Test bank for leading and managing in nursing revised reprint 5th edition by yoder wise

ANS: A The philosophy needs to state what the nurse manager and staff believe is the vision for nursing management and practice and sets the stage for establishing goals to make the visi

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Leading and Managing in Nursing: 5th Edition Test Bank – Yoder-Wise

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Sample

Yoder-Wise: Leading and Managing in Nursing, 5th Edition

Chapter 08: Understanding and Designing Organizational Structures

Test Bank

MULTIPLE CHOICE

1 A hospital and a nursing education program form a partnership to recruit more nurses to the region This organizational structure is:

a Being responsive to changes in the environment

b Being bureaucratic

c Creating permanent professional boundaries

d Delineating structures for all decision making

ANS: A

Shared decision making across organizations can lead to growth and

responsiveness in meeting emergent needs

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REF: Pages 141, 142, 153

TOP: AONE competency: Communication and Relationship-Building

2 A hospital is working toward becoming a Magnet™ hospital The chief nursing officer is aware that professional nursing departments of the future will:

a Not be directed by nurses

b Be virtual organizations

c Be designed to maintain nursing standards of practice

d Be entitled to have client care departments

ANS: C

Professional nursing departments of the future will be focused on patient care outcomes and delivery of services

REF: Pages 150, 151

TOP: AONE competency: Knowledge of Healthcare Environment

3 The chief nursing officer and the dean of the School of Nursing believe that

by establishing rules and regulations and controlling the environment, this partnership will:

a Promote professional medical authority, autonomy, and responsibility

b Need a degree of flexibility to engender success

c Be essential for self-governance

d Provide for the establishment of medical committees

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ANS: B

Centralized decision-making structures that emphasize high control and rules and regulations that lay out expectations can be slow to respond to emergent trends

REF: Page 144 TOP: AONE competency: Leadership

4 In matrix organizational structures, a nurse manager understands that this type of structure:

a Is a simplified organizational structure

b Has both a functional manager and a service or product-line manager

c Arranges departments strictly according to function

d Promotes harmony in organizational decision making

ANS: B

Matrix structures are complex, integrated organizational structures that involve both functional and service or product-line managers In this structure, team members or teams from various functional departments may combine to complete

a project or program, thereby becoming responsible to both their functional

department manager and their product-line manager Harmony or disharmony cannot be assumed

REF: Pages 147-149 TOP: AONE competency: Business Skills

5 Collaborative partnerships between hospitals and schools of nursing are examples of hybrid organizational structures A hybrid organizational structure:

a Has many divisions of labor

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b Best fits long-term care units

c Has a mixture of the characteristics of various organizational types

d Places the authority for decision making closest to the places where

workers perform

ANS: C

Hybrid structures include characteristics of various organizational types and reflect the needs of the situation and the environment

REF: Page 150

6 In opening a new dialysis unit, the nurse manager has to develop a

philosophy for the unit This philosophy needs to:

a Reflect the culture of the unit and its values

b Be developed by the nursing manager on the unit

c Identify the clients that will be served on the unit

d Replicate the organization’s philosophy

ANS: A

The philosophy needs to state what the nurse manager and staff believe is the

vision for nursing management and practice and sets the stage for establishing goals to make the vision a reality It is complementary to the organizational

philosophy but reflects the values of nursing Shared governance enables staff and management to develop a vision and is congruent with contemporary views of management The identification of clients to be served reflects a mission statement

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REF: Page 138 TOP: AONE competency: Knowledge of Healthcare

Environment

7 The hospital administration gives approval to the chief nursing officer to hire clinical nurse specialists in staff positions rather than in administrative

positions A clinical specialist who has staff authority but no line authority typically is able to:

a Function through influence

b Take complete responsibility for the care of clients

c Interview and hire staff nurses for designated nursing units

d Be granted functional authority to determine standards of nursing care

and enforce them

ANS: A

Staff positions provide support to line positions but have no direct accountability for staff or patient outcomes and therefore, function through influence

REF: Page 146

TOP: AONE competency: Knowledge of the Healthcare Environment

8 A new director of nursing in a small rural hospital wants to make changes from the traditional model of governance to a shared-governance model Select the characteristic below that best describes the traditional

organizational structure in which a staff nurse is assigned to carry out

nursing tasks for clients but is not given the chance to provide input into forming the policies and procedures by which care is delivered or the

standards by which care is evaluated:

a Bureaucratic

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b Decentralized

c Delegated authority and responsibility

d Delegated responsibility but no authority

ANS: D

In traditional structures, decision making authority is held by a centralized

decision-making body, so that staff members have responsibility for certain

functions but do not participate in decisions related to those functions

REF: Page 144

9 The chief nursing officer is given the task of reviewing and revising the organization’s mission, philosophy, and technology In reviewing them, the chief nursing officer understands that they should be reflected in:

a The organizational structure

b Line and staff responsibilities

c The policies and procedures

d Government regulations

ANS: A

The mission statement is an important foundation for the organizational structure and defines technology and human resources required for the organization

REF: Pages 139, 140

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10 The facilities department is experiencing some challenges and is undergoing reorganization Because of your familiarity with systems theory, you:

a Know that this challenge is their issue and that it has nothing to do with

your unit

b Understand that such events are localized and do not have an impact on

the organizational culture

c Know that the nature of challenges and reorganization in facilities will

have an impact on other areas

d Anticipate that your prior experiences with facilities have no effect on

the current situation

ANS: C

By nature, a system such as an organization is an interacting collection of parts that together make up the whole Changes to one part will affect other parts and the system as a whole

REF: Page 138 TOP: AONE competency: Leadership

11 “Georgia Hospital will provide care that is a national example of consumer service” is a:

a Vision statement

b Statement of philosophy

c Mission statement

d Rationale for care

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ANS: A

A vision statement is an articulated goal that provides an inspirational target to which the organization aspires

REF: Page 140 TOP: AONE competency: Knowledge of Healthcare Environment

12 “At Thoroughcare, we provide healthcare for women and children in

transition” is an example of a:

a Vision statement

b Mission statement

c Goal statement

d Statement of philosophy

ANS: B

Mission statements provide a reason or rationale for the existence of the

organization and are indicative of the structure of the organization and of who consumes the services provided

REF: Pages 139, 140

13 Which of the following would be the most appropriate mission statement for

a nursing center?

a “At Plentyville, we provide rehabilitative services for addicted

adolescents.”

b “Georgiatown provides treatment and prevention services for county

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residents.”

c “At Heart, our aim is to provide services that lead the nation in health

education and research.”

d “At Coeur, we strive to achieve optimal pain management with patients

who are experiencing chronic pain.”

ANS: D

The mission statements of nursing centers are oriented toward achieving optimal health status for a defined group of patients or consumers

REF: Pages 139, 140

14 Which of the following most influences the organizational structure of the

organization?

a Mission statement

b Statement of philosophy

c Vision statement

d Goal statement

ANS: A

Mission statements lay out the reasons for the organization and include the

population served and services offered, which, in turn, influence the technologies and human resources that will be required

REF: Pages 139, 140

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15 In which of the following situations would you expect low morale and

frustration?

a

Statement of philosophy indicates “We value our staff.” When staff

members leave, careful evaluation is done to determine whether staff

should be replaced by full- or part-time employees

b

Practices include annual staff recognition celebrations During times of

change, staff members are actively included in issue identification and

solution finding

c

Recruitment ads promise opportunities for advancement for everyone

Promotions are given only to individuals with long-standing service

and entrenched relationships

d

The vision indicates that there is strong commitment to lead in

research The organization has tried to implement a strong campaign to

attract leading nurse researchers but has experienced difficulty in doing

so

ANS: C

Although frustration may occur with external factors that affect ability to act on values and aspirations, lack of congruence between what is espoused as a value within the organization, such as promising advancement as an incentive to join the organization, and what is actually done, such as restricting advancement to internal candidates with much organizational history, can cause low morale and confusion

REF: Pages 140, 141

16 At Orangetown Hospital, the nursing department is developing a mission statement for nursing Which would be a suitable mission statement?

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a “Nursing provides services for patients admitted to Orangetown

Hospital.”

b “To participate fully in the professional services offered by

Orangetown Hospital.”

c “To lead by the lamp; services for seniors.”

d

“At Orangetown, the nursing department provides caring services that

recognize the diversity of clients and promote optimal health with

clients through partnership and education and in close partnership with

other disciplines.”

ANS: D

A nursing mission statement within an organization needs to establish the reason for nursing within the organization and lays out relationships with clients, the community, and other disciplines

REF: Pages 139, 140

TOP: AONE competency: Knowledge of Healthcare Environment

17 At Hospital XYZ, staff members on Y3 have dealt with the third head nurse

in three years Donna, the current head nurse, lacks confidence in patient-nurse relationships, and scheduling and other processes are routinely left to the last minute Staff members approached Donna first and then

administration with their concerns about Donna’s effectiveness as a leader The staff was told that the problem is likely staff related, that it is simply an unhappy group, and that there is nothing that will be done further about their concerns The philosophy of the organization indicates that “open,

transparent communication between staff and management is desired and supported,” and that “innovation and creative thinking are the foundation of the organization’s progress.” In assessing this situation as a newly hired senior executive, you anticipate that:

a Staff members will resolve the conflict on their own

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b The situation will lead to ongoing disgruntlement and attrition

c No further discussion or concerns will come out of the situation

d The head nurse will be able to resolve the conflict on her own

ANS: B

Lack of congruence between the stated philosophy of the hospital and the

experienced organizational culture does not support either the staff or the head nurse and likely will result in ongoing frustration and increased attrition

18 In Valley Hospital, there is a great deal of discussion about the balance between hospital-wide budget decision making and unit-based decision making This discussion represents:

a A search for the “sweet spot.”

b Conflict between the values of nursing and those of the healthcare

organization

c Traditional organizational values

d Differences between bureaucratic and nonlinear thinking

ANS: A

The important point for an organization, the balance between centralization and decentralization of authority and decision making, is known as the “sweet spot.”

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19 With revenue reductions and cost saving measures, the number of managers has been reduced, which has increased the number of team leaders

supervised by managers by as many as three This change may result in:

a Decreased patient satisfaction

b Increased efficiency in costs

c A more positive perception of managers

d Little change to manager-staff relationships

ANS: A

When a span of control becomes too large, supervision can become less effective, which can have a negative effect on staff-manager relationships and on the overall quality of patient care

20 Taylor Hospital has well-defined organizational units that provide

maintenance, financial services, care for cardiac patients, care for surgical patients, and so on The organizational chart indicates that surgical units report to a surgical manager, and that all nursing units report to a vice

president of nursing; financial services to an accountant and then to a

business executive; and so on The primary disadvantage of this

organizational structure is:

a Breakdown in function and communication across specialties

b Lack of congruence in culture and organizational values

c Highly centralized decision making and authority

d Wide span of control

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