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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u8th Edition by Patricia S. Yoder-Wise, Susan
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,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 u




1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is
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asked to assess and adapt the unit to better meet the unique needs of the older adult patient.
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Using complexity principles, what would be the best approach to take for implementation of
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this change?
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a. Leverage the hierarchical management position to get unit staff involved in u u u u u u u u u u



assessment and planning.
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b. Engage involved staff at all levels in the decision-making process. u u u u u u u u u



c. Focus the assessment on the unit and omit the hospital and community
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environment.
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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: Communication and Relationship-Building
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2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse whohas
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called in sick five times in the past month. He tells the manager that he very 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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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 thisnurse u u u u u u u u u u u u u



may be calling in frequently in the future.
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d. Work with the nurse, staffing office, and other nurses to arrange hisscheduled
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days off around his wife‘s treatments.
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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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and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect patient
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care and threaten the needs of staff to feel competent. Arranging the schedule around the wife‘s
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needs meets the needs of the staff and of patients while satisfying the nurse‘s need for
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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 the first
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mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair, and the
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unit manager continues to reiterate the reasons for the actions. What would be the best course of
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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. u u u u u u u u u

, 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 aboutthe
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u conflict.
ANS: C u



For resolution of conflict, one should address the interests and involvement of participants in the
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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 reach a
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u resolution. What is the appropriate next step?u u u u u u



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 u



Part of leadership is understanding conflict resolution and ability to negotiate and manage for
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resolution of issues and concerns. This situation has failed a second negotiation session,
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elevation to a manager with additional training to facilitate conflict resolution is important at
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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 of RN
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assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff
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have always practiced in a primary nursing-delivery system and are very resistant to this idea.
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What would be the best initial strategy 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 before it is
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implemented
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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 until
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the team 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 lack of
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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-term care facility, you‘ve found that
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there is little turnover among your LPN and nursing assistant (NA) staff members, but they are
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not very motivated to go beyond their job descriptions in their work. Which of the following
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strategies might motivate the 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 work for the
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night LPNs and NAs.
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b. Allow the LPNs and NAs greater decision-making power within the scope oftheir
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positions in the institution.
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c. Hire additional staff so that there are more staff available for enhanced care,and
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individual workloads are lessened.
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d. Ask the director of nursing to increase job security for night staff by having them
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sign contracts that guarantee work.
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ANS: B u



Hygiene factors such as salary, working conditions, and security are consistent with Herzberg‘s
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two-factor theory of motivation; meeting these needs avoids job dissatisfaction. Motivator
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factors such as recognition and satisfaction with work promote a satisfying and enriched work
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environment. Transformational leaders use motivator factors liberally to inspire work
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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 thenurse
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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-site u u u u u u u u



daycare services.
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b. Provide a hierarchical organizational structure. u u u u



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



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




ANS: C u



Complexity theory suggests that systems interact and adapt and that decision making occurs
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throughout systems, as opposed to being held in a hierarchy. In complexity theory, every voice
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counts, and therefore all levels of staff would be involved in decision making. This principle is
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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-based approach to teach ostomy
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patients self-management skills postoperatively. The program is to be implemented across the
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entire 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-based and is more
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familiar to staff.
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c. You decide to implement the approach at a later date because of feedback from the
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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 takethe
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lead in mentoring and teaching others how to implement it.
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ANS: D u