TEST BANK
https://www.stuvia.com/user/angelinas
, Chapter 01: Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 7th Edition
MULTIPLE CHOICE
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: 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
2. 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 tN
oUMRaSslIN‘G
ow s Tn eBe.dCh i O
e r a r c h y theory, what would be the best
approach to satisfying the needs of this nurse, other staff, and patients?
a. Line up agency nurses who can be called in to work on short notice.
b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment.
c. Sympathize with the nurse‘s dilemma and let the charge nurse know that this nurse
may be calling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his scheduled
days off around his wife‘s treatments.
ANS: D
Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic needs
and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect
patient 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 patients while satisfying the nurse‘s need
for affiliation.
TOP: AONE competency: Communication and Relationship-Building
3. 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 course
of action at this time?
a. Send the two disputants away to reach their own resolution.
b. Involve another staff nurse in the discussion for clarity issues.
https://www.stuvia.com/user/angelinas
, c. Ask each party to examine their own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the
conflict.
ANS: C
For resolution of conflict, one should address the interests and involvement of participants in
the conflict by examining the real issues of all parties.
TOP: AONE competency: Communication and Relationship-Building
4. At a second negotiation session, the unit manager and staff nurse are unable to reach a
resolution. What is the appropriate next step?
a. Arrange another meeting in a week‘s time so as to allow a cooling-off period.
b. Elevate the next negation session to the next manager, one level above.
c. Insist that participants continue to talk until a resolution has been reached.
d. 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
5. 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 patients. The RNs on the staff
have always practiced in a p rN
i m aRr y nIur s iGn g-B
d e.liC
ver yMs ys tem and are very resistant to this idea.
What would be the best initial U S for implementation of this change?
strategy
a. Exploring the values and feelings of the RN group in relationship to this change
b. Leaving the RNs alone for a time so they can think about the change before it is
implemented
c. Dropping the idea and trying for the change in a year or so when some of the
present RNs have retired
d. 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 does
not 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
https://www.stuvia.com/user/angelinas
, 6. As xthe xRN xcharge xnurse xon xthe xnight xshift xin xa xsmall xlong-term xcare xfacility, xyou‘ve
xfound xthat xthere xis xlittle xturnover xamong xyour xLPN xand xnursing xassistant x(NA) xstaff
xmembers, xbut xthey xare xnot xvery xmotivated xto xgo xbeyond xtheir xjob xdescriptions xin
xtheir xwork. xWhich xof xthe xfollowing xstrategies xmight xmotivate xthe xstaff xand xlead xto
xgreater xjob xsatisfaction?
a. Ask xthe xdirector xof xnursing xto xoffer xhigher xwages xand xbonuses xfor xextra
xwork xfor xthe xnight xLPNs xand xNAs.
b. Allow xthe xLPNs xand xNAs xgreater xdecision-making xpower xwithin xthe xscope
xof xtheir xpositions xin xthe xinstitution.
c. Hire xadditional xstaff xso xthat xthere xare xmore xstaff xavailable xfor xenhanced
xcare, xand xindividual xworkloads xare xlessened.
d. Ask xthe xdirector xof xnursing xto xincrease xjob xsecurity xfor xnight xstaff xby
xhaving xthem xsign xcontracts xthat xguarantee xwork.
ANS: x B
Hygiene xfactors xsuch xas xsalary, xworking xconditions, xand xsecurity xare xconsistent xwith
xHerzberg‘s xtwo-factor xtheory xof xmotivation; xmeeting xthese xneeds xavoids xjob
xdissatisfaction. xMotivator xfactors xsuch xas xrecognition xand xsatisfaction xwith xwork
xpromote xa xsatisfying xand xenriched xwork xenvironment. xTransformational xleaders xuse
xmotivator xfactors xliberally xto xinspire xwork xperformance xand xincrease xjob xsatisfaction.
TOP: x AONE xcompetency: xCommunication xand xRelationship-Building
7. The xnurse xmanager xwants xto xincrease xmotivation xby xproviding xmotivating xfactors xfor
xthe xnurse xon xthe xunit. xWhat xaction xwould xbe xappropriate xto xmotivate xthe xstaff?
a. Collaborate xwith xthe xhuman xresource/personnel xdepartment xto xdevelop
xon-site xdaycare xservices.
b. Provide x a x hierarchical x orgNaniR
zatiI
o nalGstr B
u c.tuCre . x M
c. Implement xa xmodel xof xshareUd xgS o v eNrn anTc e . O
d. Promote xthe xdevelopment xof xa xflexible xbenefits xpackage.
ANS: x C
Complexity xtheory xsuggests xthat xsystems xinteract xand xadapt xand xthat xdecision xmaking
xoccurs xthroughout xsystems, xas xopposed xto xbeing xheld xin xa xhierarchy. xIn xcomplexity
xtheory, xevery xvoice xcounts, xand xtherefore xall xlevels xof xstaff xwould xbe xinvolved xin
xdecision xmaking. xThis xprinciple xis xthe xfoundation xof xshared xgovernance.
TOP: x AONE xcompetency: xCommunication xand xRelationship-Building
8. A xcharge xnurse xon xa xbusy x40-bed xmedical/surgical x unit xis xapproached xby xa xfamily
xmember xwho xbegins xto xcomplain xloudly xabout xthe xquality xof xcare xhis xmother xis
xreceiving. xHis xbehavior xis xso xdisruptive xthat xit xis xoverheard xby xstaff, xphysicians, xand
xother xvisitors. xThe xfamily xmember xleaves xthe xunit xabruptly, xand xthe xnurse xis xleft
xfeeling xfrustrated. xWhich xbehavior xby xthe xcharge xnurse xbest xillustrates xrefined
xleadership xskills xin xan xemotionally xintelligent xpractitioner?
a. Reflect xto xgain xinsight xinto xhow xthe xsituation xcould xbe xhandled xdifferently
xin xthe xfuture.
b. Try xto xcatch xup xwith xthe xangry xfamily xmember xto xresolve xthe xconcern.
c. Discuss xthe xconcern xwith xthe xpatient xafter xthe xfamily xmember xhas xleft.
d. Notify xnursing xadministration xof xthe xsituation.
ANS: x A
https://www.stuvia.com/user/angelinas
