LEADING, MANAGING, & FOLLOWING: YODER-WISE EXAM 1 (1, 3,
6, 7, 8, 19) WITH QUESTIONS AND VERIFIED ANSWERS
A staff nurse has been recently promoted to unit manager. During the time on the
unit, the nurse formed a strong social network among staff, has promoted the
development of relationships between staff and workers in other areas of the
organization, and has formed relationships that generate ideas from patient
organizations and the local nursing education program. According to complexity
theory, what principle is being engaged?
a. Empowerment
b. Systematic thinking
c. Development of networks
d. Bottom-up interactions - ANS... -ANS: C
According to complexity theory, social networks evolve around areas of common
interest and are able to respond to problems in creative and novel ways.
TOP: AONE competency: Knowledge of the Health Care Environment
According to the complexity theory, what would be the focus of measurement?
a. Cost per hospital day
b. Bed utilization
c. Infection rates
d. Staff morale and budgets - ANS... -ANS: D
According to complexity theory and the principle "Think systematically," one
cannot ignore objective data or nonmeasurable data, as both inform decisions.
TOP: AONE competency: Business Skills
During a staff meeting held to discuss developing a mission statement for the unit,
the idea of placing patient needs first is discussed. What is considered when the
suggestion by the manager is for the unit mission to be derived from the
organization mission?
a. Empowering
b. A leadership tag
c. A symbol
d. A management task - ANS... -ANS: B
According to complexity theory, leadership tags, which are similar to values,
reflect the patient-centered philosophies and values-driven characteristics that
define an organization and give it personality.
,TOP: AONE competency: Knowledge of the Health Care Environment
A nurse manager of a 20-bed medical unit finds that 80% of the patients are older
adults. She is asked to assess and adapt the unit to better meet the unique needs of
the older adult patient. Using complexity principles, what would be the best
approach to take for implementation of this change?
a. Leverage the hierarchical management position to get unit staff involved in
assessment and planning.
b. Engage involved staff at all levels in the decision-making process.
c. Focus the assessment on the unit and omit the hospital and community
environment.
d. Hire a geriatric specialist to oversee and control the project. - ANS... -ANS: B
Complexity theory suggests that systems interact and adapt and that decision
making occurs throughout the systems, as opposed to being held in a hierarchy. In
complexity theory, every voice counts, and therefore, all levels of staff would be
involved in decision making.
TOP: AONE competency: Communication and Relationship-Building
A unit manager of a 25-bed medical/surgical area receives a phone call from a
nurse who has
called in sick five times in the past month. He tells the manager that he very much
wants to
come to work when scheduled but must often care for his wife, who is undergoing
treatment
for breast cancer. According to Maslow's need hierarchy theory, what would be the
best approach to satisfying the needs of this nurse, other staff, and patients?
a. Line up agency nurses who can be called in to work on short notice.
b. Place the nurse on unpaid leave for the remainder of his wife's treatment.
c. Sympathize with the nurse's dilemma and let the charge nurse know that this
nurse may be calling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his scheduled
days off around his wife's treatments. - ANS... -ANS: D
Placing the nurse on unpaid leave may threaten the nurse's capacity to meet
physiologic needs and demotivate the nurse. Unsatisfactory coverage of shifts on
short notice could affect patient care and threaten the needs of staff to feel
competent. Arranging the schedule around the wife's needs meets the needs of the
staff and of patients while satisfying the nurse's need for affiliation.
TOP: AONE competency: Communication and Relationship-Building
, A grievance brought by a staff nurse against the unit manager requires mediation.
At the first mediation session, the staff nurse repeatedly calls the unit manager's
actions unfair, and the unit manager continues to reiterate the reasons for the
actions. What would be the best course of action at this time?
a. Send the two disputants away to reach their own resolution.
b. Involve another staff nurse in the discussion for clarity issues.
c. Ask each party to examine their own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the
conflict. - ANS... -ANS: C
For resolution of conflict, one should address the interests and involvement of
participants in the conflict by examining the real issues of all parties.
TOP: AONE competency: Communication and Relationship-Building
At a second negotiation session, the unit manager and staff nurse are unable to
reach a resolution. What is the appropriate next step?
a. Arrange another meeting in a week's time so as to allow a cooling-off period.
b. Elevate the next negation session to the next manager, one level above.
c. Insist that participants continue to talk until a resolution has been reached.
d. Back the unit manager's actions and end the dispute. - ANS... -ANS: B
Part of leadership is understanding conflict resolution and ability to negotiate and
manage for resolution of issues and concerns. This situation has failed a second
negotiation session, elevation to a manager with additional training to facilitate
conflict resolution is important at this point.
TOP: AONE competency: Communication and Relationship-Building
The manager of a surgical area has a vision for the future that requires the addition
of RN
assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on
the staff
have always practiced in a primary nursing-delivery system and are very resistant
to this idea.
What would be the best initial strategy for implementation of this change?
a. Exploring the values and feelings of the RN group in relationship to this change
b. Leaving the RNs alone for a time so they can think about the change before it is
implemented
c. Dropping the idea and trying for the change in a year or so when some of the
present RNs have retired
d. Hiring the assistants and allowing the RNs to see what good additions they are -
ANS... -ANS: A
, Influencing others requires emotional intelligence in domains such as empathy,
handling relationships, deepening self-awareness in self and others, motivating
others, and managing emotions. Motivating others recognizes that values are
powerful forces that influence acceptance of change. Leaving the RNs alone for a
period of time before implementation does not provide opportunity to explore
different perspectives and values. Avoiding discussion until the team changes may
not promote adoption of the change until there is opportunity to explore
perspectives and values related to the change. Hiring of the assistants demonstrates
lack of empathy for the perspectives of the RN staff.
TOP: AONE competency: Knowledge of the Health Care Environment
As the RN charge nurse on the night shift in a small long-term care facility, you've
found that there is little turnover among your LPN and nursing assistant (NA) staff
members, but they are not very motivated to go beyond their job descriptions in
their work. Which of the following strategies might motivate the staff and lead to
greater job satisfaction?
a. Ask the director of nursing to offer higher wages and bonuses for extra work for
the night LPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the scope of
their positions in the institution.
c. Hire additional staff so that there are more staff available for enhanced care, and
individual workloads are lessened.
d. Ask the director of nursing to increase job security for night staff by having
them sign contracts that guarantee work. - ANS... -ANS: B
Hygiene factors such as salary, working conditions, and security are consistent
with Herzberg's two-factor theory of motivation; meeting these needs avoids job
dissatisfaction. Motivator factors such as recognition and satisfaction with work
promote a satisfying and enriched work environment. Transformational leaders use
motivator factors liberally to inspire work performance and increase job
satisfaction.
TOP: AONE competency: Communication and Relationship-Building
The nurse manager wants to increase motivation by providing motivating factors
for the nurse on the unit. What action would be appropriate to motivate the staff?
a. Collaborate with the human resource/personnel department to develop on-site
daycare services.
b. Provide a hierarchical organizational structure.
c. Implement a model of shared governance.
d. Promote the development of a flexible benefits package. - ANS... -ANS: C
6, 7, 8, 19) WITH QUESTIONS AND VERIFIED ANSWERS
A staff nurse has been recently promoted to unit manager. During the time on the
unit, the nurse formed a strong social network among staff, has promoted the
development of relationships between staff and workers in other areas of the
organization, and has formed relationships that generate ideas from patient
organizations and the local nursing education program. According to complexity
theory, what principle is being engaged?
a. Empowerment
b. Systematic thinking
c. Development of networks
d. Bottom-up interactions - ANS... -ANS: C
According to complexity theory, social networks evolve around areas of common
interest and are able to respond to problems in creative and novel ways.
TOP: AONE competency: Knowledge of the Health Care Environment
According to the complexity theory, what would be the focus of measurement?
a. Cost per hospital day
b. Bed utilization
c. Infection rates
d. Staff morale and budgets - ANS... -ANS: D
According to complexity theory and the principle "Think systematically," one
cannot ignore objective data or nonmeasurable data, as both inform decisions.
TOP: AONE competency: Business Skills
During a staff meeting held to discuss developing a mission statement for the unit,
the idea of placing patient needs first is discussed. What is considered when the
suggestion by the manager is for the unit mission to be derived from the
organization mission?
a. Empowering
b. A leadership tag
c. A symbol
d. A management task - ANS... -ANS: B
According to complexity theory, leadership tags, which are similar to values,
reflect the patient-centered philosophies and values-driven characteristics that
define an organization and give it personality.
,TOP: AONE competency: Knowledge of the Health Care Environment
A nurse manager of a 20-bed medical unit finds that 80% of the patients are older
adults. She is asked to assess and adapt the unit to better meet the unique needs of
the older adult patient. Using complexity principles, what would be the best
approach to take for implementation of this change?
a. Leverage the hierarchical management position to get unit staff involved in
assessment and planning.
b. Engage involved staff at all levels in the decision-making process.
c. Focus the assessment on the unit and omit the hospital and community
environment.
d. Hire a geriatric specialist to oversee and control the project. - ANS... -ANS: B
Complexity theory suggests that systems interact and adapt and that decision
making occurs throughout the systems, as opposed to being held in a hierarchy. In
complexity theory, every voice counts, and therefore, all levels of staff would be
involved in decision making.
TOP: AONE competency: Communication and Relationship-Building
A unit manager of a 25-bed medical/surgical area receives a phone call from a
nurse who has
called in sick five times in the past month. He tells the manager that he very much
wants to
come to work when scheduled but must often care for his wife, who is undergoing
treatment
for breast cancer. According to Maslow's need hierarchy theory, what would be the
best approach to satisfying the needs of this nurse, other staff, and patients?
a. Line up agency nurses who can be called in to work on short notice.
b. Place the nurse on unpaid leave for the remainder of his wife's treatment.
c. Sympathize with the nurse's dilemma and let the charge nurse know that this
nurse may be calling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his scheduled
days off around his wife's treatments. - ANS... -ANS: D
Placing the nurse on unpaid leave may threaten the nurse's capacity to meet
physiologic needs and demotivate the nurse. Unsatisfactory coverage of shifts on
short notice could affect patient care and threaten the needs of staff to feel
competent. Arranging the schedule around the wife's needs meets the needs of the
staff and of patients while satisfying the nurse's need for affiliation.
TOP: AONE competency: Communication and Relationship-Building
, A grievance brought by a staff nurse against the unit manager requires mediation.
At the first mediation session, the staff nurse repeatedly calls the unit manager's
actions unfair, and the unit manager continues to reiterate the reasons for the
actions. What would be the best course of action at this time?
a. Send the two disputants away to reach their own resolution.
b. Involve another staff nurse in the discussion for clarity issues.
c. Ask each party to examine their own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the
conflict. - ANS... -ANS: C
For resolution of conflict, one should address the interests and involvement of
participants in the conflict by examining the real issues of all parties.
TOP: AONE competency: Communication and Relationship-Building
At a second negotiation session, the unit manager and staff nurse are unable to
reach a resolution. What is the appropriate next step?
a. Arrange another meeting in a week's time so as to allow a cooling-off period.
b. Elevate the next negation session to the next manager, one level above.
c. Insist that participants continue to talk until a resolution has been reached.
d. Back the unit manager's actions and end the dispute. - ANS... -ANS: B
Part of leadership is understanding conflict resolution and ability to negotiate and
manage for resolution of issues and concerns. This situation has failed a second
negotiation session, elevation to a manager with additional training to facilitate
conflict resolution is important at this point.
TOP: AONE competency: Communication and Relationship-Building
The manager of a surgical area has a vision for the future that requires the addition
of RN
assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on
the staff
have always practiced in a primary nursing-delivery system and are very resistant
to this idea.
What would be the best initial strategy for implementation of this change?
a. Exploring the values and feelings of the RN group in relationship to this change
b. Leaving the RNs alone for a time so they can think about the change before it is
implemented
c. Dropping the idea and trying for the change in a year or so when some of the
present RNs have retired
d. Hiring the assistants and allowing the RNs to see what good additions they are -
ANS... -ANS: A
, Influencing others requires emotional intelligence in domains such as empathy,
handling relationships, deepening self-awareness in self and others, motivating
others, and managing emotions. Motivating others recognizes that values are
powerful forces that influence acceptance of change. Leaving the RNs alone for a
period of time before implementation does not provide opportunity to explore
different perspectives and values. Avoiding discussion until the team changes may
not promote adoption of the change until there is opportunity to explore
perspectives and values related to the change. Hiring of the assistants demonstrates
lack of empathy for the perspectives of the RN staff.
TOP: AONE competency: Knowledge of the Health Care Environment
As the RN charge nurse on the night shift in a small long-term care facility, you've
found that there is little turnover among your LPN and nursing assistant (NA) staff
members, but they are not very motivated to go beyond their job descriptions in
their work. Which of the following strategies might motivate the staff and lead to
greater job satisfaction?
a. Ask the director of nursing to offer higher wages and bonuses for extra work for
the night LPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the scope of
their positions in the institution.
c. Hire additional staff so that there are more staff available for enhanced care, and
individual workloads are lessened.
d. Ask the director of nursing to increase job security for night staff by having
them sign contracts that guarantee work. - ANS... -ANS: B
Hygiene factors such as salary, working conditions, and security are consistent
with Herzberg's two-factor theory of motivation; meeting these needs avoids job
dissatisfaction. Motivator factors such as recognition and satisfaction with work
promote a satisfying and enriched work environment. Transformational leaders use
motivator factors liberally to inspire work performance and increase job
satisfaction.
TOP: AONE competency: Communication and Relationship-Building
The nurse manager wants to increase motivation by providing motivating factors
for the nurse on the unit. What action would be appropriate to motivate the staff?
a. Collaborate with the human resource/personnel department to develop on-site
daycare services.
b. Provide a hierarchical organizational structure.
c. Implement a model of shared governance.
d. Promote the development of a flexible benefits package. - ANS... -ANS: C
