Leadership Chapter 20: Key Terms & Definitions for Nursing

A new nurse-manager is evaluating recent tasks that had been delegated to other staff for effectiveness. What is an inappropriate reason for delegation?

a. To empower subordinates by "stretching" them in their work assignment

b. To allow the manager to address more complex unit needs

c. To free the manager of a task that is not intellectually challenging

d. To give the task to someone who is better qualified

c.

A performance appraisal states that the manager often underdelegates. What is potential cause of this delegation error?

a. A high degree of trust in subordinates

b. A democratic leadership style

c. A need for perfectionism

d. Sufficient time to accomplish unit goals alone

c.

A manager needs to delegate some tasks. What consideration should the manager prioritize when identifying the appropriate person to whom to delegate a specific task?

a. Whose turn it is to take on a delegated task

b. The qualifications of the person regarding the task

c. The fiscal cost of delegating the task

d. Whether the person has experience with similar tasks

b.

A nurse-manager delegates many tasks in the course of a day. Which practice should the manager reconsider or discontinue?

a. The manager grants temporary authority to support completion of a delegated task.

b. The manager confirms that the person to whom a task is delegated is adequately

qualified.

c. The manager provides employees with exact instructions for each step of

completing the task.

d. The manager asks for regular updates from the employee when tasks take a long

time.

c.

A manager's subordinate is having difficulty carrying out a delegated task. What is the manager's best initial action?

a. Release the subordinate from the task so they will not become demoralized.

b. Be available to the employee as a role model and resource for the task.

c. Assign another more experienced employee to help with the task.

d. Reassign the employee a different, less complex task.

b.

What principle should guide the nurse's delegation of tasks to unlicensed nursing assistive personnel (NAP)?

a. It is safe to assume that the NAP has at least a high school diploma as a minimum

hiring criterion.

b. Like all members of the care team, NAP stands to lose their licensure in case of

negligent practice.

c. No federal or community standards have been established for training the broad

classification of NAP.

d. The nurse is protected from liability when allowing the NAP to perform only those tasks the employer includes in their job description.

c.

Which action is considered a leadership role associated with delegation?

a. Creating job descriptions for all personnel

b. Providing formal recognition or reward for completion of delegated tasks

c. Demonstrating sensitivity to how cultural phenomena affect transcultural

delegation

d. Reprimanding employees who demonstrate overt resistance to the tasks they are delegated

c.

Which statement is true regarding the general delegation liability of a registered nurse (RN)?

a. It is minimal because subordinates alone are held accountable for practicing within

the accepted scope of practice for their job classification.

b. It is high because the RN is automatically held liable for the tasks delegated to all recognized subordinates.

c. It is reduced when the RN delegates appropriately and supervises the completion of the tasks.

d. It is avoided entirely as long as the nurse delegates only other licensed personnel.

c.

What action should a nurse-manager perform when supporting the delegation of a task to a subordinate?

a. Holding the subordinate's professional development as the highest priority

b. Frequently reassuring the employee that if they are incapable of completing a

delegated task, it will be reassigned

c. Drafting a preliminary plan of how the task will be redone if the outcome does not meet stated expectations

d. Occasionally providing learning or "stretching" opportunities for employees

d.

Periodically during the day, an RN checks with the team members to determine whether they are having difficulty completing their assigned tasks. This describes which manager role?

a. Skills evaluation

b. Client safety

c. Effective delegation

d. Micromanagement

c.

A member of the team has been delegated some tasks and reports, "I've been given too much to do and I'm not going to be able to complete the work on time." What is the RN's best initial action?

a. Assign the work to another team member.

b. Take on the responsibility of the tasks.

c. Have the team member perform only the most necessary tasks.

d. Examine the workload and assist the individual in reprioritizing.

d.

Which assessment should an RN prioritize when assigning tasks to nursing assistive personnel (NAP)?

a. Determining the NAP's skills and knowledge level

b. Assessing which tasks the NAP is motivated to perform

c. Evaluating the NAP's ability to follow instructions

d. Asking colleagues to appraise the NAP's strengths and weaknesses

a.

Which task would the director of a home health agency not delegate to another staff RN?

a. Assigning home health aides to specific client care

b. Serving on a diabetic study committee of community resources

c. Meeting with the agency's administration regarding budget cuts

d. Reviewing the care assignment for the following shift

c.

An RN needs to confirm the specific delegation parameters for RNs. The RN should refer to guidelines from what organization?

a. The Joint Commission

b. U.S. Department of Health and Human Services

c. National League for Nursing (NLN)

d. The state board of nursing

d.

What must managers delegate to another RN in order to assure completion of a task?

a. Time and space

b. Leadership and creativity

c. Authority and responsibility

d. Personnel and knowledge

c.

The Omnibus Budget Reconciliation Act of 1987 established regulations for the education and training of which category of health care worker?

a. Certified nurse aide (CNA)

b. Registered nurse (RN)

c. Licensed practical nurse (LPN)

d. Ward clerk

a.

A registered nurse (RN) was working with a nursing assistive personnel (NAP) and delegated some tasks to the NAP. The NAP exceeded their scope of practice and caused injury to a client. Ultimate responsibility for this adverse event lies with whom?

a. The NAP

b. The facility's director of nursing

c. The unit's nursing manager

d. The RN

d.

A nurse-manager is new to the unit and is worried about being perceived as incompetent or underqualified by subordinates. The manager should recognize that this creates a risk for what problem?

a. Underdelegating

b. Overdelegating

c. Improper delegating

d. Inappropriate delegating

a.

A nurse-manager is overseeing a culturally diverse group of staff. The manager should consider what variables when planning delegation? Select all that apply.

a. Communication style

b. Concepts of time

c. Intelligence

d. Biologic variations

e. Social organization

a, b, d, e

An RN is leading a care team on a busy hospital unit. What tasks is the RN justified in delegating to NAP? Select all that apply.

a. Feeding a client who has unilateral weakness

b. Repositioning an immobile client every 2 hours

c. Assessing a client's surgical wound

d. Weighing a client who has chronic heart failure

e. Transporting a client to a diagnostic test

a, b, d, e

An experienced RN has seen a significant increase in the need for delegation skills over the past several years. This change is most likely attributable to:

a. increased numbers of uninsured clients.

b. increased lengths of stay.

c. increases in the use of NAP.

d. decreases in nurse-client ratios.

c.

A subordinate is reluctant to accept a task that the nurse-manager wants to delegate. The manager suspects that the subordinate's reluctance is due to a lack of self-confidence. What is the manager's best initial action?

a. Teach the subordinate about the value of self-confidence.

b. Try to empower the subordinate.

c. Offer a reward to the subordinate in order to motivate.

d. Restate the importance of the task to the subordinate.

b.

Which action on the part of a unit's nurse-manager demonstrates the mark of a great leader?

a. Acknowledging the accomplishments of staff members at the unit meeting

b. Providing onsite inservices on new equipment for the staff

c. Including funds in the unit's budget of staff development

d. Stressing the importance of client safety to all new employees

a.

A nurse-manager has asked a NAP for an update on delegated tasks, and the NAP has said, "I'm swamped right now." What is the manager's best response?

a. "Don't be afraid to let me know if you feel the project is overwhelming you."

b. "Time management is key to keeping on schedule with your tasks."

c. "I can give you a few solutions to help manage this heavy workload."

d. "Do you want more time to complete your work?"

c.

A nurse has successfully completed a difficult and complex task that the manager delegated. What is the manager's best action?

Document the fact that the nurse completed the task.

Assign a slightly more difficult task the next time.

Acknowledge the nurse's significant accomplishment.

Ask the nurse to act as a role model for other staff members.

c.

A nurse-manager has delegated some administrative tasks to an experienced RN. Which of the following is true about this act of delegation? Select all that apply.

a. The nurse's task will be beyond their scope of practice.

b. The manager transfers the authority for the task to the nurse.

c. The nurse is practicing on the manager's license.

d. The manager is released of the need to oversee the nurse.

e. The manager remains accountable for the task.

b, e

A nurse-manager has begun a new role in a community health center and will need to delegate tasks often to subordinates. What actions should the manager perform when delegating tasks? Select all that apply.

a. Choose the most time-consuming tasks to delegate to subordinates.

b. Evaluate the skills and education of subordinates before delegating.

c. Ensure that subordinates know the goal of any delegated task.

d. Avoid monitoring the subordinate unless there is evidence of a problem.

e. Evaluate subordinates' performance after they have completed a task.

b, c, e

A nurse delegated some tasks to a nurse several hours ago. The manager has now learned that the nurse did not complete any of the delegated tasks. What is the manager's best initial action?

a. Determine exactly why the nurse did not complete the delegated tasks.

b. Assertively state the expectation that delegated tasks will be completed on time.

c. Document the nurse's insubordination and arrange a private meeting.

d. Take action to reestablish the authority power gap.

a.

A registered nurse has been leading teams of NAP for several years and will soon be leading licensed practical nurses (LPNs) for the first time. In preparation for delegating to these nurses, the RN should:

a. delegate the same tasks to the LPNs that the RN normally delegated to NAPs.

b. review the LPN scope of practice in the jurisdiction in which they are working.

c. ask each LPN what tasks they are comfortable performing.

d. consult a decision tree for delegation to unlicensed assistive personnel.

b.

A health care organization has laid off several RNs and hired numerous NAPs in their place. What effect is this change most likely to have on the remaining RNs?

a. There will be a risk of the RNs underdelegating.

b. The RNs' level of liability will increase.

c. Cultural variables will become a larger consideration.

d. The RNs' scope of practice will become expanded.

b.