Test Bank for Leading and Managing inNursing 7th Edition by Yoder Wise (chapters 1-30) complete

A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. Sheis 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 inassessment 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 communityenvironment. d. Hire a geriatric specialist to oversee and control the project. ANS: B Complexity theory suggests that systems interact and adapt and that decision making occursthroughout the systems, as opposed to being held in a hierarchy. In complexity theory, everyvoice 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 hascalled 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 toUMaSslowN’s Tneed hiOerarchy 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. lOMoARcPSD| Test Bank for Leading and Managing inNursing 7th Edition by Yoder Wise (chapters 1-30) complete. 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: D Placing the nurse on unpaid leave may threaten the nurse’s capacity to meet physiologic needsand 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  The charge nurse walks into Mr. Smith’s room and finds him yelling at the LPN. He is obviously very upset. The charge nurse determines that he has not slept for three nights because of unrelieved pain levels. The LPN is very upset and calls Mr. Smith an “ugly, old man.” The charge nurse acknowledges the LPN’s feelings and concerns and then suggests thatMr. Smith’s behavior was aggressive but was related to lack of sleep and to pain. The charge nurse asks, “Can you, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling his pain?” This situation is an example of what? a. Lack of empathy and undNerstRandIingGfor BM.isCs JoMnes b. Concern with placating MrU. SmSithN T O c. Leadership behavior d. Management behavior lOMoARcPSD| ANS: C The situation between Mr. Smith and Miss Jones is a complex situation involving unrelievedpatient symptoms and aggressiveness toward a staff member. Providing engaged, collaborative guidance and decision making in a complex situation where there is no standardized solution reflects leadership. TOP: AONE competency: Leadership  After assessing an older adult patient in long-term care who has been slowly deteriorating forweeks, the nurse manager calls the family and asks them to come in, as the patient is dying. What is the most likely basis for the nurse manager’s request? a. An established clinical pathway b. Confirmatory scientific evidence c. Unit protocol d. Experience ANS: D The nurse manager is employing knowledge and experience in determining that the patient isdying, because the course of dying is not standardized and cannot be determined by clinical pathways. Test Bank for Leading and Managing inNursing 7th Edition by Yoder Wise (chapters 1-30) complete. lOMoARcPSD| TOP: AONE competency: Knowledge of the Health Care Environment  Chart audits have revealed significant omissions of data that could have legal and financial guideline ramifications. The unit manager meets with the staff to discuss audit findings and tofind approaches that will address the gaps in charting and achieve desired goals. What is the manager demonstrating? a. Leadership b. Management Decision making c. Vision ANS: B The process of guiding others to meet established goals, outcomes, and procedures is management. This can require collaborative decision making to determine how best to reachpredetermined goals and follow established practices. TOP: AONE competency: Knowledge of the Health Care Environment  A family is keeping vigil at a critically ill patient’s bedside. Distant family members call theunit continuously asking for updates and expressing concern. The nurse speaks with the distant family members and states she is referring them to the hospital social worker, whoserole is to work with family in this situation. What role is the nurse assuming through this action? a. Manager b. Leader c. Follower d. Laissez- faire ANS: A As a manager, you are concerned with managing and coordinating resources to achieve outcomes in accordance with established clinical Test Bank for Leading and Managing inNursing 7th Edition by Yoder Wise (chapters 1-30) complete. lOMoARcPSD| processes. Referral to a social workeralleviates demand on staff time and is consistent with hospital procedures. TOP: AONE competency: Communication and Relationship-Building  A family is keeping vigil at a critically ill patient’s bedside. The nurse approaches the unitmanager with concern over the family dynamics for the patient concerned there are patient-family conflicts based on patient’s wishes. The nurse suggests that the patient’s provider may need to discuss the treatment plan with the family. The unit manager states hewill arrange a discussion with the patient’s provider and ask the nurse to support the provider’s decisions. What is the role of the nurse in this situation? a. Leadership b. Management c. Follower d. Evidence-based ANS: C In the followership role, you bring to the manager your concerns about concerns for patients and the outcomes and accept the direction given by the manager in response to your concerns. Test Bank for Leading and Managing inNursing 7th Edition by Yoder Wise (chapters 1-30) complete. lOMoARcPSD| Test Bank for Leading and Managing inNursing 7th Edition by Yoder Wise (chapters 1-30) complete. TOP: AONE competency: Knowledge of the Health Care Environment  The manager calls the staff together to assess a situation in which the family of a seriously illpatient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, the manager explains that the organization values patient-centered care and that evidence supports that acting as an advocate and a listener ishelpful to families. The manager asks the staff for ideas and strategies that are effectively patient-centered in dealing with families in similar situations. What is the role of the nursemanager in this situation? a. Leadership b. Management c. Follower d. Visionary ANS: A As a leader, the manager is providing and communicating vision and direction based on evidence and experience. The manager is engaging others in decision making that moves themtoward the vision with a reasonable level of risk taking. TOP: AONE competency: Leadership  The manager of a unit is finding it difficult to work with a new graduate nurse. The new nursehas many ideas; however, his manner of presenting them irritates the manager. After reflection and discussion with others, the manager recognizes that she feels threatened by his behavior. She comes to understand that the new nurse is trying to establish his own role on theunit; is not trying to challengNe heRr; aInd nGeedBs .guCidaMnce, coaching, and affirmation. What is the nurse manager demonstrating iUn thSis siNtuatTion? O