,Test Bank Leading and Managing in Nursing 8th Edition By Patricia S. Yoder-Wise, Comprehensive Exam
Material Graded A+
Leading and Managing in Nursing, 8th Edition
Chapter 1: Leading, Managing, and Following
Section A: Multiple Choice Questions (1–30)
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 for implementation of 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.
Answer: B
Rationale: 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 .
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 satisfying the needs of this nurse,
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 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.
Answer: D
Rationale: Placing the nurse on unpaid leave may threaten the nurse's capacity to meet physiologic
needs and demotivate the nurse. 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 .
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 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 nurse in the discussion for clarity issues.
C) Ask each party to examine their own motives and issues in the conflict.
D) Continue to listen as the parties repeat their thoughts and feelings about the conflict.
Answer: C
,Rationale: For resolution of conflict, one should address the interests and involvement of participants in
the conflict by examining the real issues of all parties .
4. At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution.
What is the appropriate next step?
A) Arrange another meeting in a week's time so as to allow a cooling-off period.
B) Elevate the next negotiation session to the next manager, one level above.
C) Insist that participants continue to talk until a resolution has been reached.
D) Back the unit manager's actions and end the dispute.
Answer: B
Rationale: Part of leadership is understanding conflict resolution and ability to negotiate and manage for
resolution of issues and concerns. This situation has failed a second negotiation session; elevation to a
manager with additional training to facilitate conflict resolution is important at this point .
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 ambulate patients. The RNs on the staff have always practiced in
a primary nursing-delivery system and are very resistant to this idea. What would be the best initial
strategy for implementation of this change?
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.
Answer: A
Rationale: 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 .
6. A nurse manager is considering implementing a new evidence-based practice protocol on the unit.
According to complexity theory, what is the most effective approach? A)
Mandate the change through hierarchical authority.
B) Engage staff at all levels in decision-making about the change.
C) Implement the change without staff input to save time.
D) Delay the change indefinitely until all staff agree.
Answer: B
Rationale: Complexity theory holds that decision making occurs throughout the system, not just at the
top. Every voice counts, so all levels of staff should be involved .
7. A nurse manager is working with a staff nurse who has been late to work several times. The manager
wants to use a leadership approach. Which action best demonstrates leadership? A) Issuing a written
warning without discussion.
B) Collaborating with the nurse to identify barriers and solutions.
C) Reporting the nurse to human resources immediately.
D) Ignoring the behavior to avoid conflict.
Answer: B
, Rationale: Leadership involves engaged, collaborative guidance and decision making, especially in
complex situations where there is no standardized solution .
8. A new graduate nurse states that leadership is not part of her role because she is not a manager.
What is the best response?
A) Agree that leadership is only for those in managerial positions.
B) Explain that every nurse must lead, manage, and follow when practicing at the point of care.
C) Tell the new graduate that she will understand leadership later in her career.
D) Suggest that the new graduate focus only on clinical skills for now.
Answer: B
Rationale: 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. Every licensed individual must lead, manage, and follow .
9. A charge nurse finds a patient yelling at an LPN. The patient has not slept for three nights because of
unrelieved pain. The LPN is upset and calls the patient an "ugly, old man." The charge nurse
acknowledges the LPN's feelings and then suggests that the patient's behavior was related to lack of
sleep and pain. The charge nurse asks, "Can you, together with the patient, determine triggers for the
pain and effective approaches to controlling his pain?" This situation is an example of what? A) Lack of
empathy and understanding for the LPN.
B) Concern with placating the patient.
C) Leadership behavior.
D) Management behavior.
Answer: C
Rationale: The situation involves 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 .
10. The nurse manager has been asked to implement an evidence-based approach to teach ostomy
patients self-management skills postoperatively. The program is to be implemented across the entire
facility. What illustrates effective leadership in this situation?
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) An RN who is already familiar with the new approach volunteers to take the lead in mentoring and
teaching others how to implement it.
Answer: D
Rationale: Followership occurs when there is acquiescence to a peer who is leading in a setting where a
team has gathered to ensure the best outcomes. Effective leadership involves engagement and
mentoring .
11. 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. What is the most
likely basis for the nurse manager's request? A) An established clinical pathway.
B) Confirmatory scientific evidence.
Material Graded A+
Leading and Managing in Nursing, 8th Edition
Chapter 1: Leading, Managing, and Following
Section A: Multiple Choice Questions (1–30)
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 for implementation of 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.
Answer: B
Rationale: 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 .
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 satisfying the needs of this nurse,
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 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.
Answer: D
Rationale: Placing the nurse on unpaid leave may threaten the nurse's capacity to meet physiologic
needs and demotivate the nurse. 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 .
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 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 nurse in the discussion for clarity issues.
C) Ask each party to examine their own motives and issues in the conflict.
D) Continue to listen as the parties repeat their thoughts and feelings about the conflict.
Answer: C
,Rationale: For resolution of conflict, one should address the interests and involvement of participants in
the conflict by examining the real issues of all parties .
4. At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution.
What is the appropriate next step?
A) Arrange another meeting in a week's time so as to allow a cooling-off period.
B) Elevate the next negotiation session to the next manager, one level above.
C) Insist that participants continue to talk until a resolution has been reached.
D) Back the unit manager's actions and end the dispute.
Answer: B
Rationale: Part of leadership is understanding conflict resolution and ability to negotiate and manage for
resolution of issues and concerns. This situation has failed a second negotiation session; elevation to a
manager with additional training to facilitate conflict resolution is important at this point .
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 ambulate patients. The RNs on the staff have always practiced in
a primary nursing-delivery system and are very resistant to this idea. What would be the best initial
strategy for implementation of this change?
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.
Answer: A
Rationale: 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 .
6. A nurse manager is considering implementing a new evidence-based practice protocol on the unit.
According to complexity theory, what is the most effective approach? A)
Mandate the change through hierarchical authority.
B) Engage staff at all levels in decision-making about the change.
C) Implement the change without staff input to save time.
D) Delay the change indefinitely until all staff agree.
Answer: B
Rationale: Complexity theory holds that decision making occurs throughout the system, not just at the
top. Every voice counts, so all levels of staff should be involved .
7. A nurse manager is working with a staff nurse who has been late to work several times. The manager
wants to use a leadership approach. Which action best demonstrates leadership? A) Issuing a written
warning without discussion.
B) Collaborating with the nurse to identify barriers and solutions.
C) Reporting the nurse to human resources immediately.
D) Ignoring the behavior to avoid conflict.
Answer: B
, Rationale: Leadership involves engaged, collaborative guidance and decision making, especially in
complex situations where there is no standardized solution .
8. A new graduate nurse states that leadership is not part of her role because she is not a manager.
What is the best response?
A) Agree that leadership is only for those in managerial positions.
B) Explain that every nurse must lead, manage, and follow when practicing at the point of care.
C) Tell the new graduate that she will understand leadership later in her career.
D) Suggest that the new graduate focus only on clinical skills for now.
Answer: B
Rationale: 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. Every licensed individual must lead, manage, and follow .
9. A charge nurse finds a patient yelling at an LPN. The patient has not slept for three nights because of
unrelieved pain. The LPN is upset and calls the patient an "ugly, old man." The charge nurse
acknowledges the LPN's feelings and then suggests that the patient's behavior was related to lack of
sleep and pain. The charge nurse asks, "Can you, together with the patient, determine triggers for the
pain and effective approaches to controlling his pain?" This situation is an example of what? A) Lack of
empathy and understanding for the LPN.
B) Concern with placating the patient.
C) Leadership behavior.
D) Management behavior.
Answer: C
Rationale: The situation involves 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 .
10. The nurse manager has been asked to implement an evidence-based approach to teach ostomy
patients self-management skills postoperatively. The program is to be implemented across the entire
facility. What illustrates effective leadership in this situation?
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) An RN who is already familiar with the new approach volunteers to take the lead in mentoring and
teaching others how to implement it.
Answer: D
Rationale: Followership occurs when there is acquiescence to a peer who is leading in a setting where a
team has gathered to ensure the best outcomes. Effective leadership involves engagement and
mentoring .
11. 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. What is the most
likely basis for the nurse manager's request? A) An established clinical pathway.
B) Confirmatory scientific evidence.
