Clinical Management – Exam 1 – Study Guide & Practice Questions
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. - correct
answer ✔✔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.
D
Placing the nurse on unpaid leave may threaten the nurses 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 wifes
needs meets the needs of the staff and of patients while satisfying the nurses need for
affiliation. - correct answer ✔✔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 Maslows 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 wifes treatment.
c. Sympathize with the nurses 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 wifes treatments.
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. - correct answer ✔✔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
managers 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.
B
According to the principles outlined by Ury, Brett, and Goldberg, a cooling-off period is
recommended if resolution fails. - correct answer ✔✔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 weeks 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 managers actions and end the dispute.
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. - correct answer ✔✔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
nursingdelivery 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.
B
Hygiene factors such as salary, working conditions, and security are consistent with Herzbergs
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. - correct answer ✔✔6. As the RN charge nurse on
the night shift in a small long-term care facility, youve 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.
, 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. - correct answer ✔✔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.
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. - correct answer ✔✔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.
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
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. - correct
answer ✔✔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.
D
Placing the nurse on unpaid leave may threaten the nurses 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 wifes
needs meets the needs of the staff and of patients while satisfying the nurses need for
affiliation. - correct answer ✔✔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 Maslows 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 wifes treatment.
c. Sympathize with the nurses 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 wifes treatments.
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. - correct answer ✔✔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
managers 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.
B
According to the principles outlined by Ury, Brett, and Goldberg, a cooling-off period is
recommended if resolution fails. - correct answer ✔✔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 weeks 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 managers actions and end the dispute.
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. - correct answer ✔✔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
nursingdelivery 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.
B
Hygiene factors such as salary, working conditions, and security are consistent with Herzbergs
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. - correct answer ✔✔6. As the RN charge nurse on
the night shift in a small long-term care facility, youve 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.
, 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. - correct answer ✔✔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.
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. - correct answer ✔✔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.
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
