Yoder-Wise: Leading and Managing in Nursing, 7th Edition
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1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults.
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uShe is asked to assess and adapt the unit to better meet the unique needs of the older adult
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upatient. Using complexity principles, what would be the best approach to take for
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uimplementation of this change? u u u
a. Leverage the hierarchical management position to get unit staff involved in assessment
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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 communityenvironment.
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d. Hire a geriatric specialist to oversee and control the project.
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ANS: B u
Complexity theory suggests that systems interact and adapt and that decision making occurs
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throughout the systems, as opposed to being held in a hierarchy. In complexity theory, every
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voice counts, and therefore, all levels of staff would be involved in decision making.
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TOP: AONE competency: Communicationand Relationship-Building
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2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse
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who has called in sick five times in the past month. He tells the manager that he very
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much wants to
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come to work when scheduled but must often care for his wife, who is undergoing treatment
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for breast cancer. According to Maslow‘s need hierarchy theory, what would be the best
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NURSINGTB.COMapproach to satisfying the needs of this nurse, other staff, and u u u u u u u u u u u
patients?
a. Line up agencynurses 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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u nurse may be calling in frequently in the future.
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d. Work with the nurse, staffingoffice, and other nurses to arrange his scheduled
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u days off around his wife‘s treatments.
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Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank
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ANS: D u
Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic needs
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uand demotivate the nurse. Unsatisfactorycoverage of shifts on short notice could affect patient
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ucare and threaten the needs of staff to feel competent. Arranging the schedule around the wife‘s
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uneeds meets the needs of the staff and of patients while satisfying the nurse‘s need for
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uaffiliation.
TOP: AONE competency: Communicationand Relationship-Building
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3. A grievance brought bya staff nurse against the unit manager requires mediation. At
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the first mediation session, the staff nurse repeatedlycalls the unit manager‘s actions
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unfair, and the unit manager continues to reiterate the reasons for the actions. What
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would be the best course of action at this time?
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a. Send the two disputants awayto 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 partyto 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 about the
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conflict. u
ANS: C u
For resolution of conflict, one should address the interests and involvement of participants in the
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uconflict by examining the real issues of all parties.
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TOP: AONE competency: Communicationand Relationship-Building
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4. At a second negotiation session, the unit manager and staff nurse are unable to reach a
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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.u u u u u u u u
ANS: B u
Part of leadership is understanding conflict resolution and abilityto negotiate and manage for
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uresolution of issues and concerns. This situation has failed a second negotiation session,
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uelevation to a manager with additional training to facilitate conflict resolution is important at
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uthis point.
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TOP: AONE competency: Communicationand Relationship-Building
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5. The manager of a surgical area has a vision for the future that requires the addition of
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RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs
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on the staff
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Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank
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have always practiced in a primarynursing-delivery system and are veryresistant to this idea.
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What would be the best initial strategyfor implementation of this change?
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a. Exploringthe values and feelings of the RN group in relationship to this u u u u u u u u u u u
change u
b. Leaving the RNs alone for a time so theycan think about the change before it is
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implemented u
c. Dropping the idea and trying for the change in a year or so when some of the
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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 u
Influencing others requires emotional intelligence in domains such as empathy, handling
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relationships, deepening self-awareness in self and others, motivating others, and managing
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emotions. Motivating others recognizes that values are powerful forces that influence
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acceptance of change. Leaving the RNs alone for a period of time before implementation does
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not provide opportunity to explore different perspectives and values. Avoiding discussion
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until the team changes may not promote adoption of the change until there is opportunityto
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explore perspectives and values related to the change. Hiringof the assistants demonstrates
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lack 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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