and save organizational resources by thoughtfully delegating tasks to others.”
  3. “I just don’t understand how people think delegation is not a benefit to everyone; all you have to do is tell other people what to do.”
  4. “I never knew delegation only required me to tell others what to do, and by when to have it completed.”

 

Answer: 2

Rationale: Delegation does save time and resources if done effectively, which benefits all levels of the organization. All units have time to delegate because delegators explain the task specifics, and then can move on to the next priority task. The delegate not only needs to know what to do, and when it needs to be completed, but also needs to know why the delegator needs the delegate to do it.

 

Nursing Process: Evaluation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

  1. Which situation indicates inappropriate use of delegation?

 

  1. The nurse manager triages clients coming into the Emergency Department.
  2. The charge nurse asks the nursing assistant to obtain a complete set of vital signs.
  3. The nursing supervisor asks a nurse manager to lead a task force on improving

quality.

  1. The nurse asks a nursing assistant to assist in admitting a client by setting up the

room.

 

Answer: 1

Rationale: The purpose of delegation is to ensure that the right person does the right task. It is important for the nurse manager to manage and not do nursing responsibilities such as triage on a routine basis. It is appropriate for the charge nurse to ask a nursing assistant to obtain vital signs, appropriate for the supervisor to delegate leadership of a task force to a nurse manager, and appropriate for the nurse to delegate setting up a new client room to the nursing assistant.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

  1. The novice nurse manager is hesitant to delegate tasks to competent, experienced nurses. Which most likely explains this hesitancy? Fear of:

 

  1. Overburdening staffing resources
  2. Decreased personal satisfaction
  3. Competition and criticism
  4. Increased organizational liability

 

Answer: 3

Rationale: The novice nurse manager might be insecure and fear another staff member could perform the task more effectively. There is a fear that a successful delegate could threaten the nurse manager’s credibility as a leader. Fear of overburdening staff resources occurs when the delegator overwhelms the capabilities of others. Fear of decreased personal satisfaction should be diminished by the increased opportunity to explore new challenges and gain other skills and experiences. Fear of liability arises when the delegator experiences fear of being blamed for the delegate’s mistakes.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

Learning Objective 2:

 

List at least three guidelines for effective delegation.

 

  1. Which statements would be most important for the charge nurse to make when delegating a responsibility? Select all that apply.

 

  1. “I chose you to attend the meeting because it seems as though you have the

lightest assignment.”

  1. “I have assigned you to be the unit’s representative because I don’t have enough time to go.”
  2. “I think it would be important to our organization if you represented the unit on the Policy and Procedure Committee.”
  3. “I think your attendance at the task force meeting will be a good reflection on our unit.”
  4. “I would like you to be the unit’s representative on the client education task force committee.”

 

Answer: 3; 4

Rationale:

  • “I chose you to attend the meeting because it seems as though you have the lightest

assignment.” The delegate should be assigned because the task meets the abilities of the individual.

  • “I have assigned you to be the unit’s representative because I don’t have enough time to go.” Delegating should be done for the right reasons, and not to dump tasks for purely personal reasons.
  • “I think it would be important to our organization if you represent the unit on the Policy and Procedure Committee.” Key behaviors in delegating tasks are describing the task and providing the delegate with the benefit gained for the task.
  • “I think your attendance at the task force meeting will be a good reflection on our unit.” Key behaviors in delegating tasks are describing the task and providing the delegate with the benefit gained for the task.
  • “I would like you to be the unit’s representative on the client education task force committee.” The delegator should make the delegate aware of the reason for and the benefit gained from the delegation.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

 

  1. Which effect indicates the most important reason that effective delegation is essential for nurses to practice and master?

 

  1. Greater confidence in skills
  2. Increased time for other tasks
  3. Increased client satisfaction
  4. Increased job satisfaction

 

Answer: 3

Rationale: When effective delegation takes place in an organization, everyone benefits. Personal skills and confidence increase, and there are increased time for other tasks and management responsibilities and increased job satisfaction. All of these lead to increased client satisfaction, which is the ultimate goal of nursing care and nursing management.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

  1. Which statement made by a new nurse manager is an example of the first step of effective delegation?

 

  1. “The outcomes of this project will be evaluated by nursing administration in 6 months.”
  2. “I am going to delegate the responsibility of creating the vacation schedule.”
  3. “I will monitor your progress throughout the project and give you feedback.”
  4. “I will designate a person with good time-management skills to be the delegate for this task.”

 

Answer: 2

Rationale: The first step in effective delegation is to set goals. This includes the identification and exact definition of the task to be delegated. Designating a person as the delegate is incorrect because the appointment of a delegate occurs after the task has been identified. Evaluation of outcomes is incorrect because a clear definition of the expectations of the delegate is created midway in the delegation process. Monitoring progress is incorrect because monitoring performance occurs after the delegated tasks have been carried out.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Analysis

 

 

Learning Objective 3:

 

Discuss at least five common barriers to delegation.

 

  1. The nursing supervisor states, “I really don’t have the time to delegate this assignment to a nurse manager. I can do it faster!” What does this statement suggest?

 

  1. The nursing supervisor’s job description needs to be redefined.
  2. The process of delegation is too time-consuming.
  3. The nurse supervisor does not have time to delegate.
  4. There is a lack of confidence in the staff.

 

Answer: 4

Rationale: These statements suggest a lack of trust and confidence in the abilities of the staff. Not having time is incorrect because it is the responsibility of the supervisor to develop the staff. Failing to delegate is the time waster. Redefinition of the nursing supervisor’s job description is incorrect because an effective manager’s role is to develop staff in such roles as a delegate. That the process is too time-consuming is incorrect because that time invested in developing staff today is later repaid many times over.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

 

  1. A nurse asks an unlicensed assistant to help with discharging clients, since so many are going home at one time. The nurse states, “Can you help get these clients ready to go home by helping them pack?” Which option best describes the statement with regard to effective delegation?

 

  1. The delegation is ineffective because the nurse has no authority to ask the

unlicensed assistant to help with client discharge.

  1. Delegation could have been more effective had the nurse gone with the assistant to ensure that the assistant did the packing as requested.
  2. The delegation is ineffective, since the nurse has no responsibility to pack the client’s belongings.
  3. Delegation would have been more effective had the nurse been more specific about which clients needed help and when the task should be completed.

 

Answer: 4

Rationale: Effective delegation occurs when the delegator gives specific information to the delegate about the requested task. The nurse’s request was not specific enough. The nurse has ultimate responsibility to ensure that the client is ready for discharge, which includes packing their belongings as necessary. The nurse also has authority to ask for the assistance, but does not need to go with the assistant to ensure the task is completed.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

  1. The nursing supervisor is assessing the organization by spending time on each unit. The nurse manager seems overwhelmed and stressed trying to address many client complaints. The charge nurse is trying to help everyone at once. What might this supervisor conclude based on this assessment? Select all that apply.

 

  1. The unit culture fosters distrust and poor communication among staff.
  2. The unit has had several call-ins, or is short-staffed.
  3. Delegation is seen as too time-consuming to undertake.
  4. The nurse manager is inexperienced, and needs time to adjust.
  5. Nurses on the unit are in need of additional training and skills.

 

Answer: 1; 3; 5

Rationale:

  • The unit culture fosters distrust and poor communication among staff. The unit clearly is having problems getting client responsibilities completed in a timely manner, resulting in stress and complaints. This could indicate a distrusting unit culture.
  • The unit has had several call-ins, or is short-staffed. There is no indication the unit is short-staffed or has experienced call-ins.
  • Delegation is seen as too time-consuming to undertake. The nurses on the unit might need additional training to understand delegation and its advantages.
  • The nurse manager is inexperienced, and needs time to adjust. There is no indication the nurse manager is inexperienced.
  • Nurses on the unit are in need of additional training and skills. The supervisor’s assessment might indicate additional training and skills are needed, in delegation and unit skill requirements.

 

Nursing Process: Assessment

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

 

Learning Objective 4:

 

Identify the legal issues related to the process of delegation.

 

  1. Which situations cause concerns with liability with regard to delegation? Select all that apply.

 

  1. The nurse asks the LPN to assess a central line dressing for her.
  2. The supervisor asks the charge nurse to give a nurse a difficult assignment.
  3. The nursing supervisor asks the nurse to discuss a client’s history with the

supervisor.

  1. The nursing assistant asks a nurse to check on a client’s status.
  2. The nurse asks a nursing assistant to assist another nursing assistant to obtain vital

signs.

 

Answer: 1; 2; 3

Rationale:

  • The nurse asks the LPN to assess a central line dressing for her. The LPN cannot usually work with central lines, and cannot legally assess the dressing for the RN.
  • The supervisor asks the charge nurse to give a nurse a difficult assignment. Requesting that a nurse have a difficult assignment is leaving the organization wide open for liability issues.
  •  The nursing supervisor asks the nurse to discuss a client’s history with the supervisor. Under normal circumstances, the nursing supervisor would not need information about a client’s history. This constitutes a HIPAA violation.
  • The nursing assistant asks a nurse to check on a client’s status. This is appropriate if the nursing assistant is concerned about a client’s status and does not involve delegation, as the nurse is not assessing the client in place of the nursing assistant assessment.
  • The nurse asks a nursing assistant to assist another nursing assistant to obtain vital signs. This is appropriate, as the nurse can delegate obtaining vital signs.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

 

  1. For the nurse to effectively and legally delegate, which of the following must be consulted and followed to reduce the likelihood of liability?

 

  1. The National Council of State Boards of Nursing “Rights”
  2. The American Nurses Association By-Laws
  3. The rules of the governing specialty organization
  4. The regulations of the state nurse practice acts

 

Answer: 4

Rationale: Nurses in each state are governed by their own state’s nurse practice act, and these regulations must be consulted and followed. The ANA, NCSBN, and specialty organizations cannot make rules or regulations differing from those in the nurse practice acts.

 

Nursing Process: Planning

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

  1. If the nurse needs to delegate a task in order to work on another nursing responsibility, which characteristic must be present? Select all that apply.

 

  1. Authority by the delegator to assign the task to the delegate
  2. Accountability for the assignment on the part of the delegator
  3. Responsibility for task completion on the part of the delegate
  4. Accountability for the assignment on the part of the delegate
  5. Authority of the delegate to accomplish the task as assigned

 

Answer: 1; 2; 3; 5

Rationale:

  • Authority by the delegator to assign the task to the delegate: The delegator is the individual requesting the task completion of the delegate. Thus the delegator must have authority to make the request.
  • Accountability for the assignment on the part of the delegator: The delegator has ultimate accountability for appropriate task completion and for effectively delegating appropriate tasks to others.
  • Responsibility for task completion on the part of the delegate: Once the task is assigned to the delegate, he has responsibility for effective and appropriate task completion.
  • Accountability for the assignment on the part of the delegate: While the delegate does have accountability for completion of the task, the ultimate accountability for the end product of the task completion is on the part of the delegator, not the delegate.
  • Authority of the delegate to accomplish the task as assigned: Effective delegators transfer authority to the delegate to empower the delegate for success.

 

Nursing Process: Planning

Client Need: Safe, Effective Care Environment

Cognitive Level: Comprehension

 

 

Learning Objective 5:

 

Assess the delegation process in the clinical setting where unlicensed assistive personnel work with licensed registered nurses.

 

 

  1. If the nurse is planning to delegate a task to the nursing assistant, prioritize the nurse’s actions in the correct order of the delegation process.

 

  1. Allows the nursing assistant to decide how best to complete the task.
  2. Sets goals and expected outcome of the task to be completed.
  3. Asks the nursing assistant to describe the goals and expected outcomes of the

task.

  1. Evaluates the task completed by the nursing assistant.
  2. Describes the goals and expected outcome clearly to the nursing assistant.

 

Answer: 2, 5, 3, 1, 4

Rationale:

  • Allows the nursing assistant to decide how best to complete the task: The nurse then gives the nursing assistant the freedom to decide how to complete the task.

 

  • Sets goals and expected outcome of the task to be completed: The nurse first must set goals and decide on the expected outcome for the task to be completed.
  • Asks the nursing assistant to describe the goals and expected outcomes of the task: The nursing assistant should describe expectations to ensure clear understanding regarding goals and outcomes.
  • Evaluates the task completed by the nursing assistant: Evaluation is the final step in the delegation process to ensure appropriate completion.
  • Describes the goals and expected outcome clearly to the nursing assistant: The nurse must clearly describe expected goals and outcomes with task completion.

 

 

Nursing Process: Planning

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

 

  1. Which delegated task should the charge nurse working on a unit with team nursing question?

 

  1. The nurse asked the nursing assistant to assist the client out of bed when the client asked to go to the bathroom.
  2. The nursing assistant is asked to fill the water pitchers for all clients on the unit.
  3. The unit secretary is asked to take a client to Radiology after the orders are put into the computer.
  4. The nurse who is on the phone with a health care provider asked the unit secretary to take a message from another provider calling with client orders.

 

Answer: 4

Rationale: The unit secretary is not licensed, and cannot take a message regarding orders for client care. Therefore, the charge nurse would need to intervene and question the legality of the delegated task. It is appropriate to ask the nursing assistant to assist a client out of bed to the bathroom and fill the water pitchers for clients on the unit. The unit secretary is capable of taking a client to Radiology, although this might not be the best utilization of unit resources.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

 

 

  1. The nurse pours the medication ordered for the client. The nurse asks the nurse assistant to give the medication when the client receives breakfast. Of which concept is this an example?

 

  1. Ineffective delegation
  2. Negligence
  3. Vicarious liability
  4. Decentralization</ITAL>

 

Answer: 2

Rationale: Delegation of a task to a person who is not competent or qualified is in violation of the nurse practice act, and constitutes negligence. Ineffective delegation occurs when the steps of delegation are not properly followed or barriers remain unresolved. Vicarious liability is the principle that holds the employer legally responsible for the wrongful acts of its employees. Decentralization is moving the authority away from the central administration of the organization.

 

Nursing Process: Implementation

Client Need: Safe, Effective Care Environment

Cognitive Level: Application

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