Chapter 01: Leading, Managing, and Following
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Second 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 t
to better meet the unique needs of older adult patients. According to complexity principles, what would
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.
ANS: B
Complexity theory suggests that systems interact and adapt and that decision making occurs throughou
being held in a hierarchy. In complexity theory, everybody’s opinion counts; therefore, all levels of sta
decision making.
DIF: Cognitive Level: Apply REF: Page 14
TOP: Nursing Process: Implementation
2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in
month. He tells the manager that he very much wants to come to work when scheduled, but must often
undergoing treatment for breast cancer. In the practice of a strengths-based nursing leader, what would
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 physiologic needs and demotivate the nurse. Unsatisfac
short notice could affect patient care and threaten staff members’ sense of competence. Strengths-based
uniqueness of individuals, teams, systems, and organizations; therefore arranging the schedule around
in a win-win situation, also creating a work environment that promotes the health of all the nurses and
DIF: Cognitive Level: Analyze REF: Page 6
TOP: Nursing Process: Implementation
3. A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation
repeatedly calls the unit manager’s actions unfair, and the unit manager continues to reiterate the reaso
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.
ANS: C
Nurses and leaders must assess each situation as unique, determining appropriate actions accordingly. L
styles to complement specific issues being faced, such as conflict. Examining motives and issues for th
promotes equal representation of each point of view.
DIF: Cognitive Level: Apply REF: Pages 11–13
, 5. The manager of a surgical area envisions a future that requires the addition of registered nurse (RN) as
persons to feed, bathe, and walk patients. The RNs on the staff have always practiced in a primary nurs
very resistant to this idea.
The best initial strategy in this situation would include:
a. Exploring the values of the RNs in relation to this change.
b. Leaving the RNs alone for a time so they can think about the change before they
are approached again.
c. Dropping the idea and trying for the change in another year or so.
d. Hiring the assistants and allowing the RNs to see what good additions they are.
ANS: A
Leadership involves engaged decision making around a vision that is based on evidence and tacit know
requires emotional intelligence in domains such as empathy and handling relationships.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
6. As the charge nurse on the night shift in a small long-term care facility, you have found that there is lit
licensed practical nurse and nursing assistant (NA) staff members, but they are not very motivated to w
descriptions. Which of the following strategies might motivate the staff and lead to greater job satisfac
a. Ask the director of nursing to offer higher wages and bonuses for extra work for
the night licensed practical nurses and NAs.
b. Allow the licensed practical nurses and NAs greater decision-making power
within the scope of their positions in the institution.
c. Help the licensed practical nurses and NAs with their work, whenever possible.
d. Ask the director of nursing to increase job security for night staff by having them
sign contracts that guarantee work.
ANS: B
A nurse leader should provide an environment conducive to opinion sharing that involves staff in decis
approach is shown to increase job satisfaction. Decision making and the corresponding actions taken ar
engagement with coworkers.
DIF: Cognitive Level: Apply REF: Page 7
TOP: Nursing Process: Implementation
7. As the nurse manager, you want to increase motivation by providing motivating factors. Which action
a. Collaborate with the human resources/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.
ANS: C
Complexity theory suggests that systems interact and adapt and that decision making occurs throughou
being made unilaterally by different levels of the organizational hierarchy. In complexity theory, every
and therefore all levels of staff would be involved in decision making. This principle underlies shared g
governance is an example of nurse decision making in which nurses at different organizational levels e
practices.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
8. A charge nurse on a busy 40-bed medical/surgical unit is approached by a patient’s son, who begins to
quality of care his mother is receiving. His behaviour is so disruptive that it is overheard by staff, phys
The family member rejects any attempt to intervene therapeutically to resolve the issue. He leaves the u
is left feeling frustrated. Which behaviour by the charge nurse best illustrates refined leadership skills i
practitioner?
a. Reflection to obtain insight into how the situation could be handled differently in
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Second 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 t
to better meet the unique needs of older adult patients. According to complexity principles, what would
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.
ANS: B
Complexity theory suggests that systems interact and adapt and that decision making occurs throughou
being held in a hierarchy. In complexity theory, everybody’s opinion counts; therefore, all levels of sta
decision making.
DIF: Cognitive Level: Apply REF: Page 14
TOP: Nursing Process: Implementation
2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in
month. He tells the manager that he very much wants to come to work when scheduled, but must often
undergoing treatment for breast cancer. In the practice of a strengths-based nursing leader, what would
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 physiologic needs and demotivate the nurse. Unsatisfac
short notice could affect patient care and threaten staff members’ sense of competence. Strengths-based
uniqueness of individuals, teams, systems, and organizations; therefore arranging the schedule around
in a win-win situation, also creating a work environment that promotes the health of all the nurses and
DIF: Cognitive Level: Analyze REF: Page 6
TOP: Nursing Process: Implementation
3. A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation
repeatedly calls the unit manager’s actions unfair, and the unit manager continues to reiterate the reaso
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.
ANS: C
Nurses and leaders must assess each situation as unique, determining appropriate actions accordingly. L
styles to complement specific issues being faced, such as conflict. Examining motives and issues for th
promotes equal representation of each point of view.
DIF: Cognitive Level: Apply REF: Pages 11–13
, 5. The manager of a surgical area envisions a future that requires the addition of registered nurse (RN) as
persons to feed, bathe, and walk patients. The RNs on the staff have always practiced in a primary nurs
very resistant to this idea.
The best initial strategy in this situation would include:
a. Exploring the values of the RNs in relation to this change.
b. Leaving the RNs alone for a time so they can think about the change before they
are approached again.
c. Dropping the idea and trying for the change in another year or so.
d. Hiring the assistants and allowing the RNs to see what good additions they are.
ANS: A
Leadership involves engaged decision making around a vision that is based on evidence and tacit know
requires emotional intelligence in domains such as empathy and handling relationships.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
6. As the charge nurse on the night shift in a small long-term care facility, you have found that there is lit
licensed practical nurse and nursing assistant (NA) staff members, but they are not very motivated to w
descriptions. Which of the following strategies might motivate the staff and lead to greater job satisfac
a. Ask the director of nursing to offer higher wages and bonuses for extra work for
the night licensed practical nurses and NAs.
b. Allow the licensed practical nurses and NAs greater decision-making power
within the scope of their positions in the institution.
c. Help the licensed practical nurses and NAs with their work, whenever possible.
d. Ask the director of nursing to increase job security for night staff by having them
sign contracts that guarantee work.
ANS: B
A nurse leader should provide an environment conducive to opinion sharing that involves staff in decis
approach is shown to increase job satisfaction. Decision making and the corresponding actions taken ar
engagement with coworkers.
DIF: Cognitive Level: Apply REF: Page 7
TOP: Nursing Process: Implementation
7. As the nurse manager, you want to increase motivation by providing motivating factors. Which action
a. Collaborate with the human resources/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.
ANS: C
Complexity theory suggests that systems interact and adapt and that decision making occurs throughou
being made unilaterally by different levels of the organizational hierarchy. In complexity theory, every
and therefore all levels of staff would be involved in decision making. This principle underlies shared g
governance is an example of nurse decision making in which nurses at different organizational levels e
practices.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
8. A charge nurse on a busy 40-bed medical/surgical unit is approached by a patient’s son, who begins to
quality of care his mother is receiving. His behaviour is so disruptive that it is overheard by staff, phys
The family member rejects any attempt to intervene therapeutically to resolve the issue. He leaves the u
is left feeling frustrated. Which behaviour by the charge nurse best illustrates refined leadership skills i
practitioner?
a. Reflection to obtain insight into how the situation could be handled differently in
