Colegio De Kidapawan

Paramedical Department
MCN 107 Midterm Exam
Name :
1. A registered nurse is planning for theclient assignment for the day. Which of the following is
the most appropriate assignment for a nursing assistant?
A. a client requires tap water enemas
B. a client requiring colostomy irrigation
C. a client requiring continuous tube feeding
D. a client with difficulty swallowing food and fluid
2. A registered nurse employed in long-term care facility is planning assignments for the clients
on a nursing unit. The RN needs to assign four clients and has a licensed practical (vocational)
nurse and three nursing assistants on a nursing team. Which of the following clients would the
nurse most appropriately assign to LPN
A. a client who requires a 24-hour urine collection
B. an elderly client requiring assistance with bed bad and frequent ambulation
C. a client who requires a fleet and an oil retention enema
D. a client with an abdominal wound that requires irrigation and dressing changes every 3 hours
3. A registered nurse has received the assignment for the day shift. After making initial rounds
and checking all the assigned clients, which will the RN plan to care for first?
A. a client who is ambulatory
B. a client who has fever and who is diaphoretic and restless
C. a client scheduled for physical therapy at 1:00 pm
D. a post-operative client who has received pain medications
4. A nurse is assigned to care for four clients. In planning client rounds, which client would the
nurse assess first?
A. a client receiving oxygen via nasal cannula who had difficulty breathing the previous shift
B. a post-operative client for discharge
C. a client scheduled for x-ray
D. a client requiring daily dressing changes
5. A registered nurse (RN) is implementing a team nursing approach. The RN has a licensed
practical nurse (LPN) and a nursing assistant on the team and is planning the client assignments
for the day. The RN appropriately assigns which of the following clients to the LPN?
a) a client who needs assistance with grooming
b) a client who needs frequent ambulation
c) a client who needs to be suctioned as needed (PRN)
d) a client who needs assistance with hygiene measures
6. A nurse is planning client assignments. Which of the following is the least appropriate
assignment for the nursing assistant?
a) assisting a profoundly developmentally disabled child to eat lunch
b) obtaining frequent oral temperatures on a client
c) accompanying a 51-year old man, being discharged to home following a bowel resection
d) collecting a urine specimen from a 70-year old woman admitted 3 days ago
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7.. A nurse is assigned to care for four clients. In planning client rounds, which client would the
nurse assess first?
a) a client receiving oxygen via nasal cannula who had difficulty breathing during the previous
shift
b) a postoperative client preparing fro discharge
c) a client scheduled for a chest x-ray
d) a client requiring daily dressing changes
8.. A nurse is planning the client assignments for the shift. Which of the following clients would
the nurse appropriately assign to the nursing assistant?
a) a client requiring twice -daily dry dressing changes
b) a client requiring frequent ambulation with a walker
c) a client on a bowel management program requiring rectal suppositories and a daily enema
d) a client with diabetes mellitus requiring daily insulin and reinforcement of dietary measures
9.. A client with a spinal cord injury develops a severe, pounding headache. The client is
diaphoretic, hypertensive, and bradycardic and complains of nausea and nasal congestion. The
nurse determines that the client is experiencing autonomic hyperreflexia (autonomic dysreflexia).
Which action would the nurse take first?
a) notify the physician
b) document the findings
c) perform a rectal examination
d) place the client in a sitting position
10.A client who is mouth breathing is receiving oxygen by face mask. The nursing assistant asks
the registered nurse (RN) why a water bottle is attached to the oxygen tubing near the wall
oxygen outlet. The RN responds that the primary purpose of this feature is to:
a) prevent fluid loss from the lungs during mouth breathing
b) give the client added fluid via the respiratory rate
c) humidify the oxygen that is bypassing the client's nose
d) prevent the client from getting nosebleed
11.. A nurse and a nursing assistant are assisting the respiratory therapist to position a client for
posturaldrainage. The nursing assistant asks the nurse how the respiratory therapists selects the
position used for the procedure. The nurse responds that a position is chosen that will use gravity
to help drain secretions from which of the following areas?
a) trachea
b) main bronchi
c) lobes
d) alveoli
12. A registered nurse (RN) is observing a licensed practical nurse (LPN) caring for a deceased
client whose eyes will be donated. The RN intervenes if the LPN performs which action?
a) elevates the head of the bed
b) closes the client's eyes
c) places wet saline gauze pads and ice pack on the eyes
d) closes the client's eyes and places a dry sterile dressing over the eyes
13. The nurse has recently been assigned to manage a pulmonary progressive unit at a large
urban hospital. The nurse's leadership style is participative, with the belief that all staff members
assist in decision making and the development of the unit's goals. The nurse is implementing
which leadership style?
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a) democratic
b) laissez faire
c) auticratic
d) situational
14. A physician has written an order for a vest restraint to be applied on a client from 10:00 pm
to 7:00 am because the client becomes disoriented during the night and is at risk for falls. At
11:00 pm, the charge nurse makes rounds on all of the clients with the vest restraint, which
observation by the charge nurse would indicate that the nurse who cared for this client performed
an unsafe action in the use of the restraint?
a) a safety knot was used to secure the restraint
b) the client's record indicates that the restraint will be released every 2 hours
c) the restraint was applied tightly
d) the call light was placed within reach of the client
15. 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?
a. Identify the source of the conflict and understand the points of friction
b. Disregard what she feels and continue to work independently
c. Seek help from the Director of Nursing
d. Quit her job and look for another employment.
16. As a young manager, she knows that conflict occurs in any organization. Which of the
following statements regarding conflict is NOT true?
a. Can be destructive if the level is too high
b. Is not beneficial; hence it should be prevented at all times
c. May result in poor performance
d. May create leaders
17. Katherine tells one of the staff, I dont 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?
a. Smoothing
b. Compromise
c. Avoidance
d. Restriction
18. Kathleen knows that one of her staff is experiencing burnout. Which of the following is the
best thing for her to do?
a. Advise her staff to go on vacation.
b. Ignore her observations; it will be resolved even without intervention
c. Remind her to show loyalty to the institution.
d. Let the staff ventilate her feelings and ask how she can be of help.

19. She knows that performance appraisal consists of all the following activities EXCEPT:
a. Setting specific standards and activities for individual performance.
b. Using agency standards as a guide.
c. Determine areas of strength and weaknesses
d. Focusing activity on the correction of identified behavior.
20. Which of the following statements is NOT true about performance appraisal?
a. Informing the staff about the specific impressions of their work help improve their
performance.
b. A verbal appraisal is an acceptable substitute for a written report
c. Patients are the best source of information regarding personnel appraisal.
d. The outcome of performance appraisal rests primarily with the staff.
21. 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?
a. The staff member is observed in natural setting.
b. Incidental confrontation and collaboration is allowed.
c. The evaluation is focused on objective data systematically.
d. The evaluation may provide valid information for compilation of a formal report.
22. She conducts a 6-month performance review session with a staff member. Which of the
following actions is appropriate?
a. She asks another nurse to attest the session as a witness.
b. She informs the staff that she may ask another nurse to read the appraisal before the
session is over.
c. She tells the staff that the session is manager-centered.
d. The session is private between the two members.
23. 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?
a. Benevolent authoritative
b. Consultative
c. Exploitive-authoritative
d. Participative
24. She decides to illustrate the organizational structure. Which of the following elements is
NOT included?
a. Level of authority
b. Lines of communication
c. Span of control
d. Unity of direction

25. She plans of assigning competent people to fill the roles designed in the hierarchy. Which
process refers to this?
a. Staffing
b. Scheduling
c. Recruitment
d. Induction
25. She checks the documentary requirements for the applicants for staff nurse position. Which
one is NOT necessary?
a. Certificate of previous employment
b. Record of related learning experience (RLE)
c. Membership to accredited professional organization
d. Professional identification card
27. Which phase of the employment process includes getting on the payroll and completing
documentary requirements?
a. Orientation
b. Induction
c. Selection
d. Recruitment
28. 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?
a. Centralized
b. Decentralized
c. Matrix
d. Informal
29. In a horizontal chart, the lowest level worker is located at the
a. Left most box
b. Middle
c. Right most box
d. Bottom
30. She decides to have a decentralized staffing system. Which of the following is an advantage
of this system of staffing?
a. greater control of activities
b. Conserves time
c. Compatible with computerization
d. Promotes better interpersonal relationship
31. Aubrey thinks about primary nursing as a system to deliver care. Which of the following
activities is NOT done by a primary nurse?
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a. Collaborates with the physician

b. Provides care to a group of patients together with a group of nurses
c. Provides care for 5-6 patients during their hospital stay.
d. Performs comprehensive initial assessment
32. 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?
a. Case method
b. Modular nursing
c. Nursing case management
d. Team nursing
33. 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?
a. Make an interpretation about strengths and weaknesses
b. Identify the values of the department
c. Identify structure, process, outcome standards & criteria
d. Measure actual performances
34. Ms. Valencia develops the standards to be followed. Among the following standards, which is
considered as a structure standard?
a. The patients verbalized satisfaction of the nursing care received
b. Rotation of duty will be done every four weeks for all patient care personnel.
c. All patients shall have their weights taken recorded
d. Patients shall answer the evaluation form before discharg
35. When she presents the nursing procedures to be followed, she refers to what type of
standards?
a. Process
b. Outcome
c. Structure
d. Criteria
36. The following are basic steps in the controlling process of the department. Which of the
following is NOT included?
a. Measure actual performance
b. Set nursing standards and criteria
c. Compare results of performance to standards and objectives
d. Identify possible courses of action
37. Which of the following statements refers to criteria?

a. Agreed on level of nursing care

b. Characteristics used to measure the level of nursing care
c. Step-by-step guidelines
d. Statement which guide the group in decision making and problem solving
38. She wants to ensure that every task is carried out as planned. Which of the following tasks is
NOT included in the controlling process?
a. Instructing the members of the standards committee to prepare policies
b. Reviewing the existing policies of the hospital
c. Evaluating the credentials of all nursing staff
d. Checking if activities conform to schedule
39. Ms. Valencia prepares the process standards. Which of the following is NOT a process
standard?
a. Initial assessment shall be done to all patients within twenty four hours upon admission.
b. Informed consent shall be secured prior to any invasive procedure
c. Patients reports 95% satisfaction rate prior to discharge from the hospital.
d. Patient education about their illness and treatment shall be provided for all patients and
their families.
40. Which of the following is evidence that the controlling process is effective?
a. The things that were planned are done
b. Physicians do not complain.
c. Employees are contended
d. There is an increase in customer satisfaction rate.
41. Ms. Valencia is responsible to the number of personnel reporting to her. This principle refers
to:
a. Span of control
b. Unity of command
c. Carrot and stick principle
d. Esprit d corps
42. 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?
a. Evaluate the overall result of the unrest
b. Initiate a group interaction
c. Develop a plan and implement it
d. Identify external and internal forces.
43.. 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
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c. Country Club Management

d. Team Management
44. 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
45. 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.
46. 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 managers potential.
d. There is good evidence that certain personal qualities favor success in managerial role.
47. 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.
48. 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
49. 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
50. 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 leaders
personality and the specific situation
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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.
51. 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
52. 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
53. 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.
54. 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
55. 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
56. 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
57. Which of the following is TRUE about functional nursing?
a. Concentrates on tasks and activities
b. Emphasizes use of group collaboration
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c. One-to-one nurse-patient ratio

d. Provides continuous, coordinated and comprehensive nursing services
58. 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
59. 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
60. Which of the following is the best guarantee that the patients 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
61. 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
62. 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
63. 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 planningworkshop, 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
64. 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.
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d. The Good Shepherd Medical Center aims to provide a patient-centered care in a total healing
environment.
65. 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
66. 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
67. 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
68. 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
69. 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
70. 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. Lets 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.
71.. 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

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c. Establish rapport with patients.

d. Reduce response time to two minutes.
72. 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
73. 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
74. 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
75. 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
76. 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
77. 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
78. Stephanie delegates effectively if she has authority to act, which is BEST defined as:
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a. having responsibility to direct others

b. being accountable to the organization
c. having legitimate right to act
d. telling others what to do
79. 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.
80. 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
81. 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.
82.. 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
83.. A client who is mouth breathing is receiving oxygen by face mask. The nursing assistant
asks the registered nurse (RN) why a water bottle is attached to the oxygen tubing near the wall
oxygen outlet. The RN responds that the primary purpose of this feature is to:
a) prevent fluid loss from the lungs during mouth breathing
b) give the client added fluid via the respiratory rate
c) humidify the oxygen that is bypassing the client's nose
d) prevent the client from getting nosebleed
84. A nurse and a nursing assistant are assisting the respiratory therapist to position a client for
postural drainage. The nursing assistant asks the nurse how the respiratory therapists selects the
position used for the procedure. The nurse responds that a position is chosen that will use gravity
to help drain secretions from which of the following areas?
a) trachea
b) main bronchi
c) lobes
d) alveoli
85. A registered nurse (RN) is observing a licensed practical nurse (LPN) caring for a deceased
13

client whose eyes will be donated. The RN intervenes if the LPN performs which action?
a) elevates the head of the bed
b) closes the client's eyes
c) places wet saline gauze pads and ice pack on the eyes
d) closes the client's eyes and places a dry sterile dressing over the eyes
86. The nurse has recently been assigned to manage a pulmonary progressive unit at a large
urban hospital. The nurse's leadership style is participative, with the belief that all staff members
assist in decision making and the development of the unit's goals. The nurse is implementing
which leadership style?
a) democratic
b) laissez faire
c) auticratic
d) situational
87. A physician has written an order for a vest restraint to be applied on a client from 10:00 pm
to 7:00 am because the client becomes disoriented during the night and is at risk for falls. At
11:00 pm, the charge nurse makes rounds on all of the clients with the vest restraint, which
observation by the charge nurse would indicate that the nurse who cared for this client performed
an unsafe action in the use of the restraint?
a) a safety knot was used to secure the restraint
b) the client's record indicates that the restraint will be released every 2 hours
c) the restraint was applied tightly
d) the call light was placed within reach of the client

NCLEX RN:
ANSWERS AND RATIONALE
1) A

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- The nursing assistant can perform enema. Option B, C, and D will be done by the
LVN/LPN
2) D
- the LVN can perform more complicated procedures like wound care. Option A,
B, and C tasks done by nursing assistants
3) B
- patients with unstable condition should be given highest priority by the nurse.
The client who has fever, and who is diaphoretic and restless is with unstable
condition
4) A
- the client with problem with airways and whose condition is unstable should be
given first priority by the nurse. "ABC" is a priority.

5) C
- When a nurse delegates aspects of a client's care to another staff member, the
nurse assigning the task is responsible for ensuring that each task is appropriately
assigned on the basis of the educational level and competency of the staff member.
Option C can be assigned to the LPN because this staff member can perform
certain invasive procedures. Noninvasive interventions can be assigned to a
nursing assistant. These include the tasks identified in options A, B, and D.

6) A
- The nurse must determine the most appropriate assignment based on the skills of
the staff member and the needs of the client. In this case, the least appropriate
assignment for a nursing assistant would be assisting with feeding a profoundly
developmentally disabled child. The child is likely to have difficulty eating and
therefore a higher potential for complications such as choking and aspiration. The
remaining three options include no data indicating that these tasks carry any
unforeseen risk.
7) A
- Airway is always a high priority, so the nurse would attend to the client who has
been experiencing an airway problem first. The clients described in options B, C,
and D would be an intermediate priority.
78) B

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- Assignment of tasks needs to be implemented on the basis of the job description

of the nursing assistant, the level of clinical competence, and state law. Options A,
C, and D involve care that requires the skill of a licensed nurse. Although a nursing
assistant may be trained to administer an enema (depending on state practice acts
and agency policy), a rectal suppository needs to be administered by a licensed
nurse. Option B is the most appropriate assignment for the nursing assistant.
9) D
- Autonomic hyperreflexia is an acute emergency that occurs as a result of
exaggerated autonomic responses to stimuli that are innocuous in normal
individuals. It occurs only after spinal shock has resolved. A number of stimuli
may trigger this response, including a distended bladder (the most common cause);
distention or contraction of the visceral organs, especially the bowel (from
constipation, impaction), or stimulation of the skin. When autonomic hyperreflexia
occurs, the client is immediately placed in a sitting position to lower the blood
pressure. The nurse would then perform a rapid assessment to identify and alleviate
the cause. The client's bladder is emptied immediately via a urinary catheter, the
rectum is checked for the presence of a fecal mass, and the skin is examined for
areas of pressure, irritation, or broken skin. The physician is notified, and the nurse
documents the occurrence and the actions taken.

After you reviewed your answers through its rationale, you can also go back to the
first page to start from the beginning:

Nursing Questions about Leadership and Management:

Answers and Rationale
10) C
- The purpose of the water bottle is to humidify the oxygen that is bypassing the
nose during mouth breathing. The humidified oxygen may help keep mucous
membranes moist but will not substantially alter fluid balance (options A and B). A
client who is breathing through the mouth is not at risk for nosebleeds.
11.) C
- Postural drainage uses specific client positions that vary depending on the
affected lobe(s). The positions usually involve having the head lower than the
affected lung segment(s) to facilitate drainage of secretions. Postural drainage
often is done in conjunction with chest percussion for maximum effectiveness. The
other options are incorrect.
16

12) C
- When a corneal donor dies, the eyes are closed and gauze pads wet with saline
are placed over them with a small ice pack. Within 2 to 4 hours, the eyes are
enucleated. The cornea is usually transplanted with 24 to 48 hours. The head of the
bed should also be elevated. Placing dry sterile dressings over the eyes serves no
useful purpose.
13.) A
- Democratic leadership is defined as participative with a focus on the belief that
all members of the group have input into the decision making process. This leader
acts as a resource person and facilitator. Laissez faire leaders assume a passive
approach, with the decision making left to the group. Autocratic leadership
dominates the group, with maintenance of strong control over the group.
Situational leadership is based on the current events of the day.

14) C
- Restraints should never be applied tightly because that could impair circulation.
The restraint should be applied securely (not tightly) to prevent the client from
slipping through the restraint and endangering himself or herself. A safety knot
should be used because it can easily be released in an emergency. Restraints,
especially limb restraints, must be released every 2 hours (or per agency policy) to
inspect the skin for abnormalities. The call light must always be within the clients
reach in case the client needs assistance.
Answers from nos. 15 42.
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.
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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 nurses 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.

18

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.

19

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. CallistaRoy 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.

20

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

Anwrs from nos. 43-82.

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
managers potential.
It is not conclusive that certain qualities of a person would make him become a
good manager. It can only predict a managers 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 taskcentered.
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.
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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 70s it was termed as methods of patient
assignment; in the early 80s it was called modalities of patient care then patterns
of nursing care in the 90s 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.

22

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) Lets 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. Its their way of life in that
organization
31. Answer: (A) Proactive and caring with one another

23

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.
Answers from nos. 83 -87
16) C
- The purpose of the water bottle is to humidify the oxygen that is bypassing the nose during mouth
breathing. The humidified oxygen may help keep mucous membranes moist but will not substantially alter
fluid balance (options A and B). A client who is breathing through the mouth is not at risk for nosebleeds.
17) C
- Postural drainage uses specific client positions that vary depending on the affected lobe(s). The
positions usually involve having the head lower than the affected lung segment(s) to facilitate drainage of
secretions. Postural drainage often is done in conjunction with chest percussion for maximum
effectiveness. The other options are incorrect.
18) C
- When a corneal donor dies, the eyes are closed and gauze pads wet with saline are placed over them
with a small ice pack. Within 2 to 4 hours, the eyes are enucleated. The cornea is usually transplanted
with 24 to 48 hours. The head of the bed should also be elevated. Placing dry sterile dressings over the
eyes serves no useful purpose.
19) A
- Democratic leadership is defined as participative with a focus on the belief that all members of the group
have input into the decision making process. This leader acts as a resource person and facilitator. Laissez
faire leaders assume a passive approach, with the decision making left to the group. Autocratic leadership

24

dominates the group, with maintenance of strong control over the group. Situational leadership is based
on the current events of the day.
20) C
- Restraints should never be applied tightly because that could impair circulation. The restraint should be
applied securely (not tightly) to prevent the client from slipping through the restraint and endangering
himself or herself. A safety knot should be used because it can easily be released in an emergency.
Restraints, especially limb restraints, must be released every 2 hours (or per agency policy) to inspect the
skin for abnormalities. The call light must always be within the clients reach in case the client needs
assistance.

25

26