Complete Test Bank With Answers

 

 

 

Sample Questions Posted Below

 

 

 

 

Multiple Choice Questions

 

1) When using an innovative decision-making model, in order to help reduce the potential of group members’ reluctance to share their ideas with the group, the group leader will __________.

1. credit the individual for their creativity with a reward
2. ask each group member to write their idea on a piece of paper, then read the ideas to the group, identifying the member who developed the idea
3. Ask each group member to write their idea on a piece of paper, then read the ideas to the group without identifying the member who developed the idea
4. credit the group with a reward, pointing out who the individual was who generated the starting point

 

Answer: c

Rationale for Correct Answer:

1. Incorrect: To help individuals share their ideas with their work group, consideration must be made for giving a reward to the group, rather than rewarding individual performance.
2. Incorrect: In order to help reduce the potential reluctance of group members, this activity must be done anonymously to prevent individual ideas from being judged.
3. Correct: When using an innovative decision-making model, in order to help reduce the potential reluctance of group members to share their ideas, the group leader might ask each group member to write one idea down on a piece of paper, collect these ideas and read them to the group, and then continue the process by having members write down another idea.
4. Incorrect: To help individuals share their ideas with their work group, consideration must be made for giving reward to the group rather than the individual performance. In order to help reduce the potential reluctance of group members, this activity is done anonymously so as to prevent their ideas being judged.

Client need per NCLEX: safe and effective environment

Integrated Nursing Process: Planning, Implementation

Objective: 1—Identify different models and tools of decision making

 

2) Which of the following represents the correct order of steps for rational decision making?

1. identifying an issue, generating all potential solutions and their consequences, selecting the optimal solution, and implementing the decision
2. implementing a decision, identifying an issue, generating possible solutions and their consequences, and selecting the optimal solution
3. identifying an issue, generating all potential solutions and their consequences, implementing the decision, and selecting the optimal solution from those implemented
4. identifying an issue, selecting the optimal solution, generating possible solutions and their consequences, and implementing a decision

 

Answer: a

Rationale for Correct Answer:

1. Correct: Rational decision-making models are developed on the assumption that a person determines the best course of action through logically thinking about all possible options. The number of steps in different models may vary, but in general these models include the following sequence of steps: identifying an issue that needs a decision; generating all potential solutions; generating all possible consequences for each potential solution; selecting an optimal solution; and implementing the decision.
2. Incorrect: These are steps in rational decision making, but the steps are in the wrong sequence, thus altering the logical flow of the process.
3. Incorrect: These are steps in rational decision making, but the steps are in the wrong sequence, thus altering the logical flow of the process.
4. Incorrect: These are steps in rational decision making, but the steps are in the wrong sequence, thus altering the logical flow of the process.

Client need per NCLEX: safe and Effective Environment

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 1—Identify different models and tools of decision making

 

3) The type of decision making where a manager makes a decision without any input from others in the organization, and then implements the decision, is called __________.

1. participatory decision making
2. consultative decision making
3. collaborative decision making
4. autocratic decision making

 

Answer: d

Rationale for Correct Answer:

1. Incorrect: Participatory decision making, sometimes referred to as participatory management, refers to decision making where the manager allows employees to share in the decision.
2. Incorrect: In consultative decision making, the manager consults with employees, but after the consultation process, the manager makes the decision.
3. Incorrect: Collaborative decision making is also known as group decision making, and refers to when a decision is made by a group rather than an individual.
4. Correct: This is the definition of autocratic decision making.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation

Objective: 2—Identify a variety of styles of management decision-making

 

4) A generous donor has provided funds to a nursing unit. The nurse manager requests the input of the staff to determine how the funds will be spent. Options include redecorating the staff lounge, registration for some staff to attend educational conferences, or directing the funds towards the staff holiday party. The manager asks the staff to vote on their preferred choice. In order to ensure the staff feel valued and not betrayed, the manager indicates that not everyone will agree with the final decision, but that when it is announced, the rationale for the decision will be transparent. The decision-making style used in this scenario is __________.

1. transparency
2. consensus decision making
3. autocratic decision making
4. equity

 

Answer: b

Rationale for Correct Answer:

1. Incorrect: Transparency means being open about what is occurring and what decisions are made. It is not a decision-making style.
2. Correct: Consensus decision-making refers to the decision-making process in which the group makes the decision and there is general agreement about the decision. However, if group members believe a decision made by consensus means that all are in agreement with the decision, then those who are not in agreement may feel betrayed.
3. Incorrect: Autocratic decision making is the type of decision-making where a manager makes a decision without any input from others in the organization, and then implements the decision.
4. Incorrect: People may hold different views about what is fair and equitable, but equity is not a decision-making style.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 2—Identify a variety of styles of management decision-making

 

5) When developing strategic plans __________.

1. in small organizations, it may be possible for everyone in the building to be involved
2. in large organizations, it may be possible for everyone in the building to be involved
3. there is no link to financial and human resources required
4. in large organizations, it is considered the only plan to be followed at the organizational and departmental levels

 

Answer: a

Rationale for Correct Answer:

1. Correct: In small organizations, it may be possible for everyone in the building to be involved in the organization’s strategic plan.
2. Incorrect: In large organizations, the senior executive group may do most of the strategic planning, with input from managers and from all employees.
3. Incorrect: If an area is prioritized in the strategic plan, it needs to have the financial and human resources required for it to be successful. The strategic activities should be linked with the organization’s financial and human resource plans.
4. Incorrect: After the overall strategic plan is developed, each department may form its own strategic plan that flows from the overall strategy.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Assessment, Planning, Implementation, Evaluation

Objective: 3—Suggest how strategic planning could be used in the health care organization at both the departmental and organizational levels

 

6) Strategic planning generally includes __________.

1. an organization’s mission, values and vision
2. an organization’s human resources, financial, and succession planning
3. an organization’s mission, values, and leadership
4. only an organization’s short-term goals

 

Answer: a

Rationale for Correct Answer:

1. Correct: Strategic plans usually include the organization’s mission statement (description of focus or purpose), values, and vision statement (description of where the organization would like to be in the future).
2. Incorrect: An organization’s strategic plan should be linked to the human resource and financial plans, but these are not included in the strategic plan. Succession planning is often part of the human resource plan for an organization.
3. Incorrect: Leadership is not usually included in a strategic plan.
4. Incorrect: A strategic plan includes both short-term and long-term goals for the organization.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 3—Suggest how strategic planning could be used in the health care organization at both the departmental and organizational levels

 

7) Which of the following is a true statement about the core values of an organization?

1. They are not released to the public.
2. They are respect, equity, and transparency.
3. They assist with decision making in the organization.
4. They are different for each department in an organization.

 

Answer: c

Rationale for Correct Answer:

1. Incorrect: Statements of an organization’s core values are shared with the public and all other stakeholders.
2. Incorrect: While respect, equity, and transparency are often part of an organization’s values, they are not the only values used.
3. Correct: Most organizations have developed statements about their values, and these are often posted on their websites along with their mission and vision statements. Decisions made in the organization should be consistent with these values.
4. Incorrect: The overarching core values of an organization must be upheld within each department. Each department may add to the list but the core values must be maintained.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 4—Discuss how core values can be used to guide decision making in organizations

 

8) Employees and other onlookers consider decisions made by an organization’s administrators or board of directors to be a(n) _________________of the organization’s actual values.

1. mission statement
2. vision statement
3. reflection
4. pattern

 

Answer: c

Rationale for Correct Answer:

1. Incorrect: A mission statement is a brief description of the focus or purpose of the organization.
2. Incorrect: A vision statement is a description of where an organization would like to be in the future.
3. Correct: Employees and other onlookers consider decisions made by an organization’s administrators or board of directors to be reflections of the organization’s actual values.
4. Incorrect: Patterns and cues are recognized by experts in practice to support a recognition-primed decision making model.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 4—Discuss how core values can be used to guide decision making in organizations

 

9) In a shared governance structure, which of the following is true about nursing practice councils?

1. They help with making decisions that have time constraints.
2. They help nurses understand the work being done in their own departments.
3. They allow for administrators to direct the work of nurses.
4. They empower nurses.

Answer: d

Rationale for Correct Answer:

1. Incorrect: When issues need to be brought forward to a nursing practice council, this may take time and thus make it difficult or impossible to act when a decision is needed immediately or an organization is large.
2. Incorrect: In a shared governance structure, nurses understand the “big picture” of the organization, which includes understanding work done in departments other than their own department.
3. Incorrect: Administrators and nurses are both involved in decision making regarding the work of the nursing staff in a shared governance structure. Nurse administrators do not direct the work of nurses within this structure.
4. Correct: Nursing practice councils, and shared governance in general, involves nurses in the decision-making process, and therefore empowers them.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 5—Discuss the roles of direct care nurses, their manager, and senior administrators in decision making, and everyone’s accountability for their decisions

 

10) Respect, equity, accountability, caring, participation, and collaboration are all examples of _________.

1. key values
2. vision statement
3. mission statement
4. patterns

 

Answer: a

Rationale for Correct Answer:

1. Correct: Along with collaboration, teamwork, and transparency, these are all examples of key values an organization may identify.
2. Incorrect: A vision statement is an organization’s description of where it would like to be in the future and does not necessarily include these values.
3. Incorrect: A mission statement is a brief description of the focus or purpose of the organization and does not necessarily include these values.
4. Incorrect: Patterns are identified by experts in their fields.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 5—Discuss the roles of direct care nurses, their manager, and senior administrators in decision-making, and everyone’s accountability for their decisions

 

11) Nurse managers often have a large span of control, which contributes to a heavy workload and leaves little time to think about problems. What other factor compounds a nurse manager’s ability to find or implement a good solution to a problem?

1. interprofessional team
2. shared governance
3. “wicked” problems
4. vertical integration

 

Answer: c

Rationale for Correct Answer:

1. Incorrect: This is the type of team that works together to assess the client’s needs and care is provided by the practitioner whose expertise will most benefit the client.
2. Incorrect: This refers to an organizational structure where decision making is shared with staff.
3. Correct: “Wicked” problems is a term used to describe difficult problems that have multiple causes, some of which may not be known and are difficult to solve.
4. Incorrect: Vertical integration refers to an organization becoming larger by joining with another organization that is the supplier or purchaser of products or services of the organization.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 6—Be aware that rational decision-making models may have limited use in “wicked’ contexts

 

12) Which of the following is true about “wicked” problems as they relate to decision-making models?

1. They have multiple causes, all of which are understood, and one solution can fix them all.
2. They have multiple causes, some of which may not be known, and they are difficult to solve.
3. They have multiple causes, all of which are understood, and require multiple solutions.
4. They have a single cause, but it is not known, and they are difficult to solve.

 

Answer: b

Rationale for Correct Answer:

1. Incorrect: In “wicked” problems, each cause is not always identified or understood.
2. Correct: This is the definition of a “wicked” problem.
3. Incorrect: In “wicked” problems, all causes are not always identified.
4. Incorrect: There are usually multiple causes to a “wicked” problem.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 6—Be aware that rational decision-making models may have limited use in “wicked’ contexts

 

13) Considering alternatives until one is found that will satisfy a problem is referred to as __________.

1. safe
2. emotionally derived decision-making
3. satisficing
4. satiating

 

Answer: c

Rationale for Correct Answer:

1. Incorrect: This term does not relate to the definition in the question.
2. Incorrect: This term does not relate to the definition in the question.
3. Correct: “Satisficing” is a term coined by Herbert Simon in 1957 to describe the selection of an alternative that is satisfactory without spending additional time identifying the pros and cons of all possible solutions.
4. Incorrect: This term does not relate to the definition in the question.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 7—Apply strategies for innovative decision-making

 

14) In order to encourage innovative solutions when making decisions, you should __________.

1. offer suggestions only when asked
2. offer ideas with interest and curiosity
3. evaluate others ideas as they are presented to ensure yours is best
4. realize that if your initial reaction is that an idea is silly, it probably is

 

Answer: b

Rationale for Correct Answer:

1. Incorrect: With an innovative decision-making process, team members should feel comfortable contributing to the conversation, and not offer suggestions only when asked.
2. Correct: Offering ideas with interest and curiosity encourages innovative solutions.
3. Incorrect: In order to encourage everyone to give ideas, group members are asked to not evaluate ideas as they are presented in brainstorming sessions.
4. Incorrect: Even if your initial reaction is that an idea is silly or it has been tried before, by allowing discussion of the idea, you foster a culture of curiosity.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 7—Apply strategies for innovative decision-making

 

15) Which type of governance allows all nurses within an organization to be involved in decision making related to their professional practice?

1. shared governance
2. program management
3. horizontal governance
4. vertical governance

 

Answer: a

Rationale for Correct Answer:

1. Correct: Shared governance refers to an organizational structure where decision making is shared with staff.
2. Incorrect: Program management is a way of organizing health care organizations by groups of patients, rather than by departments with members of one professional group.
3. It does not relate to involving nurses in decision making.
4. Incorrect: Horizontal governance is not a type of governance.
5. Incorrect: Vertical governance is not a type of governance.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 8—Compare different organizational and reporting structures, including shared governance, program management and interprofessional teams

 

16) Mr. Watkins is an 84-year-old who was admitted to hospital with pneumonia. He was assessed in the emergency department by a physician, and was provided nursing care by an RPN and an RN. A respiratory therapist then conducted pulmonary function tests and social work has been consulted. A plan of care is developed for each of these practitioners to be involved in different aspects of Mr. Watkin’s care while in hospital. This is an example of implementation of which type of structure?

1. interprofessional team
2. intraprofessional team
3. hierarchical structure
4. consultative care

 

Answer: a

Rationale for Correct Answer:

1. Correct: An interprofessional team works together to assess the client’s needs and care is
2. provided by the professional(s) whose expertise will benefit the patient.
3. Incorrect: The intraprofessional team functions only within one discipline.
4. Incorrect: This type of structure has a number of layers of management.
5. Incorrect: Consultative care is not a structure within Canadian health care organizations.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 8—Compare different organizational and reporting structures, including shared governance, program management and interprofessional teams

 

17) Ronee is a health care aide (unregulated care provider). Which of the following scenarios will facilitate a safe and positive work environment for her in an acute care area?

1. All nurses on the unit will delegate their work to Ronee.
2. All nurses on the unit will work as a large team, with Ronee included.
3. All nurses and health care aides on the unit will work as a large team.
4. All nurses and Ronee will participate in change-of-shift reports.

 

Answer: d

Rationale for Correct Answer:

1. Incorrect: It will be difficult for the unregulated care provider if all nurses and licensed practical nurses on a unit can delegate their work to one person.
2. Incorrect: It is preferable to create small health care teams, such as two nurses working with one unregulated health worker, with responsibility for the same group of patients.
3. Incorrect: It is preferable to create small health care teams, such as two nurses working with one unregulated health worker, with responsibility for the same group of patients.
4. Correct: Including unregulated care providers in change-of-shift reports demonstrates to the care provider that he or she is a member of the team.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 9—Discuss what and how nursing care can be delegated (or assigned) to other nurses and non-nurses

 

18) In which of the following situations could the care of a patient be transferred to an unregulated care provider?

1. The patient’s condition is well-controlled or managed.
2. The patient’s condition is expected to change.
3. The patient is unresponsive.
4. The patient’s response to the procedure is unpredictable.

 

Answer: a

Rationale for Correct Answer:

1. Correct: As per the CNO’s decision tree regarding decisions about activities to be performed by unregulated care providers, this factor is acceptable. It is appropriate to transfer a patient’s care to an unregulated care provider if that patient’s condition is well-controlled.
2. Incorrect: In this situation it would not be appropriate to delegate patient care to an unregulated care provider.
3. Incorrect: In this situation it would not be appropriate to delegate patient care to an unregulated care provider.
4. Incorrect: In this situation it would not be appropriate to delegate patient care to an unregulated care provider.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 9—Discuss what and how nursing care can be delegated (or assigned) to other nurses and non-nurses

 

Short Answer Questions

 

19) Fill in the blanks with the appropriate term from the following list:

Intuitive decision-making

Rational decision-making

Innovative decision-making

1. __________ is the decision-making model that is a rational, cognitive process.
2. __________ is often described as a decision-making process that requires “thinking outside the box.”
3. ___________ is the decision-making model based on patterns and cues.

Answer:

• Rational decision-making is the decision-making model that is a rational, cognitive process.
• Innovative decision-making is often described as a decision-making process that requires “thinking outside the box.”
• Intuitive decision-making is the decision-making model based on patterns and cues.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 1—Identify models and tools of decision making

 

20) Name three styles of management decision making.

 

Answer:

Correct answers will include 3 items from the following list.

• autocratic decision-making
• consultative decision-making
• participatory decision-making
• collaborative decision-making

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 2—Identify a variety of styles of management decision-making

 

21) Name three things that should be included in an organization’s or department’s strategic plan.

 

Answer:

Correct answers should include 3 of the following.

• mission statement
• values
• vision statement
• goals and objectives and how they will be achieved

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 3—Suggest how strategic planning could be used in a health care organization at both the departmental and organizational levels

 

22) Name two core values often used by organizations. Provide an example of how each core value can be demonstrated.

 

Answer:

Correct answers should include 2 of the following.

• Equity, e.g., communicating how decisions will be made
• Transparency, e.g., being open about what is occurring and what decisions are being made
• Respect, e.g., communicating verbally and nonverbally in a civil way with employees
• Collaboration, e.g., use of a shared governance model

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 4—Discuss how core values can be used to guide decision making in organizations

 

23) Name three advantages of delegation.

Answer:

Correct answer should include the following.

• Decisions are made by persons who have the best information, thus the quality of decisions should be improved.
• Decisions are not delayed by the need to take them to a higher level of manager in the organization.
• Lower-level managers have the opportunity to develop their decision-making skills.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 5—Discuss the roles of direct care nurses, their managers, and senior administrators in decision making, and everyone’s accountability for their decisions

 

24) Define a “wicked” problem and provide an example you have seen in clinical practice. Explain why a rational decision-making process will not be effective for dealing with this type of problem.

 

Answer:

• A “wicked” problem cannot be solved using a rational decision-making process because “wicked” problems are difficult problems that have multiple causes, some of which may not be known, and are therefore difficult to solve.
• Various examples of “wicked” problems will be provided.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 6—Be aware that the rational decision-making models may have limited use in “wicked” contexts

 

25) Identify two strategies that can be used to engage group members who are involved in the brainstorming stage of innovative decision making.

 

Answer:

Correct answers should include 2 of the following.

• Encourage everyone to give ideas. Others in the group are asked to not evaluate the ideas as they are presented.
• Give rewards for the whole group, rather than the individual.
• Have group members write one idea on a piece of paper and collect the ideas to be read to the group.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 7—Apply strategies for innovative decision-making

 

26) Define one of the following.

1. shared governance
2. program management
3. interprofessional teams

Answer:

• Shared governance: An organizational structure in which decision making is shared with staff
• Program management: A way of organizing health care organizations by groups of patients rather than by departments with members of one professional group
• Interprofessional teams: Teams that work together to assess the client’s needs and care is provided by the various professional(s) whose expertise will benefit the patient

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 8—Compare different organizational and reporting structures, including shared governance, program management and interprofessional teams

 

27) What are the three key categories of factors used in the decision-making process about activities performed by unregulated care providers? Provide an example of each.

 

Answer:

Correct answers should include:

• Client Assessment

Examples:

• The client has established well-defined care needs, support systems, and coping mechanisms.
• The client’s condition is well controlled/managed.
• The client’s condition is not excepted to change.
• The client or representative may direct his/her own care.

• Benefits and Risks Assessment

Examples:

• The activity and client response has been established over time.
• There are identifiable outcomes that are easily recognized.
• There are no negative systemic effects.
• The activity will be performed frequently enough for the UCP to maintain competence.

• Environmental Supports

Examples

• There are clear policies.
• The appropriate resources are readily available for consultation or intervention. In the community, this can mean by telephone.

Client need per NCLEX: safe and effective environment, psychological integrity

Integrated Nursing Process: Planning, Implementation, Evaluation

Objective: 9—Discuss what and how nursing care can be delegated (or assigned) to other nurses and non-nurses