TEST BANK For Leading and Managing in Nursing, 8th Edition by Patricia S. Yoder-Wise, Susan Sportsman| Verified Chapter's 1 - 30 | Complete

,Chapter 01: Leading, Managing, and Following
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Yoder-Wise: Leading and Managing in Nursing, 8th Edition
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MULTIPLE CHOICE 2p




1. A nurse manager of a 20-
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bed medical unit finds that 80% of the patients are older adults. She is asked to assess and
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adapt the unit to better meet the unique needs of the older adult patient. Using complexity
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principles, what would be the best approach to take for implementation of this change?
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a. Leverage the hierarchical management position to get unit staff involved i
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n assessment and planning.
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b. Engage involved staff at all levels in the decision-making process.
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c. Focus the assessment on the unit and omit the hospital and communit
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y environment. 2p


d. Hire a geriatric specialist to oversee and control the project.
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ANS: B 2 p


Complexity theory suggests that systems interact and adapt and that decision making occu
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rs throughout the systems, as opposed to being held in a hierarchy. In complexity theory,
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every voice counts, and therefore, all levels of staff would be involved in decision makin
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g.

TOP: AONE competency: Communication and Relationship-Building
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2. A unit manager of a 25-
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bed medical/surgical area receives a phone call from a nurse whohas called in sick five ti
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mes in the past month. He tells the manager that he very much wants to come to work w
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hen scheduled but must often care for his wife, who is undergoing treatment for breast ca
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ncer. According to Maslow‘s need hierarchy theory, what would be the best approach to
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satisfying the needs of this nurse, other staff, and patients?
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a. Line up agency nurses who can be called in to work on short notice.
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b. Place the nurse on unpaid leave for the remainder of his wife‘s treatment.
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c. Sympathize with the nurse‘s dilemma and let the charge nurse know that this nur
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se may be calling in frequently in the future.
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d. Work with the nurse, staffing office, and other nurses to arrange hisschedul
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ed days off around his wife‘s treatments.
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ANS: D 2 p


Placing the nurse on unpaid leave may threaten the nurse‘s capacity to meet physiologic nee
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ds and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect
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patient care and threaten the needs of staff to feel competent. Arranging the schedule arou
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nd 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 fi
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rst mediation session, the staff nurse repeatedly calls the unit manager‘s actions unfair, an
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d the unit manager continues to reiterate the reasons for the actions. What would be the bes
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t course of action at this time?
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a. Send the two disputants away to reach their own resolution.
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b. Involve another staff nurse in the discussion for clarity issues.
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, 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 th
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e conflict.
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ANS: C 2p


For resolution of conflict, one should address the interests and involvement of participants i
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n 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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2p 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.
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b. Elevate the next negation session to the next manager, one level above.
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c. Insist that participants continue to talk until a resolution has been reached.
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d. Back the unit manager‘s actions and end the dispute.
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ANS: B 2p


Part of leadership is understanding conflict resolution and ability to negotiate and manage fo
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r resolution of issues and concerns. This situation has failed a second negotiation session, e
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levation to a manager with additional training to facilitate conflict resolution is important a
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t 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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assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the sta
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ff have always practiced in a primary nursing-
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delivery system and are very resistant to this idea. What would be the best initial strategy f
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or implementation of this change?
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a. Exploring the values and feelings of the RN group in relationship to this change
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b. Leaving the RNs alone for a time so they can think about the change before it
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is implemented
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c. Dropping the idea and trying for the change in a year or so when some of t
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he present RNs have retired
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d. Hiring the assistants and allowing the RNs to see what good additions they are
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ANS: A 2p


Influencing others requires emotional intelligence in domains such as empathy, handling re
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lationships, deepening self- 2p 2p


awareness in self and others, motivating others, and managing emotions. Motivating others
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precognizes that values are powerful forces that influence acceptance of change. Leaving the
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RNs alone for a period of time before implementation does not provide opportunity to expl
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ore different perspectives and values. Avoiding discussion until the team changes may not
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promote adoption of the change until there is opportunity to explore perspectives and value
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s related to the change. Hiring of the assistants demonstrates lack of empathy for the persp
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ectives of the RN staff. 2p 2p 2p 2p




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-
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term care facility, you‘ve found that there is little turnover among your LPN and nursing a
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ssistant (NA) staff members, but they are not very motivated to go beyond their job descri
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ptions in their work. Which of the following strategies might motivate the staff and lead t
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o greater job satisfaction?
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a. Ask the director of nursing to offer higher wages and bonuses for extra work f
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or the night LPNs and NAs.
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b. Allow the LPNs and NAs greater decision-2p 2p 2p 2p 2p 2p


making power within the scope of their positions in the institution.
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c. Hire additional staff so that there are more staff available for enhanced care,an
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d individual workloads are lessened.
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d. Ask the director of nursing to increase job security for night staff by having the
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m sign contracts that guarantee work.
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ANS: B 2p


Hygiene factors such as salary, working conditions, and security are consistent with Herzbe
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rg‘s two- 2p


factor theory of motivation; meeting these needs avoids job dissatisfaction. Motivator facto
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rs such as recognition and satisfaction with work promote a satisfying and enriched work e
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nvironment. Transformational leaders use motivator factors liberally to inspire work perform
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ance 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 thenur
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se on 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-
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site daycare services. 2p 2p


b. Provide a hierarchical organizational structure. 2p 2p 2p 2p


c. Implement a model of shared governance. 2p 2p 2p 2p 2p


d. Promote the development of a flexible benefits package.2p 2p 2p 2p 2p 2p 2p




ANS: C 2p


Complexity theory suggests that systems interact and adapt and that decision making occurs
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throughout systems, as opposed to being held in a hierarchy. In complexity theory, every v
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oice counts, and therefore all levels of staff would be involved in decision making. This pr
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inciple is the foundation of shared governance.
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TOP: AONE competency: Communication and Relationship-Building
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8. The nurse manager has been asked to implement an evidence-
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based approach to teach ostomy patients self-
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management skills postoperatively. The program is to be implemented across the entire faci
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lity. What illustrates effective leadership in this situation?
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a. The training modules are left in the staff room for times when staff are available.
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b. The current approach is continued because it is also evidence-
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based and is more familiar to staff. 2p 2p 2p 2p 2p 2p


c. You decide to implement the approach at a later date because of feedback from t
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he RNs that the new approach takes too much time.
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d. An RN who is already familiar with the new approach of volunteers to take t
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he lead in mentoring and teaching others how to implement it.
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ANS: D 2p