TEST BANK
LEADING AND MANAGING IN NURSING
,Table Of Contents
Part 1 Overview
1. Leading, Managing, And Following
2. Quality And Safety
3. Ethical And Legal Issues In Nursing
4. Toward Justice
5. Healthy Workplaces, Healthy Workforce
6. Translating Research Into Practice
Part 2 Know Yourself
7. Gaining Personal Insight: Being An Effective Follower And Leader
8. Communication And Conflict
Part 3 Know The Organization
9. Healthcare Organizations And Structures
10. Person-Centered Care
11. Staffing And Scheduling
12. Workforce Engagement Through Collective Action And Governance
13. Solving Problems And Influencing Positive Outcomes
14. Delegating: Authority, Accountability, And Responsibility In Delegation Decisions
15. Effecting Change, Large And Small
16. Building Effective Teams
Part 4 Use Your Skills
17. The Impact Of Technology
18. Artificial Intelligence
19. Managing Costs And Budgets
20. Selecting, Developing, And Evaluating Staff
21. Managing Personal And Personnel Problems
Part 5 Prepare For The Future
22. Role Transition
23. Managing Your Career
24. Developing Leaders, Managers, And Followers
25. Thriving For The Future
,Chapter 01: Leading, Managing, And Following
Yoder-Wise: Leading And Managing In Nursing, 8th Edition
Multiple Choice
1. 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 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.
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 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
The Needs Of This Nurse, Other Staff, And Patients?
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 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 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.
Ref: Page 10 Top: Aone Competency: Communication And Relationship-Building
,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 Unit Manager 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 Is Recommended 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. The Best 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 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: 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.
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 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: 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.
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,
Which Action Would You Select?
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: C
Complexity Theory Suggests That Systems Interact And Adapt And That Decision Making
Occurs Throughout 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. This Principle Is The Foundation Of Shared Governance.
Ref: Pages 8-11 Top: Aone Competency: Communication And Relationship-Building
8. A Charge Nurse On A Busy 40-Bed Medical/Surgical Unit Is Approached By A Family
Member Who Begins To Complain Loudly About The Quality Of Care His Mother Is
Receiving. His Behavior 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 Nurse Is Left Feeling Frustrated. Which
Behavior By The Charge Nurse Best Illustrates Refined Leadership Skills In An Emotionally
Intelligent Practitioner?
a. Reflect To Gain Insight Into How The Situation Could Be Handled Differently In The Future.
b. Try To Catch Up With The Angry Family Member To Resolve The Concern.
c. Discuss The Concern With The Patient After The Family Member Has Left.
d. Notify Nursing Administration Of The Situation.
Ans: A
Goleman Suggests That Emotional Intelligence Involves Insight And Being Able To Step
Outside Of The Situation To Envision The Context Of What Is Happening As Well As
Being Able To Manage Emotions Such As Frustration Effectively.
Ref: Page 7 | Page 8 Top: Aone Competency: Leadership
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 Feel It Is Insulting To Be Required To Participate In A
Competency Program. Which Behavior By The Staff Development Coordinator Is Most
Appropriate In This Situation?
a. Disregard Staff Concerns And Continue With Development Of The Program.
b. Inform The Nurses That This Program Is A Requirement For Jcaho Accreditation.
c. Schedule A Meeting With The Chief Nurse Executive To Apprise Her Of The Situation.
d. Facilitate A Meeting So Nurses Can Articulate Their Values And Concerns About A
Competency Program.
Ans: D
The Manager Role Involves Guiding Others Through A Set Of Derived Practices That Are
Evidence- Based And Known To Satisfy Preestablished Outcomes Such As Participation In A
Competency Program. This Involves Engagement Of Staff Through Sharing Of Concerns And
Ideas. A Close Analysis Of The Iom Report And The Summary Of The Ppaca Suggests That No
Health Reform Can Unfold Without Active Nursing Engagement. Each Document Emphasizes
That Nurses Must Lead,
, Manage, And Behave As Active Collaborators With Other Members Of The Health Team
And With Those Being Served.
Ref: Page 3 Top: Aone Competency: Communication And Relationship-Building
10. As The Manager, You Have Been Asked To Implement An Evidence-Based Approach To
Teach Ostomy Patients Self-Management Skills Postoperatively That Is Being Operationalized
Throughout Your Organization. Which Of The Following Illustrates Effective Leadership?
a. The Training Modules Are Left In The Staff Room For Times When Staff Are Available.
b. The Current Approach Is Continued Because It Is Also Evidence-Based And Is More
Familiar To Staff.
c. You Decide To Implement The Approach At A Later Date Because Of Feedback From
The Rns That The New Approach Takes Too Much Time.
d. A Rn Who Is Already Familiar With The New Approach Volunteers To Take The
Lead In Mentoring And Teaching Others How To Implement It.
Ans: D
Followership Occurs When There Is Acquiescence To A Peer Who Is Leading In A Setting
Where A Team Has Gathered To Ensure The Best Clinical Decision Making And Actions
Are Taken To Achieve Clinical Or Organizational Outcomes. Followership Promotes Good
Clinical Decisions And Use Of Clinical Resources.
Ref: Page 4 | Page 5
Top: Aone Competency: Communication And Relationship-Building
11. You Overhear A Newly Graduated Rn Telling One Of Your Colleagues That Leadership And
Management Belong To The Unit Manager And Not To Her. As A Nursing Colleague, You
Respond By Demonstrating Understanding That The Perception Of The New Graduate:
a. Is Correct. Leadership Is Not The Role Of The Staff Nurse.
b. Would Benefit From Further Understanding Of Her Role As A Professional, Whose
Influence May Affect The Decision Making Of Patients, Colleagues, And Other
Professionals.
c. Has Been Influenced By Nurse Leaders And Managers Who Leave For Other Positions.
d. Is Related To The General Perception That Nurse Leaders And Managers Are Not
Satisfied In Their Jobs.
Ans: B
Care Coordination That Involves The Intersection Of Individual, Family, And Community-
Based Needs Requires That Nurses Have Self-Confidence, Knowledge Of Organizations
And Health Systems, And An Inner Desire To Lead And Manage. There Is Often A View
That Leadership Is Isolated To Those Holding Managerial Positions And That A Direct
Care Nurse Is Subject To Following By Adhering To The Direction Of Others. Such Views
Fail To Acknowledge That To Be A Nurse Requires Each Licensed Individual To Lead,
Manage, And Follow When Practicing At The Point-Of-Care And Beyond.
, Ref: Page 3 | Page 4 Top: Aone Competency: Leadership
12. You Walk Into Mr. Smith‘S Room And Find Him Yelling At The Lpn, Miss Jones. He Is
Obviously Very Upset And After You Speak With Him Regarding His Behavior, You
Determine That He Has Not Slept For Three Nights Because Of Unrelieved Pain Levels. The
Lpn Is Very Upset With Mr. Smith And Calls Him An ―Ugly, Old Man.‖ You Acknowledge
Her Feelings And Concerns And Then Suggest That Mr. Smith‘S Behavior Was Aggressive
But Is Related To Lack Of Sleep And To Pain. You Say To Miss Jones, ―Can You Both,
Together With Mr. Smith, Determine Triggers For The Pain And Effective Approaches To
Controlling His Pain?‖ This Approach Demonstrates:
a. Lack Of Empathy And Understanding For Miss Jones.
b. Concern With Placating Mr. Smith.
c. Leadership Behavior.
d. Management Behavior.
Ans: C
The Situation Between Mr. Smith And Miss Jones Is A Complex Situation Involving
Unrelieved Patient 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.
Ref: Page 4 Top: Aone Competency: Leadership
13. After Assessing An Older Adult Patient In Long-Term Care Who Has Been Slowly
Deteriorating For Weeks, The Nurse Manager Calls The Family And Asks Them To Come In,
As The Patient Is Dying. The Nurse Manager‘S Decision And Actions Are Based On:
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 Is
Dying, Because The Course Of Dying Is Not Standardized And Cannot Be Determined By
Clinical Pathways.
Ref: Page 4 Top: Aone Competency: Knowledge Of The Health Care Environment
14. Chart Audits Have Revealed Significant Omissions Of Data That Could Have Legal And
Funding Guidelines Ramifications. As The Unit Manager, You Meet With The Staff To
Discuss Audit Findings And To Find Approaches That Will Address The Gaps In Charting
And Achieve Desired Goals. This Is An Example Of:
a. Leadership.
b. Management.
c. Decision Making.
d. 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
Reach Pre-Determined Goals And Follow Established Practices.
Ref: Page 5 Top: Aone Competency: Knowledge Of The Health Care Environment
15. A Family Is Keeping Vigil At A Critically Ill Patient‘S Bedside. Other, Distant Family
Members, Not Yet Able To Come, Call The Unit Continuously, Asking For Updates And
Wanting To Express Concern. You Speak With The Distant Family Members And Suggest
That You Are Going To Refer Them To The Hospital Social Worker, Whose Role Is To Work
With People In Such Situations. What Role Are You 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 Processes. Referral To A
Social Worker Alleviates Demand On Staff Time And Is Consistent With Hospital
Procedures.
Ref: Page 5 Top: Aone Competency: Communication And Relationship-Building
16. A Family Is Keeping Vigil At A Critically Ill Patient‘S Bedside. Other, Distant Family
Members, Not Yet Able To Come, Call The Unit Continuously, Asking For Updates And
Wanting To Express Concern. You Speak With The Distant Family Members And Suggest
That You Are Going To Refer Them To The Hospital Social Worker, Whose Role Is To Work
With People In Such Situations. In Response To This Situation, You Approach The Unit
Manager To Apprise Her Of Your Concerns That The Family Dynamics Of The Patient
Involved May Lead To Staff-Family And Patient-Family Conflicts. You Suggest That The
Physician May Need To Discuss The Treatment Plan With The Family. The Unit Manager
Advises That He Will Arrange This Discussion. If, After The Meeting With Family Members,
This Is Identified As A Desired Approach, You Support The Manager‘S Decision. Your
Actions Indicate That You Are Acting In What Role? A
. Leadership
b. Management
c. Follower
d. Evidence-Based
Ans: C
, In The Followership Role, You Bring To The Manager Your Concerns About Potential Litigation
And Maximization Of Outcomes And Accept The Direction Given By The Manager In Response
To Your Concerns.
Ref: Page 3 | Page 4
Top: Aone Competency: Knowledge Of The Health Care Environment
17. You Pull Staff Together To Assess A Situation In Which The Family Of A Seriously Ill
Patient 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, You Explain That The
Organization Values Patient-Centered Care And That Evidence Supports That Acting As An
Advocate And A Listener Is Helpful To Families. You Ask The Staff For Ideas As To
Strategies That Are Effectively Patient-Centered In These Situations. In This Situation, You
Are Taking On Which Role?
a. Leadership
b. Management
c. Follower
d. Visionary
Ans: A
As A Leader, You Provide And Communicate Vision And Direction Based On Evidence And
Experience, And You Engage Others In Decision Making That Moves Them Toward The
Vision With A Reasonable Level Of Risk Taking.
Ref: Page 4 | Page 5 Top: Aone Competency: Leadership
18. Joan, The Nursing Unit Manager, Finds It Difficult To Work With Thomas, A New Graduate.
Thomas Has Many Ideas, And His Manner Of Presenting Them Irks Joan. After Reflection
And Discussion With Others, Joan Recognizes That She Also Feels Threatened By His
Behavior. She Comes To Understand That Thomas Is Trying To Establish His Own Role On
The Unit, Is Not Trying To Challenge Her, And Needs Guidance, Coaching, And Affirmation.
Joan Is Demonstrating:
a. A Positive Self-Concept.
b. Deepening Self-Awareness.
c. Leadership.
d. Acquiescence.
Ans: B
According To Goleman (1995), Stepping Outside Oneself To Envision The Situation While
Assuming Ownership Is A Component Of Emotional Intelligence.
Ref: Page 7 | Page 8 Top: Aone Competency: Professionalism
19. As The Head Of A Nursing Program, You Consistently Invite The Ideas Of Your Team About
Innovations In Teaching, Community Partnerships, And Curriculum Design And Invite
Participation
LEADING AND MANAGING IN NURSING
,Table Of Contents
Part 1 Overview
1. Leading, Managing, And Following
2. Quality And Safety
3. Ethical And Legal Issues In Nursing
4. Toward Justice
5. Healthy Workplaces, Healthy Workforce
6. Translating Research Into Practice
Part 2 Know Yourself
7. Gaining Personal Insight: Being An Effective Follower And Leader
8. Communication And Conflict
Part 3 Know The Organization
9. Healthcare Organizations And Structures
10. Person-Centered Care
11. Staffing And Scheduling
12. Workforce Engagement Through Collective Action And Governance
13. Solving Problems And Influencing Positive Outcomes
14. Delegating: Authority, Accountability, And Responsibility In Delegation Decisions
15. Effecting Change, Large And Small
16. Building Effective Teams
Part 4 Use Your Skills
17. The Impact Of Technology
18. Artificial Intelligence
19. Managing Costs And Budgets
20. Selecting, Developing, And Evaluating Staff
21. Managing Personal And Personnel Problems
Part 5 Prepare For The Future
22. Role Transition
23. Managing Your Career
24. Developing Leaders, Managers, And Followers
25. Thriving For The Future
,Chapter 01: Leading, Managing, And Following
Yoder-Wise: Leading And Managing In Nursing, 8th Edition
Multiple Choice
1. 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 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.
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 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
The Needs Of This Nurse, Other Staff, And Patients?
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 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 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.
Ref: Page 10 Top: Aone Competency: Communication And Relationship-Building
,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 Unit Manager 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 Is Recommended 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. The Best 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 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: 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.
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 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: 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.
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,
Which Action Would You Select?
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: C
Complexity Theory Suggests That Systems Interact And Adapt And That Decision Making
Occurs Throughout 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. This Principle Is The Foundation Of Shared Governance.
Ref: Pages 8-11 Top: Aone Competency: Communication And Relationship-Building
8. A Charge Nurse On A Busy 40-Bed Medical/Surgical Unit Is Approached By A Family
Member Who Begins To Complain Loudly About The Quality Of Care His Mother Is
Receiving. His Behavior 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 Nurse Is Left Feeling Frustrated. Which
Behavior By The Charge Nurse Best Illustrates Refined Leadership Skills In An Emotionally
Intelligent Practitioner?
a. Reflect To Gain Insight Into How The Situation Could Be Handled Differently In The Future.
b. Try To Catch Up With The Angry Family Member To Resolve The Concern.
c. Discuss The Concern With The Patient After The Family Member Has Left.
d. Notify Nursing Administration Of The Situation.
Ans: A
Goleman Suggests That Emotional Intelligence Involves Insight And Being Able To Step
Outside Of The Situation To Envision The Context Of What Is Happening As Well As
Being Able To Manage Emotions Such As Frustration Effectively.
Ref: Page 7 | Page 8 Top: Aone Competency: Leadership
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 Feel It Is Insulting To Be Required To Participate In A
Competency Program. Which Behavior By The Staff Development Coordinator Is Most
Appropriate In This Situation?
a. Disregard Staff Concerns And Continue With Development Of The Program.
b. Inform The Nurses That This Program Is A Requirement For Jcaho Accreditation.
c. Schedule A Meeting With The Chief Nurse Executive To Apprise Her Of The Situation.
d. Facilitate A Meeting So Nurses Can Articulate Their Values And Concerns About A
Competency Program.
Ans: D
The Manager Role Involves Guiding Others Through A Set Of Derived Practices That Are
Evidence- Based And Known To Satisfy Preestablished Outcomes Such As Participation In A
Competency Program. This Involves Engagement Of Staff Through Sharing Of Concerns And
Ideas. A Close Analysis Of The Iom Report And The Summary Of The Ppaca Suggests That No
Health Reform Can Unfold Without Active Nursing Engagement. Each Document Emphasizes
That Nurses Must Lead,
, Manage, And Behave As Active Collaborators With Other Members Of The Health Team
And With Those Being Served.
Ref: Page 3 Top: Aone Competency: Communication And Relationship-Building
10. As The Manager, You Have Been Asked To Implement An Evidence-Based Approach To
Teach Ostomy Patients Self-Management Skills Postoperatively That Is Being Operationalized
Throughout Your Organization. Which Of The Following Illustrates Effective Leadership?
a. The Training Modules Are Left In The Staff Room For Times When Staff Are Available.
b. The Current Approach Is Continued Because It Is Also Evidence-Based And Is More
Familiar To Staff.
c. You Decide To Implement The Approach At A Later Date Because Of Feedback From
The Rns That The New Approach Takes Too Much Time.
d. A Rn Who Is Already Familiar With The New Approach Volunteers To Take The
Lead In Mentoring And Teaching Others How To Implement It.
Ans: D
Followership Occurs When There Is Acquiescence To A Peer Who Is Leading In A Setting
Where A Team Has Gathered To Ensure The Best Clinical Decision Making And Actions
Are Taken To Achieve Clinical Or Organizational Outcomes. Followership Promotes Good
Clinical Decisions And Use Of Clinical Resources.
Ref: Page 4 | Page 5
Top: Aone Competency: Communication And Relationship-Building
11. You Overhear A Newly Graduated Rn Telling One Of Your Colleagues That Leadership And
Management Belong To The Unit Manager And Not To Her. As A Nursing Colleague, You
Respond By Demonstrating Understanding That The Perception Of The New Graduate:
a. Is Correct. Leadership Is Not The Role Of The Staff Nurse.
b. Would Benefit From Further Understanding Of Her Role As A Professional, Whose
Influence May Affect The Decision Making Of Patients, Colleagues, And Other
Professionals.
c. Has Been Influenced By Nurse Leaders And Managers Who Leave For Other Positions.
d. Is Related To The General Perception That Nurse Leaders And Managers Are Not
Satisfied In Their Jobs.
Ans: B
Care Coordination That Involves The Intersection Of Individual, Family, And Community-
Based Needs Requires That Nurses Have Self-Confidence, Knowledge Of Organizations
And Health Systems, And An Inner Desire To Lead And Manage. There Is Often A View
That Leadership Is Isolated To Those Holding Managerial Positions And That A Direct
Care Nurse Is Subject To Following By Adhering To The Direction Of Others. Such Views
Fail To Acknowledge That To Be A Nurse Requires Each Licensed Individual To Lead,
Manage, And Follow When Practicing At The Point-Of-Care And Beyond.
, Ref: Page 3 | Page 4 Top: Aone Competency: Leadership
12. You Walk Into Mr. Smith‘S Room And Find Him Yelling At The Lpn, Miss Jones. He Is
Obviously Very Upset And After You Speak With Him Regarding His Behavior, You
Determine That He Has Not Slept For Three Nights Because Of Unrelieved Pain Levels. The
Lpn Is Very Upset With Mr. Smith And Calls Him An ―Ugly, Old Man.‖ You Acknowledge
Her Feelings And Concerns And Then Suggest That Mr. Smith‘S Behavior Was Aggressive
But Is Related To Lack Of Sleep And To Pain. You Say To Miss Jones, ―Can You Both,
Together With Mr. Smith, Determine Triggers For The Pain And Effective Approaches To
Controlling His Pain?‖ This Approach Demonstrates:
a. Lack Of Empathy And Understanding For Miss Jones.
b. Concern With Placating Mr. Smith.
c. Leadership Behavior.
d. Management Behavior.
Ans: C
The Situation Between Mr. Smith And Miss Jones Is A Complex Situation Involving
Unrelieved Patient 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.
Ref: Page 4 Top: Aone Competency: Leadership
13. After Assessing An Older Adult Patient In Long-Term Care Who Has Been Slowly
Deteriorating For Weeks, The Nurse Manager Calls The Family And Asks Them To Come In,
As The Patient Is Dying. The Nurse Manager‘S Decision And Actions Are Based On:
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 Is
Dying, Because The Course Of Dying Is Not Standardized And Cannot Be Determined By
Clinical Pathways.
Ref: Page 4 Top: Aone Competency: Knowledge Of The Health Care Environment
14. Chart Audits Have Revealed Significant Omissions Of Data That Could Have Legal And
Funding Guidelines Ramifications. As The Unit Manager, You Meet With The Staff To
Discuss Audit Findings And To Find Approaches That Will Address The Gaps In Charting
And Achieve Desired Goals. This Is An Example Of:
a. Leadership.
b. Management.
c. Decision Making.
d. 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
Reach Pre-Determined Goals And Follow Established Practices.
Ref: Page 5 Top: Aone Competency: Knowledge Of The Health Care Environment
15. A Family Is Keeping Vigil At A Critically Ill Patient‘S Bedside. Other, Distant Family
Members, Not Yet Able To Come, Call The Unit Continuously, Asking For Updates And
Wanting To Express Concern. You Speak With The Distant Family Members And Suggest
That You Are Going To Refer Them To The Hospital Social Worker, Whose Role Is To Work
With People In Such Situations. What Role Are You 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 Processes. Referral To A
Social Worker Alleviates Demand On Staff Time And Is Consistent With Hospital
Procedures.
Ref: Page 5 Top: Aone Competency: Communication And Relationship-Building
16. A Family Is Keeping Vigil At A Critically Ill Patient‘S Bedside. Other, Distant Family
Members, Not Yet Able To Come, Call The Unit Continuously, Asking For Updates And
Wanting To Express Concern. You Speak With The Distant Family Members And Suggest
That You Are Going To Refer Them To The Hospital Social Worker, Whose Role Is To Work
With People In Such Situations. In Response To This Situation, You Approach The Unit
Manager To Apprise Her Of Your Concerns That The Family Dynamics Of The Patient
Involved May Lead To Staff-Family And Patient-Family Conflicts. You Suggest That The
Physician May Need To Discuss The Treatment Plan With The Family. The Unit Manager
Advises That He Will Arrange This Discussion. If, After The Meeting With Family Members,
This Is Identified As A Desired Approach, You Support The Manager‘S Decision. Your
Actions Indicate That You Are Acting In What Role? A
. Leadership
b. Management
c. Follower
d. Evidence-Based
Ans: C
, In The Followership Role, You Bring To The Manager Your Concerns About Potential Litigation
And Maximization Of Outcomes And Accept The Direction Given By The Manager In Response
To Your Concerns.
Ref: Page 3 | Page 4
Top: Aone Competency: Knowledge Of The Health Care Environment
17. You Pull Staff Together To Assess A Situation In Which The Family Of A Seriously Ill
Patient 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, You Explain That The
Organization Values Patient-Centered Care And That Evidence Supports That Acting As An
Advocate And A Listener Is Helpful To Families. You Ask The Staff For Ideas As To
Strategies That Are Effectively Patient-Centered In These Situations. In This Situation, You
Are Taking On Which Role?
a. Leadership
b. Management
c. Follower
d. Visionary
Ans: A
As A Leader, You Provide And Communicate Vision And Direction Based On Evidence And
Experience, And You Engage Others In Decision Making That Moves Them Toward The
Vision With A Reasonable Level Of Risk Taking.
Ref: Page 4 | Page 5 Top: Aone Competency: Leadership
18. Joan, The Nursing Unit Manager, Finds It Difficult To Work With Thomas, A New Graduate.
Thomas Has Many Ideas, And His Manner Of Presenting Them Irks Joan. After Reflection
And Discussion With Others, Joan Recognizes That She Also Feels Threatened By His
Behavior. She Comes To Understand That Thomas Is Trying To Establish His Own Role On
The Unit, Is Not Trying To Challenge Her, And Needs Guidance, Coaching, And Affirmation.
Joan Is Demonstrating:
a. A Positive Self-Concept.
b. Deepening Self-Awareness.
c. Leadership.
d. Acquiescence.
Ans: B
According To Goleman (1995), Stepping Outside Oneself To Envision The Situation While
Assuming Ownership Is A Component Of Emotional Intelligence.
Ref: Page 7 | Page 8 Top: Aone Competency: Professionalism
19. As The Head Of A Nursing Program, You Consistently Invite The Ideas Of Your Team About
Innovations In Teaching, Community Partnerships, And Curriculum Design And Invite
Participation
