Test Bank For Leading and Managing in
Nursing 8th Edition Yoder Wise Chapter
1-25 | Complete Guide A+
Chapter 01: Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 8th Edition
MULTIPLE CHOICE
• A nurse manager of a 20-bed medical unit finds that 80% of the clients are
older adults. Sheis asked to assess and adapt the unit to better meet the
unique needs of the older adult client.Using complexity principles, what
would be the best approach to take for implementation of this change?
• Leverage the hierarchical management position to get unit
staff involved inassessment and planning.
• Engage involved staff at all levels in the decision-making process.
• Focus the assessment on the unit and omit the
hospital and community environment.
• Hire a geriatric specialist to oversee and control the project.
ANS: B
Complexity theory suggests that systems interact and adapt and that
decision making occurs throughout the systems, as opposed to being held in
a hierarchy. In complexity theory, every voice counts, and therefore, all
levels of staff would be involved in decision making.
TOP: AONE competency: Communication and Relationship-Building
• A unit manager of a 25-bed medical/surgical area receives a phone call from
a nurse who has called in sick five times in the past month. He tells the
manager that he very much wants to come to work when scheduled but
must often care for his wife, who is undergoing treatment for breast cancer.
According to Maslow‘s need hierarchy theory, what would be the best
approach to satisfying the needs of this nurse, other staff, and clients?
• Line up agency nurses who can be called in to work on short notice.
• Place the nurse on unpaid leave for the remainder of his wife‘s treatment.
• Sympathize with the nurse‘s dilemma and let the charge nurse
know that this nurse may be calling in frequently in the future.
• Work with the nurse, staffing office, and other nurses to
arrange his scheduleddays off around his wife‘s treatments.
ANS: D
, Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet
physiologic needsand demotivate the nurse. Unsatisfactory coverage of shifts
on short notice could affect client care and threaten the needs of staff to feel
competent. Arranging the schedule around the wife‘s needs meets the needs
of the staff and of clients while satisfying the nurse‘s need for affiliation.
TOP: AONE competency: Communication and Relationship-Building
• A grievance brought by a staff nurse against the unit manager requires
mediation. At the first mediation session, the staff nurse repeatedly calls the
unit manager‘s actions unfair, and the unit manager continues to reiterate the
reasons for the actions. What would be the best courseof action at this time?
• Send the two disputants away to reach their own resolution.
• Involve another staff nurse in the discussion for clarity issues.
• Ask each party to examine their own motives and issues in the conflict.
• Continue to listen as the parties repeat their thoughts and
feelings about theconflict.
ANS: C
For resolution of conflict, one should address the interests and involvement
of participants inthe conflict by examining the real issues of all parties.
TOP: AONE competency: Communication and Relationship-Building
• At a second negotiation session, the unit manager and staff nurse are
unable to reach a resolution. What is the appropriate next step?
• Arrange another meeting in a week‘s time so as to allow a cooling-off
period.
• Elevate the next negation session to the next manager, one level above.
• Insist that participants continue to talk until a resolution has been reached.
• Back the unit manager‘s actions and end the dispute.
ANS: B
Part of leadership is understanding conflict resolution and ability to negotiate
and manage for resolution of issues and concerns. This situation has failed a
second negotiation session, elevation to a manager with additional training
to facilitate conflict resolution is important at this point.
TOP: AONE competency: Communication and Relationship-Building
• The manager of a surgical area has a vision for the future that requires the
addition of RN assistants or unlicensed persons to feed, bathe, and ambulate
clients. The RNs on the staff have always practiced in a primary nursing-
delivery system and are very resistant to this idea.What would be the best
initial strategy for implementation of this change?
, • Exploring the values and feelings of the RN group in relationship to this
change
• Leaving the RNs alone for a time so they can think about the
change before it isimplemented
• Dropping the idea and trying for the change in a year or so
when some of thepresent RNs have retired
• Hiring the assistants and allowing the RNs to see what good additions they
are
ANS: A
Influencing others requires emotional intelligence in domains such as
empathy, handling relationships, deepening self-awareness in self and others,
motivating others, and managing emotions. Motivating others recognizes that
values are powerful forces that influence acceptance of change. Leaving the
RNs alone for a period of time before implementation doesnot provide
opportunity to explore different perspectives and values. Avoiding discussion
until the team changes may not promote adoption of the change until there is
opportunity to explore perspectives and values related to the change. Hiring
of the assistants demonstrates lack of empathy for the perspectives of the RN
staff.
TOP: AONE competency: Knowledge of the Health Care Environment
• As the RN charge nurse on the night shift in a small long-term care facility,
you‘ve found thatthere is little turnover among your LPN and nursing
assistant (NA) staff members, but they are not very motivated to go beyond
their job descriptions in their work. Which of the following strategies might
motivate the staff and lead to greater job satisfaction?
• Ask the director of nursing to offer higher wages and bonuses
for extra work for the night LPNs and NAs.
• Allow the LPNs and NAs greater decision-making power within
the scope of their positions in the institution.
• Hire additional staff so that there are more staff available for
enhanced care, andindividual workloads are lessened.
• Ask the director of nursing to increase job security for night
staff by having themsign contracts that guarantee work.
ANS: B
Hygiene factors such as salary, working conditions, and security are
consistent with Herzberg‘s two-factor theory of motivation; meeting these
needs avoids job dissatisfaction. Motivator factors such as recognition and
satisfaction with work promote a satisfying and enriched work environment.
Transformational leaders use motivator factors liberally to inspire work
performance and increase job satisfaction.
TOP: AONE competency: Communication and Relationship-Building
, • The nurse manager wants to increase motivation by providing motivating
factors for thenurseon the unit. What action would be appropriate to motivate
the staff?
• Collaborate with the human resource/personnel department
to develop on-sitedaycare services.
• Provide a hierarchical organizational structure.
• Implement a model of shared governance.
• Promote the development of a flexible benefits package.
ANS: C
Complexity theory suggests that systems interact and adapt and that decision
making occursthroughout systems, as opposed to being held in a hierarchy.
In complexity theory, every voice counts, and therefore all levels of staff
would be involved in decision making. This principle is the foundation of
shared governance.
TOP: AONE competency: Communication and Relationship-Building
• The nurse manager has been asked to implement an evidence-based approach
to teach ostomy clients self-management skills postoperatively. The program
is to be implemented across the entire facility. What illustrates effective
leadership in this situation?
• The training modules are left in the staff room for times when staff are
available.
• The current approach is continued because it is also evidence-
based and is more familiar to staff.
• You decide to implement the approach at a later date because of
feedback from theRNs that the new approach takes too much
time.
• An RN who is already familiar with the new approach of
volunteers to take thelead in mentoring and teaching others
how to implement it.
ANS: D
Followership occurs when there is acquiescence to a peer who is leading in a
setting where a team has gathered to ensure the best clinical decision making,
and actions are taken to achieve clinical or organizational outcomes.
Followership promotes good clinical decisions and use of clinical resources.
TOP: AONE competency: Communication and Relationship-Building
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