The New Leadership Challenge Creating the Future of Nursing 5th Edition By Sheila Grossman – Test Bank

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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 5: Followership and Empowerment

Answer Section

MULTIPLE CHOICE

1.ANS:2

Page: 77-78

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Moderate

Heading: Introduction

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Management: Nursing: Health-Care System: Collaboration

	Feedback
1	Incorrect because Chaleff’s framework fosters both the leader and followers orbiting around their purpose.
2	Correct because Chaleff’s framework is both the leader and follower(s) having a mutual purpose.
3	Incorrect because personal needs is not the focus of Chaleff’s theory.
4	Incorrect because having shared history does not relate to Chaleff’s theory.

PTS: 1 CON: Management: Nursing: Health-Care System: Collaboration

2.ANS:4

Page: 79

Objective: 1. Examine the differences and similarities between leaders and followers.

Difficulty: Moderate

Heading: Introduction

Integrated Processes: Teaching and Learning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Nursing: Health-Care System: Evidence-Based Practice: Collaboration

	Feedback
1	Incorrect because this information is true and the question asks for a statement that is not accurate.
2	Incorrect because this information is true and the question asks for a statement that is not accurate.
3	Incorrect because this information is true and the question asks for a statement that is not accurate.
4	Correct because the nurse needs more instruction since this information is inaccurate. Followers do not need to seek permission from the leader to be effective.

PTS:1

CON: Management: Nursing: Health-Care System: Evidence-Based Practice: Collaboration

3.ANS:3

Page: 81

Objective: 1. Examine the differences and similarities between leaders and followers.

Difficulty: Moderate

Heading: The Concept of Followership

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Nursing

	Feedback
1	Incorrect because followership is not a well-defined science.
2	Incorrect because followership can be cultivated and taught to others.
3	Correct because followership is voluntary.
4	Incorrect because followership is as important as leadership.

PTS:1CON:Management: Collaboration: Nursing

4.ANS:1

Page: 82

Objective: 1. Examine the differences and similarities between leaders and followers.

Difficulty: Moderate

Heading: The Concept of Followership

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Nursing: Nursing Roles: Collaboration

	Feedback
1	Correct because followers are active participants.
2	Incorrect because followers are very involved with leaders but are not dependent upon the leader.
3	Incorrect because followers do not need specific directions for each task.
4	Incorrect because followers are expected to ask questions and not always agree with the leader.

PTS: 1 CON: Management: Nursing: Nursing Roles: Collaboration

5.ANS:2

Page: 84

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Easy

Heading: Types of Followers 

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Communication: Collaboration: Nursing: Nursing Roles

	Feedback
1	Incorrect because this type of follower is not a sheep.
2	Correct because a follower described as passive with hostile tendencies is an alienated follower.
3	Incorrect because this type of follower is not a “yes” person.
4	Incorrect because this type of follower is not a contributor.

PTS: 1 CON: Management: Communication: Collaboration: Nursing: Nursing Roles

6.ANS:3

Page: 85 and 87

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Difficult

Heading: Types of Followers 

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Incorrect because followers who are “yes” people are not contributors.
2	Incorrect because followers who are effective are not politicians.
3	Correct because followers who are sheep are like subordinates.
4	Incorrect because followers who are alienated are not partners.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

7.ANS:2

Page: 90

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Moderate

Heading: Characteristics of Effective or Exemplary Followers

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Incorrect because leaders who are credible are not aggressive and always in a position of authority.
2	Correct because leaders who are credible demonstrate these characteristics.
3	Incorrect because leaders who are credible are not controlling and powerful.
4	Incorrect because leaders who are credible are not demanding and focused on maintaining the status quo.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

8.ANS:1

Page: 96

Objective: 5. Formulate strategies to develop oneself as an effective follower.

Difficulty: Moderate

Heading: Know Yourself and Your Organization, and Continue to Grow as a Person and a Professional

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Communication: Collaboration: Nursing: Nursing Roles

	Feedback
1	Correct because followers who are effective are passionate.
2	Incorrect because followers who are effective are not spectators.
3	Incorrect because followers who are effective do not wait to be told before taking action.
4	Incorrect because followers who are effective will share their creative ideas.

PTS: 1 CON: Management: Communication: Collaboration: Nursing: Nursing Roles

9.ANS:1

Page: 88

Objective: 1. Examine the differences and similarities between leaders and followers.

Difficulty: Moderate

Heading: Types of Followers 

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Correct because followers use freedom responsibly.
2	Incorrect because leaders create new ideas.
3	Incorrect because followers are risk following; leaders are risk takers.
4	Incorrect because leaders make decisions.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

10.ANS:2

Page: 93

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Moderate

Heading: Empowering Self and Others

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management

Cognitive Level: Analysis [Analyzing]

Concept: Management: Communication: Collaboration: Nursing: Nursing Roles

	Feedback
1	Incorrect because effective leaders and followers do not follow the orders of others without discussion.
2	Correct because leaders and followers who are effective empower each other.
3	Incorrect because leaders and followers do not function independently of each other.
4	Incorrect because leaders and followers who are effective would never assume a subordinate position on the health-care team.

PTS: 1 CON: Management: Communication: Collaboration: Nursing: Nursing Roles

11.ANS:3

Page: 86

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Moderate

Heading: Types of Followers 

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Management: Communication: Collaboration: Nursing: Nursing Roles

	Feedback
1	Incorrect because politicians are low performance initiative but high relationship initiative.
2	Incorrect because subordinates are low performance initiative and low relationship initiative.
3	Correct because partners are high performance initiative and high relationship initiative.
4	Incorrect because contributors are high performance initiative but low relationship initiative.

PTS: 1 CON: Management: Communication: Collaboration: Nursing: Nursing Roles

12.ANS:4

Page: 85

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Moderate

Heading: Types of Followers 

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles: Critical Thinking 

	Feedback
1	Incorrect because star followers are active participants and have independent, critical thinking.
2	Incorrect because alienated followers are passive participants but have independent, critical thinking.
3	Incorrect because sheep are passive and have dependent, uncritical thinking
4	Correct because “Yes” people are active participants but have dependent, uncritical thinking.

PTS:1

CON: Management: Collaboration: Communication: Nursing: Nursing Roles: Critical Thinking

13.ANS:3

Page: 82

Objective: 1. Examine the differences and similarities between leaders and followers.

Difficulty: Moderate

Heading: The Concept of Followership

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Incorrect because followers who are described as tentative with decision making are not effective.
2	Incorrect because followers who are described as focused on working solo are not effective.
3	Correct because effective followers are described accurately.
4	Incorrect because effective followers do not blindly accept authority or abdicate responsibilities.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

14.ANS:1

Page: 94

Objective: 5. Formulate strategies to develop oneself as an effective follower. 

Difficulty: Moderate

Heading: Developing Effective Followership Skills

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Correct because to start a movement the first follower is a crucial role, an underestimated form of leadership.
2	Incorrect because the tipping point is formed with new followers.
3	Incorrect because new followers emulate the first follower, not the leader.
4	Incorrect because the first follower needs to show others how to follow as well.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

15.ANS:2

Page: 98

Objective: Formulate strategies to develop oneself as an effective follower.

Difficulty: Moderate

Heading: Developing Effective Followership Skills: Be Active

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Management: Collaboration: Communication: Critical Thinking: Nursing: Nursing Roles

	Feedback
1	Incorrect because this would maintain the status quo or make it worse for praising inappropriate behavior.
2	Correct because developing solutions to problems improves staff’s followership skills.
3	Incorrect because this will not help the staff members grow as effective followers.
4	Incorrect because the complaining, experienced nurses need a behavior change before being assigned to work with motivated new staff.

PTS:1

CON: Management: Collaboration: Communication: Critical Thinking: Nursing: Nursing Roles

16.ANS:3

Page: 89

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Moderate

Heading: Characteristics of Effective or Exemplary Followers

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Incorrect because a star follower has a “can do” aura.
2	Incorrect because a star follower has a “can do” aura.
3	Correct because a star follower has a “can do” aura.
4	Incorrect because a star follower has a “can do” aura.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

17.ANS:1

Page: 91

Objective: 4. Examine how power can be used to empower oneself and others.

Difficulty: Moderate

Heading: Sources of Power

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Correct because power should be used only to influence others.
2	Incorrect because power should not be used to control a group.
3	Incorrect because these people should not be the only ones who are rewarded.
4	Incorrect because power should not be used to strengthen a leader’s power base.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

18.ANS:4

Page: 91

Objective: 3. Describe sources of power.

Difficulty: Moderate

Heading: Sources of Power

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Nursing: Nursing Roles: Evidence-Based Practice

	Feedback
1	Incorrect because coercive power is that which comes from the ability to penalize others.
2	Incorrect because expert power is that which comes from one’s expertise and knowledge.
3	Incorrect because reward power is that which comes from the ability to help and get things for others.
4	Correct because legitimate power is that which comes directly from one’s title or role in one’s family or culture.

PTS: 1 CON: Management: Nursing: Nursing Roles: Evidence-Based Practice

19.ANS:3

Page: 91

Objective: 3. Describe sources of power.

Difficulty: Moderate

Heading: Sources of Power

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Nursing: Nursing Roles

	Feedback
1	Incorrect because expert power comes from one’s knowledge or competence.
2	Incorrect because expert power comes from one’s knowledge or competence.
3	Correct because expert power comes from one’s knowledge or competence.
4	Incorrect because expert power comes from one’s knowledge or competence.

PTS:1CON:Management: Nursing: Nursing Roles

20.ANS:4

Page: 90

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Moderate

Heading: Characteristics of Effective or Exemplary Followers

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles: Health-Care System

	Feedback
1	Incorrect because forward looking is being oriented toward the “big picture” and is able to help followers see their important place in that picture.
2	Incorrect because forward looking is being oriented toward the “big picture” and is able to help followers see their important place in that picture.
3	Incorrect because competency is leaders who know their field of endeavor and know the work that needs to be done.
4	Correct because forward looking is being oriented toward the “big picture” and is able to help followers see their important place in that picture.

PTS:1

CON: Management: Collaboration: Communication: Nursing: Nursing Roles: Health-Care System

21.ANS:3

Page: 93

Objective: 4. Examine how power can be used to empower oneself and others.

Difficulty: Difficult

Heading: Empowering Self and Others

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Collaboration: Communication: Nursing: Nursing Roles

	Feedback
1	Incorrect because affirming values allows leaders to help followers reflect on and perhaps challenge their values and the values of others.
2	Incorrect because coercive power is the ability to penalize others.
3	Correct because renewing helps both leaders and followers break routines, habits, and fixed attitudes, allowing growth.
4	Incorrect because serving as a symbol is a risk taker who acts as the group’s source of unity, voice of anger, collective identity, and source of hope.

PTS: 1 CON: Management: Collaboration: Communication: Nursing: Nursing Roles

22.ANS:1

Page: 87

Objective: 2. Articulate the interdependence between leaders and followers.

Difficulty: Easy

Heading: Types of Followers

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Comprehension [Understanding]

Concept: Management: Nursing: Nursing Roles: Evidence-Based Practice

	Feedback
1	Correct because Kellerman’s continuum is strictly based on level of engagement.
2	Incorrect because knowledge of followership is not the unit of measurement used in the Kellerman continuum
3	Incorrect because the duration of time is not significant.
4	Incorrect because “likeness” between leaders and followers is not what is measured.

PTS: 1 CON: Management: Nursing: Nursing Roles: Evidence-Based Practice

23.ANS:2

Page: 92

Objective: 3. Describe sources of power.

Difficulty: Easy

Heading: Sources of Power

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Nursing: Evidence-Based Practice

	Feedback
1	Incorrect because Parse does not discuss expert power.
2	Correct because Parse believes strongly that it is the power lying within the person that is most significant.
3	Incorrect because Parse does not believe authority is stronger than power.
4	Incorrect because Parse does not believe leaders are more important than followers.

PTS: 1 CON: Management: Nursing: Evidence-Based Practice

24.ANS:1

Page: 87

Objective: 2. Articulate the interdependence between leaders and followers. 

Difficulty: Easy

Heading: Types of Followers

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Nursing: Nursing Roles: Collaboration: Evidence-Based Practice

	Feedback
1	Correct because diehards are deeply devoted to the leader and are highest on the continuum.
2	Incorrect because diehards are deeply devoted to the leader and are highest on the continuum.
3	Incorrect because diehards are deeply devoted to the leader and are highest on the continuum.
4	Incorrect because diehards are deeply devoted to the leader and are highest on the continuum.

PTS: 1 CON: Management: Nursing: Nursing Roles: Collaboration: Evidence-Based Practice

MULTIPLE RESPONSE

25.ANS:1, 4, 5

Page: 97

Objective: 5. Formulate strategies to develop oneself as an effective follower.

Difficulty: Moderate

Heading: Developing Effective Followership Skills: Be Involved and Speak Up

Integrated Processes: Communication and Documentation

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Management: Communication: Collaboration: Nursing: Nursing Roles

	Feedback
1.	Correct because an effective follower will become involved with professional organizations.
2.	Incorrect because effective followers are cooperative with, rather than adversarial, to leaders.
3.	Incorrect because effective followers will not just complain and walk away; effective followers will offer thoughtful feedback and/or solutions.
4.	Correct because effective followers will exercise a “courageous conscience.”
5.	Correct because effective followers will contribute as equal partners.

PTS: 1 CON: Management: Communication: Collaboration: Nursing: Nursing Roles