MEDICAL/SURGICAL NURSING II –YODER-WISE’S
LEADING AND MANAGING IN CANADIAN NURSING (2ND
EDITION) – COMPLETE PRACTICE SET WITH ANSWERS
(SECTIONS 1–32).
Section 01: Leading, Managing, and Following
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Second Edition
MULTIPLE CHOICE
1. A care provider manager of a 20-bed medical unit finds that 80% of the clients are older adults. She
is asked to assess and adapt the unit to better meet the unique needs of older adult clients.
According to 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 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.
CORR 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, everybody’s
opinion counts; therefore, all levels of staff would be involved in decision making.
2. A unit manager of a 25-bed medical/surgical area receives a phone call from a care provider 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. In the practice of a strengths-based nursing leader, what would be the best approach to
satisfying the needs of this care provider, other staff, and clients?
a.
Line up agency care providers who can be called in to work on short notice.
b.
Place the care provider on unpaid leave for the remainder of his wife’s treatment.
c.
Sympathize with the care provider’s dilemma and let the charge care provider know that
this care provider may be calling in frequently in the future.
d.
Work with the care provider, staffing office, and other care providers to arrange his
scheduled days off around his wife’s treatments.
CORR ANS: D
Placing the care provider on unpaid leave may threaten physiologic needs and demotivate the care
provider. Unsatisfactory coverage of shifts on short notice could affect client care and threaten staff
members’ sense of competence. Strengths-based care provider leaders honour the uniqueness of
individuals, teams, systems, and organizations; therefore arranging the schedule around the wife’s
needs would result in a win-win situation, also creating a work environment that promotes the
health of all the care providers and facilitates their development.
,3. A grievance brought by a staff care provider against the unit manager requires mediation. At the first
mediation session, the staff care provider 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 care provider in the discussion so as to clarify issues.
c.
Ask each party to Assessmentine her own motives and issues in the conflict.
d.
Continue to listen as the parties repeat their thoughts and feelings about the
conflict.
CORR ANS: C
Care providers and leaders must assess each situation as unique, determining appropriate actions
accordingly. Leaders must adapt their styles to complement specific issues being faced, such as
conflict. Assessmentining motives and issues for the conflict in perceptions promotes equal
representation of each point of view.
4. Shortly after being informed of fetal death, a labouring woman asks why she is not able to hear her
baby’s heartbeat on the monitor anymore. Although the monitor volume had been turned off so that
the client would be able to sleep between contractions, the care provider responded that there was
no heartbeat to hear because the baby had died in utero; then the care provider asked whether the
client would like to talk about how she was feeling. This response demonstrates:
a.
Lack of empathy.
b.
Ethical leadership.
c.
Complexity science. .
d.
A coercive relationship.
CORR ANS: B
Ethical leadership is based on a willingness to identify and act on complex problems in an ethical
manner. Leadership can be misused when coercive relationships form, and information and true
goals are withheld.
5. The manager of a surgical area envisions a future that requires the addition of registered care
provider (RN) assistants or unlicensed persons to feed, bathe, and walk clients. The RNs on the staff
have always practiced in a primary nursing-delivery system and are very resistant to this idea. The
best initial strategy in this situation would include:
a.
Exploring the values of the RNs in relation to this change.
b.
Leaving the RNs alone for a time so they can think about the change before they are
approached again.
c.
Dropping the idea and trying for the change in another year or so.
d.
Hiring the assistants and allowing the RNs to see what good additions they are.
CORR ANS: A
, Leadership involves engaged decision making around a vision that is based on evidence and tacit
knowledge. Influencing others requires emotional intelligence in domains such as empathy and
handling relationships.
6. As the charge care provider on the night shift in a small long-term care facility, you have found that
there is little turnover among your licensed practical care provider and nursing assistant (NA) staff
members, but they are not very motivated to work beyond their job descriptions. 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 licensed practical care providers and NAs.
b.
Allow the licensed practical care providers and NAs greater decision-making power
within the scope of their positions in the institution.
c.
Help the licensed practical care providers and NAs with their work, whenever possible.
d.
Ask the director of nursing to increase job security for night staff by having them sign
contracts that guarantee work.
CORR ANS: B
A care provider leader should provide an environment conducive to opinion sharing that involves staff
in decision making at all levels. This approach is shown to increase job satisfaction. Decision making
and the corresponding actions taken are core tasks performed in engagement with coworkers.
7. As the care provider manager, you want to increase motivation by providing motivating factors.
Which action would you select?
a.
Collaborate with the human resources/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.
CORR ANS: C
Complexity theory suggests that systems interact and adapt and that decision making occurs
throughout systems, as opposed to being made unilaterally by different levels of the organizational
hierarchy. In complexity theory, every person’s opinion counts, and therefore all levels of staff would
be involved in decision making. This principle underlies shared governance. Shared governance is an
Assessmentple of care provider decision making in which care providers at different organizational
levels engage in shaping policy and practices.
, 8. A charge care provider on a busy 40-bed medical/surgical unit is approached by a client’s son, who
begins to complain loudly about the quality of care his mother is receiving. His behaviour is so
disruptive that it is overheard by staff, physicians, and other visitors. The family member rejects any
attempt to intervene therapeutically to resolve the issue. He leaves the unit abruptly, and the care
provider is left feeling frustrated. Which behaviour by the charge care provider best illustrates
refined leadership skills in an emotionally intelligent practitioner?
a.
Reflection to obtain insight into how the situation could be handled differently in the
future
b.
Trying to catch up with the angry family member to resolve the concern
c.
Discussing the concern with the client after the family member has left
d.
Notifying nursing administration of the situation
CORR ANS: A
Emotional intelligence is closely aligned with individuals’ capacity to know themselves and others.
Reflecting to obtain insight and being able to “step” outside the situation to envision the context of
what is happening is an Assessmentple of the actions of an emotionally intelligent practitioner.
9. The chief nursing officer has asked the staff development coordinator to facilitate the development of
a clinical competency program for the facility. While making rounds on the units, the staff
development coordinator overhears RN staff complaining that they believe it is insulting to be
required to participate in a competency program. Which behaviour by the staff development
coordinator is most appropriate in this situation?
a. Disregard staff concerns and continue with.development of the program.
b. U S
Inform the care providers that this program is a requirement for accreditation by
the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
c.
Schedule a meeting with the chief care provider executive to apprise her of the situation.
d.
Facilitate a meeting so care providers can articulate their values and concerns
about a competency program.
CORR ANS: D
The manager role involves guiding other people through a set of derived practices that are evidence-
informed and known to satisfy pre-established outcomes such as participation in a competency
program. This involves engagement of staff through sharing of concerns and ideas. This type of
leader can instill hope and trust in followers, which influence their behaviours and attitudes (such as
engagement and satisfaction) and cause work environments to become more positive.
10. Which category is unique to leadership but is not part of management?
a.
Initiating change
b.
Personal qualities
c.
Developing people
d.
Information management
LEADING AND MANAGING IN CANADIAN NURSING (2ND
EDITION) – COMPLETE PRACTICE SET WITH ANSWERS
(SECTIONS 1–32).
Section 01: Leading, Managing, and Following
Waddell/Walton: Yoder-Wise’s Leading and Managing in Canadian Nursing, Second Edition
MULTIPLE CHOICE
1. A care provider manager of a 20-bed medical unit finds that 80% of the clients are older adults. She
is asked to assess and adapt the unit to better meet the unique needs of older adult clients.
According to 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 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.
CORR 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, everybody’s
opinion counts; therefore, all levels of staff would be involved in decision making.
2. A unit manager of a 25-bed medical/surgical area receives a phone call from a care provider 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. In the practice of a strengths-based nursing leader, what would be the best approach to
satisfying the needs of this care provider, other staff, and clients?
a.
Line up agency care providers who can be called in to work on short notice.
b.
Place the care provider on unpaid leave for the remainder of his wife’s treatment.
c.
Sympathize with the care provider’s dilemma and let the charge care provider know that
this care provider may be calling in frequently in the future.
d.
Work with the care provider, staffing office, and other care providers to arrange his
scheduled days off around his wife’s treatments.
CORR ANS: D
Placing the care provider on unpaid leave may threaten physiologic needs and demotivate the care
provider. Unsatisfactory coverage of shifts on short notice could affect client care and threaten staff
members’ sense of competence. Strengths-based care provider leaders honour the uniqueness of
individuals, teams, systems, and organizations; therefore arranging the schedule around the wife’s
needs would result in a win-win situation, also creating a work environment that promotes the
health of all the care providers and facilitates their development.
,3. A grievance brought by a staff care provider against the unit manager requires mediation. At the first
mediation session, the staff care provider 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 care provider in the discussion so as to clarify issues.
c.
Ask each party to Assessmentine her own motives and issues in the conflict.
d.
Continue to listen as the parties repeat their thoughts and feelings about the
conflict.
CORR ANS: C
Care providers and leaders must assess each situation as unique, determining appropriate actions
accordingly. Leaders must adapt their styles to complement specific issues being faced, such as
conflict. Assessmentining motives and issues for the conflict in perceptions promotes equal
representation of each point of view.
4. Shortly after being informed of fetal death, a labouring woman asks why she is not able to hear her
baby’s heartbeat on the monitor anymore. Although the monitor volume had been turned off so that
the client would be able to sleep between contractions, the care provider responded that there was
no heartbeat to hear because the baby had died in utero; then the care provider asked whether the
client would like to talk about how she was feeling. This response demonstrates:
a.
Lack of empathy.
b.
Ethical leadership.
c.
Complexity science. .
d.
A coercive relationship.
CORR ANS: B
Ethical leadership is based on a willingness to identify and act on complex problems in an ethical
manner. Leadership can be misused when coercive relationships form, and information and true
goals are withheld.
5. The manager of a surgical area envisions a future that requires the addition of registered care
provider (RN) assistants or unlicensed persons to feed, bathe, and walk clients. The RNs on the staff
have always practiced in a primary nursing-delivery system and are very resistant to this idea. The
best initial strategy in this situation would include:
a.
Exploring the values of the RNs in relation to this change.
b.
Leaving the RNs alone for a time so they can think about the change before they are
approached again.
c.
Dropping the idea and trying for the change in another year or so.
d.
Hiring the assistants and allowing the RNs to see what good additions they are.
CORR ANS: A
, Leadership involves engaged decision making around a vision that is based on evidence and tacit
knowledge. Influencing others requires emotional intelligence in domains such as empathy and
handling relationships.
6. As the charge care provider on the night shift in a small long-term care facility, you have found that
there is little turnover among your licensed practical care provider and nursing assistant (NA) staff
members, but they are not very motivated to work beyond their job descriptions. 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 licensed practical care providers and NAs.
b.
Allow the licensed practical care providers and NAs greater decision-making power
within the scope of their positions in the institution.
c.
Help the licensed practical care providers and NAs with their work, whenever possible.
d.
Ask the director of nursing to increase job security for night staff by having them sign
contracts that guarantee work.
CORR ANS: B
A care provider leader should provide an environment conducive to opinion sharing that involves staff
in decision making at all levels. This approach is shown to increase job satisfaction. Decision making
and the corresponding actions taken are core tasks performed in engagement with coworkers.
7. As the care provider manager, you want to increase motivation by providing motivating factors.
Which action would you select?
a.
Collaborate with the human resources/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.
CORR ANS: C
Complexity theory suggests that systems interact and adapt and that decision making occurs
throughout systems, as opposed to being made unilaterally by different levels of the organizational
hierarchy. In complexity theory, every person’s opinion counts, and therefore all levels of staff would
be involved in decision making. This principle underlies shared governance. Shared governance is an
Assessmentple of care provider decision making in which care providers at different organizational
levels engage in shaping policy and practices.
, 8. A charge care provider on a busy 40-bed medical/surgical unit is approached by a client’s son, who
begins to complain loudly about the quality of care his mother is receiving. His behaviour is so
disruptive that it is overheard by staff, physicians, and other visitors. The family member rejects any
attempt to intervene therapeutically to resolve the issue. He leaves the unit abruptly, and the care
provider is left feeling frustrated. Which behaviour by the charge care provider best illustrates
refined leadership skills in an emotionally intelligent practitioner?
a.
Reflection to obtain insight into how the situation could be handled differently in the
future
b.
Trying to catch up with the angry family member to resolve the concern
c.
Discussing the concern with the client after the family member has left
d.
Notifying nursing administration of the situation
CORR ANS: A
Emotional intelligence is closely aligned with individuals’ capacity to know themselves and others.
Reflecting to obtain insight and being able to “step” outside the situation to envision the context of
what is happening is an Assessmentple of the actions of an emotionally intelligent practitioner.
9. The chief nursing officer has asked the staff development coordinator to facilitate the development of
a clinical competency program for the facility. While making rounds on the units, the staff
development coordinator overhears RN staff complaining that they believe it is insulting to be
required to participate in a competency program. Which behaviour by the staff development
coordinator is most appropriate in this situation?
a. Disregard staff concerns and continue with.development of the program.
b. U S
Inform the care providers that this program is a requirement for accreditation by
the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
c.
Schedule a meeting with the chief care provider executive to apprise her of the situation.
d.
Facilitate a meeting so care providers can articulate their values and concerns
about a competency program.
CORR ANS: D
The manager role involves guiding other people through a set of derived practices that are evidence-
informed and known to satisfy pre-established outcomes such as participation in a competency
program. This involves engagement of staff through sharing of concerns and ideas. This type of
leader can instill hope and trust in followers, which influence their behaviours and attitudes (such as
engagement and satisfaction) and cause work environments to become more positive.
10. Which category is unique to leadership but is not part of management?
a.
Initiating change
b.
Personal qualities
c.
Developing people
d.
Information management
