Faculty of Nursing Zagazig University

Nursing administration 4th year exam First term Exam

Date: 9- 1-2016 Time allowed: 3 Hours
Total Marks: 80 Marks pages number: 6

Types of question MCQ Short notes T&F Differentiate Situation Total score

Number of questions 15 10 15 5 3 5 questions

Grades 15 20 15 20 10 80

Marks

Signature

Question (1) Question (3)

No. MCQ No. T or F
1. C 1 ( F )
2. C 2 ( F )
3. C 3 ( F )
4. C 4 ( T )
5. D 5 ( F )
6. B 6 ( F )
7. A 7 ( T )
8. C 8 ( F )
9. D 9 ( F )
10. D 10 ( T )
11. B 11 ( F )
12. D 12 ( F )
13. A 13 ( T )
14. B 14 ( F )
15. D 15 ( F )

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Answer all the following questions:

I. Multiple choice questions (15 marks):

Read the following questions carefully and choose only one answer

1. Factors related to patient that affecting staffing pattern include

the following Except:
a) Length of stay
b) Age group
c) Patient care objectives
d) Patient numbers
2. The decision style that is appropriate for followers with high
degrees of readiness is:
a) Facilitative
b) Authoritative
c) Delegative
d) Consultative
3. The objectives of time scheduling include the following Except:
a) Provide adequate staffing
b) Ensure patients’ care
c) Decrease staff morals
d) Achieve balance distribution of days off
4. Characteristics of effective assignment include the following
Except:
a) Clear
b) Simple
c) Oral
d) Posted in advance

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5. The internal factors that affecting decision making include the
following Except:
a) Experience
b) Knowledge
c) Attitude
d) Resources
6. When head nurse acts as a focal point for receiving information;
this considered:
a) Distribution role
b) Nerve center role
c) Negotiator role
d) Liaison role
7. Span of control is affected by:
a) Supervisors’ competence
b) Organization size
c) Organizational culture
d) All of the above
8. The power that residence in the position not in the person is:
a) Responsibility
b) Accountability
c) Authority
d) None of the above
9. One of disadvantages of the organizational chart is:
a) Showing the informal organizational relationship
b) Showing duties and responsibilities
c) Not helping in the organizational planning
d) Becoming outdated quickly

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10. Strategies for successful planning include:
a) Gathering data appropriately
b) Keeping target date realistic
c) Clear objectives
d) All of the above
11. Effective planning is characterized by:
a) False assumption
b) Based on clearly defined objectives
c) Inadequate time
d) Inadequate delegation of authority
12. Methods of recruitment includes:
a) Advertising
b) Employees’ referral
c) College recruitment
d) All of the above
13. Employee indoctrination content includes:
a) Staff development program
b) Employee motivation
c) Employee authority
d) Organization chart
14. Characteristics of good vision includes:
a) Flow from purpose
b) Relevance to the community
c) Visible in employees’ believes
d) Balance
15. In which category the head nurse act as resources allocate:
a) Interpersonal role
b) Leadership role
c) Informational role
d) Decisional role

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II. Give short answers (20 marks)
1. List (6) principles of personnel assignment?
 Made by the head nurse or nurse in charge for each individual
nurse.
 Based on:
 Nursing needs of each patient and approximate time required to
care for him.
 The capabilities, skill level, previous experience and the interest of
the staff members.
 Job description,
 Planned weekly and revised daily if necessary to assure continuity
of care.
 All nurses have a duty to provide safe and appropriate nursing care
to clients.
 Nurses act in a manner that is consistent with their standards of
practice, codes of ethics, scopes of practice and other relevant
legislation.
 Nurses practice within their own level of competence and seek
direction and guidance from other health care professionals when
aspects of the care required are beyond their individual
competence.
 Where two or more categories of nurses work together, safe and
appropriate care can best be achieved through collaboration and
cooperation among nurses, respecting the contributions of each
professional.
 Effective communication among nurses and within organizations is
essential in order to achieve quality client outcomes.
 Supervise those to whom nursing activities have been delegated.
 Determine the model of care delivery (i.e. primary nursing, team
nursing or functional nursing), the complexity of the client’s
nursing care needs; and the context of care and the degree of
direction and/or supervision available.
 Should be in written form

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  Use simple clear words in writing assignment
 Fix responsibility for all duties clearly with no over lapping
 Provide for emergency situations and provide for special nursing
activities
 Give each person time and opportunity to plan her work
 Assignment must rely on the preliminary planning
 Arrange the various parts of the assignment in logical order
 Ensure continuity of patient care
 Assignment should be made in accordance with the administrative
policy
 Based on accurate assessment
 Two workers should never be assigned to do the same work
 It should be related to previous assignment
2. Enumerate (4) responsibilities of the unit manager regarding
material resources?
 Supplies & equipment should be checked for specification
&quantity when received from the purchasing department.
 Supplies & equipment should be inspected to determine
completeness, availability for use, cleanliness, safety &
convenience in place.
 There must casual supervision of staff members to assure that
supplies & equipment are being used for specific & intended
purposes.
 Supplies & equipment should be conveniently located & easily
accessible to all staff members.
 Staff members who will use the equipment must understand its
operation, purpose &after care.
 Make provision for ordering on an emergency basis.
 Quantities of supplies on hand should be checked before recording.

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3. State (4) advantages of cyclic and block time scheduling?
 Once developed; it is relatively permanent schedules and requiring
only temporary adjustments.
 Same schedule is repeatedly, so it decrease time spent on
scheduling
 Nurse know schedule in advance
 Staff treated fairly
 Nurse can schedule social events
 Self scheduling
4. List (3) skills needed to conduct and maintain equipment?
 Convincing staff of the important of maintenance.
 Inspection check list what are present & comparing it with the
inventory list of equipment in the unit.
 Detecting & interpreting discrepancies (is the difference between
equipment entered on the inventory list & the equipment actually
present.
5. State (5) personal qualifications of the head nurse?
(Including all the qualities of the good leader)
 Good physical and mental health.
 Cheerful and accept criticism.
 Loyalty and sense of belonging.
 Can work effectively with a team.
 Teaching ability.
 She must be honest and patient.
 She must have good judgment.
 She must have the ability to communicate with people.
 She should have sense of responsibility.
 She should have good grooming and hygiene.
 She must have an ethical approach to problem.

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6. Enumerate (4) principles of good plan?
 All plans must flow from other plans. Short-range plans must be
congruent with long-range plans.
 Planning in all areas of the organization must follow the mission,
philosophy, and goals of the overall organization.
 Planning involves the same process regardless of the period
involved
 The length of the plan is determined by what actions are necessary
to make the plan successful.
 All plans must include a regular review process (an evaluation
step).
7. List (4) factors to be considered in distributing duties?
 The number, qualifications, experience and abilities of nurses
 The number, condition and location of patients
 Nursing needs of each patient and appropriate time required for
care
 Consider each nurse as individual
 It should provide for new learning experiences
 Type of service rendered should be considered
 The availability of supplies and equipment
 Architectural features of the unit
 Availability of nursing service manual for policies and procedures
8. Identify (3) methods for use of supplementary staff?
 Borrowing method
 Float staff
 On call staff

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9. Determine (4) limitations of interview?
 Inter- rater reliability is satisfactory if the interview is structured
and the same format is used by both interviewers & a low in
unstructured
 Structured interviewers have greater validity than unstructured.
 High interview assessments are not related to subsequent high-level
job performance.
 Validity increases when there is a team approach to the interview.
10. Identify (3) importance of organizing?
 Creating relationships that will minimize friction.
 Focus on objectives, and facilitate attaining them.
 Cleary define responsibilities and line of authority of all members
of staff.
 Arrangement of positions, and jobs within the hierarchy.
 Spelling out responsibility and line of authority in terms of
decision making.

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 III. True and false (15 marks)
Write (T) in front of true statement and (F) in front of false statement

No. Statement T or F
Staffing pattern is the determination of the number of
16. ( F )
personnel that must be hired
Innovative decisions are made when the problems are unusual
17. ( F )
and only partially understood.
Brainstorming create members to free flow of ideas with fear
18. ( F )
of criticism
Planning provides directions and reduces the impact of
19. ( T )
change
The traditional systems of determining the staffing pattern
20. ( F )
meet the needs of patients.
21. Orientations activities not specific for the personnel positions ( F )
In centralized scheduling one nurse in the nursing
22. ( T )
administration office plan coverage for all nursing units
Decision making is a process of determining the appropriate
23. ( F )
actions to alleviate a problem
One of the disadvantages of the functional method of
24. ( F )
assignment is that it requires highly skilled personnel
25. Demand forecasting is the first process of managing material ( T )
The formal organization structure could distribute
26. ( F )
information more broadly and rapidly than the informal one
Providing feedback on the results of decisions is unnecessary
27. ( F )
to improve the decision making
28. Staff relation is depicted by dots in the organizational chart ( T )
Summative evaluation done to provide data allowing changes
29. ( F )
in the course while it is being taught
A large number of personnel can participate in taking
30. ( F )
decision through use of decision tree

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IV. Differentiate between the following (20 marks):

Nominal group and Delphi techniques (4 degree)

1. Nominal group technique 2. Delphi – technique
 Nominal group technique It allows members who are
(NGT) is a structure & dispersed over a geographical area
precise method of eliciting to participate in decision making
written questions, ideas and without meeting face to face. A
reactions from group problem is identified, & members
members are asked to suggest potential
 This method allows every solutions through the use of
group member the questionnaire. Members
opportunity for input into anonymously return the first
decision making process. questionnaire& the results are
 NGT consists of : compiled. Each member is sent a
a) Silently generating ideas copy of the results, after reviewing
in writing them, members are asked for their
b) Round-robin presentation suggestion again .Review of the
by group members of their results of the first questionnaire
individual ideas in a terse typically triggers new solutions in
phrase on a flip chart original positions.. This process
c) Discussion of each continues until consensus is
recorded idea for reached. Little change usually
clarification & evaluation occurs after the second round.
and
Advantages:
d) Voting individually on
priority ideas, with the  Ability to involve a large
group solution being number or participants
derived mathematically  Save time
through rank ordering or  Avoid negative verbal or non
rating using the group's verbal.
decision rule. Disadvantages:
Advantages:
 Lower sense of
 Allow equal participation accomplishment or
among members involvement
 Minimize influence of  Do not communicate with
dominated personality. each other
Disadvantages:  Time consumed
 May not develop as many
 Time consuming
alternatives as the other
 Need for advance preparation technique.

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Rules and procedures (4 degree)
Procedures Rules
Procedures Are plans that have been Rules are plans that define
reduced to a sequence of steps that specific action or non action.
required actions. Procedures identify Rules like policies Provide
the process or steps needed to guidance, but a rule is stronger
implement a policy. than a policy in that the
guidance given by a rule is
o It is the process or needed to final and definite. Rules are
implement a policy and are inflexible and must be obeyed,
generally found in manuals at the under threat of punishment,
unit level of the organization. e.g. (smoking is forbidden).
o Procedures establish acceptable
ways of accomplishing a specific
task by outlining a set of steps to
follow and giving rational for
each set of activities.
o The manger also has the
responsibility to review and
revise policies and procedures
statements.
Steps of Procedure Development:
- State the task or title.
- Identify the need or purpose.
- Make draft of all the possible
steps and sub- steps.
- Type the procedure and distribute
to reviewers.
Have procedure printed and
distribute.

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 Team and modular methods of assignments (4 degree)
Team Nursing Modular Nursing
RN as team leader coordinates care for a Modification of team nursing
group of patients' plans, supervise, evaluate Patient unit is divided into
and participate in the delivery of nursing modules or units or district, with
care. Evolved in the 1950s to improve an RN as team leader. Evolved to
patient satisfaction. increase RN involvement in care.
Goal was to reduce fragmented care. Team Recent attempts to refine and
nursing usually refer to large group of improve team nursing have
patients. resulted in the concept of
Common use areas—most inpatient and “modular nursing,” which is a
outpatient areas mini –team (two or three
Advantages members) approach.
1. High-quality, comprehensive care Keeping the team small and
with a high proportion of ancillary attempting to assign personnel to
staff. the same team as often as possible
2. Development of leadership skills should allow the professional
3. Team members participate in decision nurse more time for planning and
making and contribute their own coordinating team members.
expertise Additionally, a small team
4. Nursing conferences help problem requires less communication,
solving and staff development. allowing members better use of
5. It enhances team building, their time for direct patient care
team members’ support for activities.
each other. Each small team is
6. More efficient patient care. responsible for giving the whole
7. It allows members to nursing care to a group of
contribute their own special patients. Those patients receive
expertise or skills. their care from the same mini-
8. All nurses have contact of team (module) from their
patient. admission till discharge and must
9. They share in the planning arrange for the care of their
and provision of his care patients during different shifts
10. It provides high job and off-duty.
satisfaction. Advantages
11. patient satisfaction is high 1. Useful when there are few
12. It enhances good RNs
communication. 2. Continuity of care is improved
Disadvantages 3. RN more involved in planning
1. Continuity suffers if daily team and coordinating care
assignments vary 4. Geographic closeness and
2. Team leader may not have good efficient communication
leadership skills

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 3. Insufficient time for planning and Disadvantages
communication 1. Increased costs to stock each
4. Day to day change in team member module
may reduce the care. 2. Long corridors not conducive
5. It depends basically on good to modular Nursing.
communication among members, so if Paraprofessional does
for any reason communication is technical aspects of care
disturbed patient care, will be
severally affected.
6. This can lead to blurred lines of
responsibility, errors, and fragmented
patient care.
7. Very high cost
8. Need more equipments and supplies

Fixed and movable equipment (4 degree)

Fixed equipment
Fixed equipment refers to objects Movable equipment includes
built into the walls & floors of the hospital
E.g. locker, locker sterilizers.
Movable equipment
A. Equipment that should last
for more than 5 years E.g.
furniture, stretchers, wheel
chairs……………ect.
B. Equipment having less than
5 years & are capable of being
replaced E. g. syringes , linen
,bed pans ……….ect.

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 Intrinsic and extrinsic sources of recruitment (4 degree)
Internal resources External sources
Present employees from within the Consists of public and private
organization e.g. Policy promotion. agencies advertising, educational
institutions like colleges,
Advantages: universities and business scholars,
1. Past experience helps new employees' referrals. It allows the
employees to perform new duties organization to seek people with
and can safely delegated new new ideas.
responsibilities.
 Most management exports
2. It requires less training expenses.
feel that a combination of
3. It raises the moral of existing
internal and external
employees and job satisfaction.
sources would give best
4. It stimulates preparation to possible
results.
transfer or promotion.
5. It attracts young people to join the
organization.
6. It provides great incentive to hard
work.
Disadvantages:
1. It narrows down the area of selection
because recommitment is confined it
those who are already in the service.
2. A danger of getting the system to be
stagnant, repetitious and overly
continued without intrusion of new
blood.

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V. Situation (10 marks)

In the light of this statement answer the following questions:

a) What the type of organizational structure that used in your
organization?
Matrix structure (2 degree)
b) Enumerate the advantages and disadvantages of this structure?
Advantages of matrix: (4 degree)
1. Improve communication through vertical and horizontal control
2. Increased organizational adaptability and flexibility to respond to
environmental changes
3. Increased efficiency of resources use
4. Increased job satisfaction with achievement and fulfillment
5. Improved interpersonal skills
Disadvantages:
1. Potential conflict because of multiple lines of authority,
responsibility and relationships
2. Role ambiguity
3. Loss of control over functional disciplines as a result of a
multiply disciplinary team approach

c) As a head nurse how could you apply planning in your

department? (4 degree)
- Assign each staff nurse according to level of her competency.
- Check the nursing care plan for the professional nurses.
- Design the nursing care plan for the non professional nurses.
- Determine the time for the routine activities.
- Determine the time for nursing rounds
- Determine the time for the participation in medical rounds.
- Determine the time for nursing conferences.
- Determine the equipment which will be needed for the whole unite
or in the time of emergency.

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