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,Chapter 01: Leading, Managing, and Following
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Yoder-Wise: Leading and Managing in Nursing, 7th Edition L
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MULTIPLE CHOICE L
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1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults.
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She is asked to assess and adapt the unit to better meet the unique needs of the older adult
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patient. Using complexity principles, what would be the best approach to take for
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implementation of this change?
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a. Leverage the hierarchical management position to get unit staff involved in L
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assessment and planning.YFT L YFT L Y FT L
b. Engage involved staff at all levels in the decision-making process. L
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c. Focus the assessment on the unit and omit the hospital and YFT L YFT L YFTL YFT L YFT L YFTL YFT L YFT L YFT L YFT L
community environment. YFT L YFT L
d. Hire a geriatric specialist to oversee and control the project. L
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ANS: B Y F T L
Complexity theory suggests that systems interact and adapt and that decision making YFT L Y FT L YFT L Y FT L Y FT L YFT L Y FT L YFT L Y FT L YFT L YFT L
occurs throughout the systems, as opposed to being held in a hierarchy. In complexity
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theory, every voice counts, and therefore, all levels of staff would be involved in
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decision making.
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TOP: AONE competency: Communication and Relationship-Building
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2. A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who
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has
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called in sick five times in the past month. He tells the manager that he very much wants
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to come to work when scheduled but must often care for his wife, who is undergoing
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treatment
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for breast cancer. According t oUM aSs l o w
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erarchy theory, what would be the best Y FT L Y F T L Y FT L L
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approach to satisfying the needs of this nurse, other staff, and patients? L
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a. Line up agency nurses who can be called in to work on short notice. L
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b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment. Y
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c. Sympathize with the nurse‘s dilemma and let the charge nurse know that this YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L
nurse may be calling in frequently in the future.
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d. Work with the nurse, staffing office, and other nurses to arrange his YFT L YFT L YFT L YFT L L
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scheduled days off around his wife‘s treatments.
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ANS: D Y F T L
Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic
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needs and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could
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affect patient care and threaten the needs of staff to feel competent. Arranging the
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schedule around the wife‘s needs meets the needs of the staff and of patients while
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satisfying the nurse‘s need for affiliation.
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TOP: AONE competency: Communication and Relationship-Building
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3. A grievance brought by a staff nurse against the unit manager requires mediation. At the
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first mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair,
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and the unit manager continues to reiterate the reasons for the actions. What would be the
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best course of action at this time?
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a. Send the two disputants away to reach their own resolution. YFT L YFT L YFT L YFT L L
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b. Involve another staff nurse in the discussion for clarity issues. YFT L YFT L YF
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, c. Ask each party to examine their own motives and issues in the conflict. YFT L YFT L L
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d. Continue to listen as the parties repeat their thoughts and feelings about YFT L L
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For resolution of conflict, one should address the interests and involvement of participants in
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the conflict by examining the real issues of all parties.
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TOP: AONE competency: Communication and Relationship-Building
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4. At a second negotiation session, the unit manager and staff nurse are unable to reach
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a resolution. What is the appropriate next step?
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a. Arrange another meeting in a week‘s time so as to allow a cooling-off period. YF
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b. Elevate the next negation session to the next manager, one level above. L
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c. Insist that participants continue to talk until a resolution has been reached. L
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d. Back the unit manager‘s actions and end the dispute. L
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ANS: B Y F T L
Part of leadership is understanding conflict resolution and ability to negotiate and manage for
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resolution of issues and concerns. This situation has failed a second negotiation session,
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elevation to a manager with additional training to facilitate conflict resolution is important
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at this point.
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TOP: AONE competency: Communication and Relationship-Building
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5. The manager of a surgical area has a vision for the future that requires the addition of
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RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on
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the staff
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have always practiced in a p rN
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veryMs ys tem and are very resistant to this idea. L L L L L L L L L L L L
What would be the best initialUstrategy
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a. Exploring the values and feelings of the RN group in relationship to this change L
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b. Leaving the RNs alone for a time so they can think about the change before it YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L L
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is implemented YFT L YFT L
c. Dropping the idea and trying for the change in a year or so when some of YFT L YFT L YFTL L
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the present RNs have retired
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d. Hiring the assistants and allowing the RNs to see what good additions they are Y
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Influencing others requires emotional intelligence in domains such as empathy, handling Y FT L YFT L YFT L YFT L YFT L Y FT L Y FT L Y FT L YFT L YFT L
relationships, deepening self-awareness in self and others, motivating others, and
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managing emotions. Motivating others recognizes that values are powerful forces that
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influence acceptance of change. Leaving the RNs alone for a period of time before
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implementation does not provide opportunity to explore different perspectives and values.
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Avoiding discussion until the team changes may not promote adoption of the change until
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there is opportunity to explore perspectives and values related to the change. Hiring of the
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assistants demonstrates lack of empathy for the perspectives of the RN staff.
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TOP: AONE competency: Knowledge of the Health Care Environment
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, 6. As the RN charge nurse on the night shift in a small long-term care facility, you‘ve found
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that there is little turnover among your LPN and nursing assistant (NA) staff members,
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but they are not very motivated to go beyond their job descriptions in their work. Which
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of the following strategies might motivate the staff and lead to greater job satisfaction?
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a. Ask the director of nursing to offer higher wages and bonuses for extra work YFT L YFT L L
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for the night LPNs and NAs. L
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b. Allow the LPNs and NAs greater decision-making power within the scope of YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L L
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their positions in the institution.
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c. Hire additional staff so that there are more staff available for enhanced care, L
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and individual workloads are lessened.
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d. Ask the director of nursing to increase job security for night staff by having YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L YFT L L
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them sign contracts that guarantee work.
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ANS: B Y F T L
Hygiene factors such as salary, working conditions, and security are consistent with Y FT L Y FT L YFT L Y FT L Y FT L Y FT L YFT L YFT L YFT L Y FT L YFT L
Herzberg‘s two-factor theory of motivation; meeting these needs avoids job dissatisfaction.
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Motivator factors such as recognition and satisfaction with work promote a satisfying and
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enriched work environment. Transformational leaders use motivator factors liberally to
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inspire work performance and increase job satisfaction.
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TOP: AONE competency: Communication and Relationship-Building
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7. The nurse manager wants to increase motivation by providing motivating factors for the
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a. Collaborate with the human resource/personnel department to develop on-site YFT L YFTL YFT L YFT L YFT L YFT L YFT L YFT L
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b. Provide a hierarchical orgNaniR
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c. Implement a model of shareUd gS ov e r n anTc e. O
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d. Promote the development of a flexible benefits package. L
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ANS: C Y F T L
Complexity theory suggests that systems interact and adapt and that decision making occurs YFTL YFT L YFT L YFT L YFTL YFT L YFT L YFT L L
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throughout systems, as opposed to being held in a hierarchy. In complexity theory, every
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voice counts, and therefore all levels of staff would be involved in decision making. This
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principle is the foundation of shared governance.
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TOP: AONE competency: Communication and Relationship-Building
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8. A charge nurse on a busy 40-bed medical/surgical
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who begins to complain loudly about the quality of care his mother is receiving. His
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behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The
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family member leaves the unit abruptly, and the nurse is left feeling frustrated. Which
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behavior by the charge nurse best illustrates refined leadership skills in an emotionally
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intelligent practitioner?
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a. Reflect to gain insight into how the situation could be handled differently in YFT L YFT L YFT L L
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the future. YFT L YFT L
b. Try to catch up with the angry family member to resolve the concern. L
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c. Discuss the concern with the patient after the family member has left. YFT L YFTL YFT L YFT L YFT L YFT L YFT L YFT L L
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d. Notify nursing administration of the situation. L
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ANS: A Y F T L