Test Bank - Leading and Managing in Nursing, 7th Edition (Yoder-Wise, 2019), Chapter 1-31 | All Chapters

TEST BANK
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,Chapter 01: Leading, Managing, and Following
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Yoder-Wise: Leading and Managing in Nursing, 7th Edition
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MULTIPLE CHOICE yu




1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older
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adults. She 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
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take for implementation of this change?
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a. Leverage the hierarchical management position to get unit staff involved
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in assessment and planning.
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b. Engage involved staff at all levels in the decision-making process.
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c. Focus the assessment on the unit and omit the hospital and
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community environment.
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d. Hire a geriatric specialist to oversee and control the project.
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ANS: B yu


Complexity theory suggests that systems interact and adapt and that decision making
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occurs throughout the 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 in
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decision 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 nurse who
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has
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called in sick five times in the past month. He tells the manager that he very much
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wants to come to work when scheduled but must often care for his wife, who is
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undergoing treatment
for breast cancer. According tN
oUMRaSslIN‘G
s Tn eBe.dCh i O
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yu yuow e r a r c h y theory, what would be the best
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approach to satisfying the needs of this nurse, other staff, and patients?
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a. Line up agency nurses 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 this
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nurse may be calling in frequently in the future.
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d. Work with the nurse, staffing office, and other nurses to arrange his
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scheduled days off around his wife‘s treatments.
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ANS: D yu


Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic
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needs 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 the
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schedule around the wife‘s needs meets the needs of the staff and of patients while
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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 by a 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 actions
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unfair, and the unit manager continues to reiterate the reasons for the actions. What
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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.
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, c. Ask each party to examine their own motives and issues in the conflict.
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d. Continue to listen as the parties repeat their thoughts and feelings about
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yu the conflict. yu




ANS: C yu


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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yu 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.
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b. Elevate the next negation session to the next manager, one level above.
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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.
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ANS: B yu


Part of leadership is understanding conflict resolution and ability to negotiate and manage
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for resolution of issues and concerns. This situation has failed a second negotiation
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session, elevation to a manager with additional training to facilitate conflict resolution is
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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 addition
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of RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs
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on the staff
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have always practiced in a p rN
i m aR
r y nIur s iGn g-B
S strategy for. implementation
de l iC
ver yMs ys tem and are very resistant to this
idea. What would be the best Uinitial
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yu yu yu of this change?
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a. Exploring the values and feelings of the RN group in relationship to this change
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b. Leaving the RNs alone for a time so they can think about the change
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before it is implemented
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c. Dropping the idea and trying for the change in a year or so when some
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of the present RNs have retired
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d. Hiring the assistants and allowing the RNs to see what good additions they are
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ANS: A yu


Influencing others requires emotional intelligence in domains such as empathy, handling
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relationships, deepening self-awareness in self and others, motivating others, and
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managing emotions. Motivating others recognizes that values are powerful forces that
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influence acceptance of change. Leaving the RNs alone for a period of time before
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implementation does not provide opportunity to explore different perspectives and
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values. Avoiding discussion until the team changes may not promote adoption of the
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change until there is opportunity to explore perspectives and values related to the
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change. Hiring of the assistants demonstrates lack of empathy for the perspectives of
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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
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found 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 in their
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work. Which of the following strategies might motivate the staff and lead to greater
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job satisfaction?
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a. Ask the director of nursing to offer higher wages and bonuses for extra
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work for the night LPNs and NAs.
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b. Allow the LPNs and NAs greater decision-making power within the scope of
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their positions in the institution.
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c. Hire additional staff so that there are more staff available for enhanced care,
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and individual workloads are lessened.
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d. Ask the director of nursing to increase job security for night staff by having
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them sign contracts that guarantee work.
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ANS: B yu


Hygiene factors such as salary, working conditions, and security are consistent with
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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 promote
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a satisfying and enriched work environment. Transformational leaders use motivator
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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 the
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nurse on the unit. What action would be appropriate to motivate the staff?
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a. Collaborate with the human resource/personnel department to develop on-
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site daycare services. yu yu

b. Provide a hierarchical orgNaniR
zati I
o n alGs tr B
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c. Implement a model of s har eUd gS o veN r n a nTc e . O
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d. Promote the development of a flexible benefits package.
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ANS: C yu


Complexity theory suggests that systems interact and adapt and that decision making
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occurs 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 in
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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. A charge nurse on a busy 40-bed medical/surgical unit is approached by a family
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member who begins to complain loudly about the quality of care his mother is
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receiving. His behavior is so disruptive that it is overheard by staff, physicians, and
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other visitors. The family member leaves the unit abruptly, and the nurse is left feeling
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frustrated. Which behavior by the charge nurse best illustrates refined leadership skills
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in an emotionally intelligent practitioner?
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a. Reflect to gain insight into how the situation could be handled differently in
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the future.
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b. Try to catch up with the angry family member to resolve the concern.
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c. Discuss the concern with the patient after the family member has left.
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d. Notify nursing administration of the situation.
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ANS: A yu