Test Bank Leading and Managing in Nursing 7th Edition by Patricia S.... file:///C:/Users/HP/Downloads/Test%20Bank%20Leading%20and%
Test Bank Leading and Managing in Nursing
7th Edition by Patricia S. Yoder-Wise
Chapter 1-31
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Chapter 01: Leading, Managing, and Following
MULTIPLE CHOICE
1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. Sheis
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, everyvoice
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 N Roften care B.C
for his wife, who is undergoing treatment
for breast cancer. According toUMaS NI’s TnG
slow eed hiO
erarchy 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 needsand
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 courseof 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.
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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 inthe
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 atthis 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 prN imaR
ry nIuSrsiG
U NB
ng- .liC
deT veryMsystem and are very resistant to this idea. What
would be the best initial strategy for implementation of this change?
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 doesnot 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
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6. As the RN charge nurse on the night shift in a small long-term care facility, you’ve found thatthere
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 forthe
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 themsign
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 inspirework performance
and increase job satisfaction.
TOP: AONE competency: Communication and Relationship-Building
7. The nurse manager wants to increase motivation by providing motivating factors for the nurseon
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 org anizational structure.
N R I G B. C M
c. Implement a model of sharU ed gS
oveNrnanTce. O
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.
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 behavioris so
disruptive that it is overheard by staff, physicians, and other visitors. The family memberleaves 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.
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