well updated
Chapter 01: Leading, Managing, and Following --
MULTIPLE CHOICE
1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older
adults. She isasked 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 in making this change?
a. Leverage the hierarchical management position to get unit staff involved in
assessment andplanning.
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: 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.
REF: Page 8 TOP: AONE competency: Communication and Relationship-Building
2. 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 cometo 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
the needs of this nurse, other staff, and patients?
approach to satisfying
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 becalling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his scheduled
days offaround 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.
Geekbano
, well updated
REF: Page 10 TOP: AONE competency: Communication and Relationship-Building
Geekbano
, well updated
3. 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 unitmanager continues to reiterate the reasons for her 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 so as to clarify issues.
c. Ask each party to examine her own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the conflict.
ANS: C
Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to
address the interests and involvement of participants in the conflict by examining
the real issues of all parties.
REF: Page 16 TOP: AONE competency: Communication and Relationship-Building
4. At a second negotiation session, the unit manager and staff nurse are unable to reach a
resolution.It would now be best to:
a. Arrange another meeting in a week’s time so as to allow a cooling-off period.
b. Turn the dispute over to the director of nursing.
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: B
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-off”
period isrecommended if resolution fails.
REF: Page 16 TOP: AONE competency: Communication and Relationship-Building
5. 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 walk patients. The RNs on the
staff have always practiced in a primary nursing–delivery system and are very resistant
to this idea. Thebest initial strategy in this situation would include:
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 isimplemented.
c. Dropping the idea and trying for the change in a year or so when some of the
present RNshave retired.
d. Hiring the assistants and allowing the RNs to see what good additions they are.
Geekbano
, well updated
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 doesnot provide opportunity to explore different perspectives and
values. Avoiding discussion untilthe team changes may not promote adoption of the
change until there is opportunity to exploreperspectives and values related to the
change. Hiring of the assistants demonstrates lack of empathy for the perspectives of
the RN staff.
REF: Page 7 | Page 15
TOP: AONE competency: Knowledge of the Health Care Environment
6. 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 arenot 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 nightLPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the scope of
theirpositions in the institution.
c. Hire additional staff so that there are more staff available for enhanced care and
individualworkloads are lessened.
d. Ask the director of nursing to increase job security for night staff by having
them signcontracts that guarantee work.
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 inspirework performance and increase job satisfaction.
REF: Page 9 | Page 10
TOP: AONE competency: Communication and Relationship-Building
7. As the nurse manager who wants to increase motivation by providing motivating
factors, whichaction would you select?
a. Collaborate with the human resource/personnel department to develop on-site
daycareservices.
b. Provide a hierarchical organizational structure.
c. Implement a model of shared governance.
d. Promote the development of a flexible benefits package.
Geekbano
Chapter 01: Leading, Managing, and Following --
MULTIPLE CHOICE
1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older
adults. She isasked 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 in making this change?
a. Leverage the hierarchical management position to get unit staff involved in
assessment andplanning.
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: 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.
REF: Page 8 TOP: AONE competency: Communication and Relationship-Building
2. 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 cometo 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
the needs of this nurse, other staff, and patients?
approach to satisfying
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 becalling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his scheduled
days offaround 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.
Geekbano
, well updated
REF: Page 10 TOP: AONE competency: Communication and Relationship-Building
Geekbano
, well updated
3. 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 unitmanager continues to reiterate the reasons for her 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 so as to clarify issues.
c. Ask each party to examine her own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the conflict.
ANS: C
Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to
address the interests and involvement of participants in the conflict by examining
the real issues of all parties.
REF: Page 16 TOP: AONE competency: Communication and Relationship-Building
4. At a second negotiation session, the unit manager and staff nurse are unable to reach a
resolution.It would now be best to:
a. Arrange another meeting in a week’s time so as to allow a cooling-off period.
b. Turn the dispute over to the director of nursing.
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: B
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-off”
period isrecommended if resolution fails.
REF: Page 16 TOP: AONE competency: Communication and Relationship-Building
5. 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 walk patients. The RNs on the
staff have always practiced in a primary nursing–delivery system and are very resistant
to this idea. Thebest initial strategy in this situation would include:
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 isimplemented.
c. Dropping the idea and trying for the change in a year or so when some of the
present RNshave retired.
d. Hiring the assistants and allowing the RNs to see what good additions they are.
Geekbano
, well updated
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 doesnot provide opportunity to explore different perspectives and
values. Avoiding discussion untilthe team changes may not promote adoption of the
change until there is opportunity to exploreperspectives and values related to the
change. Hiring of the assistants demonstrates lack of empathy for the perspectives of
the RN staff.
REF: Page 7 | Page 15
TOP: AONE competency: Knowledge of the Health Care Environment
6. 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 arenot 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 nightLPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the scope of
theirpositions in the institution.
c. Hire additional staff so that there are more staff available for enhanced care and
individualworkloads are lessened.
d. Ask the director of nursing to increase job security for night staff by having
them signcontracts that guarantee work.
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 inspirework performance and increase job satisfaction.
REF: Page 9 | Page 10
TOP: AONE competency: Communication and Relationship-Building
7. As the nurse manager who wants to increase motivation by providing motivating
factors, whichaction would you select?
a. Collaborate with the human resource/personnel department to develop on-site
daycareservices.
b. Provide a hierarchical organizational structure.
c. Implement a model of shared governance.
d. Promote the development of a flexible benefits package.
Geekbano
