I85PREP
⌘ K
CNML study materials
CNML study resources

CNML practice questions

One question at a time. Build your CNML understanding.

First 50 of 199 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Communication and Relationship Management

In the SBAR communication format, which component states what the sender believes should happen next?

  1. Assessment
  2. Recommendation Correct answer.
  3. Situation
  4. Background

Explanation

SBAR structures a message into Situation, Background, Assessment, and Recommendation. The recommendation is the sender's explicit request or proposed action, which gives the receiver a clear next step.

Question 2Communication and Relationship Management

Which behavior best demonstrates active listening by a nurse manager?

  1. Restating the speaker's main point in your own words Correct answer.
  2. Taking notes while planning how you will reply
  3. Completing the speaker's sentences to move the conversation along
  4. Redirecting the conversation to a similar experience of your own

Explanation

Active listening requires full attention plus verification that the message received matches the message sent, which is achieved by paraphrasing and checking accuracy. It also requires suppressing the urge to interrupt, rehearse a reply, or turn the topic to oneself.

Question 3Communication and Relationship Management

A nurse manager grants a surgeon's preferred scheduling arrangement even though it disrupts unit staffing, mainly to keep the working relationship smooth. Which conflict-handling mode is this?

  1. Collaborating
  2. Accommodating Correct answer.
  3. Avoiding
  4. Competing

Explanation

Accommodating is unassertive and cooperative: one party sets aside its own concerns to satisfy the other, usually to protect the relationship. It is reasonable for trivial issues but risky when it repeatedly sacrifices staffing or safety.

Question 4Communication and Relationship Management

A family member shouts at the nurse manager about a long wait for pain medication. Which opening response is most effective?

  1. Explain that the delay was unavoidable because the unit is short-staffed
  2. Tell the family member that the staff are doing their very best
  3. Acknowledge the frustration and ask what happened from their perspective Correct answer.
  4. Ask the family member to lower their voice before the conversation continues

Explanation

Service recovery begins with recognizing the emotion and gathering the complainant's view before explaining or solving. Defending the unit or correcting the person's tone before listening usually escalates the encounter.

Question 5Communication and Relationship Management

A nurse manager observes an experienced nurse making repeated demeaning remarks to a new graduate. Which action is most appropriate first?

  1. Wait to see whether the behavior resolves on its own
  2. Address it privately with the nurse and restate expectations Correct answer.
  3. Move the new graduate to a different preceptor assignment
  4. Confront the experienced nurse in front of the unit staff

Explanation

Incivility is best addressed early, privately, and behaviorally: name the specific observed behavior and restate the professional standard, then document and follow up if it recurs. Delayed or public responses either allow escalation or humiliate the person and harden resistance.

Question 6Communication and Relationship Management

Which feedback statement to a staff nurse is most effective?

  1. You are a great nurse and we are lucky to have you on this unit
  2. Some people feel your reports are sloppy and need to be tightened up
  3. Today's handoff omitted the patient's allergy history; include it next time Correct answer.
  4. You always have a bad attitude on the night shift and everyone notices it

Explanation

Effective feedback is specific, behavioral, timely, and future-oriented, and it names the desired behavior. Statements that rely on labels, hearsay, or general praise give the receiver nothing concrete to repeat or change.

Question 7Communication and Relationship Management

What is the primary purpose of a formal chain of command in a health care organization?

  1. Replace the need for written policies and procedures
  2. Limit the number of staff who may contact senior leaders
  3. Ensure that every concern reaches the chief nursing officer
  4. Clarify who has authority to resolve an issue at each level Correct answer.

Explanation

A chain of command defines levels of authority and the route for escalating concerns, so problems are resolved at the lowest level capable of handling them and escalated predictably when they are not. It is a decision-rights structure, not a gatekeeping or substitution mechanism.

Question 8Communication and Relationship Management

Self-awareness, self-regulation, motivation, empathy, and social skill together describe which leadership capability?

  1. Situational leadership
  2. Transactional leadership
  3. Emotional intelligence Correct answer.
  4. Servant leadership

Explanation

These five components form the widely used framework of emotional intelligence, which underpins a leader's ability to manage their own reactions and read and influence the emotional climate of a team.

Question 9Communication and Relationship Management

A staff nurse tells the manager she felt publicly humiliated by feedback given during shift report. Which manager response best separates intent from impact?

  1. Tell the nurse that public feedback is standard practice on the unit and should be expected
  2. Defer the discussion to the annual performance review so emotions can settle
  3. Explain that no offense was intended, so the nurse's reaction is misplaced
  4. Acknowledge the nurse's experience, then discuss the feedback content separately Correct answer.

Explanation

Separating intent from impact means accepting that the nurse's reaction is real regardless of what the manager meant, so the experience is validated first and the substance of the feedback is handled as a distinct issue. Defending intent, normalizing the practice, or postponing the conversation leaves the relational harm unaddressed.

Question 10Communication and Relationship Management

Which element is central to interprofessional collaborative practice?

  1. Each discipline keeping its own separate documentation record
  2. Physician-led decision making on every aspect of care
  3. Restricting family involvement to posted visiting hours
  4. Mutual respect and shared decision making among disciplines Correct answer.

Explanation

Collaborative practice rests on mutual respect, shared planning, and shared decision making among disciplines, with the patient and family as partners in the team. Structures that keep disciplines apart or concentrate authority in one group undermine the model.

Question 11Communication and Relationship Management

What is the most reliable way for a nurse to confirm that a patient understands new discharge medication instructions?

  1. Ask the patient whether they have any questions
  2. Speak slowly and repeat the instructions twice
  3. Ask the patient to explain how they will take the medication Correct answer.
  4. Give a written handout written at a twelfth-grade reading level

Explanation

Teach-back asks the patient to demonstrate understanding in their own words, which reveals gaps that a yes-or-no question cannot. Written materials should be at roughly a fifth- to sixth-grade reading level to support comprehension.

Question 12Communication and Relationship Management

A patient with limited English proficiency must discuss a new diagnosis. Which approach is best practice?

  1. Use a qualified medical interpreter, in person or by phone Correct answer.
  2. Ask the patient's bilingual roommate to interpret the discussion
  3. Speak more loudly and use hand gestures to convey the message
  4. Use the patient's adult child to interpret to save staff time

Explanation

A qualified medical interpreter supports accurate, confidential communication and is the standard of care when a patient has limited English proficiency. Untrained interpreters, including family and roommates, introduce errors, filter information, and breach confidentiality.

Question 13Communication and Relationship Management

In an interest-based negotiation over holiday scheduling, what should the manager do first?

  1. Open with the unit's minimum staffing requirement as a nonnegotiable position
  2. Identify the underlying interests of both parties before proposing options Correct answer.
  3. Give the most senior nurses first choice of holidays to end the discussion
  4. Present a finished schedule and ask staff to trade shifts among themselves

Explanation

Interest-based negotiation starts by surfacing what each party actually needs behind its stated demand, which allows options that satisfy both to be generated. Locking in positions or handing down a finished schedule forecloses that problem solving.

Question 14Communication and Relationship Management

Which practice most improves the effectiveness of a unit staff meeting?

  1. Inviting every department in the hospital to attend each meeting
  2. Holding meetings weekly regardless of whether there is business
  3. Circulating an agenda with time allotments before the meeting Correct answer.
  4. Allowing discussion to continue until every member has spoken

Explanation

An agenda with time allotments circulated in advance focuses discussion, allows preparation, and keeps the meeting within its purpose. Open-ended attendance and discussion, or meetings without a purpose, consume staff time without improving outcomes.

Question 15Communication and Relationship Management

Which is an essential element of a structured patient handoff?

  1. Sharing personal opinions about the patient's personality
  2. Transferring accountability along with the information Correct answer.
  3. Delivering the report as a one-way monologue
  4. Reciting the entire medical record aloud

Explanation

A handoff transfers both information and accountability for the patient, using a standard format that permits questions and read-back. It is a focused, interactive exchange rather than a recitation or a one-way broadcast.

Question 16Communication and Relationship Management

A manager wants to improve upward communication from night-shift staff. Which strategy is most effective?

  1. Require night staff to submit written reports to the manager
  2. Schedule periodic rounding on off-shifts to hear concerns directly Correct answer.
  3. Rely on the night charge nurse to report all concerns from the shift
  4. Add a suggestion box in the staff break room

Explanation

Direct leader presence on off-shifts removes the filtering and status barriers that suppress concerns, and it creates a two-way conversation. Mediated or one-way channels usually produce less candid and less timely information.

Question 17Communication and Relationship Management

A unit council unanimously approves a staffing change without discussing any alternative. The manager suspects groupthink. Which action is most appropriate?

  1. Accept the decision, since unanimity is the strongest evidence of a good plan
  2. Poll members anonymously after the vote to confirm agreement
  3. Add more members to the council so more views are represented
  4. Assign a member to play devil's advocate and seek outside input Correct answer.

Explanation

Groupthink is marked by pressure toward unanimity and suppression of dissent, so the remedy is to institutionalize disagreement by assigning a challenger role and bringing in outside perspectives before the decision is final. Confirming agreement afterward or enlarging the group does not reliably surface alternatives.

Question 18Communication and Relationship Management

Which statement by a nurse manager is assertive rather than aggressive or passive?

  1. You never help with admissions, and honestly it is not fair to the rest of us on the shift
  2. Everyone on the unit knows you are the slowest one at admissions
  3. I need admissions done by 3 pm - what do you need to make that happen? Correct answer.
  4. Whatever you decide about the admissions is fine with me

Explanation

Assertive communication states the need directly and specifically, respects both parties, and invites collaboration on how to meet it. Blaming, avoiding, and indirect attacks are aggressive or passive alternatives that damage the relationship.

Question 19Communication and Relationship Management

Which statement best distinguishes mentoring from precepting?

  1. Precepting is reserved exclusively for new graduate nurses during orientation
  2. Mentoring supports long-term career growth; precepting teaches unit skills Correct answer.
  3. Precepting focuses on long-term career development rather than unit tasks
  4. Mentoring is limited to a set number of shifts with a defined end point

Explanation

Mentoring is a longer-term developmental relationship centered on professional growth and career guidance, while precepting is a time-limited, competency-based relationship focused on unit-specific skills and orientation.

Question 20Communication and Relationship Management

Which message calls for the richest communication channel, such as face-to-face discussion?

  1. Posting a policy update on the unit bulletin board
  2. Addressing repeated medication errors with a nurse Correct answer.
  3. Sending the monthly schedule to all staff
  4. Announcing a staff member's award in the newsletter

Explanation

Channel richness matters most when a message is ambiguous, emotionally charged, or consequential, because those situations require immediate feedback and interpretation of nonverbal cues. Routine, unambiguous announcements are handled efficiently through lean written channels.

Question 21Communication and Relationship Management

Two nurses ask the manager to settle their dispute. The manager instead helps them talk it through and build their own agreement. What is the manager doing?

  1. Avoiding the conflict until the parties cool off
  2. Accommodating both parties by granting each request
  3. Mediating the conflict so the parties generate the solution Correct answer.
  4. Arbitrating by imposing a decision on both parties

Explanation

Mediation uses a neutral third party who facilitates the parties' own problem solving, which preserves their ownership of the outcome and builds future capacity. Arbitration instead means the third party decides the outcome for them.

Question 22Communication and Relationship Management

Which recognition practice is most likely to sustain a desired staff behavior?

  1. A quarterly bonus paid to all staff regardless of performance
  2. Specific, timely praise tied to the observed behavior Correct answer.
  3. An annual award given to one employee chosen by the manager
  4. Public ranking of staff by productivity each month

Explanation

Recognition reinforces behavior most strongly when it is specific, timely, and contingent on the behavior, so staff know exactly what to repeat. Rare, comparative, or noncontingent rewards do not link the recognition to the desired action.

Question 23Communication and Relationship Management

During a hospital merger, rumors are spreading on the unit and staff are anxious. Which communication approach is best?

  1. Communicate what is known, what is unknown, and when updates will come Correct answer.
  2. Send a single email at go-live describing the new structure
  3. Let each manager answer questions as they happen to arise
  4. Withhold information until all plans are final and approved

Explanation

In ambiguous change, credibility is preserved by frequent, honest communication that distinguishes what is settled from what is still open and commits to a next update. Silence, inconsistent answers, and one late message let rumor fill the vacuum.

Question 24Communication and Relationship Management

A nurse is worried about a deteriorating patient, but the physician dismisses the concern on the first call. Applying the two-challenge rule, what should the nurse do next?

  1. Wait for the next scheduled rounds to raise the concern again
  2. Repeat the concern with objective data, then escalate up the chain Correct answer.
  3. Document the physician's response and continue to monitor the patient closely
  4. Ask another nurse to call the physician instead

Explanation

The two-challenge rule requires the nurse to voice the concern a second time, supported by objective data, and then escalate up the chain of command if it remains unresolved. The purpose is to ensure a safety concern is never dropped after a single rebuff.

Question 25Communication and Relationship Management

Which manager behavior most reliably builds trust on a nursing unit?

  1. Making exceptions for high performers so they stay engaged
  2. Avoiding difficult conversations to keep the peace on the unit
  3. Following through on commitments and being transparent about decisions Correct answer.
  4. Sharing confidential staff information with close colleagues

Explanation

Trust grows when words and actions match and when decisions are explained openly, because staff can then predict how they will be treated. Confidentiality breaches, avoidance, and favoritism all signal that the leader's behavior depends on the situation or the person.

Question 26Communication and Relationship Management

A staff nurse tells the manager, "I'm exhausted-I had six admissions last night and never got a break." Which manager response best demonstrates active listening?

  1. Everyone works hard; that's just how nights go.
  2. It sounds like last night left you drained and unsupported. Correct answer.
  3. Did you document the missed break on the staffing form?
  4. You should have called the house supervisor for help.

Explanation

Active listening involves reflecting back the speaker's content and feeling so the person knows they were heard before any problem solving occurs. Paraphrasing here names both the exhaustion and the sense of being unsupported, which invites the nurse to continue.

Question 27Communication and Relationship Management

Which approach represents the most effective way for a nurse manager to manage the informal communication network on a unit?

  1. Identify and discipline the staff members who spread rumors.
  2. Keep staff promptly and accurately informed. Correct answer.
  3. Restrict information sharing to written memos from administration.
  4. Prohibit staff from discussing unit issues during work time.

Explanation

The grapevine thrives when formal channels are slow or silent, because people fill the information gap with speculation. Managers reduce rumor by supplying timely, accurate information through credible channels rather than by trying to suppress informal talk.

Question 28Communication and Relationship Management

In face-to-face communication, nonverbal cues such as tone, facial expression, and posture matter because they:

  1. Replace the need for spoken words in almost every encounter.
  2. Carry much of the emotional and relational meaning of the message. Correct answer.
  3. Are easier to control and disguise than spoken words are.
  4. Matter only when speaker and listener come from different cultures.

Explanation

Nonverbal behavior - tone, expression, posture, eye contact - is the primary vehicle for conveying feeling and interpersonal attitude, and it is usually interpreted as more trustworthy than words when the two conflict. This is why incongruent body language undermines even carefully worded messages.

Question 29Communication and Relationship Management

A manager must address a nurse's repeated lateness and its effect on the team. Which channel is most appropriate for the initial conversation?

  1. A text message asking the nurse to explain the lateness.
  2. A written note left in the nurse's mailbox.
  3. A private, face-to-face meeting with the nurse. Correct answer.
  4. A group email reminding all staff about punctuality.

Explanation

Sensitive, individualized performance issues call for the richest channel available, because the manager needs immediate feedback, tone control, and privacy. Face-to-face discussion also protects confidentiality and preserves the working relationship in ways written or group messages cannot.

Question 30Communication and Relationship Management

Two nurses disagree about how patients should be assigned. The issue matters greatly to one nurse for a family reason and hardly at all to the other, and both value the working relationship. Which conflict-handling mode is most appropriate?

  1. Accommodating Correct answer.
  2. Avoiding
  3. Collaborating
  4. Competing

Explanation

Accommodating is low assertiveness combined with high cooperativeness, which fits when the issue is unimportant to you, important to the other party, and the relationship matters. It preserves goodwill at little cost because the stakes for the manager or the other nurse are low.

Question 31Communication and Relationship Management

A manager wants to address a charge nurse who repeatedly interrupts others in meetings. Which statement is an I-statement?

  1. I feel frustrated when people are interrupted, and I want everyone heard. Correct answer.
  2. You are consistently rude and disrespectful when you interrupt your colleagues.
  3. Interrupting others is unprofessional and must stop immediately.
  4. Everyone on the unit has noticed that you dominate every meeting.

Explanation

An I-statement describes the speaker's observation and feeling and states a need or request, which lowers defensiveness and keeps the focus on behavior. Starting with "I feel" and naming the desired outcome meets that structure.

Question 32Communication and Relationship Management

A manager delegates a quality-improvement audit to a charge nurse. Which element is most essential for the delegation message to be effective?

  1. A statement that the task is a good opportunity for growth
  2. A reminder that the charge nurse is accountable to the manager for all results
  3. A clear description of the task, the deadline, and the expected outcome Correct answer.
  4. An assurance that the manager will check in whenever convenient

Explanation

Effective delegation communication specifies what is to be done, by when, and what a satisfactory result looks like, along with the boundaries of authority. Without those specifics the delegatee must guess, and rework or missed deadlines become likely.

Question 33Communication and Relationship Management

A nurse manager gives a staff nurse feedback about a behavior the nurse did not realize she displays. In Johari window terms, this feedback primarily reduces which area?

  1. The hidden area
  2. The open area
  3. The unknown area
  4. The blind area Correct answer.

Explanation

The blind area holds information known to others but not to oneself, and honest feedback is the tool that shrinks it by moving that information into the open area. Self-disclosure, by contrast, reduces the hidden area.

Question 34Communication and Relationship Management

Which communication practice during hiring is most likely to reduce later turnover among new nurses?

  1. Emphasizing only the unit's strengths so candidates accept quickly
  2. Giving a realistic job preview that includes both rewarding and hard aspects Correct answer.
  3. Withholding details about staffing until orientation begins
  4. Allowing recruiters rather than unit managers to describe the work

Explanation

A realistic job preview gives candidates accurate information about both satisfactions and demands, which lets them self-select and calibrates expectations. New hires whose expectations match reality experience less shock and are less likely to leave.

Question 35Communication and Relationship Management

A manager learns that staff report problems only in the form they believe the manager wants to hear, so upward information is distorted. Which communication barrier does this describe?

  1. Filtering Correct answer.
  2. Physical noise
  3. Channel overload
  4. Semantic barrier

Explanation

Filtering is the deliberate manipulation of information so it will be received favorably, typically upward toward someone with power. It increases when the sender fears consequences or when the manager reacts poorly to bad news.

Question 36Communication and Relationship Management

A unit practice council must choose among three fall-prevention approaches. Which process best builds genuine consensus?

  1. Voting is repeated until one option wins by a two-thirds margin.
  2. The chair polls members in order of seniority and records the resulting majority.
  3. Members discuss all options, air concerns, and agree on a solution all can support. Correct answer.
  4. The chair announces the preferred option and asks whether anyone objects.

Explanation

Consensus means everyone can support and commit to the decision, which requires open discussion of alternatives and concerns rather than mere vote counting. Majority rule produces winners and losers and does not by itself generate commitment.

Question 37Communication and Relationship Management

A nurse manager arrives on the unit visibly tense and makes curt remarks during rounds. Within hours, staff are short with one another. Which concept best explains this pattern?

  1. Group polarization
  2. Social loafing
  3. Emotional contagion Correct answer.
  4. Escalation of commitment

Explanation

Emotional contagion is the spread of mood and affect through a group, and leaders' emotions are especially influential because staff watch them for cues about how to interpret events. A leader's tension can therefore propagate quickly through a unit.

Question 38Communication and Relationship Management

A manager must confront a physician who repeatedly speaks disrespectfully to nurses during rounds. Using the DESC script, which element comes first?

  1. Describe the specific behavior and its impact Correct answer.
  2. State the consequences if the behavior continues
  3. Ask for a commitment to change the behavior
  4. Express appreciation for the physician's clinical expertise

Explanation

DESC stands for Describe, Express, Specify, and Consequences, so the sequence opens with a factual description of the specific behavior and its effect. Starting with observable facts rather than evaluations lowers defensiveness and grounds the conversation.

Question 39Communication and Relationship Management

A manager must inform a nurse that her position is being eliminated. Which approach is best practice?

  1. Meet privately, state the decision clearly and early, then allow time for questions. Correct answer.
  2. Delay the details about timing and severance until the nurse asks about them.
  3. Delegate the conversation to a colleague who knows the nurse well.
  4. Send the news by email the evening before so the nurse has time to process it.

Explanation

Bad-news conversations should be delivered in person and in private, with the decision stated plainly near the beginning so the recipient is not left guessing. Allowing silence and time for reaction and questions respects the person and reduces confusion.

Question 40Communication and Relationship Management

A nurse manager notices that two nurses have stopped speaking to each other, though no incident has been reported. Which action is most appropriate at this stage?

  1. Refer both nurses to the employee assistance program immediately.
  2. Wait until a specific incident occurs so there is evidence to act on.
  3. Reassign one nurse to another shift to separate them permanently.
  4. Address the tension early with each nurse before it hardens. Correct answer.

Explanation

Conflict moves from latent to perceived, felt, and finally manifest stages, and intervention is easiest before positions harden and behavior becomes overtly disruptive. Early one-on-one conversation surfaces the issue while it is still manageable and before patients or the team are affected.

Question 41Leadership

A nurse manager inspires staff through idealized influence, intellectual stimulation, and individualized consideration. Which leadership style is being described?

  1. Laissez-faire leadership (hands-off)
  2. Autocratic leadership
  3. Transactional leadership
  4. Transformational leadership Correct answer.

Explanation

Transformational leadership motivates followers through idealized influence, inspirational motivation, intellectual stimulation, and individualized consideration, producing commitment that goes beyond simple compliance. It is distinguished from exchange-based or abdicating styles by its emphasis on shared vision and follower development.

Question 42Leadership

A new graduate in her second week cannot yet perform a complex dressing change and is visibly unsure of herself. Using Hersey and Blanchard's situational leadership model, which style best fits this follower?

  1. Participating (low task, high relationship)
  2. Selling/coaching (high task, high relationship)
  3. Delegating (low task, low relationship)
  4. Telling (high task, low relationship) Correct answer.

Explanation

Situational leadership matches style to follower readiness; a follower who is both unable and insecure needs clear direction with limited two-way emotional support, which is the telling style. As competence and confidence grow, the leader moves toward coaching, then participating, then delegating.

Question 43Leadership

In a just culture, which event is generally managed through system improvement rather than disciplinary action?

  1. Reckless behavior that knowingly disregards substantial risk
  2. Working while impaired by a controlled substance
  3. Intentional violation of a known safety policy
  4. An unintended slip or lapse by a competent nurse Correct answer.

Explanation

Just culture separates human error from at-risk and reckless behavior; unintended slips by competent staff are consoled and addressed by redesigning systems and defenses. Discipline is reserved for reckless behavior and intentional violations of known rules.

Question 44Leadership

What is the primary purpose of shared governance in nursing?

  1. Moves all staffing decisions to the executive team
  2. Replaces the nurse manager's accountability to the organization
  3. Eliminates the need for unit-based councils
  4. Gives frontline nurses authority over practice decisions Correct answer.

Explanation

Shared governance distributes authority and accountability for nursing practice to frontline nurses, usually through councils that address practice, quality, and professional development. It does not remove the manager's accountability to the organization; it changes how decisions are made.

Question 45Leadership

Which element completes the five rights of delegation: right task, right circumstance, right person, right direction and communication, and right ___?

  1. Licensure and certification status
  2. Pay grade and seniority ranking
  3. Shift and weekend rotation assignment
  4. Supervision and evaluation Correct answer.

Explanation

The fifth right of delegation is the right supervision and evaluation, which requires the delegating nurse to monitor performance and follow up on outcomes. Delegation is incomplete without a plan for oversight and feedback.

Question 46Leadership

A nurse manager can accurately name her own frustration as it arises during a tense meeting. Which component of emotional intelligence does this reflect?

  1. Social awareness of the group's mood
  2. Organizational awareness of politics
  3. Empathy for others' feelings
  4. Self-awareness Correct answer.

Explanation

Self-awareness is the ability to recognize and accurately label one's own emotions as they occur, which is the foundation for regulating them. Empathy and social awareness concern reading other people, while organizational awareness concerns the wider system.

Question 47Leadership

Two charge nurses disagree about a scheduling practice, the issue matters to both of them, and there is time for discussion. Which conflict-handling mode is most appropriate?

  1. Accommodating
  2. Avoiding
  3. Competing
  4. Collaborating Correct answer.

Explanation

Collaborating is high in both assertiveness and cooperativeness and is indicated when the issue is important to both parties and time allows a search for mutual solutions. The other modes fit situations where the issue is trivial, urgent, or more important to the other party.

Question 48Leadership

What does a vision statement primarily communicate?

  1. The organization's current operating budget
  2. The specific rules used to discipline employees
  3. The desired future state the organization seeks Correct answer.
  4. The daily nurse-to-patient assignment plan

Explanation

A vision statement paints a compelling picture of the desired future state and gives direction to strategy and decision-making. The mission statement explains present purpose and who the organization serves, while budgets, policies, and assignments are operational documents.

Question 49Leadership

According to Kotter's model of leading change, which step comes first?

  1. Anchoring new approaches in the culture
  2. Creating a vision and strategy
  3. Building a guiding coalition
  4. Establishing a sense of urgency Correct answer.

Explanation

Kotter's sequence begins with establishing a sense of urgency so that people are motivated to move, and only then forms a powerful guiding coalition, creates a vision, and communicates it. Anchoring changes in the culture is the final step, not an early one.

Question 50Leadership

In Lewin's three-stage change model, what is the purpose of unfreezing?

  1. Measuring outcomes against benchmarks
  2. Creating readiness to change Correct answer.
  3. Reinforcing new behaviors so they persist
  4. Documenting the change for an accreditation survey

Explanation

Unfreezing loosens the existing equilibrium and builds readiness so that staff are willing and able to move to a new way of working. Moving implements the change, and refreezing stabilizes and reinforces the new behaviors.