TEST BANK For Leading and Managing in Nursing, 8th Edition by Patricia S. Yoder-Wise, Susan Sportsman| Verified Chapter's 1 - 30 | Complete

,Chapter 01: Leading, Managing, and Following
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Yoder-Wise: Leading and Managing in Nursing, 8th Edition
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MULTIPLE CHOICE x@




1. A nurse manager of a 20-
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bed medical unit finds that 80% of the patients are older adults. She is asked to asses
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s and adapt the unit to better meet the unique needs of the older adult patient. Using
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complexity principles, what would be the best approach to take for implementation of
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@this change? x@


a. Leverage the hierarchical management position to get unit staff involve
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d 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 comm
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unity environment. x@


d. Hire a geriatric specialist to oversee and control the project.
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ANS: B x @


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 complexit
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y theory, every voice counts, and therefore, all levels of staff would be involved in d
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ecision making. x@




TOP: AONE competency: Communication and Relationship-Building
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2. A unit manager of a 25-
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bed medical/surgical area receives a phone call from a nurse whohas called in sick fi
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ve times in the past month. He tells the manager that he very much wants to come
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to work when scheduled but must often care for his wife, who is undergoing treatme
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nt for breast cancer. According to Maslow‘s need hierarchy theory, what would be th
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e best 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 hissche
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duled days off around his wife‘s treatments.
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ANS: D x @


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 coul
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d affect patient care and threaten the needs of staff to feel competent. Arranging the s
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chedule around the wife‘s needs meets the needs of the staff and of patients while sat
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isfying 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 t
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he 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 w
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ould 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 abo
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ut the conflict.
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ANS: C x@


For resolution of conflict, one should address the interests and involvement of participan
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ts 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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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 x@


Part of leadership is understanding conflict resolution and ability to negotiate and manag
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e 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 i
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s 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 have always practiced in a primary nursing-
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delivery system and are very resistant to this idea. What would be the best initial strat
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egy for implementation 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 bef
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ore it is implemented x@ x@ x@


c. Dropping the idea and trying for the change in a year or so when som
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e 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 x@


Influencing others requires emotional intelligence in domains such as empathy, handlin
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g relationships, deepening self-
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awareness in self and others, motivating others, and managing emotions. Motivating ot
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hers recognizes that values are powerful forces that influence acceptance of change. Le
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aving the RNs alone for a period of time before implementation does not provide oppor
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tunity to explore different perspectives and values. Avoiding discussion until the team
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changes may not promote adoption of the change until there is opportunity to explore
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perspectives and values related to the change. Hiring of the assistants demonstrates lac
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k of empathy for the perspectives of 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-
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term care facility, you‘ve found that there is little turnover among your LPN and nurs
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ing assistant (NA) staff members, but they are not very motivated to go beyond their
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@job descriptions in their work. Which of the following strategies might motivate the
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staff and lead to greater job satisfaction?
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a. Ask the director of nursing to offer higher wages and bonuses for extra w
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ork for the night LPNs and NAs.
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b. Allow the LPNs and NAs greater decision-
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making power within the scope of their positions in the institution.
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c. Hire additional staff so that there are more staff available for enhanced ca
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re, and individual workloads are lessened.
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d. Ask the director of nursing to increase job security for night staff by havin
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g them sign contracts that guarantee work.
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ANS: B x@


Hygiene factors such as salary, working conditions, and security are consistent with He
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rzberg‘s two- x@


factor theory of motivation; meeting these needs avoids job dissatisfaction. Motivator f
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actors such as recognition and satisfaction with work promote a satisfying and enriched
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work environment. Transformational leaders use motivator factors liberally to inspire wo
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rk 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 th
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enurse 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. x@ x@


b. Provide a hierarchical organizational structure.
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c. Implement a model of shared governance. x@ x@ x@ x@ x@


d. Promote the development of a flexible benefits package.
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ANS: C x@


Complexity theory suggests that systems interact and adapt and that decision making occ
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urs throughout systems, as opposed to being held in a hierarchy. In complexity theory,
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every voice counts, and therefore all levels of staff would be involved in decision m
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aking. This principle is the foundation of shared governance.
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TOP: AONE competency: Communication and Relationship-Building
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8. The nurse manager has been asked to implement an evidence-
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based approach to teach ostomy patients self-
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management skills postoperatively. The program is to be implemented across the entire
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@facility. What illustrates effective leadership in this situation?
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a. The training modules are left in the staff room for times when staff are available.
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b. The current approach is continued because it is also evidence-
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based and is more familiar to staff.
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c. You decide to implement the approach at a later date because of feedback fr
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om the RNs that the new approach takes too much time.
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d. An RN who is already familiar with the new approach of volunteers to t
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ake the lead in mentoring and teaching others how to implement it.
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ANS: D x@