Ethics
A nurse manager respects staff opinions during decision-making. Which ethical value is demonstrated?
a) Fidelity
b) Autonomy
c) Nonmaleficence
d) Confidentiality
Autonomy
What is the first step in evidence-based leadership decision-making?
a) Collecting research articles
b) Identifying the problem
c) Implementing a solution immediately
d) Writing a policy
Identifying the problem
A nurse refuses to administer an unsafe medication. How should an ethical leader BEST respond?
a) Support the nurse's decision and advocate for patient safety
b) Have the nurse document refusal
c) Have the unit secretary contact the pharmacy
d) Validate the order of the medication
Support the nurse and advocate for safety
True or False: Ethical leadership always requires following hospital policy.
False (ethics may require challenging policy for patient safety)
A nurse reports feeling overwhelmed because they have 8 patients, including two who require frequent monitoring. What is the most ethical and evidence-based response by the nurse leader?
a) Tell the nurse to “do their best” with no changes
b) Reassign patients to balance workload based on acuity
c) Ignore the concern and maintain assignments
d) Advise the nurse to work faster to keep up
Reassign patients to balance workload based on acuity
Which ethical principle requires leaders to avoid causing harm to patients or staff?
a) Beneficence
b) Veracity
c) Nonmaleficence
d) Justice
Nonmaleficence
Safe staffing ratios are an example of what type of evidence?
a) Expert opinion
b) Research evidence
c) Tried & True staffing ratio
d) Hospital staffing model
Research evidence
During a staffing crisis, which data would an evidence-based leader cite to request help?
a) Patient acuity scores and staffing ratios
b) Job satisfaction survey
c) Annual budget for overtime pay
d) Past quarterly report of staffing trends
Patient acuity scores and staffing ratios
True or False: Evidence-based leadership includes using staff feedback as part of decision-making.
True
A new guideline recommends a change in wound-care dressing technique. Some staff prefer the “old way” because it’s quicker. What should the nurse leader do?
a) Allow staff to choose whichever method they prefer
b) Ignore the guideline since staff are more comfortable with tradition
c) Provide training on the new evidence-based technique and explain the improved patient outcomes
d) Immediately reprimand staff who don’t comply
Provide training on the new evidence-based technique and explain the improved patient outcomes.
A leader who openly communicates mistakes to staff demonstrates which ethical quality?
a) Justice
b) Honesty / Transparency
c) Fidelity
d) Respect
Honesty / Transparency
Which source is most reliable for evidence-based leadership decisions?
a) Peer-reviewed journals
b) Nursing handbook
c) Charge Nurse
d) Personal opinion
Peer-reviewed journals
A manager develops a new falls-prevention protocol using best practices. This is an example of:
a) Ethical leadership
b) Evidence-based leadership
c) Traditional leadership
d) Authoritarian leadership
Evidence-based leadership
True or False: A leader who advocates for fair scheduling is practicing ethical leadership.
True
A patient’s family insists on continuing aggressive treatment, but evidence shows it is not beneficial and may cause suffering.
How should the nurse leader guide the team?
a) Support staff in following the family’s wishes without question
b) Use evidence to explain the risks/benefits while ethically advocating for the patient’s comfort and dignity
c) Avoid discussing the issue to prevent conflict
d) Discharge the patient early to end the dilemma
Use evidence to explain the risks/benefits while ethically advocating for the patient’s comfort and dignity.
Which of the following best fosters moral courage among nurses?
a) Ignoring ethical concerns
b) Supporting whistleblowing and advocacy
c) Discouraging open discussion
d) Prioritizing speed over safety
Supporting whistleblowing and advocacy
Which of the following best describes evidence-based leadership?
a) Guided by personal experiences
b) Only follow organizational traditions and policies
c) Integrating research, clinical expertise, and staff feedback
d) Relying solely on the team's consensus when making a decision
Integrating research, clinical expertise, and staff feedback
A leader addresses workplace bullying by creating a safe reporting system. This is an example of:
a) Ethical leadership
b) Evidence-based leadership
c) Autocratic
d) Bureaucratic
Ethical leadership
True or False: Evidence-based leadership means using only published research and ignoring bedside experience.
False
Staff members report bullying from a senior nurse. Evidence shows workplace bullying decreases morale and increases turnover.
What is the best leadership action?
a) Ignore the issue to avoid upsetting the senior nurse
b) Review evidence on workplace culture, create a safe reporting system, and address the behavior directly with fairness
c) Reassign the staff who reported bullying to another unit
d) Wait until more nurses complain before acting
Review evidence on workplace culture, create a safe reporting system, and address the behavior directly with fairness.
What core nursing principle guides ethical leadership when distributing patient assignments fairly?
Justice
Which source is most reliable for evidence-based leadership decisions?
Peer-reviewed journals
A nurse manager develops a new falls prevention protocol based on best practices. Which type of leadership is this?
Evidence-based leadership
True or False: Ethical and evidence-based leadership are completely separate and do not overlap.
False (they complement each other)
Hospital administration pressures the nurse leader to reduce staffing to cut costs, despite research showing that unsafe staffing ratios increase errors and mortality.
What is the most appropriate evidence-based and ethical response?
a) Accept the administration’s directive to protect your job
b) Use research evidence on staffing and patient outcomes to advocate for safe ratios, while ethically emphasizing patient safety
c) Allow unsafe staffing temporarily without documenting concerns
d) Shift blame onto frontline nurses when errors occur
Use research evidence on staffing and patient outcomes to advocate for safe ratios, while ethically emphasizing patient safety