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LEADERSHIP AND MANAGEMENT RNSG 2121 CHAPTER 1-22 EXAM 1 WITH RATIONED ANSWERS

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As the RN charge nurse on the night shift in a small long-term care facility, you've found that there 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 m...

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  • November 14, 2024
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LEADERSHIP AND
MANAGEMENT RNSG 2121
CHAPTER 1-22 EXAM 1 WITH
RATIONED ANSWERS 2024-
2025

,As the RN charge nurse on the night shift in a small long-term care facility, you've found that

there 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?

a. Ask the director of nursing to offer higher wages and bonuses for extra work for

the night LPNs and NAs.

b. Allow the LPNs and NAs greater decision-making power within the scope of their

positions in the institution.

c. Hire additional staff so that there are more staff available for enhanced care, and

individual workloads are lessened.

d. Ask the director of nursing to increase job security for night staff by having them

sign contracts that guarantee work. - ANS- 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.



1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She

is asked to assess and adapt the unit to better meet the unique needs of the older adult patient.

Using complexity principles, what would be the best approach to take for implementation of

this change?

a. Leverage the hierarchical management position to get unit staff involved in

assessment and planning.

b. Engage involved staff at all levels in the decision-making process.

c. Focus the assessment on the unit and omit the hospital and community

environment.

d. Hire a geriatric specialist to oversee and control the project. - ANS- 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.

,The nurse manager wants to increase motivation by providing motivating factors for the nurse

on the unit. What action would be appropriate to motivate the staff?

a. Collaborate with the human resource/personnel department to develop on-site

daycare services.

b. Provide a hierarchical organizational structure.

c. Implement a model of shared governance.

d. Promote the development of a flexible benefits package. - ANS- ANS: C

Complexity theory suggests that systems interact and adapt and that decision making occurs

throughout 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.



As a leader on a rehab unit, the manager encourages all staff members to see themselves as

having a role in decision making and quality care. The manager sees their role as involving

particular responsibilities in decision making but not as a hierarchal role. What is this view of

the role consistent with in this situation?

a. Trait theories

b. Complexity theory

c. Situated theory

d. Emotional intelligence - ANS- ANS: B

Complexity theory involves envisioning each member of the team involved in decision

making, management, and leadership, with the leader not seen in a hierarchal relationship to

other team members.



A staff nurse has been recently promoted to unit manager. During the time on the unit, the

nurse formed a strong social network among staff, has promoted the development of

relationships between staff and workers in other areas of the organization, and has formed

relationships that generate ideas from patient organizations and the local nursing education

program. According to complexity theory, what principle is being engaged?

a. Empowerment

, b. Systematic thinking

c. Development of networks

d. Bottom-up interactions - ANS- ANS: C

According to complexity theory, social networks evolve around areas of common interest and

are able to respond to problems in creative and novel ways.



According to the complexity theory, what would be the focus of measurement?

a. Cost per hospital day

b. Bed utilization

c. Infection rates

d. Staff morale and budgets - ANS- ANS: D

According to complexity theory and the principle "Think systematically," one cannot ignore

objective data or nonmeasurable data, as both inform decisions.



During a staff meeting held to discuss developing a mission statement for the unit, the idea of

placing patient needs first is discussed. What is considered when the suggestion by the

manager is for the unit mission to be derived from the organization mission?

a. Empowering

b. A leadership tag

c. A symbol

d. A management task - ANS- ANS: B

According to complexity theory, leadership tags, which are similar to values, reflect the

patient-centered philosophies and values-driven characteristics that define an organization and

give it personality.



The manager calls the staff together to assess a situation in which the family of a seriously ill

patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and

questioning of treatment decisions. Staff members are becoming distanced from the family.

After inviting the concerns of staff, the manager explains that the organization values

patient-centered care and that evidence supports that acting as an advocate and a listener is

helpful to families. The manager asks the staff for ideas and strategies that are effectively

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