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