Chapter 01: Leading, Managing, and Following
Waddell/Walton: Yoder-
Wise’s Leading and Managing in Canadian Nursing, third Edition
MULTIPLE CHOICE
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 older adult patients. According to compl
exity principles, what would be the best approach to take in making this change?
Leverage the hierarchical management position to get unit staff involved
i n assessment and planning.
Engage involved staff at all levels in the decision-making process.
Focus the assessment on the unit, and omit the hospital and commun
i ty environment.
Hire a geriatric specialist to oversee and control the project.
ANS: B
Complexity theory suggests that systems interact and adapt and that decision making occur
s throughout the systems, as opposed to being held in a hierarchy. In complexity theory, e
verybody‘s opinion counts; therefore, all levels of staff would be involved in decision ma
king.
DIF: Cognitive Level: Apply
REF: Page 14 TOP: Nursing Process: Implement
ation
NRIGB.CM
UvbS
vbvb N
vbvb T
vbHHHvb vb O
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 t
o come to work when scheduled, but must often care for his wife, who is undergoing treat
ment for breast cancer. In the practice of a strengths-
based nursing leader, what would be the best approach to satisfying the needs of this nurs
e, 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 thi
s nur se may be calling in frequently in the future.
d.
Work with the nurse, staffing office, and other nurses to arrange his sc
hedul ed days off around his wife‘s treatments.
ANS: D
Placing the nurse on unpaid leave may threaten physiologic needs and demotivate the nurs
e . Unsatisfactory coverage of shifts on short notice could affect patient care and threaten s
t aff members‘ sense of competence. Strengths-
based nurse leaders honour the uniqueness of individuals, teams, systems, and organizatio
ns; 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 nurses
and facilitates their development.
DIF: Cognitive Level: Analyze
REF: Page 6 TOP: Nursing Process: Implement
ation
,PASINGGRADES.
COM
,Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
A grievance brought by a staff nurse against the unit manager requires mediation. At the fi
rst mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair, an
the unit manager continues to reiterate the reasons for the actions. What would be the be
st course of action at this time?
Send the two disputants away to reach their own resolution.
Involve another staff nurse in the discussion so as to clarify issues. Ask
each party to examine her own motives and issues in the conflict.
Continue to listen as the parties repeat their thoughts and feelings about
t he conflict.
ANS: C
Nurses and leaders must assess each situation as unique, determining appropriate actions a
ccordingly. Leaders must adapt their styles to complement specific issues being faced, suc
h as conflict. Examining motives and issues for the conflict in perceptions promotes equal
representation of each point of view.
DIF: Cognitive Level: Apply REF: Pages 11–
13 TOP: Nursing Process: Implementation
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 patient would be able to sleep between contractions, the nurse respon
ded that there was no heartbeat to hear because the baby had died in utero; then the nurse a
sked whether the patient would like to talk about how she was feeling. This response dem
onstrates:
Lack of empathy.
Ethical leadership.
Complexity science.PASINGGRADES.COM
A coercive relationship.
ANS: B
Ethical leadership is based on a willingness to identify and act on complex problems in an e
thical manner. Leadership can be misused when coercive relationships form, and informatio
n and true goals are withheld.
DIF: Cognitive Level: Analyze
REF: Page 7 TOP: Nursing Process: Implement
ation
The manager of a surgical area envisions a future that requires the addition of registered nu
r se (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. The best initial strategy in this situation
would include:
Exploring the values of the RNs in relation to this change.
Leaving the RNs alone for a time so they can think about the change before th
ey are approached again.
Dropping the idea and trying for the change in another year or so.
Hiring the assistants and allowing the RNs to see what good additions they are.
ANS: A
PASINGGRADES.
COM
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
Leadership involves engaged decision making around a vision that is based on evidence a
n d tacit knowledge. Influencing others requires emotional intelligence in domains such as
e mpathy and handling relationships.
DIF: Cognitive Level: Apply
REF: Page 5 TOP: Nursing Process: Implement
ation
As the charge nurse on the night shift in a small long-
term care facility, you have found that there is little turnover among your licensed practical
nurse and nursing assistant (NA) staff members, but they are not very motivated to work b
eyond their job descriptions. Which of the following strategies might motivate the staff and
lead to greater job satisfaction?
Ask the director of nursing to offer higher wages and bonuses for extra work f
or the night licensed practical nurses and NAs.
Allow the licensed practical nurses and NAs greater decision-
making power within the scope of their positions in the institution.
Help the licensed practical nurses and NAs with their work, whenever possible.
Ask the director of nursing to increase job security for night staff by having th
em sign contracts that guarantee work.
ANS: B
A nurse leader should provide an environment conducive to opinion sharing that involves st
a
in decision making at all levels. This approach is shown to increase job satisfaction. Deci
sion making and the corresponding actions taken are core tasks performed in engagement w
ith coworkers.
DIF: Cognitive Level: Apply
REF: Page 7 TOP: Nursing Process:G ImplB.CemMNen
vb vb
tRati onI
USNT O
As the nurse manager, you want to increase motivation by providing motivating factor s.
Which action would you select?
Collaborate with the human resources/personnel department to develop on
-site daycare services.
Provide a hierarchical organizational structure.
Implement a model of shared governance.
Promote the development of a flexible benefits package.
ANS: C
Complexity theory suggests that systems interact and adapt and that decision making occu
rs throughout systems, as opposed to being made unilaterally by different levels of the or
ganizational 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 g
overnance. Shared governance is an example of nurse decision making in which nurses at
different organizational levels engage in shaping policy and practices.
DIF: Cognitive Level: Apply
REF: Page 5 TOP: Nursing Process: Implement
ation
Waddell/Walton: Yoder-
Wise’s Leading and Managing in Canadian Nursing, third Edition
MULTIPLE CHOICE
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 older adult patients. According to compl
exity principles, what would be the best approach to take in making this change?
Leverage the hierarchical management position to get unit staff involved
i n assessment and planning.
Engage involved staff at all levels in the decision-making process.
Focus the assessment on the unit, and omit the hospital and commun
i ty environment.
Hire a geriatric specialist to oversee and control the project.
ANS: B
Complexity theory suggests that systems interact and adapt and that decision making occur
s throughout the systems, as opposed to being held in a hierarchy. In complexity theory, e
verybody‘s opinion counts; therefore, all levels of staff would be involved in decision ma
king.
DIF: Cognitive Level: Apply
REF: Page 14 TOP: Nursing Process: Implement
ation
NRIGB.CM
UvbS
vbvb N
vbvb T
vbHHHvb vb O
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 t
o come to work when scheduled, but must often care for his wife, who is undergoing treat
ment for breast cancer. In the practice of a strengths-
based nursing leader, what would be the best approach to satisfying the needs of this nurs
e, 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 thi
s nur se may be calling in frequently in the future.
d.
Work with the nurse, staffing office, and other nurses to arrange his sc
hedul ed days off around his wife‘s treatments.
ANS: D
Placing the nurse on unpaid leave may threaten physiologic needs and demotivate the nurs
e . Unsatisfactory coverage of shifts on short notice could affect patient care and threaten s
t aff members‘ sense of competence. Strengths-
based nurse leaders honour the uniqueness of individuals, teams, systems, and organizatio
ns; 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 nurses
and facilitates their development.
DIF: Cognitive Level: Analyze
REF: Page 6 TOP: Nursing Process: Implement
ation
,PASINGGRADES.
COM
,Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
A grievance brought by a staff nurse against the unit manager requires mediation. At the fi
rst mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair, an
the unit manager continues to reiterate the reasons for the actions. What would be the be
st course of action at this time?
Send the two disputants away to reach their own resolution.
Involve another staff nurse in the discussion so as to clarify issues. Ask
each party to examine her own motives and issues in the conflict.
Continue to listen as the parties repeat their thoughts and feelings about
t he conflict.
ANS: C
Nurses and leaders must assess each situation as unique, determining appropriate actions a
ccordingly. Leaders must adapt their styles to complement specific issues being faced, suc
h as conflict. Examining motives and issues for the conflict in perceptions promotes equal
representation of each point of view.
DIF: Cognitive Level: Apply REF: Pages 11–
13 TOP: Nursing Process: Implementation
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 patient would be able to sleep between contractions, the nurse respon
ded that there was no heartbeat to hear because the baby had died in utero; then the nurse a
sked whether the patient would like to talk about how she was feeling. This response dem
onstrates:
Lack of empathy.
Ethical leadership.
Complexity science.PASINGGRADES.COM
A coercive relationship.
ANS: B
Ethical leadership is based on a willingness to identify and act on complex problems in an e
thical manner. Leadership can be misused when coercive relationships form, and informatio
n and true goals are withheld.
DIF: Cognitive Level: Analyze
REF: Page 7 TOP: Nursing Process: Implement
ation
The manager of a surgical area envisions a future that requires the addition of registered nu
r se (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. The best initial strategy in this situation
would include:
Exploring the values of the RNs in relation to this change.
Leaving the RNs alone for a time so they can think about the change before th
ey are approached again.
Dropping the idea and trying for the change in another year or so.
Hiring the assistants and allowing the RNs to see what good additions they are.
ANS: A
PASINGGRADES.
COM
, Yoder-Wise's Leading and Managing in Canadian Nursing 3rd Edition Yoder-
Leadership involves engaged decision making around a vision that is based on evidence a
n d tacit knowledge. Influencing others requires emotional intelligence in domains such as
e mpathy and handling relationships.
DIF: Cognitive Level: Apply
REF: Page 5 TOP: Nursing Process: Implement
ation
As the charge nurse on the night shift in a small long-
term care facility, you have found that there is little turnover among your licensed practical
nurse and nursing assistant (NA) staff members, but they are not very motivated to work b
eyond their job descriptions. Which of the following strategies might motivate the staff and
lead to greater job satisfaction?
Ask the director of nursing to offer higher wages and bonuses for extra work f
or the night licensed practical nurses and NAs.
Allow the licensed practical nurses and NAs greater decision-
making power within the scope of their positions in the institution.
Help the licensed practical nurses and NAs with their work, whenever possible.
Ask the director of nursing to increase job security for night staff by having th
em sign contracts that guarantee work.
ANS: B
A nurse leader should provide an environment conducive to opinion sharing that involves st
a
in decision making at all levels. This approach is shown to increase job satisfaction. Deci
sion making and the corresponding actions taken are core tasks performed in engagement w
ith coworkers.
DIF: Cognitive Level: Apply
REF: Page 7 TOP: Nursing Process:G ImplB.CemMNen
vb vb
tRati onI
USNT O
As the nurse manager, you want to increase motivation by providing motivating factor s.
Which action would you select?
Collaborate with the human resources/personnel department to develop on
-site daycare services.
Provide a hierarchical organizational structure.
Implement a model of shared governance.
Promote the development of a flexible benefits package.
ANS: C
Complexity theory suggests that systems interact and adapt and that decision making occu
rs throughout systems, as opposed to being made unilaterally by different levels of the or
ganizational 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 g
overnance. Shared governance is an example of nurse decision making in which nurses at
different organizational levels engage in shaping policy and practices.
DIF: Cognitive Level: Apply
REF: Page 5 TOP: Nursing Process: Implement
ation
