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 communityenvironment.
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: Communicationand 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
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patients?
a. Line up agencynurses 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, staffingoffice, and other nurses to arrange his scheduled
days off around his wife‘s treatments.
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ANS: D
Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic needs
and demotivate the nurse. Unsatisfactorycoverage 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: Communicationand Relationship-Building
3. A grievance brought bya staff nurse against the unit manager requires mediation. At
the first mediation session, the staff nurse repeatedlycalls 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 awayto reach their own resolution.
b. Involve another staff nurse in the discussion for clarity issues.
c. Ask each partyto 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: Communicationand 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 abilityto 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: Communicationand 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
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Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank
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have always practiced in a primarynursing-delivery system and are veryresistant to this idea.
What would be the best initial strategyfor implementation of this change?
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a. Exploringthe values and feelings of the RN group in relationship to this
change
b. Leaving the RNs alone for a time so theycan 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 opportunityto
explore perspectives and values related to the change. Hiringof 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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