MAKING DECISIONS AND SOLVING
PROBLEMS YODER-WISE: LEADING
AND MANAGING IN NURSING, 7TH
EDITION CHAPTER 15: EXAM
QUESTIONS AND ANSWERS
1. The risk manager informs the nurse manager of an orthopedic unit that her unit has
had an increase in incident reports related to patients falling during the 11-7 shift. The
nurse manager knows that the best way to resolve the problem is to:
a. use creativity.
b. obtain support from the 7-3 shift.
c. use institutional research.
d. identify the problem. - Answer-ANS: D
Identification of a problem is the first step in problem solving and occurs before any
other step. The most common cause for failure to resolve problems is the improper
identification of the problem/issue; therefore, problem recognition and identification are
considered the most vital steps.
2. The nurse manager of a rehab unit wants to purchase a new antiembolic stocking for
use with patients. To make a high-quality decision, the nurse manager would:
a. involve the rehab staff in the decision.
b. involve the sales representative.
c. make the decision alone.
d. involve administration in the decision. - Answer-ANS: A
In a shared decision model, the decisions are made through an interactive, deliberate
process and the staff may express and discuss options and preferences. The shared
decision model has been shown to increase work performance and productivity,
decrease employee turnover, and enhance employee satisfaction.
3. Several nurses on an adolescent psychiatric unit complain that the teens are
becoming unmanageable on the 0700-1900 shift. To resolve this problem, the nurse
manager decides that the staff should have a brainstorming session. The goal of
brainstorming is to:
a. evaluate problem solutions.
b. critique the ideas of others.
c. generate as many solutions as possible.
d. identify only practical and realistic ideas. - Answer-ANS: C
Brainstorming encourages creativity when one is beginning to problem-solve and avoids
premature shutting down of ideas through early evaluation. The goal is to generate
ideas, no matter how seemingly unrealistic or absurd.
, 4. During a fire drill, several psychiatric patients become agitated. The nurse manager
quickly assigns a staff member to each patient. This autocratic decision style is most
appropriate for:
a. routine problems.
b. crisis situations.
c. managers who prefer a "telling" style.
d. followers who cannot agree on a solution. - Answer-ANS: B
An autocratic style is appropriate when rapid decision making is required, such as in a
crisis situation.
5. After the nurses who work on an adolescent psychiatric unit have had a
brainstorming session, they are ready to resolve the problem of unmanageable teenage
patients. To maximize group effectiveness in decision making and problem solving, the
nurse manager has:
a. prevented conflict.
b. formed highly cohesive groups.
c. used majority rule to arrive at decisions.
d. encouraged equal participation among members. - Answer-ANS: D
Groups are more likely to be effective if members are involved, the group is cohesive,
communication is encouraged, and members demonstrate some understanding of the
group process. The nurse leader or manager should provide a nonthreatening and
positive environment in which group members are encouraged to participate actively.
6. To solve a problem, the nurse manager understands that the most important
problem-solving step is:
a. the implementation phase.
b. identification of numerous solutions.
c. accurate identification of the problem.
d. evaluation of the effectiveness of problem resolution. - Answer-ANS: C
To proceed effectively, it is important to determine if a problem exists and to accurately
identify a problem. Failure to resolve problems is most often linked to improper
identification of the problem.
7. A clinic nurse has observed another nurse deviating from agency policy in performing
wound care. The best approach for the clinic nurse to take is to:
a. stay out of it.
b. inform the nursing supervisor.
c. fill out a notification form (incident report).
d. assess the risk to the client and the agency before proceeding. - Answer-ANS: D
If the situation is subjective, nonroutine, and unstructured or if outcomes are unknown
or unpredictable, the nurse leader and manager may need to take a descriptive or
behavioral approach. More information (such as degree of risk to the client and to the
agency) needs to be gathered to address this situation effectively.
8. In a rural hospital, the unit for which you are charge nurse has a particularly busy
morning. A 52-year-old patient is complaining of left-sided chest pain and a multiparous
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