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