Chapter_01.bnk
MULTIPLE CHOICE
1. A nurse manager of a 20-bed medical unit finds that 80% of the
patients are older adults. She is asked to assess and adapt the unit to
better meet the unique needs of the older adult patient. Using complexity
principles, what would be the best approach to take for implementation
of 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 throughout the systems, as opposed to being
held in a hierarchy. In complexity theory, every voice counts, and
therefore, all levels of staff would be involved in decision making.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
2. A unit manager of a 25-bed medical/surgical area receives a phone
call from a nurse who has called in sick five times in the past month. He
tells the manager that he very much wants to come to work when
scheduled but must often care for his wife, who is undergoing treatment
for breast cancer. According to Maslow's need hierarchy theory, what
would be the best approach to 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 the nurse's capacity to
meet physiologic needs and demotivate the nurse. Unsatisfactory
coverage of shifts on short notice could affect patient care and threaten
the needs of staff to feel competent. Arranging the schedule around the
wife's needs meets the needs of the staff and of patients while satisfying
the nurse's need for affiliation.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
3. A grievance brought by a staff nurse against the unit manager requires
mediation. At the first mediation session, the staff nurse repeatedly calls
the unit manager's actions unfair, and the unit manager continues to
reiterate the reasons for the actions. What 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 for clarity issues.
c. Ask each party to examine their own motives and issues in the
conflict.
d. Continue to listen as the parties repeat their thoughts and feelings
about the conflict.
ANS: c
For resolution of conflict, one should address the interests and
involvement of participants in the conflict by examining the real issues
of all parties.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
4.At a second negotiation session, the unit manager and staff nurse are
unable to reach a resolution. What is the appropriate next step?
,a. Arrange another meeting in a week's time so as to allow a cooling-off
period.
b. Elevate the next negation session to the next manager, one level
above.
c. Insist that participants continue to talk until a resolution has been
reached.
d. Back the unit manager's actions and end the dispute.
ANS: b
Part of leadership is understanding conflict resolution and ability to
negotiate and manage for resolution of issues and concerns. This
situation has failed a second negotiation session, elevation to a manager
with additional training to facilitate conflict resolution is important at
this point.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
5. The manager of a surgical area has a vision for the future that requires
the addition of RN assistants or unlicensed persons to feed, bathe, and
ambulate patients. The RNs on the staff have always practiced in a
primary nursing-delivery system and are very resistant to this idea. What
would be the best initial strategy for implementation of this change?
a. Exploring the values and feelings of the RN group in relationship to
this change
b. Leaving the RNs alone for a time so they can think about the change
before it is implemented
c. Dropping the idea and trying for the change in a year or so when some
of the present RNs have retired
d. Hiring the assistants and allowing the RNs to see what good additions
they are
ANS: a
Influencing others requires emotional intelligence in domains such as
empathy, handling relationships, deepening self-awareness in self and
others, motivating others, and managing emotions. Motivating others
recognizes that values are powerful forces that influence acceptance of
, change. Leaving the RNs alone for a period of time before
implementation does not provide opportunity to explore different
perspectives and values. Avoiding discussion until the team changes
may not promote adoption of the change until there is opportunity to
explore perspectives and values related to the change. Hiring of the
assistants demonstrates lack of empathy for the perspectives of the RN
staff.
PTS: 1
TOP: AONE competency: Knowledge of the Health Care Environment
6. As the RN charge nurse on the night shift in a small long-term care
facility, you've found that there is little turnover among your LPN and
nursing assistant (NA) staff members, but they are not very motivated to
go beyond their job descriptions in their work. Which of the following
strategies might motivate the staff and lead to greater job satisfaction?
a. Ask the director of nursing to offer higher wages and bonuses for
extra work for the night LPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the
scope of their positions in the institution.
c. Hire additional staff so that there are more staff available for enhanced
care, and individual workloads are lessened.
d. Ask the director of nursing to increase job security for night staff by
having them sign contracts that guarantee work.
ANS: b
Hygiene factors such as salary, working conditions, and security are
consistent with Herzberg's two-factor theory of motivation; meeting
these needs avoids job dissatisfaction. Motivator factors such as
recognition and satisfaction with work promote a satisfying and enriched
work environment. Transformational leaders use motivator factors
liberally to inspire work performance and increase job satisfaction.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
The nurse manager wants to increase motivation by providing
7.
motivating factors for the nurse on the unit. What action would be
MULTIPLE CHOICE
1. A nurse manager of a 20-bed medical unit finds that 80% of the
patients are older adults. She is asked to assess and adapt the unit to
better meet the unique needs of the older adult patient. Using complexity
principles, what would be the best approach to take for implementation
of 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 throughout the systems, as opposed to being
held in a hierarchy. In complexity theory, every voice counts, and
therefore, all levels of staff would be involved in decision making.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
2. A unit manager of a 25-bed medical/surgical area receives a phone
call from a nurse who has called in sick five times in the past month. He
tells the manager that he very much wants to come to work when
scheduled but must often care for his wife, who is undergoing treatment
for breast cancer. According to Maslow's need hierarchy theory, what
would be the best approach to 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 the nurse's capacity to
meet physiologic needs and demotivate the nurse. Unsatisfactory
coverage of shifts on short notice could affect patient care and threaten
the needs of staff to feel competent. Arranging the schedule around the
wife's needs meets the needs of the staff and of patients while satisfying
the nurse's need for affiliation.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
3. A grievance brought by a staff nurse against the unit manager requires
mediation. At the first mediation session, the staff nurse repeatedly calls
the unit manager's actions unfair, and the unit manager continues to
reiterate the reasons for the actions. What 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 for clarity issues.
c. Ask each party to examine their own motives and issues in the
conflict.
d. Continue to listen as the parties repeat their thoughts and feelings
about the conflict.
ANS: c
For resolution of conflict, one should address the interests and
involvement of participants in the conflict by examining the real issues
of all parties.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
4.At a second negotiation session, the unit manager and staff nurse are
unable to reach a resolution. What is the appropriate next step?
,a. Arrange another meeting in a week's time so as to allow a cooling-off
period.
b. Elevate the next negation session to the next manager, one level
above.
c. Insist that participants continue to talk until a resolution has been
reached.
d. Back the unit manager's actions and end the dispute.
ANS: b
Part of leadership is understanding conflict resolution and ability to
negotiate and manage for resolution of issues and concerns. This
situation has failed a second negotiation session, elevation to a manager
with additional training to facilitate conflict resolution is important at
this point.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
5. The manager of a surgical area has a vision for the future that requires
the addition of RN assistants or unlicensed persons to feed, bathe, and
ambulate patients. The RNs on the staff have always practiced in a
primary nursing-delivery system and are very resistant to this idea. What
would be the best initial strategy for implementation of this change?
a. Exploring the values and feelings of the RN group in relationship to
this change
b. Leaving the RNs alone for a time so they can think about the change
before it is implemented
c. Dropping the idea and trying for the change in a year or so when some
of the present RNs have retired
d. Hiring the assistants and allowing the RNs to see what good additions
they are
ANS: a
Influencing others requires emotional intelligence in domains such as
empathy, handling relationships, deepening self-awareness in self and
others, motivating others, and managing emotions. Motivating others
recognizes that values are powerful forces that influence acceptance of
, change. Leaving the RNs alone for a period of time before
implementation does not provide opportunity to explore different
perspectives and values. Avoiding discussion until the team changes
may not promote adoption of the change until there is opportunity to
explore perspectives and values related to the change. Hiring of the
assistants demonstrates lack of empathy for the perspectives of the RN
staff.
PTS: 1
TOP: AONE competency: Knowledge of the Health Care Environment
6. As the RN charge nurse on the night shift in a small long-term care
facility, you've found that there is little turnover among your LPN and
nursing assistant (NA) staff members, but they are not very motivated to
go beyond their job descriptions in their work. Which of the following
strategies might motivate the staff and lead to greater job satisfaction?
a. Ask the director of nursing to offer higher wages and bonuses for
extra work for the night LPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the
scope of their positions in the institution.
c. Hire additional staff so that there are more staff available for enhanced
care, and individual workloads are lessened.
d. Ask the director of nursing to increase job security for night staff by
having them sign contracts that guarantee work.
ANS: b
Hygiene factors such as salary, working conditions, and security are
consistent with Herzberg's two-factor theory of motivation; meeting
these needs avoids job dissatisfaction. Motivator factors such as
recognition and satisfaction with work promote a satisfying and enriched
work environment. Transformational leaders use motivator factors
liberally to inspire work performance and increase job satisfaction.
PTS: 1
TOP: AONE competency: Communication and Relationship-Building
The nurse manager wants to increase motivation by providing
7.
motivating factors for the nurse on the unit. What action would be
