Deck 10: Understanding and Designing Organizational Structures

Question 1

The facilities department is experiencing some challenges and is undergoing reorganization.Because of your familiarity with systems theory,you:

A) Know that this challenge is their issue and that it has nothing to do with your unit.
B) Understand that such events are localized and do not have an effect on the organizational culture.
C) Know that the nature of challenges and reorganization in facilities will have an effect on other areas.
D) Anticipate that your prior experiences with facilities have no effect on the current situation.

Answer 1

Know that the nature of challenges and reorganization in facilities will have an effect on other areas.

Question 2

Which of the following is the most appropriate mission statement for a nursing centre?

A) "At Wellness,we provide rehabilitative services for addicted adolescents."
B) "Georgetown provides treatment and prevention services for county residents."
C) "At Heart,our aim is to provide services that lead the nation in health education and research."
D) "At Coeur,we strive to achieve optimal pain management with patients who are experiencing chronic pain."

Answer 2

"At Coeur,we strive to achieve optimal pain management with patients who are experiencing chronic pain."

Question 3

In which of the following situations would you expect low morale and frustration?

A) Statement of philosophy indicates "We value our staff." When staff members resign,careful evaluation is done to determine whether staff should be replaced by full- or part-time employees.
B) Practices include annual staff recognition celebrations.During times of change,staff members are actively included in issue identification and solution finding.
C) Recruitment ads promise opportunities for advancement for everyone.Promotions are given only to individuals with long-standing service and entrenched relationships.
D) The vision indicates that there is strong commitment to lead in research.The organization has tried to implement a strong campaign to attract leading nurse researchers but has experienced difficulty in doing so.

Answer 3

Recruitment ads promise opportunities for advancement for everyone.Promotions are given only to individuals with long-standing service and entrenched relationships.

Question 4

The chief nursing officer is given the task of reviewing and revising the organization's mission,philosophy,and technology.In reviewing them,the chief nursing officer understands that they should be reflected in:

A) The organizational structure.
B) Line and staff responsibilities.
C) The policies and procedures.
D) Government regulations.

Question 5

Which of the following most influences the organizational structure of the organization?

A) Mission statement.
B) Statement of philosophy.
C) Vision statement.
D) Goal statement.

Question 6

Lachine Hospital has well-defined organizational units that provide maintenance,financial services,care for cardiac patients,care for surgical patients,and so on.The organizational chart indicates that surgical units report to a surgical manager,all nursing units report to a vice president of nursing,financial services units report to an accountant and then to a business executive,and so on.The primary disadvantage of this organizational structure is:

A) Breakdown in function and communication across specialties.
B) Lack of congruence in culture and organizational values.
C) Highly centralized decision making and authority.
D) Wide span of control.

Question 7

In opening a new dialysis unit,the nurse manager has to develop a philosophy for the unit.This philosophy needs to:

A) Reflect the culture of the unit and its values.
B) Be developed by the nursing manager on the unit.
C) Identify the patients who will be served on the unit.
D) Replicate the organization's philosophy.

Question 8

A hospital and a nursing education program form a partnership to recruit more nurses to the region.This organizational structure is:

A) Being responsive to changes in the environment.
B) Being bureaucratic.
C) Creating permanent professional boundaries.
D) Delineating structures for all decision making.

Question 9

"Bayshore Hospital will provide care that is a national example of consumer service" is a:

A) Vision statement.
B) Statement of philosophy.
C) Mission statement.
D) Rationale for care.

Question 10

At Limeville Hospital,the nursing department is developing a mission statement for nursing.Which of the following would be a suitable mission statement?

A) "Nursing provides services for patients admitted to Limeville Hospital."
B) "Nurses participate fully in the professional services offered by Limeville Hospital."
C) "Limeville Hospital leads by the lamp,providing services for seniors."
D) "At Limeville,the nursing department provides caring services that recognize the diversity of patients and promote optimal health with patients through partnership and education and in close partnership with other disciplines."

Question 11

Collaborative partnerships between hospitals and schools of nursing are examples of hybrid organizational structures.A hybrid organizational structure:

A) Has many divisions of labour.
B) Best fits long-term care units.
C) Has a mixture of the characteristics of various organizational types.
D) Places the authority for decision making closest to the places where workers perform.

Question 12

With revenue reductions and cost saving measures,the number of managers has been reduced,which has increased the number of team leaders,supervised by managers,by as many as three.This change may result in:

A) Decreased patient satisfaction.
B) Increased efficiency in costs.
C) A more positive perception of managers.
D) Little change to manager-staff relationships.

Question 13

A hospital is working toward becoming a Magnet hospital.The chief nursing officer is aware that professional nursing departments of the future will:

A) Not be directed by nurses.
B) Be virtual organizations.
C) Be designed to maintain nursing standards of practice.
D) Be entitled to have patient care departments.

Question 14

In Valley Hospital,there is a great deal of discussion about the balance between hospital-wide budget decision making and unit-based budget decision making.This discussion represents:

A) A search for the "sweet spot."
B) Conflict between the values of nursing and those of the health care organization.
C) Traditional organizational values.
D) Differences between bureaucratic and nonlinear thinking.

Question 15

A new director of nursing in a small rural hospital wants to make changes from the traditional model of governance to a shared-governance model.Of the following characteristics,which best describes the traditional organizational structure in which a staff nurse is assigned to carry out nursing tasks for patients but is not given the chance to provide input into forming the policies and procedures by which care is delivered or the standards by which care is evaluated?

A) Bureaucratic.
B) Decentralized.
C) Delegated authority and responsibility.
D) Delegated responsibility but no authority.

Question 16

The hospital administration gives approval to the chief nursing officer to hire clinical nurse specialists in staff positions rather than in administrative positions.A clinical specialist who has staff authority but no line authority typically is able to:

A) Function through influence.
B) Take complete responsibility for the care of patients.
C) Interview and hire staff nurses for designated nursing units.
D) Be granted functional authority to determine standards of nursing care and enforce them.

Question 17

The chief nursing officer and the dean of the school of nursing believe that by establishing rules and regulations and controlling the environment,this partnership will:

A) Promote professional medical authority,autonomy,and responsibility.
B) Diminish quickly with no central figure.
C) Be essential for self-governance.
D) Provide for the establishment of medical committees.

Question 18

A nurse manager understands that a matrix organizational structure:

A) Is a simplified organizational structure.
B) Has both a functional manager and a service or product-line manager.
C) Arranges departments strictly according to function.
D) Promotes harmony in organizational decision making.

Question 19

At Hospital XYZ,the current head nurse on unit Y3 is the third in 3 years.Donna,the current head nurse,lacks confidence in patient-nurse relationships,and scheduling and other processes are routinely left to the last minute.Staff members approached Donna first and then administration with their concerns about Donna's effectiveness as a leader.They were told that the problem is probably staff related,that it is simply an unhappy group,and that nothing further will be done about their concerns.The philosophy of the organization indicates that "open,transparent communication between staff and management is desired and supported" and that "innovation and creative thinking are the foundation of the organization's progress." In assessing this situation as a newly hired senior executive,you anticipate that:

A) Staff members will resolve the conflict on their own.
B) The situation will lead to ongoing disgruntlement and attrition.
C) No further discussion or concerns will come out of the situation.
D) The head nurse will be able to resolve the conflict on her own.

Question 20

"At Thoroughcare,we provide health care for women and children in transition" is an example of a:

A) Vision statement.
B) Mission statement.
C) Goal statement.
D) Statement of philosophy.

Question 21

Organizational culture includes: (Select all that apply.)

A) Norms.
B) Traditions.
C) Behaviours.
D) Values.
E) None of above

Question 22

What are key features of positive organizational culture? (Select all that apply.)

A) Supports professional development of members.
B) Promotes positive perceptions of unit leadership and workplace empowerment.
C) Respects values and norms.
D) Promotes new ways of improving practice.
E) None of above

Question 23

In the Unity Health Care organization,decisions,including those at the unit level,are made by a group of senior executives.Rules for employees are clear,and nursing care is delineated by procedures and protocols.This exemplifies:

A) Transformational leadership.
B) Transactional leadership.
C) Bureaucratic organization.
D) Chaos theory.

Question 24

A nurse manager working in a hospital-based matrix structure understands that: (Select all that apply.)

A) This structure includes reporting to both a functional manager and a service- or product-line manager
B) This structure can be effective in the current health care environment
C) This structure leads to a decrease in bureaucracy
D) This structure permits better cross-communication among various organizational units or departments

Question 25

A statement such as "We believe in the right of patients to make choices and to have care that is sensitive to their preferences and needs" is a _____ statement.

A) Mission.
B) Goal.
C) Vision.
D) Philosophy.

Question 26

Saskia is a clinical nurse educator in the dialysis unit at Pineview Health Centre and provides education,consultation,and training support.Saskia has:

A) Direct responsibility for patient care.
B) Direct accountability for patient outcomes.
C) A relationship of authority over staff.
D) An influence over patient outcomes.

Question 27

In a health care agency that has a bureaucratic organization,communication flows:

A) Laterally.
B) Bottom to top.
C) Top to bottom.
D) Intermittently.

Question 28

Shared governance is a flat type of organizational structure that: (Select all that apply.)

A) Helps nursing staff have more autonomy to govern their practice.
B) Has a foundation of accountability.
C) Provides the functional areas needed to support professional practice.
D) Requires new behaviours of all staff.
E) None of above