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Leading and Managing in Nursing 6th Edition Yoder-Wise Test Bank/Leadership Exam 1 Test Bank
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Leading and Managing in Nursing 6th Edition Yoder-Wise Test Bank Leadership Exam 1 Test Bank
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Chapter 01: Leading, Managing, and FollowingChapter 01: Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 6th 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 in making 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.
REF: Page 8 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 to Maslow’s need hierarchy 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.
REF: Page 10 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 her 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 so as to clarify issues.
c. Ask each party to examine her own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the conflict.
ANS: C
,Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to address the interests
and involvement of participants in the conflict by examining the real issues of all parties.
REF: Page 16 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. It would now be best to:
a. Arrange another meeting in a week’s time so as to allow a cooling-off period.
b. Turn the dispute over to the director of nursing.
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
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-off” period is
recommended if resolution fails.
REF: Page 16 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 walk patients. The RNs on the staff have
always practiced in a primary nursing–delivery system and are very resistant to this idea. The best
initial strategy in this situation would include:
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.
REF: Page 7 | Page 15
TOP: AONE competency: Knowledge of the Health Care Environment
6. 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: 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.
REF: Page 9 | Page 10
TOP: AONE competency: Communication and Relationship-Building
7. As the nurse manager who wants to increase motivation by providing motivating factors, which
action would you select?
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: 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.
REF: Pages 8-11 TOP: AONE competency: Communication and Relationship-Building
8. A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who
begins to complain loudly about the quality of care his mother is receiving. His behavior is so
disruptive that it is overheard by staff, physicians, and other visitors. The family member rejects any
attempt to intervene therapeutically to resolve the issue. He leaves the unit abruptly, and the nurse is
left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in
an emotionally intelligent practitioner?
a. Reflect to gain insight into how the situation could be handled differently in the future.
b. Try to catch up with the angry family member to resolve the concern.
c. Discuss the concern with the patient after the family member has left.
d. Notify nursing administration of the situation.
ANS: A
Goleman suggests that emotional intelligence involves insight and being able to step outside of the
situation to envision the context of what is happening as well as being able to manage emotions
such as frustration effectively.
REF: Page 7 | Page 8 TOP: AONE competency: Leadership
9. The chief nursing officer has asked the staff development coordinator to facilitate the development
of a clinical competency program for the facility. While making rounds on the units, the staff
development coordinator overhears RN staff complaining that they feel it is insulting to be required to
participate in a competency program. Which behavior by the staff development coordinator is most
appropriate in this situation?
a. Disregard staff concerns and continue with development of the program.
b. Inform the nurses that this program is a requirement for JCAHO accreditation.
c. Schedule a meeting with the chief nurse executive to apprise her of the situation.
d. Facilitate a meeting so nurses can articulate their values and concerns about a competency
program.
ANS: D
, The manager role involves guiding others through a set of derived practices that are evidence-based
and known to satisfy preestablished outcomes such as participation in a competency program. This
involves engagement of staff through sharing of concerns and ideas. A close analysis of the IOM
report and the summary of the PPACA suggests that no health reform can unfold without active
nursing engagement. Each document emphasizes that nurses must lead, manage, and behave as
active collaborators with other members of the health team and with those being served.
REF: Page 3 TOP: AONE competency: Communication and Relationship-Building
10. As the manager, you have been asked to implement an evidence-based approach to teach
ostomy patients self-management skills postoperatively that is being operationalized throughout your
organization. Which of the following illustrates effective leadership?
a. The training modules are left in the staff room for times when staff are available.
b. The current approach is continued because it is also evidence-based and is more familiar to staff.
c. You decide to implement the approach at a later date because of feedback from the RNs that the
new approach takes too much time.
d. A RN who is already familiar with the new approach volunteers to take the lead 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.
REF: Page 4 | Page 5
TOP: AONE competency: Communication and Relationship-Building
11. You overhear a newly graduated RN telling one of your colleagues that leadership and
management belong to the unit manager and not to her. As a nursing colleague, you respond by
demonstrating understanding that the perception of the new graduate:
a. Is correct. Leadership is not the role of the staff nurse.
b. Would benefit from further understanding of her role as a professional, whose influence may affect
the decision making of patients, colleagues, and other professionals.
c. Has been influenced by nurse leaders and managers who leave for other positions.
d. Is related to the general perception that nurse leaders and managers are not satisfied in their jobs.
ANS: B
Care coordination that involves the intersection of individual, family, and community-based needs
requires that nurses have self-confidence, knowledge of organizations and health systems, and an
inner desire to lead and manage. There is often a view that leadership is isolated to those holding
managerial positions and that a direct care nurse is subject to following by adhering to the direction
of others. Such views fail to acknowledge that to be a nurse requires each licensed individual to
lead, manage, and follow when practicing at the point-of-care and beyond.
REF: Page 3 | Page 4 TOP: AONE competency: Leadership
12. You walk into Mr. Smith’s room and find him yelling at the LPN, Miss Jones. He is obviously very
upset and after you speak with him regarding his behavior, you determine that he has not slept for
three nights because of unrelieved pain levels. The LPN is very upset with Mr. Smith and calls him
an “ugly, old man.” You acknowledge her feelings and concerns and then suggest that Mr. Smith’s
behavior was aggressive but is related to lack of sleep and to pain. You say to Miss Jones, “Can you
both, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling
his pain?” This approach demonstrates:
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