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Chapter01:Leading, Managing,andFollowing
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Yoder-Wise:Leading andManaging inNursing,8thEdition vv vv vv vv vv vv vv
MULTIPLE CHOICE vv
1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She
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is 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
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of this change?
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a. Leverage the hierarchical management position to get unit staff involved in vv vv vv vv vv vv vv vv vv vv
assessment and planning.
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b. Engage involved staff at all levels in the decision-making process. vv vv vv vv vv vv vv vv vv
c. Focus the assessment on the unit and omit the hospital and community vv vv vv vv vv vv vv vv vv vv vv
environment. vv
d. Hire a geriatric specialist to oversee and control the project.vv vv vv vv vv vv vv vv vv
ANS: v v B
Complexity theory suggests that systems interact and adapt and that decision making vv vv vv vv vv vv vv vv vv vv vv
occurs throughout the systems, as opposed to being held in a hierarchy. In complexity
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theory, every voice counts, and therefore, all levels of staff would be involved in
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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
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whohas called in sick five times in the past month. He tells the manager that he very
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much wants to come to work when scheduled but must often care for his wife, who is
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undergoing treatment for breast cancer. According to Maslow‘s need hierarchy theory,
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what would be the best approach to satisfying the needs of this nurse, other staff, and
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patients?
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a. Line up agencynurses who can be called in to work on short notice. vv vv vv vv vv vv vv vv vv vv vv vv vv
b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment. vv vv vv vv vv vv vv vv vv vv vv vv
c. Sympathize with the nurse‘s dilemma and let the charge nurse know that thisnurse vv vv vv vv vv vv vv vv vv vv vv vv vv
may be calling in frequently in the
vv future. vv vv vv vv vv vv v v
d. Work with the nurse, staffing office, and other nurses to arrange vv vv vv vv vv vv vv vv vv vv
hisscheduled days off around his wife‘s treatments.
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ANS: v v D
Placing the nurse on unpaid leave maythreaten the nurse‘s capacityto meet physiologic needs
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and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect
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patient care and threaten the needs of staff to feel competent. Arranging the schedule
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around the wife‘s needs meets the needs of the staff and of patients while satisfying the
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nurse‘s need for affiliation.
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TOP: AONE competency: Communication and Relationship-Building
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3. A grievance brought bya staff nurse against the unitmanager requires mediation. At the
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first 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 best
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course of action at this time?
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a. Send the two disputants awayto reach their own resolution. vv vv vv vv vv vv vv vv vv
b. Involve another staff nurse in the discussion for clarity issues. vv vv vv vv vv vv vv vv vv
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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 aboutthe vv vv vv vv vv vv vv vv vv vv vv vv
vv conflict.
ANS: C vv
For resolution of conflict, one should address the interests and involvement of participants in
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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 reach a
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vv resolution. What is the appropriate next step? vv vv vv vv vv v v
a. Arrange another meeting in a week‘s time so as to allow a cooling-off period. vv vv vv vv vv vv vv vv vv vv vv vv vv
b. Elevate the next negation session to the next manager, one level above. vv vv vv vv vv vv vv vv vv vv vv
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. vv vv vv vv vv vv vv vv
ANS: B vv
Part of leadership is understanding conflict resolution and abilityto 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
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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 of
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RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on
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the staff have always practiced in a primarynursing-delivery system and are veryresistant to
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this idea. What would be the best initial strategy for implementation of this change?
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a. Exploringthe values and feelings of the RN group in relationship to thischange vv vv vv vv vv vv vv vv vv vv vv vv vv
b. Leaving the RNs alone for a time so theycan think about the change before it is vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
implemented vv
c. Dropping the idea and trying for the change in a year or so when some of the vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
present RNs have retired
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d. Hiring the assistants and allowing the RNs to see what good additions they arevv vv vv vv vv vv vv vv vv vv vv vv vv
ANS: A vv
Influencing others requires emotional intelligence in domains such as empathy, handling vv vv vv vv vv vv vv vv vv vv
relationships, deepening self-awareness in self and others, motivating others, and
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managing emotions. Motivating others recognizes that values are powerful forces that
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influence acceptance of change. Leaving the RNs alone for a period of time before
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implementation does not provide opportunity to explore different perspectives and values.
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Avoiding discussion until the team changes may not promote adoption of the change
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until there is opportunity to explore perspectives and values related to the change. Hiring
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of the assistants demonstrates 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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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
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they are not very motivated to go beyond their job descriptions in their work. Which of
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the following 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 workfor
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the night LPNs and NAs.
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b. Allow the LPNs and NAs greater decision-making power within the scope oftheir vv vv vv vv vv vv vv vv vv vv vv vv
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 byhaving them
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sign contracts that guarantee work.
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ANS: B vv
Hygiene factors such as salary, working conditions, and security are consistent with
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Herzberg‘s two-factor theory of motivation; meeting these needs avoids job
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dissatisfaction. Motivator factors such as recognition and satisfaction with work promote
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a satisfying and enriched work environment. Transformational leaders use motivator factors
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liberallyto inspire work 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
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vvthenurse on the unit. What action would be appropriate to motivate the staff? vv vv vv vv vv vv vv vv vv vv vv vv
a. Collaborate with the human resource/personnel department to develop on-site vv vv vv vv vv vv vv vv
vvdaycare services. vv
b. Providea hierarchical organizational structure. vv vv vv vv
c. Implement a model of shared governance. vv vv vv vv vv
d. Promote the development of a flexible benefits package. vv vv vv vv vv vv vv
ANS: C vv
Complexitytheorysuggests that systems interact and adapt and that decision makingoccurs vv vv vv vv vv vv vv vv vv vv vv vv
throughout 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. This
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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-based approach to teach
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ostomy patients self-management skills postoperatively. The program is to be implemented
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across the entire facility. What illustrates effective leadership in this
vv vv situation? vv vv vv vv vv vv vv vv v v
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 fromthe
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RNs that the new approach takes too much time.
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d. An RN who isalreadyfamiliar with the new approach of volunteers to takethe
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lead in mentoring and teaching others how to implement
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ANS: D vv
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