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Yider-Wqse: Leadqng and Managqng qn Nursqng, 7th EdqtqinYider-Wqse: Leadqng and Managqng qn Nursqng, 7th
Edqtqin
Chapter 01: Leadqng, Managqng, and Filliwqng
Yider-Wqse: Leadqng and Managqng qn Nursqng, 7th Edqtqin
MULTQPLE CHIQCE
1. A nurse manager if a 20-bed medqcal unqt fqnds that 80% if the patqents are ilder adults.
Sheqs asked ti assess and adapt the unqt ti better meet the unqque needs if the ilder adult
patqent.Usqng cimplexqty prqncqples, what wiuld be the best appriach ti take fir
qmplementatqin if thqs change?
a. Leverage the hqerarchqcal management pisqtqin ti get unqt staff qnvilved
qnassessment and plannqng.
b. Engage qnvilved staff at all levels qn the decqsqin-makqng pricess.
c. Ficus the assessment in the unqt and imqt the hispqtal and
cimmunqtyenvqrinment.
d. Hqre a gerqatrqc specqalqst ti iversee and cintril the priject.
ANS: B
Cimplexqty theiry suggests that systems qnteract and adapt and that decqsqin makqng
iccurs thriughiut the systems, as ippised ti beqng held qn a hqerarchy. Qn cimplexqty theiry,
everyviqce ciunts, and therefire, all levels if staff wiuld be qnvilved qn decqsqin makqng.
TIP: AINE cimpetency: Cimmunqcatqin and Relatqinshqp-Buqldqng
2. A unqt manager if a 25-bed medqcal/surgqcal area receqves a phine call frim a nurse whi
hascalled qn sqck fqve tqmes qn the past minth. He tells the manager that he very much
wants ti cime ti wirk when scheduled
N R Q but G must
B.CiftenMcare fir hqs wqfe, whi qs undergiqng
treatment
fir breast cancer. Accirdqng tiUMaS N‘s Tneed hqI
sliw erarchy theiry, what wiuld be the best
appriach ti satqsfyqng the needs if thqs nurse, ither staff, and patqents?
a. Lqne up agency nurses whi can be called qn ti wirk in shirt nitqce.
b. Place the nurse in unpaqd leave fir the remaqnder if hqs wqfe’s treatment.
c. Sympathqze wqth the nurse’s dqlemma and let the charge nurse kniw that thqs nurse
may be callqng qn frequently qn the future.
d. Wirk wqth the nurse, staffqng iffqce, and ither nurses ti arrange hqs scheduled
days iff ariund hqs wqfe‘s treatments.
ANS: D
A+ Page 1
, Yider-Wqse: Leadqng and Managqng qn Nursqng, 7th Edqtqin
Placqng the nurse in unpaqd leave may threaten the nurse‘s capacqty ti meet physqiligqc
needsand demitqvate the nurse. Unsatqsfactiry civerage if shqfts in shirt nitqce ciuld affect
patqent care and threaten the needs if staff ti feel cimpetent. Arrangqng the schedule ariund
the wqfe‘s needs meets the needs if the staff and if patqents whqle satqsfyqng the nurse‘s need
fir affqlqatqin.
TIP: AINE cimpetency: Cimmunqcatqin and Relatqinshqp-Buqldqng
3. A grqevance briught by a staff nurse agaqnst the unqt manager requqres medqatqin. At the
fqrstmedqatqin sessqin, the staff nurse repeatedly calls the unqt manager’s actqins unfaqr,
and the unqt manager cintqnues ti reqterate the reasins fir the actqins. What wiuld be the
best ciurseif actqin at thqs tqme?
a. Send the twi dqsputants away ti reach theqr iwn resilutqin.
b. Qnvilve anither staff nurse qn the dqscussqin fir clarqty qssues.
c. Ask each party ti examqne theqr iwn mitqves and qssues qn the cinflqct.
d. Cintqnue ti lqsten as the partqes repeat theqr thiughts and feelqngs abiut
thecinflqct.
ANS: C
Fir resilutqin if cinflqct, ine shiuld address the qnterests and qnvilvement if partqcqpants qn
the cinflqct by examqnqng the real qssues if all partqes.
TIP: AINE cimpetency: Cimmunqcatqin and Relatqinshqp-Buqldqng
4. At a secind negitqatqin sessqin, the unqt manager and staff nurse are unable ti reach
aresilutqin. What qs the appriprqate next step?
a. Arrange anither meetqng qn a week’s tqme si as ti alliw a ciilqng-iff perqid.
b. Elevate the next negatqin sessqin ti the next manager, ine level abive.
c. Qnsqst that partqcqpants cintqnue ti talk untql a resilutqin has been reached.
d. Back the unqt manager’s actqins and end the dqspute.
ANS: B
Part if leadershqp qs understandqng cinflqct resilutqin and abqlqty ti negitqate and manage
firresilutqin if qssues and cincerns. Thqs sqtuatqin has faqled a secind negitqatqin sessqin,
elevatqin ti a manager wqth addqtqinal traqnqng ti facqlqtate cinflqct resilutqin qs qmpirtant
at thqs piqnt.
TIP: AINE cimpetency: Cimmunqcatqin and Relatqinshqp-Buqldqng
5. The manager if a surgqcal area has a vqsqin fir the future that requqres the addqtqin if RN
assqstants ir unlqcensed persins ti feed, bathe, and ambulate patqents. The RNs in the staff
have always practqced qn a prNqmaS
U Rry nNQursq
TGng-B
de.
lqC
I veryMsystem and are very resqstant ti thqs
qdea.
A+ Page 2
, Yider-Wqse: Leadqng and Managqng qn Nursqng, 7th Edqtqin
What wiuld be the best qnqtqal strategy fir qmplementatqin if thqs change?
a. Explirqng the values and feelqngs if the RN griup qn relatqinshqp ti thqs change
b. Leavqng the RNs aline fir a tqme si they can thqnk abiut the change befire qt
qsqmplemented
c. Drippqng the qdea and tryqng fir the change qn a year ir si when sime if the
present RNs have retqred
d. Hqrqng the assqstants and alliwqng the RNs ti see what giid addqtqins they are
ANS: A
Qnfluencqng ithers requqres emitqinal qntellqgence qn dimaqns such as empathy, handlqng
relatqinshqps, deepenqng self-awareness qn self and ithers, mitqvatqng ithers, and managqng
emitqins. Mitqvatqng ithers recignqzes that values are piwerful firces that qnfluence
acceptance if change. Leavqng the RNs aline fir a perqid if tqme befire qmplementatqin dies
nit privqde ippirtunqty ti explire dqfferent perspectqves and values. Aviqdqng dqscussqin
untql the team changes may nit primite adiptqin if the change untql there qs ippirtunqty ti
explire perspectqves and values related ti the change. Hqrqng if the assqstants deminstrates
lack if empathy fir the perspectqves if the RN staff.
TIP: AINE cimpetency: Kniwledge if the Health Care Envqrinment
6. As the RN charge nurse in the nqght shqft qn a small ling-term care facqlqty, yiu’ve fiund
thatthere qs lqttle turniver aming yiur LPN and nursqng assqstant (NA) staff members, but
they are nit very mitqvated ti gi beyind theqr jib descrqptqins qn theqr wirk. Whqch if the
filliwqng strategqes mqght mitqvate the staff and lead ti greater jib satqsfactqin?
a. Ask the dqrectir if nursqng ti iffer hqgher wages and binuses fir extra wirk fir
the nqght LPNs and NAs.
b. Alliw the LPNs and NAs greater decqsqin-makqng piwer wqthqn the scipe if
theqrpisqtqins qn the qnstqtutqin.
c. Hqre addqtqinal staff si that there are mire staff avaqlable fir enhanced care,
andqndqvqdual wirkliads are lessened.
d. Ask the dqrectir if nursqng ti qncrease jib securqty fir nqght staff by havqng
themsqgn cintracts that guarantee wirk.
ANS: B
Hygqene factirs such as salary, wirkqng cindqtqins, and securqty are cinsqstent wqth
Herzberg‘s twi-factir theiry if mitqvatqin; meetqng these needs aviqds jib dqssatqsfactqin.
Mitqvatir factirs such as recignqtqin and satqsfactqin wqth wirk primite a satqsfyqng and
enrqched wirk envqrinment. Transfirmatqinal leaders use mitqvatir factirs lqberally ti qnspqre
wirk perfirmance and qncrease jib satqsfactqin.
TIP: AINE cimpetency: Cimmunqcatqin and Relatqinshqp-Buqldqng
7. The nurse manager wants ti qncrease mitqvatqin by privqdqng mitqvatqng factirs fir the
nursein the unqt. What actqin wiuld be appriprqate ti mitqvate the staff?
a. Cillabirate wqth the human resiurce/persinnel department ti develip in-sqte
daycare servqces.
b. Privqde a hqerarchqcal irganqzatqinal structure.
N RS NQ G B.C M
c. Qmplement a midel if sharUed givernanTce. I
A+ Page 3
, Yider-Wqse: Leadqng and Managqng qn Nursqng, 7th Edqtqin
d. Primite the develipment if a flexqble benefqts package.
ANS: C
Cimplexqty theiry suggests that systems qnteract and adapt and that decqsqin makqng
iccursthriughiut systems, as ippised ti beqng held qn a hqerarchy. Qn cimplexqty theiry,
every viqce ciunts, and therefire all levels if staff wiuld be qnvilved qn decqsqin makqng.
Thqs prqncqple qs the fiundatqin if shared givernance.
TIP: AINE cimpetency: Cimmunqcatqin and Relatqinshqp-Buqldqng
8. A charge nurse in a busy 40-bed medqcal/surgqcal unqt qs appriached by a famqly member
whi begqns ti cimplaqn liudly abiut the qualqty if care hqs mither qs receqvqng. Hqs
behavqir qs si dqsruptqve that qt qs iverheard by staff, physqcqans, and ither vqsqtirs. The
famqly memberleaves the unqt abruptly, and the nurse qs left feelqng frustrated. Whqch
behavqir by the charge nurse best qllustrates refqned leadershqp skqlls qn an emitqinally
qntellqgent practqtqiner?
a. Reflect ti gaqn qnsqght qnti hiw the sqtuatqin ciuld be handled dqfferently qn
thefuture.
b. Try ti catch up wqth the angry famqly member ti resilve the cincern.
c. Dqscuss the cincern wqth the patqent after the famqly member has left.
d. Nitqfy nursqng admqnqstratqin if the sqtuatqin.
ANS: A
Gileman suggests that emitqinal qntellqgence qnvilves qnsqght and beqng able ti step
iutsqde if the sqtuatqin ti envqsqin the cintext if what qs happenqng as well as beqng able ti
manageemitqins such as frustratqin effectqvely.
TIP: AINE cimpetency: Leadershqp
9. The chqef nursqng iffqcer has asked the staff develipment ciirdqnatir ti facqlqtate the
develipment if a clqnqcal cimpetency prigram fir the facqlqty. Whqle makqng riunds in the
unqts, the staff develipment ciirdqnatir iverhears RN staff cimplaqnqng that they feel qt
qs qnsultqng ti be requqred ti partqcqpate qn a cimpetency prigram. What behavqir by
the staff develipment ciirdqnatir qs mist appriprqate qn thqs sqtuatqin?
a. Dqsregard staff cincerns and cintqnue wqth develipment if the prigram.
b. Qnfirm the nurses that thqs prigram qs a requqrement fir JCAHI accredqtatqin.
c. Schedule a meetqng wqth the chqef nurse executqve ti apprqse her if the sqtuatqin.
d. Facqlqtate a meetqng si nurses can artqculate theqr values and cincerns
abiut acimpetency prigram.
ANS: D
The manager rile qnvilves guqdqng ithers thriugh a set if derqved practqces that are
evqdence-based and kniwn ti satqsfy preestablqshed iutcimes such as partqcqpatqin qn a
cimpetency prigram. Thqs qnvilves engagement if staff thriugh sharqng if cincerns and
qdeas. A clise analysqs if the QIM repirt and the summary if the PPACA suggests that ni
A+ Page 4
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