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Leading and Managing in Nursing, 7th
EditionChapter 15-18 : Making Decisions
and Solving ProblemsYoder-Wise: ,
Chapter 18: Leading Change, Chapter
17: Delegating: Authority, Accountability,
Responsibility in Delegation Decisions
Yoder-Wise: Leading and... Questions
and Correct Answers the Latest Update
and Recommended Version
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.
→ 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.
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b. involve the sales representative.
c. make the decision alone.
d. involve administration in the decision.
→ 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.
→ 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.
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d. followers who cannot agree on a solution.
→ 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.
→ 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.
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→ 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.
→ 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 patient is
about to deliver. A child with asthma is experiencing early signs of an attack. The other RN on
the unit is a recent graduate who has not yet been orientated to the labor room and has
limited cardiac nursing experience. An unlicensed assistant is available to assist. You must
decide which patient situation you will take and where the new graduate RN's skills can best
be used. Given the limitations in skills and experience, number of staff available, and time
constraints,
you must make a decision that involves:
a. a higher order thinking process.
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