NURS 3325 LEADING AND MANAGING IN NURSING CORRECT QUESTIONS AND ANSWERS 100%

. 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 her 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. - ANSWERS-ANS: C Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to address the interests and involvement of participants in the conflict by examining the real issues of all parties. REF: Page 17 .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 in making this change? - ANSWERS-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 .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. - ANSWERS-ANS: 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 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. REF: Page 10 .4. At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. It would now be best to: a. Arrange another meeting in a week's time so as to allow a cooling-off period. b. Turn the dispute over to the director of nursing. c. Insist that participants continue to talk until a resolution has been reached. d. Back the unit manager's actions and end the dispute. - ANSWERS-ANS: B According to the principles outlined by Ury, Brett, and Goldberg, a "cooling-off" period is recommended if resolution fails. REF: Page 17 .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 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 RN group in relationship 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. - ANSWERS-ANS: 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. REF: Pages 6, 7 .A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior 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 behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner? a. Reflect to gain insight into how the situation could be handled differently in the future. b. Try to catch up with the angry family member to resolve the concern. c. Discuss the concern with the patient after the family member has left. d. Notify nursing administration of the situation. - ANSWERS-A .A client refuses a simple procedure that you believe is in the client's best interest. The two ethical principles that are directly in conflict in such a situation are: a. Fidelity and justice. b. Veracity and fidelity. c. Autonomy and beneficence. d. Paternalism and respect for others. - ANSWERS-C .A client requires an appendectomy. The surgeon explains the procedure and asks the client to sign the consent. The patient speaks very little English and looks worried. As a nurse, you would: a. Suggest that an interpreter explain the procedure to the client and answer any questions. b. Ask the client if he has any questions. c. Draw a picture to show the incision. d. Not intervene. - ANSWERS-A .A clinic nurse has observed another nurse deviating from agency policy in performing wound care. The best approach for the clinic nurse to take is to: a. Stay out of it. b. Inform the nursing supervisor. c. Fill out a notification form (incident report). d. Assess the risk to the client and the agency before proceeding. - ANSWERS-D .A colleague asks you to give her your password access so that she can view her partner's healthcare record. This request violates the patient's right to: a. Privacy. b. Confidentiality. c. Undue authorization of treatment. d. Protection against slander. - ANSWERS-A .A dispute arises between an RN staff member and an LPN over a patient issue. The tension between the two begins to affect other staff members, who are drawn into the conflict; eventually, the team becomes polarized toward either the RN or the LPN. This situation might have been prevented through: a. Expediency in responding to the initial dispute, once it became apparent that it could not be resolved by the two parties themselves. b. Asking other staff members what the real issues were in the dispute between the RN and the LPN. c. Reassigning one of the parties to another unit when it became apparent that the two individuals could not resolve the dispute themselves. d. Calling a staff meeting at the onset of the dispute to allow the team and the RN and LPN to discuss the initial dispute. - ANSWERS-A .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 - ANSWERS-A .A good nursing decision maker is one who: a. Uses various models to guide the process based on the circumstances of the situation. b. Adopts one model and uses it to guide all decision making. c. Decides not to use any models because they are all useless. d. Develops a new model each time a decision has to be made. - ANSWERS-A .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 her 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. - ANSWERS-C .A group of managers is meeting to discuss ideas related to the successful implementation of evidence-based practice on their units. Susan has been asked by the director of care to assume leadership of these discussion groups. After two such sessions, Susan expresses disappointment to her mentor that the group seems disinterested in her ideas and that they are listening to Ken, who has much less experience with leadership. In discussing this with Susan, the mentor understands that leadership: a. Is a designated role. b. Must be earned. c. Is more likely to be taken by someone who is more talkative. d. Rarely is taken over by someone with less experience. - ANSWERS-B .A hospital and a nursing education program form a partnership to recruit more nurses to the region. This organizational structure is: a. Being responsive to changes in the environment. b. Being bureaucratic. c. Creating permanent professional boundaries. d. Delineating structures for all decision making. - ANSWERS-A .A hospital is working toward becoming a Magnet™ hospital. The chief nursing officer is aware that professional nursing departments of the future will: a. Not be directed by nurses. b. Be virtual organizations. c. Be designed to maintain nursing standards of practice. d. Be entitled to have client care departments. - ANSWERS-C .A logical response to the final step of the STAR Approach to Patient Safety might be to: a. Seek further learning. b. Finish the care that was started. c. Think about what needs to be done. d. Concentrate on the task at hand. - ANSWERS-A .A manager relies on his director (immediate supervisor) for advice about enrolling in graduate school to prepare for a career as a nurse executive. The director may exercise what kinds of power in the relationship with the manager in this advisory situation? a. Expert, coercive, and referent b. Reward, connection, and information c. Referent, expert, and information d. Reward, referent, and information - ANSWERS-C .A manager who is concerned with ensuring that patients on her surgical unit have the necessary information to make informed choices is: a. Practicing legal nursing care. b. Demonstrating respect for patient rights. c. Avoiding risks. d. Likely experiencing issues with informed consent. - ANSWERS-B .A new director of nursing in a small rural hospital wants to make changes from the traditional model of governance to a shared-governance model. Select the characteristic below that best describes the traditional organizational structure in which a staff nurse is assigned to carry out nursing tasks for clients but is not given the chance to provide input into forming the policies and procedures by which care is delivered or the standards by which care is evaluated: a. Bureaucratic b. Decentralized c. Delegated authority and responsibility d. Delegated responsibility but no authority - ANSWERS-D .A nurse belongs to several professional organizations, serving on a state-level committee of one group and on two task forces at work. The nurse is committed to a range of health issues. This nurse exemplifies which level of political activism in nursing? a. Gladiator b. Buy-in c. Self-interest d. Political sophistication - ANSWERS-D .A nurse executive is hired to restore a unit's productivity, which has decreased as the result of low staff morale. The nurse executive utilizes which of the following leadership principles? a. The leader sets the tone, which allows nurses to feel in control of the environment. b. If the staff members are not satisfied, they will insist on a different leader, who will get them what they want. c. Leaders at the national level who are seeking relief for nurses in the workplace are seen as the solution to the nursing shortage. d. Workplace satisfaction depends on staffing ratios, adequate pay, and tuition reimbursement, and these are things the leader can control. - ANSWERS-A .A nurse executive who considers herself a Baby Boomer will have the challenge of convincing the emerging workforce of the necessity of committee meetings. One of the primary reasons that the Baby Boom generation appears to have so many meetings in the work environment is that: a. They feel more comfortable in a group. b. They find that the journey to the solution is as important as the solution itself. c. They were deprived of collective action opportunities in the past and now feel that solutions are better when many people have input. d. Baby Boomers are aging and need the respite from work that meetings offer, so they can recuperate from the physical demands of the work environment. - ANSWERS-B .A nurse is participating in a baccalaureate course. For the class, she has to attend the legislative session regarding the new role of medication assistants. Nurses should be involved in shaping public policy primarily because: a. Involvement will enable nurses to take over the healthcare system at some point in the future. b. Other healthcare professions are less concerned about the essential needs of clients. c. Such activities are important career builders for nurses who seek top-level executive positions. d. They are closest to the front line of health care and see how it affects clients and families. - ANSWERS-D .A nurse manager has worked rapidly to bring the staff to accept changes in the unit's mission, so that downsizing can be avoided. This nurse manager is using quantum leadership by: a. Focusing on past concerns related to the mission. b. Teaching staff members how to self-manage themselves. c. Determining accurately the direction of change in the institution. d. Requiring all staff members to review and reinforce their technological skills. - ANSWERS-C .A nurse manager in a hospital is deeply concerned that senior administration makes decisions about budgetary directions that affect staffing and other resources without sharing the rationale for changes or demonstrating concern as to how these changes may affect patients or staff. She says she does not feel respected and is emotionally tired as a result. This situation represents: a. Bureaucratic organization. b. Realities of current healthcare. c. Negative organizational culture. d. Quantum leadership. - ANSWERS-D .A nurse manager is discussing with unit staff the repeated lack of staff compliance in documenting exercise activity for post-cardiac surgery clients. The unit's licensed practical/vocational nurses are responsible for ensuring that clients carry out the prescribed exercise regimen and that the activity is documented. Using Drucker's five basic functions of a manager, identify appropriate functions for the nurse manager to use when addressing this situation (select all that apply): a. Divide the necessary activities into manageable tasks, so clients adhere to the exercise regimen. b. Establish objectives and goals for each area and decide who is accountable for them. c. Allow clients to organize the activities. d. Engage in activities that motivate the team, and communicate effectively with the responsible staff members. e. Analyze, appraise, and interpret the performance of responsible staff, and communicate these f - ANSWERS-ABDE