,
,chapter 01: Leading, Managing, and Following
+j +j +j +j +j
Yoder-Wise: Leading and Managing in Nursing, 8th Edition +j +j +j +j +j +j +j
MULTIPLE CHOICE +j
1. A nurse manager of a 20-
+j +j +j +j +j
bed medical unit finds that 80% of the patients are older adults. She is asked to assess and ad
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
apt the unit to better meet the unique needs of the older adult patient. Using complexity princ
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
iples, what would be the best approach to take for implementation of this change?
+j +j +j +j +j +j +j +j +j +j +j +j +j
a. Leverage the hierarchical management position to get unit staff involved in
+j +j +j +j +j +j +j +j +j +j +
assessment and planning.
j +j +j
b. Engage involved staff at all levels in the decision-making process.
+j +j +j +j +j +j +j +j +j
c. Focus the assessment on the unit and omit the hospital and community
+j +j +j +j +j +j +j +j +j +j +j +
environment. j
d. Hire a geriatric specialist to oversee and control the project.
+j +j +j +j +j +j +j +j +j
ANS: B + j
Complexity theory suggests that systems interact and adapt and that decision making occurs
+j +j +j +j +j +j +j +j +j +j +j +j
throughout the systems, as opposed to being held in a hierarchy. In complexity theory, ever
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
y voice counts, and therefore, all levels of staff would be involved in decision making.
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
2. A unit manager of a 25-
+j +j +j +j +j
bed medical/surgical area receives a phone call from a nurse whohas called in sick five tim
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
es in the past month. He tells the manager that he very much wants to come to work when
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
scheduled but must often care for his wife, who is undergoing treatment for breast cancer.
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
According to Maslow‘s need hierarchy theory, what would be the best approach to satisfyi
+j +j +j +j +j +j +j +j +j +j +j +j +j
ng the needs of this nurse, other staff, and patients?
+j +j +j +j +j +j +j +j +j
a. Line up agency nurses who can be called in to work on short notice.
+j +j +j +j +j +j +j +j +j +j +j +j +j
b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment.
+j +j +j +j +j +j +j +j +j +j +j +j
c. Sympathize with the nurse‘s dilemma and let the charge nurse know that this nurse +j +j +j +j +j +j +j +j +j +j +j +j +j +
may be calling in frequently in the future.
j +j +j +j +j +j +j + j
d. Work with the nurse, staffing office, and other nurses to arrange hisschedule
+j +j +j +j +j +j +j +j +j +j +j
d days off around his wife‘s treatments.
+j +j +j +j +j +j
ANS: D + j
Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic needs
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect pati
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
ent care and threaten the needs of staff to feel competent. Arranging the schedule around the
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +
wife‘s needs meets the needs of the staff and of patients while satisfying the nurse‘s need fo
j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
r affiliation.
+j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
3. A grievance brought by a staff nurse against the unit manager requires mediation. At the firs
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
t mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair, and t
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
he unit manager continues to reiterate the reasons for the actions. What would be the best cou
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
rse of action at this time?
+j +j +j +j +j
a. Send the two disputants away to reach their own resolution.
+j +j +j +j +j +j +j +j +j
b. Involve another staff nurse in the discussion for clarity issues.
+j +j +j +j +j +j +j +j +j
, c. Ask each party to examine their own motives and issues in the conflict.
+j +j +j +j +j +j +j +j +j +j +j +j
d. Continue to listen as the parties repeat their thoughts and feelings about the
+j +j +j +j +j +j +j +j +j +j +j +j +
j conflict.
ANS: C +j
For resolution of conflict, one should address the interests and involvement of participants in t
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
he conflict by examining the real issues of all parties.
+j +j +j +j +j +j +j +j +j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
4. At a second negotiation session, the unit manager and staff nurse are unable to reach a
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
resolution. What is the appropriate next step?
+j +j +j +j +j +j + j
a. Arrange another meeting in a week‘s time so as to allow a cooling-off period.
+j +j +j +j +j +j +j +j +j +j +j +j +j
b. Elevate the next negation session to the next manager, one level above.
+j +j +j +j +j +j +j +j +j +j +j
c. Insist that participants continue to talk until a resolution has been reached.
+j +j +j +j +j +j +j +j +j +j +j
d. Back the unit manager‘s actions and end the dispute.
+j +j +j +j +j +j +j +j
ANS: B +j
Part of leadership is understanding conflict resolution and ability to negotiate and manage for
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
resolution of issues and concerns. This situation has failed a second negotiation session, elev
+j +j +j +j +j +j +j +j +j +j +j +j +j
ation to a manager with additional training to facilitate conflict resolution is important at this
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
point.
+j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
5. The manager of a surgical area has a vision for the future that requires the addition of RN a
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
ssistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff h
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
ave always practiced in a primary nursing-
+j +j +j +j +j +j
delivery system and are very resistant to this idea. What would be the best initial strategy for
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
implementation of this change?
+j +j +j +j
a. Exploring the values and feelings of the RN group in relationship to this change
+j +j +j +j +j +j +j +j +j +j +j +j +j
b. Leaving the RNs alone for a time so they can think about the change before it is
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
implemented
+j
c. Dropping the idea and trying for the change in a year or so when some of the
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
present RNs have retired
+j +j +j +j
d. Hiring the assistants and allowing the RNs to see what good additions they are
+j +j +j +j +j +j +j +j +j +j +j +j +j
ANS: A +j
Influencing others requires emotional intelligence in domains such as empathy, handling rela
+j +j +j +j +j +j +j +j +j +j +j
tionships, deepening self- +j +j
awareness in self and others, motivating others, and managing emotions. Motivating others r
+j +j +j +j +j +j +j +j +j +j +j +j
ecognizes that values are powerful forces that influence acceptance of change. Leaving the R
+j +j +j +j +j +j +j +j +j +j +j +j +j
Ns alone for a period of time before implementation does not provide opportunity to explore
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
different perspectives and values. Avoiding discussion until the team changes may not prom
+j +j +j +j +j +j +j +j +j +j +j +j
ote adoption of the change until there is opportunity to explore perspectives and values relat
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
ed to the change. Hiring of the assistants demonstrates lack of empathy for the perspectives
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
of the RN staff.
+j +j +j
TOP: AONE competency: Knowledge of the Health Care Environment
+j +j +j +j +j +j +j +j
,chapter 01: Leading, Managing, and Following
+j +j +j +j +j
Yoder-Wise: Leading and Managing in Nursing, 8th Edition +j +j +j +j +j +j +j
MULTIPLE CHOICE +j
1. A nurse manager of a 20-
+j +j +j +j +j
bed medical unit finds that 80% of the patients are older adults. She is asked to assess and ad
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
apt the unit to better meet the unique needs of the older adult patient. Using complexity princ
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
iples, what would be the best approach to take for implementation of this change?
+j +j +j +j +j +j +j +j +j +j +j +j +j
a. Leverage the hierarchical management position to get unit staff involved in
+j +j +j +j +j +j +j +j +j +j +
assessment and planning.
j +j +j
b. Engage involved staff at all levels in the decision-making process.
+j +j +j +j +j +j +j +j +j
c. Focus the assessment on the unit and omit the hospital and community
+j +j +j +j +j +j +j +j +j +j +j +
environment. j
d. Hire a geriatric specialist to oversee and control the project.
+j +j +j +j +j +j +j +j +j
ANS: B + j
Complexity theory suggests that systems interact and adapt and that decision making occurs
+j +j +j +j +j +j +j +j +j +j +j +j
throughout the systems, as opposed to being held in a hierarchy. In complexity theory, ever
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
y voice counts, and therefore, all levels of staff would be involved in decision making.
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
2. A unit manager of a 25-
+j +j +j +j +j
bed medical/surgical area receives a phone call from a nurse whohas called in sick five tim
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
es in the past month. He tells the manager that he very much wants to come to work when
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
scheduled but must often care for his wife, who is undergoing treatment for breast cancer.
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
According to Maslow‘s need hierarchy theory, what would be the best approach to satisfyi
+j +j +j +j +j +j +j +j +j +j +j +j +j
ng the needs of this nurse, other staff, and patients?
+j +j +j +j +j +j +j +j +j
a. Line up agency nurses who can be called in to work on short notice.
+j +j +j +j +j +j +j +j +j +j +j +j +j
b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment.
+j +j +j +j +j +j +j +j +j +j +j +j
c. Sympathize with the nurse‘s dilemma and let the charge nurse know that this nurse +j +j +j +j +j +j +j +j +j +j +j +j +j +
may be calling in frequently in the future.
j +j +j +j +j +j +j + j
d. Work with the nurse, staffing office, and other nurses to arrange hisschedule
+j +j +j +j +j +j +j +j +j +j +j
d days off around his wife‘s treatments.
+j +j +j +j +j +j
ANS: D + j
Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic needs
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect pati
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
ent care and threaten the needs of staff to feel competent. Arranging the schedule around the
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +
wife‘s needs meets the needs of the staff and of patients while satisfying the nurse‘s need fo
j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
r affiliation.
+j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
3. A grievance brought by a staff nurse against the unit manager requires mediation. At the firs
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
t mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair, and t
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
he unit manager continues to reiterate the reasons for the actions. What would be the best cou
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
rse of action at this time?
+j +j +j +j +j
a. Send the two disputants away to reach their own resolution.
+j +j +j +j +j +j +j +j +j
b. Involve another staff nurse in the discussion for clarity issues.
+j +j +j +j +j +j +j +j +j
, c. Ask each party to examine their own motives and issues in the conflict.
+j +j +j +j +j +j +j +j +j +j +j +j
d. Continue to listen as the parties repeat their thoughts and feelings about the
+j +j +j +j +j +j +j +j +j +j +j +j +
j conflict.
ANS: C +j
For resolution of conflict, one should address the interests and involvement of participants in t
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
he conflict by examining the real issues of all parties.
+j +j +j +j +j +j +j +j +j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
4. At a second negotiation session, the unit manager and staff nurse are unable to reach a
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
resolution. What is the appropriate next step?
+j +j +j +j +j +j + j
a. Arrange another meeting in a week‘s time so as to allow a cooling-off period.
+j +j +j +j +j +j +j +j +j +j +j +j +j
b. Elevate the next negation session to the next manager, one level above.
+j +j +j +j +j +j +j +j +j +j +j
c. Insist that participants continue to talk until a resolution has been reached.
+j +j +j +j +j +j +j +j +j +j +j
d. Back the unit manager‘s actions and end the dispute.
+j +j +j +j +j +j +j +j
ANS: B +j
Part of leadership is understanding conflict resolution and ability to negotiate and manage for
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
resolution of issues and concerns. This situation has failed a second negotiation session, elev
+j +j +j +j +j +j +j +j +j +j +j +j +j
ation to a manager with additional training to facilitate conflict resolution is important at this
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
point.
+j
TOP: AONE competency: Communication and Relationship-Building
+j +j +j +j +j
5. The manager of a surgical area has a vision for the future that requires the addition of RN a
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
ssistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff h
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
ave always practiced in a primary nursing-
+j +j +j +j +j +j
delivery system and are very resistant to this idea. What would be the best initial strategy for
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
implementation of this change?
+j +j +j +j
a. Exploring the values and feelings of the RN group in relationship to this change
+j +j +j +j +j +j +j +j +j +j +j +j +j
b. Leaving the RNs alone for a time so they can think about the change before it is
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
implemented
+j
c. Dropping the idea and trying for the change in a year or so when some of the
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
present RNs have retired
+j +j +j +j
d. Hiring the assistants and allowing the RNs to see what good additions they are
+j +j +j +j +j +j +j +j +j +j +j +j +j
ANS: A +j
Influencing others requires emotional intelligence in domains such as empathy, handling rela
+j +j +j +j +j +j +j +j +j +j +j
tionships, deepening self- +j +j
awareness in self and others, motivating others, and managing emotions. Motivating others r
+j +j +j +j +j +j +j +j +j +j +j +j
ecognizes that values are powerful forces that influence acceptance of change. Leaving the R
+j +j +j +j +j +j +j +j +j +j +j +j +j
Ns alone for a period of time before implementation does not provide opportunity to explore
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
different perspectives and values. Avoiding discussion until the team changes may not prom
+j +j +j +j +j +j +j +j +j +j +j +j
ote adoption of the change until there is opportunity to explore perspectives and values relat
+j +j +j +j +j +j +j +j +j +j +j +j +j +j
ed to the change. Hiring of the assistants demonstrates lack of empathy for the perspectives
+j +j +j +j +j +j +j +j +j +j +j +j +j +j +j
of the RN staff.
+j +j +j
TOP: AONE competency: Knowledge of the Health Care Environment
+j +j +j +j +j +j +j +j