,Chapter 01: Leading, Managing, and Following k k k k k
MULTIPLE CHOICE k
1. A nurse manager of a 20-
k k k k k
bed medical unit finds that 80% of the patients are older adults. She is asked t
k k k k k k k k k k k k k k k
o assess and adapt the unit to better meet the unique needs of the older adult p
k k k k k k k k k k k k k k k k
atient. Using complexity principles, what would be the best approach to take
k k k k k k k k k k k k
in making this change?
k k k
a. Leverage the hierarchical management position to get unit staff involved in a
k k k k k k k k k k k
ssessment and planning. k k
b. Engage involved staff at all levels in the decision-making process.
k k k k k k k k k
c. Focus the assessment on the unit, and omit the hospital and community e
k k k k k k k k k k k k
nvironment.
d. Hire a geriatric specialist to oversee and control the project.
k k k k k k k k k
ANS: B k
Complexity theory suggests that systems interact and adapt and that decision ma
k k k k k k k k k k k
king occurs throughout the systems, as opposed to being held in a hierarchy. In
k k k k k k k k k k k k k k
complexity theory, every voice counts, and therefore, all levels of staff would b
k k k k k k k k k k k k
e involved in decision making.
k k k k
2. A unit manager of a 25-
k k k k k
bed medical/surgical area receives a phone call from a nurse who has called in
k k k k k k k k k k k k k k
sick five times in the past month. He tells the manager that he very much wants
k k k k k k k k k k k k k k k k
to come to work when scheduled but must often care for his wife, who is under
k k k k k k k k k k k k k k k
going treatment for breast cancer. According to Maslow’s need hierarchy theo
k k k k k k k k k k
ry, what would be the best approach to satisfying the needs of this nurse, other
k k k k k k k k k k k k k k k
staff, and patients? k k
a. Line up agency nurses who can be called in to work on short notice.
k k k k k k k k k k k k k
b. Place the nurse on unpaid leave for the remainder of his wife’s treatment.
k k k k k k k k k k k k
c. Sympathize with the nurse’s dilemma and let the charge nurse know that th k k k k k k k k k k k k
is nurse may be calling in frequently in the future.
k k k k k k k k k
d. Work with the nurse, staffing office, and other nurses to arrange his sc
k k k k k k k k k k k k
heduled days off around his wife’s treatments.
k k k k k k
ANS: D k
Placing the nurse on unpaid leave may threaten the nurse’s capacity to meet phy
k k k k k k k k k k k k k
siologic needs and demotivate the nurse. Unsatisfactory coverage of shifts on sh
k k k k k k k k k k k
ort notice could affect patient care and threaten the needs of staff to feel compet
k k k k k k k k k k k k k k
ent. Arranging the schedule around the wife’s needs meets the needs of the staff
k k k k k k k k k k k k k k
and of patients while satisfying the nurse’s need for affiliation.
k k k k k k k k k
,3. A grievance brought by a staff nurse against the unit manager requires medi
k k k k k k k k k k k k
ation. At the first mediation session, the staff nurse repeatedly calls the unit ma
k k k k k k k k k k k k k
nager’s actions unfair, and the unit manager continues to reiterate the reasons f
k k k k k k k k k k k k
or her actions. What would be the best course of action at this time?
k k k k k k k k k k k k k
a. Send the two disputants away to reach their own resolution.
k k k k k k k k k
b. Involve another staff nurse in the discussion so as to clarify issues.
k k k k k k k k k k k
c. Ask each party to examine her own motives and issues in the conflict.
k k k k k k k k k k k k
d. Continue to listen as the parties repeat their thoughts and feelings about the co
k k k k k k k k k k k k k
nflict.
ANS: C k
Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to a
k k k k k k k k k k k k k k k
ddress the interests and involvement of participants in the conflict by examinin
k k k k k k k k k k k
g the real issues of all parties.
k k k k k k
4. At a second negotiation session, the unit manager and staff nurse are u
k k k k k k k k k k k k
nable to reach a resolution. It would now be best to:
k k k k k k k k k k
a. Arrange another meeting in a week’s time so as to allow a cooling-
k k k k k k k k k k k k
off period. k
b. Turn the dispute over to the director of nursing.
k k k k k k k k
c. Insist that participants continue to talk until a resolution has been reached.
k k k k k k k k k k k
d. Back the unit manager’s actions and end the dispute.
k k k k k k k k
ANS: B k
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-
k k k k k k k k k k k
koff” period is recommended if resolution fails.
k k k k k k
5. The manager of a surgical area has a vision for the future that requires the ad
k k k k k k k k k k k k k k k
dition of RN assistants or unlicensed persons to feed, bathe, and walk patients.
k k k k k k k k k k k k k
The RNs on the staff have always practiced in a primary nursing–
k k k k k k k k k k k
kdelivery system and are very resistant to this idea. The best initial strategy in th
k k k k k k k k k k k k k k
is situation would include:
k k k
a. Exploring the values and feelings of the RN group in relationship to this ch
k k k k k k k k k k k k k
ange.
b. Leaving the RNs alone for a time so they can think about the change be
k k k k k k k k k k k k k k
fore it is implemented.
k k k
c. Dropping the idea and trying for the change in a year or so when some of the
k k k k k k k k k k k k k k k k
kpresent RNs have retired. k k k
d. Hiring the assistants and allowing the RNs to see what good additions they ar
k k k k k k k k k k k k k
e.
ANS: A k
, Influencing others requires emotional intelligence in domains such as empathy,
k k k k k k k k k
khandling relationships, deepening self- k k k
awareness in self and others, motivating others, and managing emotions. Motiv
k k k k k k k k k k
ating others recognizes that values are powerful forces that influence acceptanc
k k k k k k k k k k
e of change. Leaving the RNs alone for a period of time before implementation
k k k k k k k k k k k k k k
does not provide opportunity to explore different perspectives and values. Avoi
k k k k k k k k k k
ding discussion until the team changes may not promote adoption of the change
k k k k k k k k k k k k k
until there is opportunity to explore perspectives and values related to the chang
k k k k k k k k k k k k
e. Hiring of the assistants demonstrates lack of empathy for the perspectives of t
k k k k k k k k k k k k k
he RN staff.k k
6. As the RN charge nurse on the night shift in a small long-
k k k k k k k k k k k k
term care facility, you’ve found that there is little turnover among your LPN and
k k k k k k k k k k k k k
knursing assistant (NA) staff members, but they are not very motivated to go bey
k k k k k k k k k k k k k
ond their job descriptions in their work. Which of the following strategies might
k k k k k k k k k k k k
kmotivate the staff and lead to greater job satisfaction?
k k k k k k k k
a. Ask the director of nursing to offer higher wages and bonuses for extra w
k k k k k k k k k k k k k
ork for the night LPNs and NAs.
k k k k k k
b. Allow the LPNs and NAs greater decision- k k k k k k
making power within the scope of their positions in the institution.
k k k k k k k k k k
c. Hire additional staff so that there are more staff available for enhanced care an
k k k k k k k k k k k k k
d individual workloads are lessened.
k k k k
d. Ask the director of nursing to increase job security for night staff by ha
k k k k k k k k k k k k k
ving them sign contracts that guarantee work.
k k k k k k
ANS: B k
Hygiene factors such as salary, working conditions, and security are consistent
k k k k k k k k k k k
with Herzberg’s two- k k
factor theory of motivation; meeting these needs avoids job dissatisfaction. Mot
k k k k k k k k k k
ivator factors such as recognition and satisfaction with work promote a satisfyin
k k k k k k k k k k k
g and enriched work environment. Transformational leaders use motivator fact
k k k k k k k k k
ors liberally to inspire work performance and increase job satisfaction.
k k k k k k k k k
7. As the nurse manager who wants to increase motivation by providing m
k k k k k k k k k k k
otivating factors, which action would you select?k k k k k k
a. Collaborate with the human resource/personnel department to develop on- k k k k k k k k
ksite daycare services.
k k
b. Provide a hierarchical organizational structure. k k k k
c. Implement a model of shared governance. k k k k k
d. Promote the development of a flexible benefits package. k k k k k k k
MULTIPLE CHOICE k
1. A nurse manager of a 20-
k k k k k
bed medical unit finds that 80% of the patients are older adults. She is asked t
k k k k k k k k k k k k k k k
o assess and adapt the unit to better meet the unique needs of the older adult p
k k k k k k k k k k k k k k k k
atient. Using complexity principles, what would be the best approach to take
k k k k k k k k k k k k
in making this change?
k k k
a. Leverage the hierarchical management position to get unit staff involved in a
k k k k k k k k k k k
ssessment and planning. k k
b. Engage involved staff at all levels in the decision-making process.
k k k k k k k k k
c. Focus the assessment on the unit, and omit the hospital and community e
k k k k k k k k k k k k
nvironment.
d. Hire a geriatric specialist to oversee and control the project.
k k k k k k k k k
ANS: B k
Complexity theory suggests that systems interact and adapt and that decision ma
k k k k k k k k k k k
king occurs throughout the systems, as opposed to being held in a hierarchy. In
k k k k k k k k k k k k k k
complexity theory, every voice counts, and therefore, all levels of staff would b
k k k k k k k k k k k k
e involved in decision making.
k k k k
2. A unit manager of a 25-
k k k k k
bed medical/surgical area receives a phone call from a nurse who has called in
k k k k k k k k k k k k k k
sick five times in the past month. He tells the manager that he very much wants
k k k k k k k k k k k k k k k k
to come to work when scheduled but must often care for his wife, who is under
k k k k k k k k k k k k k k k
going treatment for breast cancer. According to Maslow’s need hierarchy theo
k k k k k k k k k k
ry, what would be the best approach to satisfying the needs of this nurse, other
k k k k k k k k k k k k k k k
staff, and patients? k k
a. Line up agency nurses who can be called in to work on short notice.
k k k k k k k k k k k k k
b. Place the nurse on unpaid leave for the remainder of his wife’s treatment.
k k k k k k k k k k k k
c. Sympathize with the nurse’s dilemma and let the charge nurse know that th k k k k k k k k k k k k
is nurse may be calling in frequently in the future.
k k k k k k k k k
d. Work with the nurse, staffing office, and other nurses to arrange his sc
k k k k k k k k k k k k
heduled days off around his wife’s treatments.
k k k k k k
ANS: D k
Placing the nurse on unpaid leave may threaten the nurse’s capacity to meet phy
k k k k k k k k k k k k k
siologic needs and demotivate the nurse. Unsatisfactory coverage of shifts on sh
k k k k k k k k k k k
ort notice could affect patient care and threaten the needs of staff to feel compet
k k k k k k k k k k k k k k
ent. Arranging the schedule around the wife’s needs meets the needs of the staff
k k k k k k k k k k k k k k
and of patients while satisfying the nurse’s need for affiliation.
k k k k k k k k k
,3. A grievance brought by a staff nurse against the unit manager requires medi
k k k k k k k k k k k k
ation. At the first mediation session, the staff nurse repeatedly calls the unit ma
k k k k k k k k k k k k k
nager’s actions unfair, and the unit manager continues to reiterate the reasons f
k k k k k k k k k k k k
or her actions. What would be the best course of action at this time?
k k k k k k k k k k k k k
a. Send the two disputants away to reach their own resolution.
k k k k k k k k k
b. Involve another staff nurse in the discussion so as to clarify issues.
k k k k k k k k k k k
c. Ask each party to examine her own motives and issues in the conflict.
k k k k k k k k k k k k
d. Continue to listen as the parties repeat their thoughts and feelings about the co
k k k k k k k k k k k k k
nflict.
ANS: C k
Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to a
k k k k k k k k k k k k k k k
ddress the interests and involvement of participants in the conflict by examinin
k k k k k k k k k k k
g the real issues of all parties.
k k k k k k
4. At a second negotiation session, the unit manager and staff nurse are u
k k k k k k k k k k k k
nable to reach a resolution. It would now be best to:
k k k k k k k k k k
a. Arrange another meeting in a week’s time so as to allow a cooling-
k k k k k k k k k k k k
off period. k
b. Turn the dispute over to the director of nursing.
k k k k k k k k
c. Insist that participants continue to talk until a resolution has been reached.
k k k k k k k k k k k
d. Back the unit manager’s actions and end the dispute.
k k k k k k k k
ANS: B k
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-
k k k k k k k k k k k
koff” period is recommended if resolution fails.
k k k k k k
5. The manager of a surgical area has a vision for the future that requires the ad
k k k k k k k k k k k k k k k
dition of RN assistants or unlicensed persons to feed, bathe, and walk patients.
k k k k k k k k k k k k k
The RNs on the staff have always practiced in a primary nursing–
k k k k k k k k k k k
kdelivery system and are very resistant to this idea. The best initial strategy in th
k k k k k k k k k k k k k k
is situation would include:
k k k
a. Exploring the values and feelings of the RN group in relationship to this ch
k k k k k k k k k k k k k
ange.
b. Leaving the RNs alone for a time so they can think about the change be
k k k k k k k k k k k k k k
fore it is implemented.
k k k
c. Dropping the idea and trying for the change in a year or so when some of the
k k k k k k k k k k k k k k k k
kpresent RNs have retired. k k k
d. Hiring the assistants and allowing the RNs to see what good additions they ar
k k k k k k k k k k k k k
e.
ANS: A k
, Influencing others requires emotional intelligence in domains such as empathy,
k k k k k k k k k
khandling relationships, deepening self- k k k
awareness in self and others, motivating others, and managing emotions. Motiv
k k k k k k k k k k
ating others recognizes that values are powerful forces that influence acceptanc
k k k k k k k k k k
e of change. Leaving the RNs alone for a period of time before implementation
k k k k k k k k k k k k k k
does not provide opportunity to explore different perspectives and values. Avoi
k k k k k k k k k k
ding discussion until the team changes may not promote adoption of the change
k k k k k k k k k k k k k
until there is opportunity to explore perspectives and values related to the chang
k k k k k k k k k k k k
e. Hiring of the assistants demonstrates lack of empathy for the perspectives of t
k k k k k k k k k k k k k
he RN staff.k k
6. As the RN charge nurse on the night shift in a small long-
k k k k k k k k k k k k
term care facility, you’ve found that there is little turnover among your LPN and
k k k k k k k k k k k k k
knursing assistant (NA) staff members, but they are not very motivated to go bey
k k k k k k k k k k k k k
ond their job descriptions in their work. Which of the following strategies might
k k k k k k k k k k k k
kmotivate the staff and lead to greater job satisfaction?
k k k k k k k k
a. Ask the director of nursing to offer higher wages and bonuses for extra w
k k k k k k k k k k k k k
ork for the night LPNs and NAs.
k k k k k k
b. Allow the LPNs and NAs greater decision- k k k k k k
making power within the scope of their positions in the institution.
k k k k k k k k k k
c. Hire additional staff so that there are more staff available for enhanced care an
k k k k k k k k k k k k k
d individual workloads are lessened.
k k k k
d. Ask the director of nursing to increase job security for night staff by ha
k k k k k k k k k k k k k
ving them sign contracts that guarantee work.
k k k k k k
ANS: B k
Hygiene factors such as salary, working conditions, and security are consistent
k k k k k k k k k k k
with Herzberg’s two- k k
factor theory of motivation; meeting these needs avoids job dissatisfaction. Mot
k k k k k k k k k k
ivator factors such as recognition and satisfaction with work promote a satisfyin
k k k k k k k k k k k
g and enriched work environment. Transformational leaders use motivator fact
k k k k k k k k k
ors liberally to inspire work performance and increase job satisfaction.
k k k k k k k k k
7. As the nurse manager who wants to increase motivation by providing m
k k k k k k k k k k k
otivating factors, which action would you select?k k k k k k
a. Collaborate with the human resource/personnel department to develop on- k k k k k k k k
ksite daycare services.
k k
b. Provide a hierarchical organizational structure. k k k k
c. Implement a model of shared governance. k k k k k
d. Promote the development of a flexible benefits package. k k k k k k k
