,Chapter01:Leading,Managing, andFollowing
3
b 3
b b3 H b 3 3
b
Yoder-Wise: Leading and Managing in Nursing, 8th Edition b 3 H b 3 H b 3 b 3 b 3 b 3 b 3
MULTIPLE CHOICE b 3
1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is
b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b 3 b3 b3 b3 b 3
asked to assess and adapt the unit to better meet the unique needs of the older
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
adult patient. Using complexity principles, what would be the best approach to take for
b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
implementation of this change?
b3 b 3 b 3 b 3
a. Leverage the hierarchical management position to get unit staff involved in b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
assessment and planning. b 3 b 3 b 3
b. Engage involved staff at all levels in the decision-making process. b 3 b 3 b 3 b 3 b 3 b 3 H b 3 b 3 b 3
c. Focus the assessment on the unit and omit the hospital and community b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
environment. b3
d. Hire a geriatric specialist to oversee and control the project. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: B
Complexity theory suggests that systems interact and adapt and that decision b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 H b3
throughout , as opposed to being held in a hierarchy. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
voice , and therefore, all levels of staff would be H b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
decision involved in b 3 b 3
making. b 3
TOP: AONE competency: Communication and Relationship-Building
b 3 b 3 b 3 b 3 b 3
2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse
b3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b3
whohas called in sick five times in the past month. He tells the manager that
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bhe very much wants to come to work when scheduled but must often care for his
3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 H b 3 b 3 b 3 b 3
bwife, who is undergoing treatment for breast cancer. According to Maslow‘s need
3 b 3 b 3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bhierarchy theory, what would be the best approach to satisfying the needs of this
3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bnurse, other staff, and patients?
3 b 3 b 3 b 3 b3
a. Line up agencynurses who can be called in to work on short notice. b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b3 H b 3 b 3
b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
c. Sympathize with the nurse‘s dilemma and let the charge nurse know that b3 b3 b3 b3 b3 b3 H b 3 b3 b3 b3 b3
thisnurse may be calling in frequently in the future.
b3 b 3 b3 b 3 b 3 b 3 b 3 b 3
d. Work with the nurse, staffing office, and other nurses to arrange b3 b3 b3 b3 b3 b 3 b3 b3 b 3 b3
hisscheduled days off around his wife‘s treatments.
b3 b 3 b 3 b 3 b 3 b 3 b 3
HH: D
Placing the nurse on unpaid leave maythreaten the nurse‘s capacity to meet physiologic needs
b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
affect patient care and threaten the needs of staff to feel competent. Arranging
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
the schedule around the wife‘s needs meets the needs of the staff and of patients
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
while satisfying the nurse‘s need for affiliation.
b 3 b3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building
b 3 b 3 b 3 b 3 b 3
3. A grievance brought bya staff nurse against the unit manager requires mediation. At the
b3 b3 b 3 b3 b 3 b3 b3 b 3 b 3 Hb3 b 3 b 3 b 3 b3
first mediation session, the staff nurse repeatedly calls the unit manager‘s
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
actions unfair, and the unit manager continues to reiterate the reasons for the actions.
b 3 b3 b 3 b 3 b 3 H b 3 b3 b3 b 3 b3 b3 b 3 b3 b3
What wouldbe the best course of action at this time?
b3 b3 b3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3
a. Send the two disputants awayto reach their own resolution. H b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3
b. Involve another staff nurse in the discussion for clarity issues. b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3
, c. Ask each partyto examine their own motives and issues in the conflict. b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
d. Continue to listen as the parties repeat their thoughts and feelings b3 b3 b3 b3 b3 H b 3 b3 b3 b3 b3
b3 aboutt he conflict. H b 3 b 3
HH: C b3
For resolution of conflict, one should address the interests and involvement of participants in
b3 b3 b3 b3 b3 b3 b3 b3 b3 H b 3 b3 b3 b3
the conflict by examining the real issues of all parties.
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
4. At a second negotiation session, the unitmanager and staff nurse are unable to
b3 b3 b3 b3 b3 b3 b3 b3 H b 3 b3 b3 b3 b3
b3 reach a resolution. What is the appropriate nextstep? b3 b 3 b 3 b 3 b 3 b 3 b 3
a. Arrange another meeting in a week‘s time so as to allow a cooling-off period. H b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
b. Elevate the next negation session to the next manager, one level above. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
c. Insist that participants continue to talk until a resolution has beenreached. b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b3
d. Back the unit manager‘s actions and end the dispute. b 3 b 3 b3 b 3 b3 b 3 b 3 b 3
HH: B b3
Part of leadership is understanding conflict resolution and abilityto negotiate and manage
b3 b3 b 3 b 3 b3 b 3 b 3 b 3 b3 b 3 b 3 b 3
for resolution of issues and concerns. This situation has failed a second
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
negotiation session, elevation to a manager with additional training to facilitate
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
conflict resolution is important at this point.
b 3 b 3 b 3 b3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
5. The manager of a surgical area has a vision for the future that requires the
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
addition of RN assistants or unlicensed persons to feed, bathe, and ambulate
b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
patients. The RNs on the staff have always practiced in a primarynursing-delivery
b 3 b 3 b 3 b 3 b3 b 3 b 3 b3 b3 b 3 b3 b3 b3
system and are veryresistant to this idea. What would be the best initial strategy for
b3 b3 b 3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
implementation of this change?
b 3 b 3 b 3 b 3
a. Exploring the values and feelings of the RN group in relationship to thischange H b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b3
b. Leaving the RNs alone for a time so theycan think about the change before it is b3 b3 b3 b 3 b3 b3 b3 b3 b3 b3 b 3 b 3 b3 b3 b3 H b 3
implemented b 3
c. Dropping the idea and trying for the change in a year or so when some of the b3 b3 b3 b3 H b 3 b3 b3 b3 b3 b 3 b3 b3 b3 H b 3 b3 b3
present RNs have retired b 3 b 3 b 3 b 3
d. Hiring the assistants and allowing the RNs to see what good additions they are b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: A b3
Influencing others requires emotional intelligence in domains such as empathy, b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bhandling relationships, deepening self-awareness in self and others, motivating
3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bothers, and managing emotions. Motivating others recognizes that values are
3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bpowerful forces that influence acceptance of change. Leaving the RNs alone for a period
3 b 3 b 3 b3 b 3 b3 b3 b 3 b3 b3 b3 b3 b3 b3
of time before implementation does not provide opportunity to explore different
b3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bperspectives and values. Avoiding discussion until the team changes may not
3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bpromote adoption of the change until there is opportunity to explore perspectives
3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
band values related to the change. Hiring of the assistants demonstrates lack of
3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bempathy for the perspectives of the RN staff.
3 b 3 b 3 b 3 b 3 b3 b 3 b 3
TOP: AONE competency: Knowledge of the Health Care Environment b3 b 3 b3 b 3 b3 b 3 b 3 b 3
, 6. As the RN charge nurse on the night shift in a small long-term care facility, you‘ve found that
b3 b3 b3 b3 b3 b3 b3 b3 H b 3 H b 3 b3 b3 b3 b3 b 3 b3 b3
bthere is little turnover among your LPN and nursing assistant (NA) staff members,
3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
but they are not very motivated to go beyond their job descriptions in their
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bwork. Which of the following strategies might motivate the staff and lead to
3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bgreater job satisfaction?
3 b 3 b3
a. Ask the director of nursing to offer higher wages and bonuses for extra work for b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
the night LPNs and NAs. b 3 b 3 b 3 b 3 b 3
b. Allow the LPNs and NAs greater decision-makingpower within the scope of their b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
positions in the institution.
b 3 b 3 b 3 b 3
c. Hire additional staff so that there are more staff available for enhanced H b 3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
care,and individual workloads are lessened. b3 b 3 b 3 b 3 b 3
d. Ask the director of nursing to increase job security for night staff byhaving them
b3 b3 b3 b3 H b 3 b3 b3 b3 b3 b3 b3 b3 b3 b3
sign contracts that guarantee work.b 3 b 3 b 3 b 3 b 3
HH: B b3
Hygiene factors such as salary, working conditions, and security are consistent with b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
Herzberg‘s two-factor theory of motivation; meeting these needs avoids job
b3 H HHH HHH HHH HHH b 3 b 3 b 3 b 3 b 3
dissatisfaction. Motivator factors such as recognition and satisfaction with work
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
promote a satisfying and enriched work environment. Tr HHformational leaders use
b 3 b3 b 3 b 3 b 3 b3 b3 b3 b3 b3 b3
motivator factors liberally to inspire work performance and increase job satisfaction.
b3 b3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
7. The nurse manager wants to increase motivation by providing motivating factors for
b3 b3 b3 b 3 b3 b 3 b3 b3 b3 b3 b3
thenurse on the unit. What action would be appropriate to motivate the
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
staff?
b 3
a. Collaborate with the human resource/personnel department to develop on- site b3 b3 b3 b3 b3 b3 b3 b3 b3
daycare services. b 3 b 3
b. Providea hierarchical organizational structure. b3 b 3 b 3 b 3
c. Implement a model of shared governance. b 3 b 3 b 3 b 3 b 3
d. Promote the development of a flexible benefits package. b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: C b3
Complexitytheorysuggests that systems interact and adapt and that decision making occurs b3 b3 b3 H b 3 b3 b 3 b3 b3 b3 b3 b3 H b 3
throughout systems, as opposed to being held in a hierarchy. In complexity
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
theory, every voice counts, and therefore all levels of staff would be involved in
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
decision making. This principle is the foundation of shared governance.
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
8. The nurse manager has been asked to implement an evidence-based approach to teach
b3 b3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3
ostomy patients self-management skills postoperatively. The program is to be
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
implemented across the entire facility. What illustrates effective leadership in this
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
situation?
b3
a. The training modules are left in the staff room for times when staff are available.
b3 H b 3 b 3 b 3 H b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
b. The current approach iscontinued because it is also evidence-based and is more b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
familiar to staff. b 3 b 3 b 3
c. You decide to implement the approach at a later date because of feedback from the b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
RNs that the new approach takes too much time.
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
d. An RN who is alreadyfamiliar with the new approach of volunteers to take the
b3 b3 b3 Hb 3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
lead in mentoring and teaching others how to implement it.
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: D b3
3
b 3
b b3 H b 3 3
b
Yoder-Wise: Leading and Managing in Nursing, 8th Edition b 3 H b 3 H b 3 b 3 b 3 b 3 b 3
MULTIPLE CHOICE b 3
1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is
b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b 3 b3 b3 b3 b 3
asked to assess and adapt the unit to better meet the unique needs of the older
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
adult patient. Using complexity principles, what would be the best approach to take for
b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
implementation of this change?
b3 b 3 b 3 b 3
a. Leverage the hierarchical management position to get unit staff involved in b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
assessment and planning. b 3 b 3 b 3
b. Engage involved staff at all levels in the decision-making process. b 3 b 3 b 3 b 3 b 3 b 3 H b 3 b 3 b 3
c. Focus the assessment on the unit and omit the hospital and community b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
environment. b3
d. Hire a geriatric specialist to oversee and control the project. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: B
Complexity theory suggests that systems interact and adapt and that decision b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 H b3
throughout , as opposed to being held in a hierarchy. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
voice , and therefore, all levels of staff would be H b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
decision involved in b 3 b 3
making. b 3
TOP: AONE competency: Communication and Relationship-Building
b 3 b 3 b 3 b 3 b 3
2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse
b3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b3
whohas called in sick five times in the past month. He tells the manager that
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bhe very much wants to come to work when scheduled but must often care for his
3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 H b 3 b 3 b 3 b 3
bwife, who is undergoing treatment for breast cancer. According to Maslow‘s need
3 b 3 b 3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bhierarchy theory, what would be the best approach to satisfying the needs of this
3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bnurse, other staff, and patients?
3 b 3 b 3 b 3 b3
a. Line up agencynurses who can be called in to work on short notice. b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b3 H b 3 b 3
b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
c. Sympathize with the nurse‘s dilemma and let the charge nurse know that b3 b3 b3 b3 b3 b3 H b 3 b3 b3 b3 b3
thisnurse may be calling in frequently in the future.
b3 b 3 b3 b 3 b 3 b 3 b 3 b 3
d. Work with the nurse, staffing office, and other nurses to arrange b3 b3 b3 b3 b3 b 3 b3 b3 b 3 b3
hisscheduled days off around his wife‘s treatments.
b3 b 3 b 3 b 3 b 3 b 3 b 3
HH: D
Placing the nurse on unpaid leave maythreaten the nurse‘s capacity to meet physiologic needs
b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
affect patient care and threaten the needs of staff to feel competent. Arranging
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
the schedule around the wife‘s needs meets the needs of the staff and of patients
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
while satisfying the nurse‘s need for affiliation.
b 3 b3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building
b 3 b 3 b 3 b 3 b 3
3. A grievance brought bya staff nurse against the unit manager requires mediation. At the
b3 b3 b 3 b3 b 3 b3 b3 b 3 b 3 Hb3 b 3 b 3 b 3 b3
first mediation session, the staff nurse repeatedly calls the unit manager‘s
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
actions unfair, and the unit manager continues to reiterate the reasons for the actions.
b 3 b3 b 3 b 3 b 3 H b 3 b3 b3 b 3 b3 b3 b 3 b3 b3
What wouldbe the best course of action at this time?
b3 b3 b3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3
a. Send the two disputants awayto reach their own resolution. H b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3
b. Involve another staff nurse in the discussion for clarity issues. b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3
, c. Ask each partyto examine their own motives and issues in the conflict. b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
d. Continue to listen as the parties repeat their thoughts and feelings b3 b3 b3 b3 b3 H b 3 b3 b3 b3 b3
b3 aboutt he conflict. H b 3 b 3
HH: C b3
For resolution of conflict, one should address the interests and involvement of participants in
b3 b3 b3 b3 b3 b3 b3 b3 b3 H b 3 b3 b3 b3
the conflict by examining the real issues of all parties.
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
4. At a second negotiation session, the unitmanager and staff nurse are unable to
b3 b3 b3 b3 b3 b3 b3 b3 H b 3 b3 b3 b3 b3
b3 reach a resolution. What is the appropriate nextstep? b3 b 3 b 3 b 3 b 3 b 3 b 3
a. Arrange another meeting in a week‘s time so as to allow a cooling-off period. H b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
b. Elevate the next negation session to the next manager, one level above. b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
c. Insist that participants continue to talk until a resolution has beenreached. b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b3
d. Back the unit manager‘s actions and end the dispute. b 3 b 3 b3 b 3 b3 b 3 b 3 b 3
HH: B b3
Part of leadership is understanding conflict resolution and abilityto negotiate and manage
b3 b3 b 3 b 3 b3 b 3 b 3 b 3 b3 b 3 b 3 b 3
for resolution of issues and concerns. This situation has failed a second
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
negotiation session, elevation to a manager with additional training to facilitate
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
conflict resolution is important at this point.
b 3 b 3 b 3 b3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
5. The manager of a surgical area has a vision for the future that requires the
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
addition of RN assistants or unlicensed persons to feed, bathe, and ambulate
b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
patients. The RNs on the staff have always practiced in a primarynursing-delivery
b 3 b 3 b 3 b 3 b3 b 3 b 3 b3 b3 b 3 b3 b3 b3
system and are veryresistant to this idea. What would be the best initial strategy for
b3 b3 b 3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
implementation of this change?
b 3 b 3 b 3 b 3
a. Exploring the values and feelings of the RN group in relationship to thischange H b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b3
b. Leaving the RNs alone for a time so theycan think about the change before it is b3 b3 b3 b 3 b3 b3 b3 b3 b3 b3 b 3 b 3 b3 b3 b3 H b 3
implemented b 3
c. Dropping the idea and trying for the change in a year or so when some of the b3 b3 b3 b3 H b 3 b3 b3 b3 b3 b 3 b3 b3 b3 H b 3 b3 b3
present RNs have retired b 3 b 3 b 3 b 3
d. Hiring the assistants and allowing the RNs to see what good additions they are b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: A b3
Influencing others requires emotional intelligence in domains such as empathy, b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bhandling relationships, deepening self-awareness in self and others, motivating
3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bothers, and managing emotions. Motivating others recognizes that values are
3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bpowerful forces that influence acceptance of change. Leaving the RNs alone for a period
3 b 3 b 3 b3 b 3 b3 b3 b 3 b3 b3 b3 b3 b3 b3
of time before implementation does not provide opportunity to explore different
b3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bperspectives and values. Avoiding discussion until the team changes may not
3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bpromote adoption of the change until there is opportunity to explore perspectives
3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
band values related to the change. Hiring of the assistants demonstrates lack of
3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bempathy for the perspectives of the RN staff.
3 b 3 b 3 b 3 b 3 b3 b 3 b 3
TOP: AONE competency: Knowledge of the Health Care Environment b3 b 3 b3 b 3 b3 b 3 b 3 b 3
, 6. As the RN charge nurse on the night shift in a small long-term care facility, you‘ve found that
b3 b3 b3 b3 b3 b3 b3 b3 H b 3 H b 3 b3 b3 b3 b3 b 3 b3 b3
bthere is little turnover among your LPN and nursing assistant (NA) staff members,
3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
but they are not very motivated to go beyond their job descriptions in their
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bwork. Which of the following strategies might motivate the staff and lead to
3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
bgreater job satisfaction?
3 b 3 b3
a. Ask the director of nursing to offer higher wages and bonuses for extra work for b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
the night LPNs and NAs. b 3 b 3 b 3 b 3 b 3
b. Allow the LPNs and NAs greater decision-makingpower within the scope of their b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
positions in the institution.
b 3 b 3 b 3 b 3
c. Hire additional staff so that there are more staff available for enhanced H b 3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
care,and individual workloads are lessened. b3 b 3 b 3 b 3 b 3
d. Ask the director of nursing to increase job security for night staff byhaving them
b3 b3 b3 b3 H b 3 b3 b3 b3 b3 b3 b3 b3 b3 b3
sign contracts that guarantee work.b 3 b 3 b 3 b 3 b 3
HH: B b3
Hygiene factors such as salary, working conditions, and security are consistent with b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
Herzberg‘s two-factor theory of motivation; meeting these needs avoids job
b3 H HHH HHH HHH HHH b 3 b 3 b 3 b 3 b 3
dissatisfaction. Motivator factors such as recognition and satisfaction with work
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
promote a satisfying and enriched work environment. Tr HHformational leaders use
b 3 b3 b 3 b 3 b 3 b3 b3 b3 b3 b3 b3
motivator factors liberally to inspire work performance and increase job satisfaction.
b3 b3 b3 b3 b3 b 3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
7. The nurse manager wants to increase motivation by providing motivating factors for
b3 b3 b3 b 3 b3 b 3 b3 b3 b3 b3 b3
thenurse on the unit. What action would be appropriate to motivate the
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
staff?
b 3
a. Collaborate with the human resource/personnel department to develop on- site b3 b3 b3 b3 b3 b3 b3 b3 b3
daycare services. b 3 b 3
b. Providea hierarchical organizational structure. b3 b 3 b 3 b 3
c. Implement a model of shared governance. b 3 b 3 b 3 b 3 b 3
d. Promote the development of a flexible benefits package. b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: C b3
Complexitytheorysuggests that systems interact and adapt and that decision making occurs b3 b3 b3 H b 3 b3 b 3 b3 b3 b3 b3 b3 H b 3
throughout systems, as opposed to being held in a hierarchy. In complexity
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
theory, every voice counts, and therefore all levels of staff would be involved in
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
decision making. This principle is the foundation of shared governance.
b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
TOP: AONE competency: Communication and Relationship-Building b 3 b 3 b 3 b 3 b 3
8. The nurse manager has been asked to implement an evidence-based approach to teach
b3 b3 b 3 b 3 b 3 b 3 b 3 b3 b 3 b 3 b 3 b 3
ostomy patients self-management skills postoperatively. The program is to be
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
implemented across the entire facility. What illustrates effective leadership in this
b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
situation?
b3
a. The training modules are left in the staff room for times when staff are available.
b3 H b 3 b 3 b 3 H b 3 b3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
b. The current approach iscontinued because it is also evidence-based and is more b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
familiar to staff. b 3 b 3 b 3
c. You decide to implement the approach at a later date because of feedback from the b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
RNs that the new approach takes too much time.
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
d. An RN who is alreadyfamiliar with the new approach of volunteers to take the
b3 b3 b3 Hb 3 b3 b3 b3 b3 b3 b3 b3 b3 b3 b3
lead in mentoring and teaching others how to implement it.
b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3 b 3
HH: D b3
