Leadership mgt

1.     Ms. Castro is newly-promoted to a patient care manager position. She updates her knowledge on the
theories in management and leadership in order to become effective in her new role. She learns that some
managers have low concern for services and high concern for staff. Which style of management refers to
this?
a.       Organization Man
b.      Impoverished Management
c.       Country Club Management
d.      Team Management
      2.     Her former manager demonstrated passion for serving her staff rather than being served. She takes

time to listen, prefers to be a teacher first before being a leader, which is characteristic of
a.       Transformational leader
b.      Transactional leader
c.       Servant leader
d.      Charismatic leader
      3.     On the other hand, Ms. Castro notices that the Chief Nurse Executive has charismatic leadership style.

Which of the following behaviors best describes this style?

a.       Possesses inspirational quality that makes followers gets attracted of him and regards him with reverence
b.      Acts as he does because he expects that his behavior will yield positive results
c.       Uses visioning as the core of his leadership
d.      Matches his leadership style to the situation at hand.
      4.     Which of the following conclusions of Ms. Castro about leadership characteristics is TRUE?

a.       There is a high correlation between the communication skills of a leader and the ability to get the job
done.
b.      A manager is effective when he has the ability to plan well.
c.       Assessment of personal traits is a reliable tool for predicting a manager’s potential.
d.      There is good evidence that certain personal qualities favor success in managerial role.
      5.     She reads about Path Goal theory. Which of the following behaviors is manifested by the leader who

uses this theory?

a.       Recognizes staff for going beyond expectations by giving them citations
b.      Challenges the staff to take individual accountability for their own practice
c.       Admonishes staff for being laggards.
d.      Reminds staff about the sanctions for non performance.
      6.     One leadership theory states that “leaders are born and not made,” which refers to which of the

following theories?
a.       Trait
b.      Charismatic
c.       Great Man
d.      Situational
      7.     She came across a theory which states that the leadership style is effective dependent on the

situation. Which of the following styles best fits a situation when the followers are self-directed, experts
and are matured individuals?
a.       Democratic
b.      Authoritarian
c.       Laissez faire
d.      Bureaucratic
      8.     She surfs the internet for more information about leadership styles. She reads about shared leadership

as a practice in some magnet hospitals. Which of the following describes this style of leadership?
a.       Leadership behavior is generally determined by the relationship between the leader’s personality and the
specific situation
b.      Leaders believe that people are basically good and need not be closely controlled
c.       Leaders rely heavily on visioning and inspire members to achieve results
d.      Leadership is shared at the point of care.
      9.     Ms. Castro learns that some leaders are transactional leaders. Which of the following does NOT

characterize a transactional leader?

a.       Focuses on management tasks
b.      Is a caretaker
c.       Uses trade-offs to meet goals
d.      Inspires others with vision
  10.     She finds out that some managers have benevolent-authoritative style of management. Which of the

following behaviors will she exhibit most likely?

a.       Have condescending trust and confidence in their subordinates
b.      Gives economic or ego awards
c.       Communicates downward to the staff
d.      Allows decision making among subordinates
  11.     Harry is a Unit Manager I the Medical Unit. He is not satisfied with the way things are going in his unit.

Patient satisfaction rate is 60% for two consecutive months and staff morale is at its lowest. He decides to
plan and initiate changes that will push for a turnaround in the condition of the unit. Which of the following
actions is a priority for Harry?
a.       Call for a staff meeting and take this up in the agenda.
b.      Seek help from her manager.
c.       Develop a strategic action on how to deal with these concerns.
d.      Ignore the issues since these will be resolved naturally.
  12.     She knows that there are external forces that influence changes in his unit. Which of the following is

NOT an external force?

a.       Memo from the CEO to cut down on electrical consumption
b.      Demands of the labor sector to increase wages
c.       Low morale of staff in her unit
d.      Exacting regulatory and accreditation standards
  13.     After discussing the possible effects of the low patient satisfaction rate, the staff started to list down

possible strategies to solve the problems head-on. Should they decide to vote on the best change strategy,
which of the following strategies is referred to this?
a.       Collaboration
b.      Majority rule
c.       Dominance
d.      Compromise
  14.     One staff suggests that they review the pattern of nursing care that they are using, which is described

as a:
a.       job description
b.      system used to deliver care
c.       manual of procedure
d.      rules to be followed
  15.     Which of the following is TRUE about functional nursing?

a.       Concentrates on tasks and activities

b.      Emphasizes use of group collaboration
c.       One-to-one nurse-patient ratio
d.      Provides continuous, coordinated and comprehensive nursing services
  16.     Functional nursing has some advantages, which one is an EXCEPTION?
a.       Psychological and sociological needs are emphasized.
b.      Great control of work activities.
c.       Most economical way of delivering nursing services.
d.      Workers feel secure in dependent role
  17.     He raised the issue on giving priority to patient needs. Which of the following offers the best way for

setting priority?
a.       Assessing nursing needs and problems
b.      Giving instructions on how nursing care needs are to be met
c.       Controlling and evaluating the delivery of nursing care
d.      Assigning safe nurse: patient ratio
  18.     Which of the following is the best guarantee that the patient’s priority needs are met?

a.       Checking with the relative of the patient

b.      Preparing a nursing care plan in collaboration with the patient
c.       Consulting with the physician
d.      Coordinating with other members of the team
  19.     When Harry uses team nursing as a care delivery system, he and his team need to assess the priority of

care for a group of patients, which of the following should be a priority?

a.       Each patient as listed on the worksheet
b.      Patients who needs least care
c.       Medications and treatments required for all patients
d.      Patients who need the most care
  20.     She is hopeful that her unit will make a big turnaround in the succeeding months. Which of the

following actions of Harry demonstrates that he has reached the third stage of change?
a.       Wonders why things are not what it used to be
b.      Finds solutions to the problems
c.       Integrate the solutions to his day-to-day activities
d.      Selects the best change strategy
  21.     Julius is a newly-appointed nurse manager of The Good Shepherd Medical Center, a tertiary hospital

located within the heart of the metropolis. He thinks of scheduling planning workshop with his staff in order
to ensure an effective and efficient management of the department. Should he decide to conduct a strategic
planning workshop, which of the following is NOT a characteristic of this activity?
a.       Long-term goal-setting
b.      Extends to 3-5 years in the future
c.       Focuses on routine tasks
d.      Determines directions of the organization
  22.     Which of the following statements refer to the vision of the hospital?

a.       The Good Shepherd Medical Center is a trendsetter in tertiary health care in the Philippines in the next
five years Goal
b.      The officers and staff of The Good Shepherd Medical Center believe in the unique nature of the human
person
c.       All the nurses shall undergo continuing competency training program.
d.      The Good Shepherd Medical Center aims to provide a patient-centered care in a total healing
environment.
  23.     The statement, “The Good Shepherd Medical Center aims to provide patient-centered care in a total

healing environment” refers to which of the following?

a.       Vision
b.      Goal
c.       Philosophy
d.      Mission
  24.     Julius plans to revisit the organizational chart of the department. He plans to create a new position of

a Patient Educator who has a coordinating relationship with the head nurse in the unit. Which of the
following will likely depict this organizational relationship?
a.       Box
b.      Solid line
c.       Broken line
d.      Dotted line
  25.     He likewise stresses the need for all the employees to follow orders and instructions from him and not

from anyone else. Which of the following principles does he refer to?
a.       Scalar chain
b.      Discipline
c.       Unity of command
d.      Order
  26.     Julius orients his staff on the patterns of reporting relationship throughout the organization. Which of

the following principles refer to this?

a.       Span of control
b.      Hierarchy
c.       Esprit d’ corps
d.      Unity of direction
  27.     He emphasizes to the team that they need to put their efforts together towards the attainment of the

goals of the program. Which of the following principles refers to this?

a.       Span of control
b.      Unity of direction
c.       Unity of command
d.      Command responsibility
  28.     Julius stresses the importance of promoting ‘esprit d corps’ among the members of the unit. Which of

the following remarks of the staff indicates that they understand what he pointed out?
a.       “Let’s work together in harmony; we need to be supportive of one another”
b.      “In order that we achieve the same results; we must all follow the directives of Julius and not from other
managers.”
c.       “We will ensure that all the resources we need are available when needed.”
d.      “We need to put our efforts together in order to raise the bar of excellence in the care we provide to all
our patients.”
  29.     He discusses the goal of the department. Which of the following statements is a goal?

a.       Increase the patient satisfaction rate

b.      Eliminate the incidence of delayed administration of medications
c.       Establish rapport with patients.
d.      Reduce response time to two minutes.
  30.     He wants to influence the customary way of thinking and behaving that is shared by the members of

the department. Which of the following terms refer to this?

a.       Organizational chart
b.      Cultural network
c.       Organizational structure
d.      Organizational culture
  31.     He asserts the importance of promoting a positive organizational culture in their unit. Which of the

following behaviors indicate that this is attained by the group?

a.       Proactive and caring with one another
b.      Competitive and perfectionist
c.       Powerful and oppositional
d.      Obedient and uncomplaining
  32.     Stephanie is a new Staff Educator of a private tertiary hospital. She conducts orientation among new

staff nurses in her department. Joseph, one of the new staff nurses, wants to understand the channel of
communication, span of control and lines of communication. Which of the following will provide this
information?
a.       Organizational structure
b.      Policy
c.       Job description
d.      Manual of procedures
  33.     Stephanie is often seen interacting with the medical intern during coffee breaks and after duty hours.

What type of organizational structure is this?

a.       Formal
b.      Informal
c.       Staff
d.      Line
  34.     She takes pride in saying that the hospital has a decentralized structure. Which of the following is NOT

compatible with this type of model?

a.       Flat organization
b.      Participatory approach
c.       Shared governance
d.      Tall organization
  35.     Centralized organizations have some advantages. Which of the following statements are TRUE?

1. Highly cost-effective
2. Makes management easier
3. Reflects the interest of the worker
4. Allows quick decisions or actions.
a.       1 & 2
b.      2 & 4
c.       2, 3& 4
d.      1, 2, & 4
  36.     Stephanie delegates effectively if she has authority to act, which is BEST defined as:

a.       having responsibility to direct others

b.      being accountable to the organization
c.       having legitimate right to act
d.      telling others what to do
  37.     Regardless of the size of a work group, enough staff must be available at all times to accomplish

certain purposes. Which of these purposes is NOT included?

a.       Meet the needs of patients
b.      Provide a pair of hands to other units as needed
c.       Cover all time periods adequately.
d.      Allow for growth and development of nursing staff.
  38.     Which of the following guidelines should be least considered in formulating objectives for nursing

care?
a.       Written nursing care plan
b.      Holistic approach
c.       Prescribed standards
d.      Staff preferences
  39.     Stephanie considers shifting to transformational leadership. Which of the following statements best
describes this type of leadership?
a.       Uses visioning as the essence of leadership.
b.      Serves the followers rather than being served.
c.       Maintains full trust and confidence in the subordinates
d.      Possesses innate charisma that makes others feel good in his presence.
  40.     As a manager, she focuses her energy on both the quality of services rendered to the patients as well

as the welfare of the staff of her unit. Which of the following management styles does she adopt?
a.       Country club management
b.      Organization man management
c.       Team management
d.      Authority-obedience management
answers:
1. Answer: (C) Country Club Management
Country club management style puts concern for the staff as number one priority at the expense of the delivery of
services. He/she runs the department just like a country club where every one is happy including the manager.
2. Answer: (C) Servant leader
Servant leaders are open-minded, listen deeply, try to fully understand others and not being judgmental
3. Answer: (A) Possesses inspirational quality that makes followers gets attracted of him and regards him with
reverence
Charismatic leaders make the followers feel at ease in their presence. They feel that they are in good hands whenever
the leader is around.
4. Answer: (C) Assessment of personal traits is a reliable tool for predicting a manager’s potential.
It is not conclusive that certain qualities of a person would make him become a good manager. It can only predict a
manager’s potential of becoming a good one.
5. Answer: (A) Recognizes staff for going beyond expectations by giving them citations
Path Goal theory according to House and associates rewards good performance so that others would do the same
6. Answer: (C) Great Man
Leaders become leaders because of their birth right. This is also called Genetic theory or the Aristotelian theory
7. Answer: (C) Laissez faire
Laissez faire leadership is preferred when the followers know what to do and are experts in the field. This leadership
style is relationship-oriented rather than task-centered.
8. Answer: (D) Leadership is shared at the point of care.
Shared governance allows the staff nurses to have the authority, responsibility and accountability for their own practice.
9. Answer: (D) Inspires others with vision
Inspires others with a vision is characteristic of a transformational leader. He is focused more on the day-to-day
operations of the department/unit.
10. Answer: (A) Have condescending trust and confidence in their subordinates
Benevolent-authoritative managers pretentiously show their trust and confidence to their followers
11. Answer: (A) Call for a staff meeting and take this up in the agenda.
This will allow for the participation of every staff in the unit. If they contribute to the solutions of the problem, they will
own the solutions; hence the chance for compliance would be greater.
12. Answer: (C) Low morale of staff in her unit
Low morale of staff is an internal factor that affects only the unit. All the rest of the options emanate from the top
executive or from outside the institution.
13. Answer: (B) Majority rule
Majority rule involves dividing the house and the highest vote wins.1/2 + 1 is a majority.
14. Answer: (B) system used to deliver care
A system used to deliver care. In the 70’s it was termed as methods of patient assignment; in the early 80’s it was called
modalities of patient care then patterns of nursing care in the 90’s until recently authors called it nursing care systems.
15. Answer: (A) Concentrates on tasks and activities
Functional nursing is focused on tasks and activities and not on the holistic care of the patients
16. Answer: (A) Psychological and sociological needs are emphasized.
When the functional method is used, the psychological and sociological needs of the patients are neglected; the patients
are regarded as ‘tasks to be done ‘
17. Answer: (A) Assessing nursing needs and problems
This option follows the framework of the nursing process at the same time applies the management process of planning,
organizing, directing and controlling
18. Answer: (B) Preparing a nursing care plan in collaboration with the patient
The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care
plan based on his expressed priority needs would ensure meeting his needs effectively.
19. Answer: (D) Patients who need the most care
In setting priorities for a group of patients, those who need the most care should be number-one priority to ensure that
their critical needs are met adequately. The needs of other patients who need less care ca be attended to later or even
delegated to assistive personnel according to rules on delegation.
20. Answer: (C) Integrate the solutions to his day-to-day activities
Integrate the solutions to his day-to-day activities is expected to happen during the third stage of change when the
change agent incorporate the selected solutions to his system and begins to create a change.
21. Answer: (C) Focuses on routine tasks
Strategic planning involves options A, B and D except C which is attributed to operational planning
22. Answer: (A) The Good Shepherd Medical Center is a trendsetter in tertiary health care in the Philippines in the
next five years
A vision refers to what the institution wants to become within a particular period of time.
23. Answer: (B) Goal
B
24. Answer: (C) Broken line
This is a staff relationship hence it is depicted by a broken line in the organizational structure
25. Answer: (C) Unity of command
The principle of unity of command means that employees should receive orders coming from only one manager and not
from two managers. This averts the possibility of sowing confusion among the members of the organization
26. Answer: (B) Hierarchy
Hierarchy refers to the pattern of reporting or the formal line of authority in an organizational structure.
27. Answer: (B) Unity of direction
Unity of direction means having one goal or one objective for the team to pursue; hence all members of the organization
should put their efforts together towards the attainment of their common goal or objective.
28. Answer: (A) “Let’s work together in harmony; we need to be supportive of one another”
The principle of ‘esprit d’ corps’ refers to promoting harmony in the workplace, which is essential in maintaining a
climate conducive to work.
29. Answer: (A) Increase the patient satisfaction rate
Goal is a desired result towards which efforts are directed. Options AB, C and D are all objectives which are aimed at
specific end.
30. Answer: (D) Organizational culture
An organizational culture refers to the way the members of the organization think together and do things around them
together. It’s their way of life in that organization
31. Stephanie is a new Staff Educator of a private tertiary hospital. She conducts orientation among new staff nurses in
her department. Joseph, one of the new staff nurses, wants to understand the channel of communication, span of
control and lines of communication. Which of the following will provide this information?
32. Answer: (A) Organizational structure
Organizational structure provides information on the channel of authority, i.e., who reports to whom and with what
authority; the number of people who directly reports to the various levels of hierarchy and the lines of communication
whether line or staff.
33. Answer: (B) Informal
This is usually not published and oftentimes concealed.
34. Answer: (D) Tall organization
Tall organizations are highly centralized organizations where decision making is centered on one authority level.
35. Answer: (A) 1 & 2
Centralized organizations are needs only a few managers hence they are less expensive and easier to manage
36. Answer: (C) having legitimate right to act
Authority is a legitimate or official right to give command. This is an officially sanctioned responsibility
37. Answer: (B) Provide a pair of hands to other units as needed
Providing a pair of hands for other units is not a purpose in doing an effective staffing process. This is a function of a
staffing coordinator at a centralized model.
38. Answer: (D) Staff preferences
Staff preferences should be the least priority in formulating objectives of nursing care. Individual preferences should be
subordinate to the interest of the patients.
39. Answer: (A) Uses visioning as the essence of leadership.
Transformational leadership relies heavily on visioning as the core of leadership.
40. Answer: (C) Team management
Team management has a high concern for services and high concern for staff.
Part ii
1. Katherine is a young Unit Manager of the Pediatric Ward. Most of her staff nurses are senior
to her, very articulate, confident and sometimes aggressive. Katherine feels uncomfortable
believing that she is the scapegoat of everything that goes wrong in her department. Which of
the following is the best action that she must take?
Identify the source of the conflict and understand the points of friction
Disregard what she feels and continue to work independently
Seek help from the Director of Nursing
Quit her job and look for another employment.
2. As a young manager, she knows that conflict occurs in any organization. Which of the
following statements regarding conflict is NOT true?
Can be destructive if the level is too high
Is not beneficial; hence it should be prevented at all times
May result in poor performance
May create leaders
3. Katherine tells one of the staff, “I don’t have time to discuss the matter with you now. See
me in my office later” when the latter asks if they can talk about an issue. Which of the
following conflict resolution strategies did she use?
Smoothing
Compromise
Avoidance
Restriction
4. Kathleen knows that one of her staff is experiencing burnout. Which of the following is the
best thing for her to do?
Advise her staff to go on vacation.
Ignore her observations; it will be resolved even without intervention
Remind her to show loyalty to the institution.
Let the staff ventilate her feelings and ask how she can be of help.
5. She knows that performance appraisal consists of all the following activities EXCEPT:
Setting specific standards and activities for individual performance.
Using agency standards as a guide.
Determine areas of strength and weaknesses
Focusing activity on the correction of identified behavior.
6. Which of the following statements is NOT true about performance appraisal?
Informing the staff about the specific impressions of their work help improve their performance.
A verbal appraisal is an acceptable substitute for a written report
Patients are the best source of information regarding personnel appraisal.
The outcome of performance appraisal rests primarily with the staff.
7. There are times when Katherine evaluates her staff as she makes her daily rounds. Which of
the following is NOT a benefit of conducting an informal appraisal?
The staff member is observed in natural setting.
Incidental confrontation and collaboration is allowed.
The evaluation is focused on objective data systematically.
The evaluation may provide valid information for compilation of a formal report.
8. She conducts a 6-month performance review session with a staff member. Which of the
following actions is appropriate?
She asks another nurse to attest the session as a witness.
She informs the staff that she may ask another nurse to read the appraisal before the session is over.
She tells the staff that the session is manager-centered.
The session is private between the two members.
9. Alexandra is tasked to organize the new wing of the hospital. She was given the authority to
do as she deems fit. She is aware that the director of nursing has substantial trust and
confidence in her capabilities, communicates through downward and upward channels and
usually uses the ideas and opinions of her staff. Which of the following is her style of
management?
Benevolent –authoritative
Consultative
Exploitive-authoritative
Participative
10. She decides to illustrate the organizational structure. Which of the following elements is
NOT included?
Level of authority
Lines of communication
Span of control
Unity of direction
11. She plans of assigning competent people to fill the roles designed in the hierarchy. Which
process refers to this?
Staffing
Scheduling
Recruitment
Induction
12. She checks the documentary requirements for the applicants for staff nurse position. Which
one is NOT necessary?
Certificate of previous employment
Record of related learning experience (RLE)
Membership to accredited professional organization
Professional identification card
13. Which phase of the employment process includes getting on the payroll and completing
documentary requirements?
Orientation
Induction
Selection
Recruitment
14. She tries to design an organizational structure that allows communication to flow in all
directions and involve workers in decision making. Which form of organizational structure is
this?
Centralized
Decentralized
Matrix
Informal
15. In a horizontal chart, the lowest level worker is located at the
Left most box
Middle
Right most box
Bottom
16. She decides to have a decentralized staffing system. Which of the following is an advantage
of this system of staffing?
greater control of activities
Conserves time
Compatible with computerization
Promotes better interpersonal relationship
17. Aubrey thinks about primary nursing as a system to deliver care. Which of the following
activities is NOT done by a primary nurse?
Collaborates with the physician
Provides care to a group of patients together with a group of nurses
Provides care for 5-6 patients during their hospital stay.
Performs comprehensive initial assessment
18. Which pattern of nursing care involves the care given by a group of paraprofessional
workers led by a professional nurse who take care of patients with the same disease conditions
and are located geographically near each other?
Case method
Modular nursing
Nursing case management
Team nursing
19. St. Raphael Medical Center just opened its new Performance Improvement Department. Ms.
Valencia is appointed as the Quality Control Officer. She commits herself to her new role and
plans her strategies to realize the goals and objectives of the department. Which of the
following is a primary task that they should perform to have an effective control system?
Make an interpretation about strengths and weaknesses
Identify the values of the department
Identify structure, process, outcome standards & criteria
Measure actual performances
20. Ms. Valencia develops the standards to be followed. Among the following standards, which
is considered as a structure standard?
The patients verbalized satisfaction of the nursing care received
Rotation of duty will be done every four weeks for all patient care personnel.
All patients shall have their weights taken recorded
Patients shall answer the evaluation form before discharge
21. When she presents the nursing procedures to be followed, she refers to what type of
standards?
Process
Outcome
Structure
Criteria
22. The following are basic steps in the controlling process of the department. Which of the
following is NOT included?
Measure actual performance
Set nursing standards and criteria
Compare results of performance to standards and objectives
Identify possible courses of action
23. Which of the following statements refers to criteria?
Agreed on level of nursing care
Characteristics used to measure the level of nursing care
Step-by-step guidelines
Statement which guide the group in decision making and problem solving
24. She wants to ensure that every task is carried out as planned. Which of the following tasks
is NOT included in the controlling process?
Instructing the members of the standards committee to prepare policies
Reviewing the existing policies of the hospital
Evaluating the credentials of all nursing staff
Checking if activities conform to schedule
25. Ms. Valencia prepares the process standards. Which of the following is NOT a process
standard?
Initial assessment shall be done to all patients within twenty four hours upon admission.
Informed consent shall be secured prior to any invasive procedure
Patients’ reports 95% satisfaction rate prior to discharge from the hospital.
Patient education about their illness and treatment shall be provided for all patients and their families.
26. Which of the following is evidence that the controlling process is effective?
The things that were planned are done
Physicians do not complain.
Employees are contended
There is an increase in customer satisfaction rate.
27. Ms. Valencia is responsible to the number of personnel reporting to her. This principle
refers to:
Span of control
Unity of command
Carrot and stick principle
Esprit d’ corps
28. She notes that there is an increasing unrest of the staff due to fatigue brought about by
shortage of staff. Which action is a priority?
Evaluate the overall result of the unrest
Initiate a group interaction
Develop a plan and implement it
Identify external and internal forces.
29. Kevin is a member of the Nursing Research Council of the hospital. His first assignment is
to determine the level of patient satisfaction on the care they received from the hospital. He
plans to include all adult patients admitted from April to May, with average length of stay of 3-
4 days, first admission, and with no complications. Which of the following is an extraneous
variable of the study?
Date of admission
Length of stay
Age of patients
Absence of complications
30. He thinks of an appropriate theoretical framework. Whose theory addresses the four modes
of adaptation?
Martha Rogers
Sr. Callista Roy
Florence Nightingale
Jean Watson
31. He opts to use a self-report method. Which of the following is NOT TRUE about this
method?
Most direct means of gathering information
Versatile in terms of content coverage
Most accurate and valid method of data gathering
Yields information that would be difficult to gather by another method
32. Which of the following articles would Kevin least consider for his review of literature?
“Story-Telling and Anxiety Reduction Among Pediatric Patients”
“Turnaround Time in Emergency Rooms”
“Outcome Standards in Tertiary Health Care Institutions”
“Environmental Manipulation and Client Outcomes”
33. Which of the following variables will he likely EXCLUDE in his study?
Competence of nurses
Caring attitude of nurses
Salary of nurses
Responsiveness of staff
34. He plans to use a Likert Scale to determine
degree of agreement and disagreement
compliance to expected standards
level of satisfaction
degree of acceptance
35. He checks if his instruments meet the criteria for evaluation. Which of the following criteria
refers to the consistency or the ability to yield the same response upon its repeated
administration?
Validity
Reliability
Sensitivity
Objectivity
36. Which criteria refer to the ability of the instrument to detect fine differences among the
subjects being studied?
Sensitivity
Reliability
Validity
Objectivity
37. Which of the following terms refer to the degree to which an instrument measures what it
is supposed to be measure?
Validity
Reliability
Meaningfulness
Sensitivity
38. He plans for his sampling method. Which sampling method gives equal chance to all units in
the population to get picked?
Random
Accidental
Quota
Judgment
39. Raphael is interested to learn more about transcultural nursing because he is assigned at
the family suites where most patients come from different cultures and countries. Which of the
following designs is appropriate for this study?
Grounded theory
Ethnography
Case study
Phenomenology
40. The nursing theorist who developed transcultural nursing theory is
Dorothea Orem
Madeleine Leininger
Betty Newman
Sr. Callista Roy
Answer part ii
1.       Answer: (A) Identify the source of the conflict and understand the points of friction
This involves a problem solving approach, which addresses the root cause of the problem.
2.       Answer: (B) Is not beneficial; hence it should be prevented at all times
Conflicts are beneficial because it surfaces out issues in the open and can be solved right away. Likewise, members of the team
become more conscientious with their work when they are aware that other members of the team are watching them.
3.       Answer: (C) Avoidance
This strategy shuns discussing the issue head-on and prefers to postpone it to a later time. In effect the problem remains unsolved and
both parties are in a lose-lose situation.
4.       Answer: (D) Let the staff ventilate her feelings and ask how she can be of help.
Reaching out and helping the staff is the most effective strategy in dealing with burn out. Knowing that someone is ready to help makes
the staff feel important; hence her self-worth is enhanced.
5.       Answer: (D) Focusing activity on the correction of identified behavior.
Performance appraisal deal with both positive and negative performance; is not meant to be a fault-finding activity
6.       Answer: (C) Patients are the best source of information regarding personnel appraisal.
The patient can be a source of information about the performance of the staff but it is never the best source. Directly observing the staff
is the best source of information for personnel appraisal.
7.       Answer: (C) The evaluation is focused on objective data systematically.
Collecting objective data systematically can not be achieved in an informal appraisal. It is focused on what actually happens in the
natural work setting.
8.       Answer: (D) The session is private between the two members.
The session is private between the manager and the staff and remains to be so when the two parties do not divulge the information to
others.
9.       Answer: (B) Consultative
A consultative manager is almost like a participative manager. The participative manager has complete trust and confidence in the
subordinate, always uses the opinions and ideas of subordinates and communicates in all directions.
10.    Answer: (D) Unity of direction
Unity of direction is a management principle, not an element of an organizational structure.
11.    Answer: (A) Staffing
Staffing is a management function involving putting the best people to accomplish tasks and activities to attain the goals of the
organization.
12.    Answer: (B) Record of related learning experience (RLE)
Record of RLE is not required for employment purposes but it is required for the nurse’s licensure examination.
13.    Answer: (B) Induction
This step in the recruitment process gives time for the staff to submit all the documentary requirements for employment.
14.    Answer: (B) Decentralized
Decentralized structures allow the staff to make decisions on matters pertaining to their practice and communicate in downward,
upward, lateral and diagonal flow.
15.    Answer: (C) Rightmost box
The leftmost box is occupied by the highest authority while the lowest level worker occupies the rightmost box.
16.    Answer: (D) Promotes better interpersonal relationship
Decentralized structures allow the staff to solve decisions by themselves, involve them in decision making; hence they are always given
opportunities to interact with one another.
17.    Answer: (B) Provides care to a group of patients together with a group of nurses
This function is done in team nursing where the nurse is a member of a team that provides care for a group of patients.
18.    Answer: (B) Modular nursing
Modular nursing is a variant of team nursing. The difference lies in the fact that the members in modular nursing are paraprofessional
workers.
19.    Answer: (B) Identify the values of the department
Identify the values of the department will set the guiding principles within which the department will operate its activities
20.    Answer: (B) Rotation of duty will be done every four weeks for all patient care personnel.
Structure standards include management system, facilities, equipment, materials needed to deliver care to patients. Rotation of duty is
a management system.
21.    Answer: (A) Process
Process standards include care plans, nursing procedure to be done to address the needs of the patients.
22.    Answer: (D) Identify possible courses of action
This is a step in a quality control process and not a basic step in the control process.
23.    Answer: (B) Characteristics used to measure the level of nursing care
Criteria are specific characteristics used to measure the standard of care.
24.    Answer: (A) Instructing the members of the standards committee to prepare policies
Instructing the members involves a directing function.
25.    Answer: (C) Patients’ reports 95% satisfaction rate prior to discharge from the hospital.
This refers to an outcome standard, which is a result of the care that is rendered to the patient.
26.    Answer: (A) The things that were planned are done
Controlling is defined as seeing to it that what is planned is done.
27.    Answer: (A) Span of control
Span of control refers to the number of workers who report directly to a manager.
28.    Answer: (B) Initiate a group interaction
Initiate a group interaction will be an opportunity to discuss the problem in the open.
29.    Answer: (C) Age of patients
An extraneous variable is not the primary concern of the researcher but has an effect on the results of the study. Adult patients may be
young, middle or late adult.
30.    Answer: (B) Sr. Callista Roy
Sr. Callista Roy developed the Adaptation Model which involves the physiologic mode, self-concept mode, role function mode and
dependence mode
31.    Answer: (C) Most accurate and valid method of data gathering
The most serious disadvantage of this method is accuracy and validity of information gathered
32.    Answer: (B) “Turnaround Time in Emergency Rooms”
The article is for pediatric patients and may not be relevant for adult patients.
33.    Answer: (C) Salary of nurses
Salary of staff nurses is not an indicator of patient satisfaction, hence need not be included as a variable in the study.
34.    Answer: (A) degree of agreement and disagreement
Likert scale is a 5-point summated scale used to determine the degree of agreement or disagreement of the respondents to a
statement in a study.
35.    Answer: (B) Reliability
Reliability is repeatability of the instrument; it can elicit the same responses even with varied administration of the instrument
36.    Answer: (A) Sensitivity
Sensitivity is an attribute of the instrument that allow the respondents to distinguish differences of the options where to choose from
37.    Answer: (A) Validity
Validity is ensuring that the instrument contains appropriate questions about the research topic
38.    Answer: (A) Random
Random sampling gives equal chance for all the elements in the population to be picked as part of the sample.
39.    Answer: (B) Ethnography
Ethnography is focused on patterns of behavior of selected people within a culture
40.    Answer: (B) Madeleine Leininger
Madeleine Leininger developed the theory on transcultural theory based on her observations on the behavior of selected people within
a culture
 Rn pedia
1. The best explanation of what Title VI of the Civil Rights Act mandates is the freedom
to:
A. Pick any physician and insurance company despite one’s income
B. Receive free medical benefits as needed within the county of residence
C. Have equal access to all health care regardless of race and religion
D. Have basic care with a sliding scale payment plan from all health care
facilities
2. Which statement would best explain the role of the nurse when planning care for a
culturally diverse population? The nurse will plan care to:
A. Include care that is culturally congruent with the staff from
predetermined criteria
B. Focus only on the needs of the client, ignoring the nurse’s beliefs and
practices
C. Blend the values of the nurse that are for the good of the client and
minimize the client’s individual values and beliefs during care
D. Provide care while aware of one’s own bias, focusing on the client’s
individual needs rather than the staff’s practices
3. Which factor is least significant during assessment when gathering information
about cultural practices?
A.  Language, timing
B. Touch, eye contact
C. Biocultural needs
D. Pain perception, management expectations
4. Transcultural nursing implies:
A. Using a comparative study of cultures to understand similarities and
differences across human groups to provide specific individualized care that
is culturally appropriate
B. Working in another culture to practice nursing within their limitations
C. Combining all cultural beliefs into a practice that is a nonthreatening
approach to minimize cultural barriers for all clients’ equality of care
D. Ignoring all cultural differences to provide the best generalized care to
all clients.
5. What should the nurse do when planning nursing care for a client with a different
cultural background? The nurse should:
A. Allow the family to provide care during the hospital stay so no rituals or
customs are broken
B. Identify how these cultural variables affect the health problem
C. Speak slowly and show pictures to make sure the client always
understands
D. Explain how the client must adapt to hospital routines to be effectively
cared for while in the hospital
6. Which activity would not be expected by the nurse to meet the cultural needs of the
client?
A. Promote and support attitudes, behaviors, knowledge, and skills to
respectfully meet client’s cultural needs despite the nurse’s own beliefs and
practices
B. Ensure that the interpreter understands not only the language of the
client but feelings and attitudes behind cultural practices to make sure an
ethical balance can be achieved
C. Develop structure and process for meeting cultural needs on a regular
basis and means to avoid overlooking these needs with clients
D. Expect the family to keep an interpreter present at all times to assist in
meeting the communication needs all day and night while hospitalized
7. Ethical principles for professional nursing practice in a clinical setting are guided by
the principles of conduct that are written as the:
A. American Nurses Association’s (ANA’s) Code of Ethics
B. Nurse Practice Act (NPA) written by state legislation
C. Standards of care from experts in the practice field
D. Good Samaritan laws for civil guidelines
8. A bioethical issue should be described as:
A. The physician’s making all decisions of client management without
getting input from the client
B. A research project that included treating all the white men and not
treating all the black men to compare the outcomes of a specific drug
therapy.
C. The withholding of food and treatment at the request of the client in a
written advance directive given before a client acquired permanent brain
damage from an accident.
D. After the client gives permission, the physician’s disclosing all
information to the family for their support in the management of the client.
9. When the nurse described the client as “that nasty old man in 354,” the nurse is
exhibiting which ethical dilemma?
A. Gender bias and ageism
B. HIPPA violation
C. Beneficence
D. Code of ethics violation
10. The distribution of nurses to areas of “most need” in the time of a nursing shortage
is an example of:
A. Utilitarianism theory
B. Deontological theory
C. Justice
D. Beneficence
11. Nurses are bound by a variety of laws. Which description of a type of law is
correct?
A. Statutory law is created by elected legislature, such as the state
legislature that defines the Nurse Practice Act (NPA).
B. Regulatory law includes prevention of harm for the public and
punishment for those laws that are broken.
C. Common law protects the rights of the individual within society for fair
and equal treatment.
D. Criminal law creates boards that pass rules and regulations to control
society.
12. Besides the Joint Commission on Accreditation of Healthcare Organizations
(JACHO), which governing agency regulates hospitals to allow continued safe services
to be provided, funding to be received from the government and penalties if guidelines
are not followed?
A. Board of Nursing Examiners (BNE)
B. Nurse Practice Act (NPA)
C. American Nurses Association (ANA)
D. Americans With Disabilities Act (ADA)
13. When a client is confused, left alone with the side rails down, and the bed in a high
position, the client falls and breaks a hip. What law has been broken?
A. Assault
B. Battery
C. Negligence
D. Civil tort
14. When signing a form as a witness, your signature shows that the client:
A. Is fully informed and is aware of all consequences.
B. Was awake and fully alert and not medicated with narcotics.
C. Was free to sign without pressure
D. Has signed that form and the witness saw it being done
15. Which criterion is needed for someone to give consent to a procedure?
A. An appointed guardianship
B. Unemancipated minor
C. Minimum of 21 years or older
D. An advocate for a child
 16. Which statement is correct?
A. Consent for medical treatment can be given by a minor with a sexually
transmitted disease (STD).
B. A second trimester abortion can be given without state involvement.
C. Student nurses cannot be sued for malpractice while in a nursing
clinical class.
D. Nurses who get sick and leave during a shift are not abandoning clients
if they call their supervisor and leave a message about their emergency
illness.
17. Most litigation in the hospital comes from the:
A. Nurse abandoning the clients when going to lunch
B. Nurse following an order that is incomplete or incorrect
C. Nurse documenting blame on the physician when a mistake is made
D. Supervisor watching a new employee check his or her skills level
18. The nurse places an aquathermia pad on a client with a muscle sprain. The nurse
informs the client the pad should be removed in 30 minutes. Why will the nurse return
in 30 minutes to remove the pad?
A. Reflex vasoconstriction occurs.
B. Reflex vasodilation occurs.
C. Systemic response occurs.
D. Local response occurs.
19. A client has recently been told he has terminal cancer. As the nurse enters the
room, he yells, “My eggs are cold, and I’m tired of having my sleep interrupted by noisy
nurses!” The nurse may interpret the client’s behavior as:
A. An expression of the anger stage of dying
B. An expression of disenfranchised grief
C. The result of maturational loss
D. The result of previous losses
20. When helping a person through grief work, the nurse knows:
A. Coping mechanisms that were effective in the past are often
disregarded in response to the pain of a loss
B. A person’s perception of a loss has little to do with the grieving
process.
C. The sequencing of stages of grief may occur in order, they may be
skipped, or they may recur.
D. Most clients want to be left alone.
21. A client is hospitalized in the end stage of terminal cancer. His family members are
sitting at his bedside. What can the nurse do to best aid the family at this time?
A. Limit the time visitors may stay so they do not become overwhelmed
by the situation.
B. Avoid telling family members about the client’s actual condition so
they will not lose hope.
C. Discourage spiritual practices because this will have little connection to
the client at this time.
D. Find simple and appropriate care activities for the family to perform.
22. When caring for a terminally ill client, it is important for the nurse maintain the
client’s dignity. This can be facilitated by:
A. Spending time to let clients share their life experiences
B. Decreasing emphasis on attending to the clients’ appearance because
it only increases their fatigue
C. Making decisions for clients so they do not have to make them
D. Placing the client in a private room to provide privacy at all times
23. What are the stages of dying according to Elizabeth Kubler-Ross?
A. Numbing; yearning and searching; disorganization and despair; and
reorganization.
B. Accepting the reality of loss, working through the pain of grief,
adjusting to the environment without the deceased, and emotionally
relocating the deceased and moving on with life.
C. Anticipatory grief, perceived loss, actual loss, and renewal.
D. Denial, anger, bargaining, depression, and acceptance.
24. Bereavement may be defined as:
A. The emotional response to loss.
B. The outward, social expression of loss.
C. Postponing the awareness of the reality of the loss.
D. The inner feeling and outward reactions of the survivor.
25. A client who had a “Do Not Resuscitate” order passed away. After verifying there is
no pulse or respirations, the nurse should next:
A. Have family members say goodbye to the deceased.
B. Call the transplant team to retrieve vital organs.
C. Remove all tubes and equipment (unless organ donation is to take
place), clean the body, and position appropriately.
D. Call the funeral director to come and get the body.
26. A client’s family member says to the nurse, “The doctor said he will provide
palliative care. What does that mean?” The nurse’s best response is:
A. “Palliative care is given to those who have less than 6 months to live.”
B.  “Palliative care aims to relieve or reduce the symptoms of a disease.”
C.  “The goal of palliative care is to affect a cure of a serious illness or
disease.”
D. “Palliative care means the client and family take a more passive role
and the doctor focuses on the physiological needs of the client. The location
of death will most likely occur in the hospital setting.”
27. Which of the following is not included in evaluating the degree of heritage
consistency in a client?
A. Gender
B. Culture
C. Ethnicity
D. Religion
28. When providing care to clients with varied cultural backgrounds, it is imperative for
the nurse to recognize that:
A. Cultural considerations must be put aside if basic needs are in
jeopardy.
B. Generalizations about the behavior of a particular group may be
inaccurate.
C. Current health standards should determine the acceptability of cultural
practices.
D. Similar reactions to stress will occur when individuals have the same
cultural background.
29. To respect a client’s personal space and territoriality, the nurse:
A. Avoids the use of touch
B. Explains nursing care and procedures
C. Keeps the curtains pulled around the clients bed
D. Stands 8 feet away from the bed, if possible.
30. To be effective in meeting various ethnic needs, the nurse should:
A. Treat all clients alike.
B. Be aware of clients’ cultural differences.
C. Act as if he or she is comfortable with the client’s behavior.
D. Avoid asking questions about the client’s cultural background.
31. The most important factor in providing nursing care to clients in a specific ethnic
group is:
A. Communication
B. Time orientation
C. Biological variation
D. Environmental control
32. A health care issue often becomes an ethical dilemma because:
A. A clients legal rights coexist with a health professionals obligation.
B. Decisions must be made quickly, often under stressful conditions.
C. Decisions must be made based on value systems.
D. The choices involved do not appear to be clearly right or wrong.
33. A document that lists the medical treatment a person chooses to refuse if unable to
make decisions is the:
A. Durable power of attorney
B. Informed consent
C. Living will
D. Advance directives
34. Which statement about an institutional ethics committee is correct?
A. The ethics committee is an additional resource for clients and health
care professionals.
B. The ethics committee relieves health care professionals from dealing
with ethical issues.
C. The ethics committee would be the first option in addressing an ethical
dilemma.
D. The ethics committee replaces decision making by the client and
health care providers.
35. The nurse is working with parents of a seriously ill newborn. Surgery has been
proposed for the infant, but the chances of success are unclear. In helping the parents
resolve this ethical conflict, the nurse knows that the first step is:
A. Exploring reasonable courses of action
B. Collecting all available information about the situation
C. Clarifying values related to the cause of the dilemma.
D. Identifying people who can solve the difficulty.
36. Miss Mary, an 88-year old woman, believes that life should not be prolonged when
hope is gone. She has decided that she does not want extraordinary measures taken
when her life is at its end. Because she feels this way, she has talked with her
daughter about her desires, completing a living will and left directions with her
physician. This is an example of:
A. Affirming a value
B. Choosing a value
C. Prizing a value
D. Reflecting a value
37. The scope of Nursing practice is legally defined by:
A. State nurses practice acts
B. Professional nursing organizations
C. Hospital policy and procedure manuals
D. Physicians in the employing institutions
38. A student nurse who is employed as a nursing assistant may perform any functions
that:
A. Have been learned about in school
B. Are expected of a nurse at that level
C. Are identified in the positions job description
D. Require technical rather than professional skill.
39. A confused client who fell out of bed because side rails were not used is an
example of which type of liability?
A. Felony
B. Assault
C. Battery
D. Negligence
40. The nurse puts a restraint jacket on a client without the client’s permission and
without the physicians order. The nurse may be guilty of:
A. Assault
B. Battery
C. Invasion of privacy
D. Neglect
41. In a situation in which there is insufficient staff to implement competent care, a
nurse should:
A. Organize a strike
B. Inform the clients of the situation
C. Refuse the assignment
D. Accept the assignment but make a protest in writing to the
administration.
42. Which statement about loss is accurate?
A. Loss is only experienced when there is an actual absence of something
valued.
B. The more the individual has invested in what is lost, the less the
feeling of loss.
C. Loss may be maturational, situational, or both.
D. The degree of stress experienced is unrelated to the type of loss.
43. Trying questionable and experimental forms of therapy is a behavior that is
characterized of which stage of dying?
A. Anger
B. Depression
C. Bargaining
D. Acceptance
44. All of the following are crucial needs of the dying client except:
A. Control of pain
B. Preservation of dignity and self-worth
C. Love and belonging
D. Freedom from decision making
45. Cultural awareness is an in-depth self-examination of one’s:
A. Background, recognizing biases and prejudices.
B. Social, cultural, and biophysical factors
C.  Engagement in cross-cultural interactions
D. Motivation and commitment to caring.
46. Cultural competence is the process of:
A. Learning about vast cultures
B. Acquiring specific knowledge, skills, and attitudes
C. Influencing treatment and care of clients
D. Motivation and commitment to caring.
47. Ethnocentrism is the root of:
A. Biases and prejudices
B. Meanings by which people make sense of their experiences.
C. Cultural beliefs
D. Individualism and self-reliance in achieving and maintaining health.
48. When action is taken on one’s prejudices:
A. Discrimination occurs
B. Sufficient comparative knowledge of diverse groups is obtained.
C. Delivery of culturally congruent care is ensured.
D. People think/know you are a dumbass for being prejudiced.
49. The dominant value orientation in North American society is:
A. Use of rituals symbolizing the supernatural.
B. Group reliance and interdependence
C. Healing emphasizing naturalistic modalities
D. Individualism and self-reliance in achieving and maintaining health.
50. Disparities in health outcomes between the rich and the poor illustrates: a (an)
A. Illness attributed to natural, impersonal, and biological forces.
B.  Creation of own interpretation and descriptions of biological and
psychological malfunctions.
C.  Influence of socioeconomic factors in morbidity and mortality.
D. Combination of naturalistic, religious, ad supernatural modalities.
 51. Culture strongly influences pain expression and need for pain medication.
However, cultural pain:
A. May be suffered by a client whose valued way of life is disregarded by
practitioners.
B. Is more intense, thus necessitating more medication.
C. Is not expressed verbally or physically
D. Is expressed only to others of like culture.
52. The dominant values in American society on individual autonomy and self-
determination:
A.  Rarely have an effect on other cultures
B. Do have an effect on health care
C. May hinder ability to get into a hospice program
D. May be in direct conflict with diverse groups.
53. In the United States, access to health care usually depends on a client’s ability to
pay for health care, either through insurance or by paying cash. The client the nurse is
caring for needs a liver transplant to survive. This client has been out of work for
several months and does not have insurance or enough cash. A discussion about the
ethics of this situation would involve predominantly the principle of:
A. Accountability, because you as the nurse are accountable for the well
being of this client.
B. Respect of autonomy, because this client’s autonomy will be violated if
he does not receive the liver transplant.
C. Ethics of care, because the caring thing that a nurse could provide this
patient is resources for a liver transplant.
D. Justice, because the first and greatest question in this situation is how
to determine the just distribution of resources.
54. The code of ethics for nurses is composed and published by:
A. The national league for Nursing
B. The American Nurses Association
C. The Medical American Association
D. The National Institutes of Health, Nursing division.
55. Nurses agree to be advocates for their patients. Practice of advocacy calls for the
nurse to:
A. Seek out the nursing supervisor in conflicting situations
B. Work to understand the law as it applies to the client’s clinical
condition.
C. Assess the client’s point of view and prepare to articulate this point of
view.
D. Document all clinical changes in the medical record in a timely
manner.
56. Successful ethical discussion depends on people who have a clear sense of
personal values. When many people share the same values it may be possible to
identify a philosophy of utilitarianism, with proposes that:
A. The value of people is determined solely by leaders in the Unitarian
church.
B. The decision to perform a lover transplant depends on a measure of
the moral life that the client has led so far.
C. The best way to determine the solution to an ethical dilemma is to
refer the case to the attending physician.
D. The value of something is determined by its usefulness to society.
57. The philosophy sometimes called the code of ethics of care suggests that ethical
dilemmas can best be solved by attention to:
A. Relationships
B. Ethical principles
C. Clients
D. Code of ethics for nurses.
58. In most ethical dilemmas, the solution to the dilemma requires negotiation among
members of the health care team. The nurse’s point of view is valuable because:
A. Nurses have a legal license that encourages their presence during
ethical discussions.
B. The principle of autonomy guides all participants to respect their own
self-worth.
C. Nurses develop a relationship to the client that is unique among all
professional health care providers.
D. The nurse’s code of ethics recommends that a nurse be present at any
ethical discussion about client care.
59. Ethical dilemmas often arise over a conflict of opinion. Once the nurse has
determined that the dilemma is ethical, a critical first step in negotiating the difference
of opinion would be to:
A. Consult a professional ethicist to ensure that the steps of the process
occur in full.
B. Gather all relevant information regarding the clinical, social, and
spiritual aspects of the dilemma.
C.  List the ethical principles that inform the dilemma so that negotiations
agree on the language of the discussion.
D. Ensure that the attending physician has written an order for an ethics
consultation to support the ethics process.
 60. The nurse practice acts are an example of:
A. Statutory law
B. Common law
C. Civil law
D. Criminal law
61. The scope of Nursing Practice, the established educational requirements for
nurses, and the distinction between nursing and medical practice is defined by:
A. Statutory law
B. Common law
C. Civil law
D. Nurse practice acts
62. The client’s right to refuse treatment is an example of:
A. Statutory law
B. Common law
C. Civil laws
D. Nurse practice acts
63. Even though the nurse may obtain the clients signature on a form, obtaining
informed consent is the responsibility of the:
A. Client
B. Physician
C. Student nurse
D. Supervising nurse.
64. The nurse is obligated to follow a physician’s order unless:
A. The order is a verbal order
B. The physicians order is illegible
C. The order has not been transcribed
D.  The order is an error, violates hospital policy, or would be detrimental
to the client.
65. The nursing theorist who developed transcultural nursing theory is
A. Dorothea Orem
B. Madeleine Leininger
C. Betty Newman
D. Sr. Callista Roy
Answers and Rationales

1. C. Have equal access to all health care regardless of race and religion
2. D. Without understanding one’s own beliefs and values, a bias or
preconceived belief by the nurse could create an unexpected conflict or an
 area of neglect in the plan of care for a client (who might be expecting
something totally different from the care). During assessment values,
beliefs, practices should be identified by the nurse and used as a guide to
identify the choices by the nurse to meet specific needs/outcomes of that
client. Therefore identification of values, beliefs, and practices allows for
planning meaningful and beneficial care specific for this client.
3. C. Cultural practices do not influence biocultural needs because they are
inborn risks that are related to a biological need and not a learned cultural
belief or practice.
4. A. Transcultural care means that by understanding and learning about
specific cultural practices the nurse can integrate these practices into the
plan of care for a specific individual client who has the same beliefs or
practices to meet the client’s needs in a holistic manner of care.
5. B. Without assessment and identification of the cultural needs, the nurse
cannot begin to understand how these might influence the health problem
or health care management.
6. D. It is not the family’s responsibility to assist in the communication
process. Many families will leave someone to help at times, but it is the
hospital’s legal obligation to find an interpreter for continued understanding
by the client to make sure the client is fully informed and comprehends in
his or her primary language.
7. A. This set of ethical principles provides the professional guidelines
established by the ANA to maintain the highest standards for ideal conduct
in practice. As a profession, the ANA wanted to establish rules and then
incorporate guidelines for accountability and responsibility of each nurse
within the practice setting.
8. B. The ethical issue was the inequality of treatment based strictly upon
racial differences. Secondly, the drug was deliberately withheld even after
results showed that the drug was working to cure the disease process in the
white men for many years. So after many years, the black men were still not
treated despite the outcome of the research process that showed the drug
to be effective in controlling the disease early in the beginning of the
research project. Therefore harm was done. Nonmaleficence, veracity, and
justice were not followed.
9. A. Stereotyping an “old man” as “nasty”is a gender bias and an ageism
issue. The nurse is verbalizing a negative descriptor about the client.
10. C. Justice is defined as the fairness of distribution of resources. However,
guidelines for a hierarchy of needs have been established, such as with
organ transplantation. Nurses are moved to areas of greatest need when
shortages occur on the floors. No floor is left without staff, and another floor
that had five staff will give up two to go help the floor that had no staff.
11. A. Statutory law is created by legislature. It creates statues such as the
NPA, which defines the role of the nurse and expectations of the
 performance of one’s duties and explains what is contraindicated as
guidelines for breech of those regulations.
12. D. If the hospital fails to follow ADA guidelines for meeting special needs,
the facility loses funding and status for receiving low-income loans or
reimbursement of expenses. ADA protects the civil rights of disabled people.
It applies to both the hospital clients and hospital staff. Privacy issues for
persons who are positive for human immunodeficiency virus (HIV) have
been one issue in relationship to getting information when hospital staff
have been exposed to unclean sticks. The ADA allows the infected client the
right to choose whether or not to disclose that information.
13. C. Knowing what to do to prevent injury is a part of the standards of care
for nurses to follow. Safety guidelines dictate raising the side rails, staying
with the client, lowering the bed, and observing the client until the
environment is safe. As a nurse, these activities are known as basic safety
measures that prevent injuries, and to not perform them is not acting in a
safe manner. Negligence is conduct that falls below the standard of care
that protects others against unreasonable risk of harm.
14. D. Your signature as a witness only states that the person signing the
form was the person who was listed in the procedure.
15. A. A guardian has been appointed by a court and has full legal rights to
choose management of care.
16. A. Anyone, at any age, can be treated without parental permission for an
STD infection. The client is “advised” to contact sexual partners but is not
“required” to give names. Permission from parents is not needed, based
upon current privacy laws.
17. B. The nurse is responsible for clarifying all orders that are illegible,
unreasonable, unsafe, or incorrect. The failure of the nurse to question the
physician about an order creates an area of liability on the nurse’s part
because this is perceived as a medical action and not the role of the nurse
to write orders. Some RNs do have prescriptive privileges based upon
advanced degrees and certification. Therefore the nurse who cannot correct
the order must document that the physician was called and clarification or a
new order was given to correct the unclear or illegible one that was
currently on the chart. Phone calls, follow-up, and lack of follow-up by the
physician should also be documented if there is a problem with getting the
information in a timely manner. The nurse must show the sequence of
events of a situation in a clear manner if there is any conflict or question
about any orders or procedures that were not appropriate. Assessments and
documentation of the client’s status should also be included if there is a
potential risk for harm present. Contact of the staff’s chain of command
should also be specifically stated for the proof of the responsibilities being
followed according to hospital policy.
18. A. If heat is applied for 1 hour or more, blood flow is reduced by reflex
vasoconstriction. Vasoconstriction is the opposite of the desired effect of
heat application
19. A. In the anger stage of Kubler-Ross’s stages of dying, the individual
resists the loss and may strike out at everyone and everything, in this case,
the nurse.
20. C. Grief is manifested in a variety of ways that are unique to an individual
and based on personal experiences, cultural expectations, and spiritual
beliefs. The sequencing of stages or behaviors of grief may occur in order,
they may be skipped, or they may reoccur. The amount of time to resolve
grief also varies among individuals.
21. D. It is helpful for the nurse to find simple care activities for the family to
perform, such as feeding the client, washing the client’s face, combing hair,
and filling out the client’s menu. This helps the family demonstrate their
caring for the client and enables the client to feel their closeness and
concern. a. Older adults often become particularly lonely at night and may
feel more secure if a family member stays at the bedside during the night.
The nurse should allow visitors to remain with dying clients at any time if
the client wants them. It is up to the family to determine if they are feeling
overwhelmed, not the nurse.
22. A. Spending time to let clients share their life experiences enables the
nurse to know clients better. Knowing clients then facilitates choice of
therapies that promote client decision making and autonomy, thus
promoting a client’s self-esteem and dignity.
23. D. Denial, anger, bargaining, depression, and acceptance.

24. D. The inner feeling and outward reactions of the survivor.

25. C. The body of the deceased should be prepared before the family comes
in to view and say their goodbyes. This includes removing all equipment,
tubes, supplies, and dirty linens according to protocol, bathing the client,
applying clean sheets, and removing trash from the room.
26. B. The goal of palliative care is the prevention, relief, reduction, or
soothing of symptoms of disease or disorders without effecting a cure.
27. A.
28. B.
29. B.
30. B.
31. A.
32. D.
33. D.
34. A.
35. B.
36. C.
37. A.
38. C.
39. D.
40. B.
41. D.
42. C.
43. C.
44. D.
45. A. Cultural awareness is an in-depth examination of one’s own
background, recognizing biases and prejudices and assumptions about
other people.
46. B. Cultural competence is the process of acquiring specific knowledge,
skills, and attitudes that ensure delivery of culturally congruent care.
47. A.
48. A.
49. D.
50. C. Disparities in health outcomes between the rich and the poor illustrate
the influence of socioeconomic factors in morbidity and mortality. Social
factors such as poverty and lack of universal medical insurance compromise
the health status of the poor and unemployed.
51. A. Nurses need not assume that pain relief is equally valued across
groups. Cultural pain may be suffered by a client whose valued way of life is
disregarded by practitioners.
52. D. The dominant value in American society of individual autonomy and
self-determination may be in direct conflict with diverse groups. Advance
directives, informed consent, and consent for hospice are examples of
mandates that my violate client’s values.
53. D. Justice refers to fairness. Health care providers agree to strive for
justice in health care. The term often is used during discussions about
resources. Decisions about who should receive available organs are always
difficult.
54. B. the ANA has established widely accepted codes that professional
nurses attempt to follow.
55. C. Nurses strengthen their ability to advocate for a client when nurses are
able to identify personal values and then accurately identify the values of
the client and articulate the client’s point of view.
56. D. A utilitarian system of ethics proposes that the value of something is
determined by its usefulness.
57. A. The ethic of care explores the notion of care as a central activity of
human behavior. Those who write about the ethics of care advocate a more
female biased theory that is based on understanding relationships,
especially personal narratives.
58. C. When ethical dilemmas arise, the nurses point of view unique and
critical. The nurse usually interacts with clients over longer time intervals
than do other disciples.
59. B. Each step in the processing of an ethical dilemma resembles steps in
critical thinking. The nurse begins by gathering information and moves
through assessment, identification of the problem, planning,
implementation, and evaluation.
60. A.
61. D.
62. B.
63. B.
64. D.  The order is an error, violates hospital policy, or would be detrimental
to the client.
65. B. Madeleine Leininger developed the theory on transcultural theory
based on her observations on the behavior of selected people within a
culture.