Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
Chapter 01: Leading, Managing, and Following Yoder-Wise: Leading and Managing in
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Nursing, 7th Edition
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1. A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She
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is
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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 Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
assessment and planning. .i Il`.i Il`.i Il`
b. Engage involved staff at all levels in the decision-making process. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
c. Focus the assessment on the unit and omit the hospital and community environment. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
d. Hire a geriatric specialist to oversee and control the project. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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Complexity theory suggests that systems interact and adapt and that decision making occurs Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
throughout the 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.
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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 has
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.i in sick five times in the past month. He tells the manager that he very much wants to come to
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.i when scheduled but must often care for his wife, who is undergoing treatment
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Il` forbreastcancer.AccordingtoUM
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approach to satisfying the needs of this nurse, other staff, and patients? Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
a. Line up agency nurses who can be called in to work on short notice. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
b. Place the nurse on unpaid leave for the remainder of his wife’s treatment. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
c. Sympathize with the nurse’s dilemma and let the charge nurse know that this nurse Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
may be calling in frequently in the future. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
d. Work with the nurse, staffing office, and other nurses to arrange his scheduled Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
days off around his wife’s treatments. Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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Placing the nurse on unpaid leave may threaten the nurse’s capacity to meet physiologic Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i
needs and Il`.i Il`.i Il`
demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect
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patient care
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and threaten the needs of staff to feel competent. Arranging the schedule around
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, Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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the wife’s needs meets the needs of the staff and of patients while satisfying the nurse’s
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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 first
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mediation session, the staff nurse repeatedly calls the unit manager’s actions unfair, and
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the unit manager continues to reiterate the reasons for the actions. What would be the best
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course of action at this time?
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a. Send the two disputants away to reach their own resolution. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
b. Involve another staff nurse in the discussion for clarity issues. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
c. Ask each party to examine their own motives and issues in the conflict.
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d. Continue to listen as the parties repeat their thoughts and feelings about the conflict. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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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 a
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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. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
b. Elevate the next negation session to the next manager, one level above. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
c. Insist that participants continue to talk until a resolution has been reached. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
d. Back the unit manager’s actions and end the dispute. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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Part of leadership is understanding conflict resolution and ability to negotiate and manage
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for 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 RN
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.i assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff
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.i Whatalwayswould practicedbe inthe a pbestrNiminitialaRry nstrategyIuUrsS iGN nT gfor- Il`.i Il`.i Il` Il`. Il`i Il` Il`.i Il`.i Il` Il` Il` Il`
Il` Bdimplementatione.liCveryMO Il` systeofmthis and change? are very resistant
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a. Exploring the values and feelings of the RN group in relationship to this change Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
b. Leaving the RNs alone for a time so they can think about the change before it is Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
implemented .i Il`
c. Dropping the idea and trying for the change in a year or so when some of the Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
present RNs have retired.i Il`.i Il`.i Il`.i Il`
d. Hiring the assistants and allowing the RNs to see what good additions they are Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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, Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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Influencing others requires emotional intelligence in domains such as empathy, handling Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
relationships, deepening self-awareness in self and others, motivating others, and managing
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emotions. Motivating others recognizes that values are powerful forces that influence
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acceptance
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of change. Leaving the RNs alone for a period of time before implementation does not
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provide
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opportunity to explore different perspectives and values. Avoiding discussion until the team
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.i changes may not promote adoption of the change until there is opportunity to explore
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Il`.i perspectives and values related to the change. Hiring of the assistants demonstrates lack of Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i
Il`.i empathy for the perspectives of the RN staff. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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 that
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is little turnover among your LPN and nursing assistant (NA) staff members, but they are not
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very
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motivated to go beyond their job descriptions in their work. Which of the following
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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 for the
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night LPNs and NAs..i Il`.i Il`.i Il`.i Il`
b. Allow the LPNs and NAs greater decision-making power within the scope of their Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
positions in the institution.
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c. Hire additional staff so that there are more staff available for enhanced care, and
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individual workloads are lessened.
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d. Ask the director of nursing to increase job security for night staff by having them sign
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contracts that guarantee work.
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Hygiene factors such as salary, working conditions, and security are consistent with
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Herzberg’s two-factor theory of motivation; meeting these needs avoids job dissatisfaction. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
Motivator factors such as recognition and satisfaction with work promote a satisfying
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and enriched work environment. Transformational leaders use motivator factors liberally
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to 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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the unit. What action would be appropriate to motivate the staff?
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a. Collaborate with the human resource/personnel department to develop on-site Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
daycare services. .i Il`.i Il`
b. Provide a hierarchical orgNaniRzatiIonalGstrBuc.tuCre. Il`. Il`i Il` Il`. Il`i Il` Il`. Il`i Il` Il`.i
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c. Implement a model of sharUed gSoveNrnanTce. Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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d. Promote the development of a flexible benefits package. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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, Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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Complexity theory suggests that systems interact and adapt and that decision making occurs Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
.i throughout systems, as opposed to being held in a hierarchy. In complexity theory, every Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i
Il`.i voice counts, and therefore all levels of staff would be involved in decision making. This
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Il`.i principle is the foundation of shared governance. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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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 unit is approached by a family member
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Il`.iwho begins to complain loudly about the quality of care his mother is receiving. His
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Il`.ibehavior is so Il`.i Il`.i Il`
disruptive that it is overheard by staff, physicians, and other visitors. The family member
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leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the
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charge nurse best illustrates refined leadership skills in an emotionally intelligent
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practitioner?
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a. Reflect to gain insight into how the situation could be handled differently in the future. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
b. Try to catch up with the angry family member to resolve the concern.
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c. Discuss the concern with the patient after the family member has left. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
d. Notify nursing administration of the situation. Il`.i Il`.i Il`.i Il`.i Il`.i Il`
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Goleman suggests that emotional intelligence involves insight and being able to step outside
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of
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the situation to envision the context of what is happening as well as being able to manage
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emotions such as frustration effectively.
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TOP: AONE competency: Leadership
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9. The chief nursing officer has asked the staff development coordinator to facilitate the
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development of a clinical competency program for the facility. While making rounds on the
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.i units, the staff development coordinator overhears RN staff complaining that they feel it is
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Il`.iinsulting to be required to participate in a competency program. What behavior by the staff
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Il`.i development coordinator is most appropriate in this situation? Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
a. Disregard staff concerns and continue with development of the program. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
b. Inform the nurses that this program is a requirement for JCAHO accreditation. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
c. Schedule a meeting with the chief nurse executive to apprise her of the situation. Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`
d. Facilitate a meeting so nurses can articulate their values and concerns about a Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i Il`.i
competency program.
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The manager role involves guiding others through a set of derived practices that are
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evidence-
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based and known to satisfy preestablished outcomes such as participation in a competency
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program. This involves engagement of staff through sharing of concerns and ideas. A close
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analysis of the IOM report and the summary of the PPACA suggests that no
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