Test Bank For Yoder-Wise’s Leading And Managing
In Canadian Nursing, 2nd Edition,
Patricia S. Yoder-Wise, Chapters 1 - 32
, TEST BANK FOR YODER-WISE’S LEADING AND MANAGING IN CANADIAN NURSING, 2ND
EDITION, PATRICIA S. YODER-WISE, JANICE WADDELL, NANCY WALTON,
ISBN: 9781771721684,
ISBN: 9781771721745,
ISBN: 9781771721677
Table of Contents
Part I: Core Concepts
Overview
1. Leading, Managing, and Following
2. Developing the Role of Leader
3. Developing the Role of Manager
4. Nursing Leadership and Indigenous Health
5. Patient Focus
Context
6. Ethical Issues
7. Legal Issues
8. Making Decisions and Solving Problems
9. Health Care Organizations
10. Understanding and Designing Organizational Structures
11. Cultural Diversity in Health Care
12. Power, Politics, and Influence
Part II: Managing Resources
13. Caring, Communicating, and Managing with Technology
14. Managing Costs and Budgets
15. Care Delivery Strategies
16. Staffing and Scheduling (available only on Evolve)
17. Selecting, Developing, and Evaluating Staff (available only on Evolve)
,Part III: Changing the Status Quo
18. Strategic Planning, Goal-Setting, and Marketing
19. Nurses Leading Change: A Relational Emancipatory Framework for Health and Social
Action
20. Building Teams Through Communication and Partnerships
21. Collective Nursing Advocacy
22. Understanding Quality, Risk, and Safety
23. Translating Research into Practice
Part IV: Interpersonal and Personal Skills
Interpersonal
24. Understanding and Resolving Conflict
25. Managing Personal/Personnel Problems
26. Workplace Violence and Incivility
27. Inter and Intraprofessional Practice and Leading in Professional Practice Settings
Personal
28. Role Transition
29. Self-Management: Stress and Time
Future
30. Thriving for the Future
31. Leading and Managing Your Career
32. Nursing Students as Leaders
,Chapter 01: Leading, Managing, and Following
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Second
Edition
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 older adult patients.
According to complexity principles, what would be the best approach to take in making 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.
ANSWER: 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,
everybody’s opinion counts; therefore, all levels of staff would be involved in decision
making.
DIF: Cognitive Level: Apply REF: Page 14
TOP: Nursing Process: Implementation
.T
2. A unit manager of a 25-bed medical/surgical areaO
U S N 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. In the practice of a strengths-based nursing leader, 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.
ANSWER: D
Placing the nurse on unpaid leave may threaten physiologic needs and demotivate the nurse.
Unsatisfactory coverage of shifts on short notice could affect patient care and threaten staff
members’ sense of competence. Strengths-based nurse leaders honour the uniqueness of
individuals, teams, systems, and organizations; therefore arranging the schedule around the
wife’s needs would result in a win-win situation, also creating a work environment that
promotes the health of all the nurses and facilitates their development.
DIF: Cognitive Level: Analyze REF: Page 6
TOP: Nursing Process: Implementation
,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 so as to clarify issues.
c. Ask each party to examine her own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the
conflict.
ANSWER: C
Nurses and leaders must assess each situation as unique, determining appropriate actions
accordingly. Leaders must adapt their styles to complement specific issues being faced, such
as conflict. Examining motives and issues for the conflict in perceptions promotes equal
representation of each point of view.
DIF: Cognitive Level: Apply REF: Pages 11–13
TOP: Nursing Process: Implementation
4. Shortly after being informed of fetal death, a labouring woman asks why she is not able to
hear her baby’s heartbeat on the monitor anymore. Although the monitor volume had been
turned off so that the patient would be able to sleep between contractions, the nurse responded
that there was no heartbeat to hear because the baby had died in utero; then the nurse asked
whether the patient would like to talk about how she was feeling. This response demonstrates:
a. Lack of empathy.
b. Ethical leadership.
c. Complexity science. .
d. A coercive relationship.
ANSWER: B
Ethical leadership is based on a willingness to identify and act on complex problems in an
ethical manner. Leadership can be misused when coercive relationships form, and information
and true goals are withheld.
DIF: Cognitive Level: Analyze REF: Page 7
TOP: Nursing Process: Implementation
5. The manager of a surgical area envisions a future that requires the addition of registered nurse
(RN) assistants or unlicensed persons to feed, bathe, and walk patients. The RNs on the staff
have always practiced in a primary nursing-delivery system and are very resistant to this idea.
The best initial strategy in this situation would include:
a. Exploring the values of the RNs in relation to this change.
b. Leaving the RNs alone for a time so they can think about the change before they
are approached again.
c. Dropping the idea and trying for the change in another year or so.
d. Hiring the assistants and allowing the RNs to see what good additions they are.
ANSWER: A
, Leadership involves engaged decision making around a vision that is based on evidence and
tacit knowledge. Influencing others requires emotional intelligence in domains such as
empathy and handling relationships.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
6. As the charge nurse on the night shift in a small long-term care facility, you have found that
there is little turnover among your licensed practical nurse and nursing assistant (NA) staff
members, but they are not very motivated to work beyond their job descriptions. 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 licensed practical nurses and NAs.
b. Allow the licensed practical nurses and NAs greater decision-making power within
the scope of their positions in the institution.
c. Help the licensed practical nurses and NAs with their work, whenever possible.
d. Ask the director of nursing to increase job security for night staff by having them
sign contracts that guarantee work.
ANSWER: B
A nurse leader should provide an environment conducive to opinion sharing that involves staff
in decision making at all levels. This approach is shown to increase job satisfaction. Decision
making and the corresponding actions taken are core tasks performed in engagement with
coworkers.
DIF: Cognitive Level: Apply REF: Page 7
NentR
TOP: Nursing Process: Implem ationI
7.
8. As the nurse manager, you want to increase motivation by providing motivating factors.
Which action would you select?
a. Collaborate with the human resources/personnel department to develop on-site
daycare services.
b. Provide a hierarchical organizational structure.
c. Implement a model of shared governance.
d. Promote the development of a flexible benefits package.
ANSWER: C
Complexity theory suggests that systems interact and adapt and that decision making occurs
throughout systems, as opposed to being made unilaterally by different levels of the
organizational hierarchy. In complexity theory, every person’s opinion counts, and therefore
all levels of staff would be involved in decision making. This principle underlies shared
governance. Shared governance is an example of nurse decision making in which nurses at
different organizational levels engage in shaping policy and practices.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
, 9. A charge nurse on a busy 40-bed medical/surgical unit is approached by a patient’s son, who
begins to complain loudly about the quality of care his mother is receiving. His behaviour is
so disruptive that it is overheard by staff, physicians, and other visitors. The family member
rejects any attempt to intervene therapeutically to resolve the issue. He leaves the unit
abruptly, and the nurse is left feeling frustrated. Which behaviour by the charge nurse best
illustrates refined leadership skills in an emotionally intelligent practitioner?
a. Reflection to obtain insight into how the situation could be handled differently in
the future
b. Trying to catch up with the angry family member to resolve the concern
c. Discussing the concern with the patient after the family member has left
d. Notifying nursing administration of the situation
ANSWER: A
Emotional intelligence is closely aligned with individuals’ capacity to know themselves and
others. Reflecting to obtain insight and being able to “step” outside the situation to envision
the context of what is happening is an example of the actions of an emotionally intelligent
practitioner.
DIF: Cognitive Level: Apply REF: Page 8
TOP: Nursing Process: Implementation
10. The chief nursing officer has asked the staff development coordinator to facilitate the
development of a clinical competency program for the facility. While making rounds on the
units, the staff development coordinator overhears RN staff complaining that they believe it is
insulting to be required to participate in a competency program. Which behaviour by the staff
development coordinator is most appropriate in this situation?
a. Disregard staff concerns N andR conI
tinuGe wB
ith.dCeveMlopment of the program.
U S N T
b. Inform the nurses that this program is a requirement for accreditation by the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO).
c. Schedule a meeting with the chief nurse executive to apprise her of the situation.
d. Facilitate a meeting so nurses can articulate their values and concerns about a
competency program.
ANSWER: D
The manager role involves guiding other people through a set of derived practices that are
evidence-informed and known to satisfy pre-established outcomes such as participation in a
competency program. This involves engagement of staff through sharing of concerns and
ideas. This type of leader can instill hope and trust in followers, which influence their
behaviours and attitudes (such as engagement and satisfaction) and cause work environments
to become more positive.
DIF: Cognitive Level: Apply REF: Pages 11–13
TOP: Nursing Process: Implementation
11. Which category is unique to leadership but is not part of management?
a. Initiating change
b. Personal qualities
c. Developing people
d. Information management
, ANSWER: C
Developing people—coaching, mentoring, succession planning—is a category of solely
leadership, not management. Initiating change and personal qualities are categories of both
management and leadership. Information management is a category of management only.
DIF: Cognitive Level: Understand REF: Page 17
TOP: Nursing Process: Assessment
12. You overhear a newly graduated RN telling one of your colleagues that leadership and
management belong to the unit manager and not to her. Because you are a nursing colleague,
your response demonstrates understanding that the perception of the new graduate:
a. Is accurately reflected in the new graduate’s statement.
b. Would benefit from further understanding of her role as a professional in relation
to decision-making.
c. Has been influenced by nurse leaders and managers who leave for other positions.
d. Is related to the general perception that nurse leaders and managers are not
satisfied in their jobs.
ANSWER: B
Decision making and the corresponding actions taken are the core work performed in
engagement with co-workers. This core work requires that nurses be leaders, managers, and
followers at the point-of-care, unit, institutional, and even societal levels.
DIF: Cognitive Level: Understand REF: Page 7 TOP: Nursing Process: Evaluation
13. You walk into a patient’s room and find him yelling at the licensed practical nurse. The
patient is obviously very upset, and after you speak with him regarding his behaviour, you
NUforRSthre
determine that he has not slept INe GniTghts
B.C beO
cause of unrelieved pain levels. The licensed
practical nurse is very upset with him and calls him an “ugly, old man.” You acknowledge her
feelings and concerns and then suggest that the patient’s behaviour was aggressive but is
related to lack of sleep and to pain. You ask, “Can both you and the patient together determine
triggers for the pain and effective approaches to controlling his pain?” This approach
demonstrates:
a. Lack of empathy and understanding for the licensed practical nurse.
b. Concern with placating the patient.
c. Leadership behaviour.
d. Management behaviour.
ANSWER: C
The situation between the patient and the licensed practical nurse is complex, involving
unrelieved symptoms and aggressiveness toward a staff member. Health care is now delivered
in a collaborative, and most often, an interdisciplinary manner, whereby select
leadership/management roles (e.g., first-line nurse leaders) serve as conduits for information
and care coordination. Providing engaged, collaborative guidance and decision making in a
complex situation for which there is no standardized solution reflects leadership.
DIF: Cognitive Level: Apply REF: Page 7
TOP: Nursing Process: Implementation
14. Which category is unique to management but is not part of leadership?
, a. Initiating change
b. Personal qualities
c. Developing people
d. Information management
ANSWER: D
Information management is a category of management only. Developing people is a category
of solely leadership, not management. Initiating change and personal qualities are categories
of both management and leadership.
DIF: Cognitive Level: Understand REF: Page 15
TOP: Nursing Process: Assessment
15. Chart audits have revealed significant omissions of data that could have legal and funding
guidelines. As the unit manager, you meet with the staff to discuss audit findings and to find
approaches that will address the gaps in charting and achieve desired goals. This is an
example of:
a. Leadership.
b. Management.
c. Decision making.
d. Vision.
ANSWER: B
The process of guiding other people to meet established goals, outcomes, and procedures is
management. This can require collaborative decision making to determine how best to reach
predetermined goals and follow established practices.
N R INGRTEB
DIF: Cognitive Level: Apply U S
.C geMs 6–7
F: PaO
TOP: Nursing Process: Implementation
16. A family is keeping vigil at a critically ill patient’s bedside. Other distant family members, not
yet able to come, call the unit continuously, asking for updates and wanting to express
concern. You speak with the distant family members and suggest that you are going to refer
them to the hospital social worker, whose role is to work with such situations. What role are
you assuming through this action?
a. Manager
b. Leader
c. Follower
d. Laissez faire
ANSWER: A
Management is the process of getting the job done and ensuring that people have the
necessary resources to get the job done. Referral to a social worker alleviates demand on nurse
staff time and is consistent with hospital procedures.
DIF: Cognitive Level: Apply REF: Page 6
TOP: Nursing Process: Implementation
17. After a meeting with members of the family of a dying patient, the nursing manager discusses
with you the family’s desired approach to care, and you support the manager’s decision. Your
actions indicate that you are acting in what role?
, a. Leadership
b. Management
c. Followership
d. Evidence-informed
ANSWER: C
Followership is engaging with other people who are leading or managing by contributing to
the work that needs to be done. By accepting and implementing the desired approach to care
direction given by the manager in response to your concerns, you are demonstrating
followership.
DIF: Cognitive Level: Analyze REF: Page 7
TOP: Nursing Process: Implementation
18. You pull staff together to assess a situation in which the family of a seriously ill patient is
anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning
of treatment decisions. Staff members are beginning to distance themselves from the family.
After inviting the concerns of staff, you explain that the organization values patient-centred
care and suggest that evidence indicates that acting as an advocate and a listener is helpful to
families. You ask the staff for ideas as to strategies that are effectively patient-centred in these
situations. In this situation, you are taking on which role?
a. Leadership
b. Management
c. Follower
d. Visionary
ANSWER: A .U S N T O
Leadership is the process of engaging and influencing others. Strong leaders are associated
with words such as visionary, energetic, inspirational, and innovative; they go beyond the
status quo to make a difference for others. As a leader, you engage other people in decision
making that moves them toward a goal with a reasonable level of risk taking.
DIF: Cognitive Level: Apply REF: Page 7
TOP: Nursing Process: Implementation
19. Marie-Claire, the nursing unit manager, finds it difficult to work with Thomas, a new
graduate. Thomas has many ideas and his manner of presenting them irks Marie-Claire. After
reflection and discussion with others, Marie-Claire recognizes that she also feels threatened by
his behaviour. She comes to understand that Thomas is trying to establish his own role on the
unit, is not trying to challenge her, and needs guidance, coaching, and affirmation.
Marie-Claire is demonstrating
a. A positive self-concept.
b. Deepening self-awareness.
c. Leadership.
d. Acquiescence.
ANSWER: B
Individuals demonstrate emotional intelligence by raising their self-awareness and better
regulating their emotions. Being empathetic and showing sensitivity to the experiences of
others help nurse leaders develop their emotional intelligence.
In Canadian Nursing, 2nd Edition,
Patricia S. Yoder-Wise, Chapters 1 - 32
, TEST BANK FOR YODER-WISE’S LEADING AND MANAGING IN CANADIAN NURSING, 2ND
EDITION, PATRICIA S. YODER-WISE, JANICE WADDELL, NANCY WALTON,
ISBN: 9781771721684,
ISBN: 9781771721745,
ISBN: 9781771721677
Table of Contents
Part I: Core Concepts
Overview
1. Leading, Managing, and Following
2. Developing the Role of Leader
3. Developing the Role of Manager
4. Nursing Leadership and Indigenous Health
5. Patient Focus
Context
6. Ethical Issues
7. Legal Issues
8. Making Decisions and Solving Problems
9. Health Care Organizations
10. Understanding and Designing Organizational Structures
11. Cultural Diversity in Health Care
12. Power, Politics, and Influence
Part II: Managing Resources
13. Caring, Communicating, and Managing with Technology
14. Managing Costs and Budgets
15. Care Delivery Strategies
16. Staffing and Scheduling (available only on Evolve)
17. Selecting, Developing, and Evaluating Staff (available only on Evolve)
,Part III: Changing the Status Quo
18. Strategic Planning, Goal-Setting, and Marketing
19. Nurses Leading Change: A Relational Emancipatory Framework for Health and Social
Action
20. Building Teams Through Communication and Partnerships
21. Collective Nursing Advocacy
22. Understanding Quality, Risk, and Safety
23. Translating Research into Practice
Part IV: Interpersonal and Personal Skills
Interpersonal
24. Understanding and Resolving Conflict
25. Managing Personal/Personnel Problems
26. Workplace Violence and Incivility
27. Inter and Intraprofessional Practice and Leading in Professional Practice Settings
Personal
28. Role Transition
29. Self-Management: Stress and Time
Future
30. Thriving for the Future
31. Leading and Managing Your Career
32. Nursing Students as Leaders
,Chapter 01: Leading, Managing, and Following
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Second
Edition
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 older adult patients.
According to complexity principles, what would be the best approach to take in making 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.
ANSWER: 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,
everybody’s opinion counts; therefore, all levels of staff would be involved in decision
making.
DIF: Cognitive Level: Apply REF: Page 14
TOP: Nursing Process: Implementation
.T
2. A unit manager of a 25-bed medical/surgical areaO
U S N 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. In the practice of a strengths-based nursing leader, 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.
ANSWER: D
Placing the nurse on unpaid leave may threaten physiologic needs and demotivate the nurse.
Unsatisfactory coverage of shifts on short notice could affect patient care and threaten staff
members’ sense of competence. Strengths-based nurse leaders honour the uniqueness of
individuals, teams, systems, and organizations; therefore arranging the schedule around the
wife’s needs would result in a win-win situation, also creating a work environment that
promotes the health of all the nurses and facilitates their development.
DIF: Cognitive Level: Analyze REF: Page 6
TOP: Nursing Process: Implementation
,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 so as to clarify issues.
c. Ask each party to examine her own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the
conflict.
ANSWER: C
Nurses and leaders must assess each situation as unique, determining appropriate actions
accordingly. Leaders must adapt their styles to complement specific issues being faced, such
as conflict. Examining motives and issues for the conflict in perceptions promotes equal
representation of each point of view.
DIF: Cognitive Level: Apply REF: Pages 11–13
TOP: Nursing Process: Implementation
4. Shortly after being informed of fetal death, a labouring woman asks why she is not able to
hear her baby’s heartbeat on the monitor anymore. Although the monitor volume had been
turned off so that the patient would be able to sleep between contractions, the nurse responded
that there was no heartbeat to hear because the baby had died in utero; then the nurse asked
whether the patient would like to talk about how she was feeling. This response demonstrates:
a. Lack of empathy.
b. Ethical leadership.
c. Complexity science. .
d. A coercive relationship.
ANSWER: B
Ethical leadership is based on a willingness to identify and act on complex problems in an
ethical manner. Leadership can be misused when coercive relationships form, and information
and true goals are withheld.
DIF: Cognitive Level: Analyze REF: Page 7
TOP: Nursing Process: Implementation
5. The manager of a surgical area envisions a future that requires the addition of registered nurse
(RN) assistants or unlicensed persons to feed, bathe, and walk patients. The RNs on the staff
have always practiced in a primary nursing-delivery system and are very resistant to this idea.
The best initial strategy in this situation would include:
a. Exploring the values of the RNs in relation to this change.
b. Leaving the RNs alone for a time so they can think about the change before they
are approached again.
c. Dropping the idea and trying for the change in another year or so.
d. Hiring the assistants and allowing the RNs to see what good additions they are.
ANSWER: A
, Leadership involves engaged decision making around a vision that is based on evidence and
tacit knowledge. Influencing others requires emotional intelligence in domains such as
empathy and handling relationships.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
6. As the charge nurse on the night shift in a small long-term care facility, you have found that
there is little turnover among your licensed practical nurse and nursing assistant (NA) staff
members, but they are not very motivated to work beyond their job descriptions. 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 licensed practical nurses and NAs.
b. Allow the licensed practical nurses and NAs greater decision-making power within
the scope of their positions in the institution.
c. Help the licensed practical nurses and NAs with their work, whenever possible.
d. Ask the director of nursing to increase job security for night staff by having them
sign contracts that guarantee work.
ANSWER: B
A nurse leader should provide an environment conducive to opinion sharing that involves staff
in decision making at all levels. This approach is shown to increase job satisfaction. Decision
making and the corresponding actions taken are core tasks performed in engagement with
coworkers.
DIF: Cognitive Level: Apply REF: Page 7
NentR
TOP: Nursing Process: Implem ationI
7.
8. As the nurse manager, you want to increase motivation by providing motivating factors.
Which action would you select?
a. Collaborate with the human resources/personnel department to develop on-site
daycare services.
b. Provide a hierarchical organizational structure.
c. Implement a model of shared governance.
d. Promote the development of a flexible benefits package.
ANSWER: C
Complexity theory suggests that systems interact and adapt and that decision making occurs
throughout systems, as opposed to being made unilaterally by different levels of the
organizational hierarchy. In complexity theory, every person’s opinion counts, and therefore
all levels of staff would be involved in decision making. This principle underlies shared
governance. Shared governance is an example of nurse decision making in which nurses at
different organizational levels engage in shaping policy and practices.
DIF: Cognitive Level: Apply REF: Page 5
TOP: Nursing Process: Implementation
, 9. A charge nurse on a busy 40-bed medical/surgical unit is approached by a patient’s son, who
begins to complain loudly about the quality of care his mother is receiving. His behaviour is
so disruptive that it is overheard by staff, physicians, and other visitors. The family member
rejects any attempt to intervene therapeutically to resolve the issue. He leaves the unit
abruptly, and the nurse is left feeling frustrated. Which behaviour by the charge nurse best
illustrates refined leadership skills in an emotionally intelligent practitioner?
a. Reflection to obtain insight into how the situation could be handled differently in
the future
b. Trying to catch up with the angry family member to resolve the concern
c. Discussing the concern with the patient after the family member has left
d. Notifying nursing administration of the situation
ANSWER: A
Emotional intelligence is closely aligned with individuals’ capacity to know themselves and
others. Reflecting to obtain insight and being able to “step” outside the situation to envision
the context of what is happening is an example of the actions of an emotionally intelligent
practitioner.
DIF: Cognitive Level: Apply REF: Page 8
TOP: Nursing Process: Implementation
10. The chief nursing officer has asked the staff development coordinator to facilitate the
development of a clinical competency program for the facility. While making rounds on the
units, the staff development coordinator overhears RN staff complaining that they believe it is
insulting to be required to participate in a competency program. Which behaviour by the staff
development coordinator is most appropriate in this situation?
a. Disregard staff concerns N andR conI
tinuGe wB
ith.dCeveMlopment of the program.
U S N T
b. Inform the nurses that this program is a requirement for accreditation by the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO).
c. Schedule a meeting with the chief nurse executive to apprise her of the situation.
d. Facilitate a meeting so nurses can articulate their values and concerns about a
competency program.
ANSWER: D
The manager role involves guiding other people through a set of derived practices that are
evidence-informed and known to satisfy pre-established outcomes such as participation in a
competency program. This involves engagement of staff through sharing of concerns and
ideas. This type of leader can instill hope and trust in followers, which influence their
behaviours and attitudes (such as engagement and satisfaction) and cause work environments
to become more positive.
DIF: Cognitive Level: Apply REF: Pages 11–13
TOP: Nursing Process: Implementation
11. Which category is unique to leadership but is not part of management?
a. Initiating change
b. Personal qualities
c. Developing people
d. Information management
, ANSWER: C
Developing people—coaching, mentoring, succession planning—is a category of solely
leadership, not management. Initiating change and personal qualities are categories of both
management and leadership. Information management is a category of management only.
DIF: Cognitive Level: Understand REF: Page 17
TOP: Nursing Process: Assessment
12. You overhear a newly graduated RN telling one of your colleagues that leadership and
management belong to the unit manager and not to her. Because you are a nursing colleague,
your response demonstrates understanding that the perception of the new graduate:
a. Is accurately reflected in the new graduate’s statement.
b. Would benefit from further understanding of her role as a professional in relation
to decision-making.
c. Has been influenced by nurse leaders and managers who leave for other positions.
d. Is related to the general perception that nurse leaders and managers are not
satisfied in their jobs.
ANSWER: B
Decision making and the corresponding actions taken are the core work performed in
engagement with co-workers. This core work requires that nurses be leaders, managers, and
followers at the point-of-care, unit, institutional, and even societal levels.
DIF: Cognitive Level: Understand REF: Page 7 TOP: Nursing Process: Evaluation
13. You walk into a patient’s room and find him yelling at the licensed practical nurse. The
patient is obviously very upset, and after you speak with him regarding his behaviour, you
NUforRSthre
determine that he has not slept INe GniTghts
B.C beO
cause of unrelieved pain levels. The licensed
practical nurse is very upset with him and calls him an “ugly, old man.” You acknowledge her
feelings and concerns and then suggest that the patient’s behaviour was aggressive but is
related to lack of sleep and to pain. You ask, “Can both you and the patient together determine
triggers for the pain and effective approaches to controlling his pain?” This approach
demonstrates:
a. Lack of empathy and understanding for the licensed practical nurse.
b. Concern with placating the patient.
c. Leadership behaviour.
d. Management behaviour.
ANSWER: C
The situation between the patient and the licensed practical nurse is complex, involving
unrelieved symptoms and aggressiveness toward a staff member. Health care is now delivered
in a collaborative, and most often, an interdisciplinary manner, whereby select
leadership/management roles (e.g., first-line nurse leaders) serve as conduits for information
and care coordination. Providing engaged, collaborative guidance and decision making in a
complex situation for which there is no standardized solution reflects leadership.
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TOP: Nursing Process: Implementation
14. Which category is unique to management but is not part of leadership?
, a. Initiating change
b. Personal qualities
c. Developing people
d. Information management
ANSWER: D
Information management is a category of management only. Developing people is a category
of solely leadership, not management. Initiating change and personal qualities are categories
of both management and leadership.
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TOP: Nursing Process: Assessment
15. Chart audits have revealed significant omissions of data that could have legal and funding
guidelines. As the unit manager, you meet with the staff to discuss audit findings and to find
approaches that will address the gaps in charting and achieve desired goals. This is an
example of:
a. Leadership.
b. Management.
c. Decision making.
d. Vision.
ANSWER: B
The process of guiding other people to meet established goals, outcomes, and procedures is
management. This can require collaborative decision making to determine how best to reach
predetermined goals and follow established practices.
N R INGRTEB
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F: PaO
TOP: Nursing Process: Implementation
16. A family is keeping vigil at a critically ill patient’s bedside. Other distant family members, not
yet able to come, call the unit continuously, asking for updates and wanting to express
concern. You speak with the distant family members and suggest that you are going to refer
them to the hospital social worker, whose role is to work with such situations. What role are
you assuming through this action?
a. Manager
b. Leader
c. Follower
d. Laissez faire
ANSWER: A
Management is the process of getting the job done and ensuring that people have the
necessary resources to get the job done. Referral to a social worker alleviates demand on nurse
staff time and is consistent with hospital procedures.
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TOP: Nursing Process: Implementation
17. After a meeting with members of the family of a dying patient, the nursing manager discusses
with you the family’s desired approach to care, and you support the manager’s decision. Your
actions indicate that you are acting in what role?
, a. Leadership
b. Management
c. Followership
d. Evidence-informed
ANSWER: C
Followership is engaging with other people who are leading or managing by contributing to
the work that needs to be done. By accepting and implementing the desired approach to care
direction given by the manager in response to your concerns, you are demonstrating
followership.
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18. You pull staff together to assess a situation in which the family of a seriously ill patient is
anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning
of treatment decisions. Staff members are beginning to distance themselves from the family.
After inviting the concerns of staff, you explain that the organization values patient-centred
care and suggest that evidence indicates that acting as an advocate and a listener is helpful to
families. You ask the staff for ideas as to strategies that are effectively patient-centred in these
situations. In this situation, you are taking on which role?
a. Leadership
b. Management
c. Follower
d. Visionary
ANSWER: A .U S N T O
Leadership is the process of engaging and influencing others. Strong leaders are associated
with words such as visionary, energetic, inspirational, and innovative; they go beyond the
status quo to make a difference for others. As a leader, you engage other people in decision
making that moves them toward a goal with a reasonable level of risk taking.
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19. Marie-Claire, the nursing unit manager, finds it difficult to work with Thomas, a new
graduate. Thomas has many ideas and his manner of presenting them irks Marie-Claire. After
reflection and discussion with others, Marie-Claire recognizes that she also feels threatened by
his behaviour. She comes to understand that Thomas is trying to establish his own role on the
unit, is not trying to challenge her, and needs guidance, coaching, and affirmation.
Marie-Claire is demonstrating
a. A positive self-concept.
b. Deepening self-awareness.
c. Leadership.
d. Acquiescence.
ANSWER: B
Individuals demonstrate emotional intelligence by raising their self-awareness and better
regulating their emotions. Being empathetic and showing sensitivity to the experiences of
others help nurse leaders develop their emotional intelligence.
