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