Test Bank complete For Leading and Managing in Nursing, 8th Edition by Patricia S. Yoder-Wise, Susan Sportsman Chapter 1-25

Test Bank For Leading and Managing in Nursing,
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8th EditionbyPatricia S. Yoder-
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Wise, Susan Sportsman Chapter 1-25
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,Chapter01:Leading, Managing,and Following
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Yoder-Wise:Leading andManaging inNursing,8thEdition t t t t t t t




MULTIPLE CHOICE t




1. A nurse manager of a 20bed medical unit finds that 80% of the patients are older adults. Sh
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e is asked to assess and adapt the unit to better meet the unique needs of the older adult pat
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ient. Using complexity principles, what would be the best approach to take for implemen
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tation of this change? t t t




a. Leverage the hierarchical management position to get unitstaff involve t t t t t t t t t




d in assessment and planning. t t t t



b. Engage involved staff at all levels in the decision-making process. t t t t t t t t t



c. Focus the assessment on the unit and omit the hospital and commun t t t t t t t t t t t




ity environment. t




d. Hire a geriatric specialist to oversee and control the project. t t t t t t t t t




ANS: B t




Complexity theory suggests that systems interact and adapt and that decision making oc t t t t t t t t t t t t




curs throughout the systems, as opposed to being held in a hierarchy. In complexity theo
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ry, every voice counts, and therefore, all levels of staff would be involved in decision mak
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ing.

TOP: AONE competency: Communication and Relationship-Building
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2. A unit manager of a 25bed medical/surgical area receives a phone call from a nurse whoh
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as called in sick five times in the past month. He tells the manager that he very much want
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s to come to work when scheduled but must often care for his wife, who is undergoing tre
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atment for breast cancer. According to Maslow‘s need hierarchy theory, what would be t
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he 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. t t t t t t t t t t t t t



b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment. t t t t t t t t t t t t



c. Sympathize with the nurse‘s dilemma and let the charge nurse know that thisn t t t t t t t t t t t t t




urse may be calling in frequently in the future. t t t t t t t t



d. Work with the nurse, staffing office, and other nurses to arrange hisschedu t t t t t t t t t t t




led days off around his wife‘s treatments. t t t t t t




ANS: D t




Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic n
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eeds and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could aff
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ect patient care and threaten the needs of staff to feel competent. Arranging the schedule a
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round the wife‘s needs meets the needs of the staff and of patients while satisfying the nur
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se‘s need for affiliation. t t t




TOP: AONE competency: Communication and Relationship-Building
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3. A grievance brought bya staff nurse against the unit manager requires mediation. At the f
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irst mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair,
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and the unit manager continues to reiterate the reasons for the actions. What wouldbe the
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best course of action at this time? t t t t t t




a. Send the two disputants away to reach their own resolution. t t t t t t t t t




b. Involve another staff nurse in the discussion for clarity issues. t t t t t t t t t

, 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 about t t t t t t t t t t t t




the conflict. t




ANS: C t




For resolution of conflict, one should address the interests and involvement of participant
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s 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 reac
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h 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. t t t t t t t t t t t t t



b. Elevate the next negation session to the next manager, one level above. t t t t t t t t t t t



c. Insist that participants continue to talk until a resolution has beenreached. t t t t t t t t t t t



d. Back the unit manager‘s actions and end the dispute. t t t t t t t t




ANS: B t




Part of leadership is understanding conflict resolution and abilityto negotiate and manag
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e for resolution of issues and concerns. This situation has failed a second negotiation sessi
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on, elevation to a manager with additional training to facilitate conflict resolution is impo
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rtant at this point. t t t




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 of RN a
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ssistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staf
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f have always practiced in a primarynursing-
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delivery system and are veryresistant to this idea. What would be the best initial strategy f
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or implementation of this change?
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a. Exploring the values and feelings of the RN group in relationship to thischange t t t t t t t t t t t t t



b. Leaving the RNs alone for a time so they can think about the change before it i t t t t t t t t t t t t t t t t




s implemented t




c. Dropping the idea and trying for the change in a year or so when some of th t t t t t t t t t t t t t t t t




e present RNs have retired t t t t




d. Hiring the assistants and allowing the RNs to see what good additions they are t t t t t t t t t t t t t




ANS: A t




Influencing others requires emotional intelligence in domains such as empathy, handlin t t t t t t t t t t




g relationships, deepening self-
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awareness in self and others, motivating others, and managing emotions. Motivating oth t t t t t t t t t t t




ers recognizes that values are powerful forces that influence acceptance of change. Leavin
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g the RNs alone for a period of time before implementation does not provide opportunity t
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o explore different perspectives and values. Avoiding discussion until the team changes
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may not promote adoption of the change until there is opportunity to explore perspective
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s and values related to the change. Hiring of the assistants demonstrates lack of empathy f
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or 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 nursing
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assistant (NA) staff members, but they are not very motivated to go beyond their job desc
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riptions in their work. Which of the following strategies might motivate the staff and lead
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to greater job satisfaction?
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a. Ask the director of nursing to offer higher wages and bonuses for extra workf
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or the night LPNs and NAs. t t t t t



b. Allow the LPNs and NAs greater decision- t t t t t t




making power within the scope oftheir positions in the institution. t t t t t t t t t t




c. Hire additional staff so that there are more staff available for enhanced care,a
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nd individual workloads are lessened. t t t t



d. Ask the director of nursing to increase job security for night staff byhaving the
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m sign contracts that guarantee work.
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ANS: B t




Hygiene factors such as salary, working conditions, and security are consistent with Herz
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berg‘s two- t




factor theory of motivation; meeting these needs avoids job dissatisfaction. Motivator fact
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ors such as recognition and satisfaction with work promote a satisfying and enriched wor
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k environment. Transformational leaders use motivator factors liberally to inspire work p
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erformance and increase job satisfaction. t t t t




TOP: AONE competency: Communication and Relationship-Building
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7. The nurse manager wants to increase motivation by providing motivating factors for the
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nurse 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 o t t t t t t t t




n-site daycare services. t t



b. Provide a hierarchical organizational structure. t t t t



c. Implement a model of shared governance. t t t t t



d. Promote the development of a flexible benefits package. t t t t t t t




ANS: C t




Complexitytheorysuggests that systems interact and adapt and that decision making occ t t t t t t t t t t t t




urs throughout systems, as opposed to being held in a hierarchy. In complexity theory, ev
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ery voice counts, and therefore all levels of staff would be involved in decision making. Th
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is 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 f t t t t t t t t t t t t




acility. 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. t t t t t t




c. You decide to implement the approach at a later date because of feedback fromt
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he RNs that the new approach takes too much time.
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d. An RN who isalready familiar with the new approach of volunteers to taket
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he lead in mentoring and teaching others how to implement it.
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