TEST BANK
YODER WISE’S LEADING AND MANAGING IN CANADIAN NURSING
,Table Of Contents
Part i: Core Concepts
ws
Overview
1. Leading, Managing, And Following
2. Developing The Role Of Leader
3. Developing The Role Of Manager
4. Nursing Leadership And Indigenous Health
5. Patient Focus
Context
6. Ethical Issues
7. Legal Issues
8. Making Decisions And Solving Problems
9. Health Care Organizations
10. Understanding And Designing Organizational Structures
11. Cultural Diversity In Health Care
12. Power, Politics, And Influence
Part II: Managing Resources
13. Caring, Communicating, And Managing With Technology
14. Managing Costs And Budgets
15. Care Delivery Strategies
16. Staffing And Scheduling (Available Only On Evolve)
17. Selecting, Developing, And Evaluating Staff (Available Only On Evolve)
Part III: Changing The Status Quo
18. Strategic Planning, Goal-Setting, And Marketing
19. Nurses Leading Change: A Relational Emancipatory Framework For Health
And Social Action
20. Building Teams Through Communication And Partnerships
21. Collective Nursing Advocacy
22. Understanding Quality, Risk, And Safety
23. Translating Research Into Practice
,Part IV: Interpersonal And Personal Skills
Interpersonal
24. Understanding And Resolving Conflict
25. Managing Personal/Personnel Problems
26. Workplace Violence And Incivility
27. Inter And Intraprofessional Practice And Leading In Professional Practice Settings
Personal
28. Role Transition
29. Self-Management: Stress And Time
Future
30. Thriving For The Future
31. Leading And Managing Your Career
32. Nursing Students As Leaders
,Chapter 01 : Leading, Managing, And Following
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 Older Adult Patients. According To 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.
ANSWER: 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, Everybody‘S Opinion Counts; Therefore, All Levels Of Staff
Would Be Involved In Decision Making.
DIF: Cognitive Level: Apply REF: Page
4 TOP: Nursing Process: Implementation
NrI gb.CM
2. A Unit Manager Of A 25-BedUMedical/Surgical
S N T OArea Receives A Phone Call From A Nurse Who
s
w ws
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. In The Practice Of A Strengths-
Based Nursing Leader, 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
Placing The Nurse On Unpaid Leave May Threaten Physiologic Needs And Demotivate
The Nurse. Unsatisfactory Coverage Of Shifts On Short Notice Could Affect Patient
Care And Threaten Staff Members‘ Sense Of Competence. Strengths-Based Nurse
Leaders Honour The Uniqueness Of Individuals, Teams, Systems, And Organizations;
Therefore Arranging The Schedule Around The Wife‘S Needs Would Result In A Win-
Win Situation, Also Creating A Work Environment That Promotes The Health Of All
The Nurses And Facilitates Their Development.
DIF: Cognitive Level: Analyze REF: Page
6 TOP: Nursing Process: Implementation
,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 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.
ANSWER: C
Nurses And Leaders Must Assess Each Situation As Unique, Determining Appropriate
Actions Accordingly. Leaders Must Adapt Their Styles To Complement Specific Issues
Being Faced, Such As Conflict. Examining Motives And Issues For The Conflict In
Perceptions Promotes Equal Representation Of Each Point Of View.
DIF: Cognitive Level: Apply REF: Pages –
3 TOP: Nursing Process: Implementation
4. Shortly After Being Informed Of Fetal Death, A Labouring Woman Asks Why She Is
Not Able To Hear Her Baby‘S Heartbeat On The Monitor Anymore. Although The
Monitor Volume Had Been Turned Off So That The Patient Would Be Able To Sleep
Between Contractions, The Nurse Responded That There Was No Heartbeat To Hear
Because The Baby Had Died In Utero; Then The Nurse Asked Whether The Patient
Would Like To Talk About How She Was Feeling. This Response Demonstrates:
a. Lack Of Empathy.
b. Ethical Leadership.
c. Complexity Science.
d. A Coercive
Relationship.
ANSWER: B
Ethical Leadership Is Based On A Willingness To Identify And Act On Complex
Problems In An Ethical Manner. Leadership Can Be Misused When Coercive
Relationships Form, And Information And True Goals Are Withheld.
DIF: Cognitive Level: Analyze REF: Page
7 TOP: Nursing Process: Implementation
5. The Manager Of A Surgical Area Envisions A Future That Requires The Addition Of
Registered Nurse (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 Of The Rns In Relation To This Change.
b. Leaving The Rns Alone For A Time So They Can Think About The Change
Before They Are Approached Again.
c. Dropping The Idea And Trying For The Change In Another Year Or So.
d. Hiring The Assistants And Allowing The Rns To See What Good Additions They Are.
ANSWER: A
, Leadership Involves Engaged Decision Making Around A Vision That Is Based On
Evidence And Tacit Knowledge. Influencing Others Requires Emotional Intelligence In
Domains Such As Empathy And Handling Relationships.
DIF: Cognitive Level: Apply REF: Page
5 TOP: Nursing Process: Implementation
6. As The Charge Nurse On The Night Shift In A Small Long-Term Care Facility, You
Have Found That There Is Little Turnover Among Your Licensed Practical Nurse And
Nursing Assistant (NA) Staff Members, But They Are Not Very Motivated To Work
Beyond Their Job Descriptions. 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 Licensed Practical Nurses And Nas.
b. Allow The Licensed Practical Nurses And Nas Greater Decision-Making
Power Within The Scope Of Their Positions In The Institution.
c. Help The Licensed Practical Nurses And Nas With Their Work, Whenever Possible.
d. Ask The Director Of Nursing To Increase Job Security For Night Staff By
Having Them Sign Contracts That Guarantee Work.
ANSWER: B
A Nurse Leader Should Provide An Environment Conducive To Opinion Sharing That
Involves Staff In Decision Making At All Levels. This Approach Is Shown To
Increase Job Satisfaction. Decision Making And The Corresponding Actions Taken
Are Core Tasks Performed In Engagement With Coworkers.
DIF: Cognitive Level: Apply REF: Page
7 TOP: Nursing Process: Impl E Mne N t r
a ti
ws ws
O nigb.CM
w
s
USNT O
7. As The Nurse Manager, You Want To Increase Motivation By Providing Motivating Factors.
Which Action Would You Select?
a. Collaborate With The Human Resources/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.
ANSWER: C
Complexity Theory Suggests That Systems Interact And Adapt And That Decision
Making Occurs Throughout Systems, As Opposed To Being Made Unilaterally By
Different Levels Of The Organizational Hierarchy. In Complexity Theory, Every
Person‘S Opinion Counts, And Therefore All Levels Of Staff Would Be Involved In
Decision Making. This Principle Underlies Shared Governance. Shared Governance Is
An Example Of Nurse Decision Making In Which Nurses At Different Organizational
Levels Engage In Shaping Policy And Practices.
DIF: Cognitive Level: Apply REF: Page
5 TOP: Nursing Process: Implementation
, 8. A Charge Nurse On A Busy 40-Bed Medical/Surgical Unit Is Approached By A
Patient‘S Son, Who Begins To Complain Loudly About The Quality Of Care His
Mother Is Receiving. His Behaviour 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 Behaviour By The Charge Nurse Best
Illustrates Refined Leadership Skills In An Emotionally Intelligent Practitioner?
a. Reflection To Obtain Insight Into How The Situation Could Be Handled
Differently In The Future
b. Trying To Catch Up With The Angry Family Member To Resolve The Concern
c. Discussing The Concern With The Patient After The Family Member Has Left
d. Notifying Nursing Administration Of The Situation
ANSWER: A
Emotional Intelligence Is Closely Aligned With Individuals‘ Capacity To Know
Themselves And Others. Reflecting To Obtain Insight And Being Able To ―Step‖
Outside The Situation To Envision The Context Of What Is Happening Is An
Example Of The Actions Of An Emotionally Intelligent Practitioner.
DIF: Cognitive Level: Apply REF: Page
8 TOP: Nursing Process: Implementation
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 Believe It Is Insulting To Be Required To Participate In A
Competency Program. Which Behaviour By The Staff Development Coordinator Is Most
Appropriate In This Situation?
a. Disregard staffcOncernsn
ws ws w
s w
sa n d rconit inuge Wb
w
s w
s ith.Dcevemlopment Of the program.
ws ws
b. Inform The Nurses That This Program Is A Requirement For Accreditation By The Joint
Commission On Accreditation Of Healthcare Organizations (JCAHO).
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.
ANSWER: D
The Manager Role Involves Guiding Other People Through A Set Of Derived
Practices That Are Evidence-Informed And Known To Satisfy Pre-Established
Outcomes Such As Participation In A Competency Program. This Involves
Engagement Of Staff Through Sharing Of Concerns And Ideas. This Type Of Leader
Can Instill Hope And Trust In Followers, Which Influence Their Behaviours And
Attitudes (Such As Engagement And Satisfaction) And Cause Work Environments To
Become More Positive.
DIF: Cognitive Level: Apply REF: Pages –
3 TOP: Nursing Process: Implementation
10. Which Category Is Unique To Leadership But Is Not Part Of Management?
a. Initiating Change
b. Personal Qualities
c. Developing People
d. Information Management
, ANSWER: C
Developing People—Coaching, Mentoring, Succession Planning—Is A Category Of
Solely Leadership, Not Management. Initiating Change And Personal Qualities Are
Categories Of Both Management And Leadership. Information Management Is A
Category Of Management Only.
DIF: Cognitive Level: Understand REF: Page
7 TOP: Nursing Process: Assessment
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. Because
You Are A Nursing Colleague, Your Response Demonstrates Understanding That The
Perception Of The New Graduate:
a. Is Accurately Reflected In The New Graduate‘S Statement.
b. Would Benefit From Further Understanding Of Her Role As A
Professional In Relation To Decision-Making.
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.
ANSWER: B
Decision Making And The Corresponding Actions Taken Are The Core Work Performed
In Engagement With Co-Workers. This Core Work Requires That Nurses Be Leaders,
Managers, And Followers At The Point-Of-Care, Unit, Institutional, And Even
Societal Levels.
DIF: Cognitive Level: Understand REF: Page 7 TOP: Nursing Process: Evaluation
12. You Walk Into A Patient‘S Room And Find Him Yelling At The Licensed
Practical Nurse. The Patient Is Obviously Very Upset, And After You Speak With
Him Regarding His
Behaviour, N R I G B
You
, Determine That He Has Not Slept ufor S
thren
e N i tg Hts B e o
c a u Se Of Unrelieved Pain Levels. The
Licensed Practical Nurse Is Very Upset With Him And Calls Him An ―Ugly, Old Man.‖ You
Acknowledge
Her Feelings And Concerns And Then Suggest That The Patient‘S Behaviour Was
Aggressive But Is Related To Lack of Sleep And To Pain. You Ask, ―Can Both You And
ws
The Patient Together Determine Triggers For The Pain And Effective Approaches To
Controlling His Pain?‖ This Approach Demonstrates:
a. Lack Of Empathy And Understanding For The Licensed Practical Nurse.
b. Concern With Placating The Patient.
c. Leadership Behaviour.
d. Management Behaviour.
ANSWER: C
The Situation Between The Patient And The Licensed Practical Nurse Is Complex,
Involving Unrelieved Symptoms And Aggressiveness Toward A Staff Member. Health Care
Is Now Delivered In A Collaborative, And Most Often, An Interdisciplinary Manner,
Whereby Select Leadership/Management Roles (E.G., First-Line Nurse Leaders) Serve
As Conduits For Information And Care Coordination. Providing Engaged, Collaborative
Guidance And Decision Making In A Complex Situation For Which There Is No
Standardized Solution Reflects Leadership.
DIF: Cognitive Level: Apply REF: Page
7 TOP: Nursing Process: Implementation
13. Which Category Is Unique To Management But Is Not Part Of Leadership?
a. Initiating Change
b. Personal Qualities
c. Developing People
d. Information Management
ANSWER: D
Information Management Is A Category Of Management Only. Developing People Is A
Category Of Solely Leadership, Not Management. Initiating Change And Personal
Qualities Are Categories Of Both Management And Leadership.
DIF: Cognitive Level: Understand REF: Page
5 TOP: Nursing Process: Assessment
14. Chart Audits Have Revealed Significant Omissions Of Data That Could Have
Legal And Funding Guidelines. 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.
ANSWER: B
The Process Of Guiding Other People To Meet Established Goals, Outcomes, And
Procedures Is Management. This Can Require Collaborative Decision Making To
Determine How Best To Reach Predetermined Goals And Follow Established Practices.
ws
N R I G B .c m
DIF: Cognitivelevel: Apply U S N RTE F : P ao
ge s 6–
7 TOP: Nursing Process: Implementation
, 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 Such Situations. What Role Are You Assuming
Through This Action?
a. Manager
b. Leader
c. Follower
d. Laissez Faire
ANSWER: A
Management Is The Process Of Getting The Job Done And Ensuring That People
Have The Necessary Resources To Get The Job Done. Referral To A Social Worker
Alleviates Demand On Nurse Staff Time And Is Consistent With Hospital Procedures.
DIF: Cognitive Level: Apply REF: Page
6 TOP: Nursing Process: Implementation
16. After A Meeting With Members Of The Family Of A Dying Patient, The Nursing Manager
Discusses With You The Family‘S Desired Approach To Care, And You Support The
Manager‘S Decision. Your Actions Indicate That You Are Acting In What Role?
a. Leadership
b. Management
c. Followership
d. Evidence-Informed
ANSWER: C
Followership Is Engaging With Other People Who Are Leading Or Managing By
Contributing To The Work That Needs To Be Done. By Accepting And Implementing
The Desired Approach To Care Direction Given By The Manager In Response To
Your Concerns, You Are Demonstrating Followership.
DIF: Cognitive Level: Analyze REF: Page
7 TOP: Nursing Process: Implementation
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 Beginning
To Distance Themselves From The Family. After Inviting The Concerns Of Staff, You
Explain That The Organization Values Patient-Centred Care And Suggest That
Evidence Indicates 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-
Centred In These Situations. In This Situation, You Are Taking On Which Role?
a. Leadership
b. Management
c. Follower
d. Visionary
ANSWER: A Nur I
ws
S Gn b t
.C M O
ws
Leadership Is The Process Of Engaging And Influencing Others. Strong Leaders Are
Associated With Words Such As Visionary, Energetic, Inspirational, And Innovative;
They Go Beyond
The Status Quo To Make A Difference For Others. As A Leader, You Engage Other
People In Decision Making That Moves Them Toward A Goal With A Reasonable
YODER WISE’S LEADING AND MANAGING IN CANADIAN NURSING
,Table Of Contents
Part i: Core Concepts
ws
Overview
1. Leading, Managing, And Following
2. Developing The Role Of Leader
3. Developing The Role Of Manager
4. Nursing Leadership And Indigenous Health
5. Patient Focus
Context
6. Ethical Issues
7. Legal Issues
8. Making Decisions And Solving Problems
9. Health Care Organizations
10. Understanding And Designing Organizational Structures
11. Cultural Diversity In Health Care
12. Power, Politics, And Influence
Part II: Managing Resources
13. Caring, Communicating, And Managing With Technology
14. Managing Costs And Budgets
15. Care Delivery Strategies
16. Staffing And Scheduling (Available Only On Evolve)
17. Selecting, Developing, And Evaluating Staff (Available Only On Evolve)
Part III: Changing The Status Quo
18. Strategic Planning, Goal-Setting, And Marketing
19. Nurses Leading Change: A Relational Emancipatory Framework For Health
And Social Action
20. Building Teams Through Communication And Partnerships
21. Collective Nursing Advocacy
22. Understanding Quality, Risk, And Safety
23. Translating Research Into Practice
,Part IV: Interpersonal And Personal Skills
Interpersonal
24. Understanding And Resolving Conflict
25. Managing Personal/Personnel Problems
26. Workplace Violence And Incivility
27. Inter And Intraprofessional Practice And Leading In Professional Practice Settings
Personal
28. Role Transition
29. Self-Management: Stress And Time
Future
30. Thriving For The Future
31. Leading And Managing Your Career
32. Nursing Students As Leaders
,Chapter 01 : Leading, Managing, And Following
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 Older Adult Patients. According To 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.
ANSWER: 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, Everybody‘S Opinion Counts; Therefore, All Levels Of Staff
Would Be Involved In Decision Making.
DIF: Cognitive Level: Apply REF: Page
4 TOP: Nursing Process: Implementation
NrI gb.CM
2. A Unit Manager Of A 25-BedUMedical/Surgical
S N T OArea Receives A Phone Call From A Nurse Who
s
w ws
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. In The Practice Of A Strengths-
Based Nursing Leader, 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
Placing The Nurse On Unpaid Leave May Threaten Physiologic Needs And Demotivate
The Nurse. Unsatisfactory Coverage Of Shifts On Short Notice Could Affect Patient
Care And Threaten Staff Members‘ Sense Of Competence. Strengths-Based Nurse
Leaders Honour The Uniqueness Of Individuals, Teams, Systems, And Organizations;
Therefore Arranging The Schedule Around The Wife‘S Needs Would Result In A Win-
Win Situation, Also Creating A Work Environment That Promotes The Health Of All
The Nurses And Facilitates Their Development.
DIF: Cognitive Level: Analyze REF: Page
6 TOP: Nursing Process: Implementation
,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 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.
ANSWER: C
Nurses And Leaders Must Assess Each Situation As Unique, Determining Appropriate
Actions Accordingly. Leaders Must Adapt Their Styles To Complement Specific Issues
Being Faced, Such As Conflict. Examining Motives And Issues For The Conflict In
Perceptions Promotes Equal Representation Of Each Point Of View.
DIF: Cognitive Level: Apply REF: Pages –
3 TOP: Nursing Process: Implementation
4. Shortly After Being Informed Of Fetal Death, A Labouring Woman Asks Why She Is
Not Able To Hear Her Baby‘S Heartbeat On The Monitor Anymore. Although The
Monitor Volume Had Been Turned Off So That The Patient Would Be Able To Sleep
Between Contractions, The Nurse Responded That There Was No Heartbeat To Hear
Because The Baby Had Died In Utero; Then The Nurse Asked Whether The Patient
Would Like To Talk About How She Was Feeling. This Response Demonstrates:
a. Lack Of Empathy.
b. Ethical Leadership.
c. Complexity Science.
d. A Coercive
Relationship.
ANSWER: B
Ethical Leadership Is Based On A Willingness To Identify And Act On Complex
Problems In An Ethical Manner. Leadership Can Be Misused When Coercive
Relationships Form, And Information And True Goals Are Withheld.
DIF: Cognitive Level: Analyze REF: Page
7 TOP: Nursing Process: Implementation
5. The Manager Of A Surgical Area Envisions A Future That Requires The Addition Of
Registered Nurse (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 Of The Rns In Relation To This Change.
b. Leaving The Rns Alone For A Time So They Can Think About The Change
Before They Are Approached Again.
c. Dropping The Idea And Trying For The Change In Another Year Or So.
d. Hiring The Assistants And Allowing The Rns To See What Good Additions They Are.
ANSWER: A
, Leadership Involves Engaged Decision Making Around A Vision That Is Based On
Evidence And Tacit Knowledge. Influencing Others Requires Emotional Intelligence In
Domains Such As Empathy And Handling Relationships.
DIF: Cognitive Level: Apply REF: Page
5 TOP: Nursing Process: Implementation
6. As The Charge Nurse On The Night Shift In A Small Long-Term Care Facility, You
Have Found That There Is Little Turnover Among Your Licensed Practical Nurse And
Nursing Assistant (NA) Staff Members, But They Are Not Very Motivated To Work
Beyond Their Job Descriptions. 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 Licensed Practical Nurses And Nas.
b. Allow The Licensed Practical Nurses And Nas Greater Decision-Making
Power Within The Scope Of Their Positions In The Institution.
c. Help The Licensed Practical Nurses And Nas With Their Work, Whenever Possible.
d. Ask The Director Of Nursing To Increase Job Security For Night Staff By
Having Them Sign Contracts That Guarantee Work.
ANSWER: B
A Nurse Leader Should Provide An Environment Conducive To Opinion Sharing That
Involves Staff In Decision Making At All Levels. This Approach Is Shown To
Increase Job Satisfaction. Decision Making And The Corresponding Actions Taken
Are Core Tasks Performed In Engagement With Coworkers.
DIF: Cognitive Level: Apply REF: Page
7 TOP: Nursing Process: Impl E Mne N t r
a ti
ws ws
O nigb.CM
w
s
USNT O
7. As The Nurse Manager, You Want To Increase Motivation By Providing Motivating Factors.
Which Action Would You Select?
a. Collaborate With The Human Resources/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.
ANSWER: C
Complexity Theory Suggests That Systems Interact And Adapt And That Decision
Making Occurs Throughout Systems, As Opposed To Being Made Unilaterally By
Different Levels Of The Organizational Hierarchy. In Complexity Theory, Every
Person‘S Opinion Counts, And Therefore All Levels Of Staff Would Be Involved In
Decision Making. This Principle Underlies Shared Governance. Shared Governance Is
An Example Of Nurse Decision Making In Which Nurses At Different Organizational
Levels Engage In Shaping Policy And Practices.
DIF: Cognitive Level: Apply REF: Page
5 TOP: Nursing Process: Implementation
, 8. A Charge Nurse On A Busy 40-Bed Medical/Surgical Unit Is Approached By A
Patient‘S Son, Who Begins To Complain Loudly About The Quality Of Care His
Mother Is Receiving. His Behaviour 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 Behaviour By The Charge Nurse Best
Illustrates Refined Leadership Skills In An Emotionally Intelligent Practitioner?
a. Reflection To Obtain Insight Into How The Situation Could Be Handled
Differently In The Future
b. Trying To Catch Up With The Angry Family Member To Resolve The Concern
c. Discussing The Concern With The Patient After The Family Member Has Left
d. Notifying Nursing Administration Of The Situation
ANSWER: A
Emotional Intelligence Is Closely Aligned With Individuals‘ Capacity To Know
Themselves And Others. Reflecting To Obtain Insight And Being Able To ―Step‖
Outside The Situation To Envision The Context Of What Is Happening Is An
Example Of The Actions Of An Emotionally Intelligent Practitioner.
DIF: Cognitive Level: Apply REF: Page
8 TOP: Nursing Process: Implementation
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 Believe It Is Insulting To Be Required To Participate In A
Competency Program. Which Behaviour By The Staff Development Coordinator Is Most
Appropriate In This Situation?
a. Disregard staffcOncernsn
ws ws w
s w
sa n d rconit inuge Wb
w
s w
s ith.Dcevemlopment Of the program.
ws ws
b. Inform The Nurses That This Program Is A Requirement For Accreditation By The Joint
Commission On Accreditation Of Healthcare Organizations (JCAHO).
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.
ANSWER: D
The Manager Role Involves Guiding Other People Through A Set Of Derived
Practices That Are Evidence-Informed And Known To Satisfy Pre-Established
Outcomes Such As Participation In A Competency Program. This Involves
Engagement Of Staff Through Sharing Of Concerns And Ideas. This Type Of Leader
Can Instill Hope And Trust In Followers, Which Influence Their Behaviours And
Attitudes (Such As Engagement And Satisfaction) And Cause Work Environments To
Become More Positive.
DIF: Cognitive Level: Apply REF: Pages –
3 TOP: Nursing Process: Implementation
10. Which Category Is Unique To Leadership But Is Not Part Of Management?
a. Initiating Change
b. Personal Qualities
c. Developing People
d. Information Management
, ANSWER: C
Developing People—Coaching, Mentoring, Succession Planning—Is A Category Of
Solely Leadership, Not Management. Initiating Change And Personal Qualities Are
Categories Of Both Management And Leadership. Information Management Is A
Category Of Management Only.
DIF: Cognitive Level: Understand REF: Page
7 TOP: Nursing Process: Assessment
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. Because
You Are A Nursing Colleague, Your Response Demonstrates Understanding That The
Perception Of The New Graduate:
a. Is Accurately Reflected In The New Graduate‘S Statement.
b. Would Benefit From Further Understanding Of Her Role As A
Professional In Relation To Decision-Making.
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.
ANSWER: B
Decision Making And The Corresponding Actions Taken Are The Core Work Performed
In Engagement With Co-Workers. This Core Work Requires That Nurses Be Leaders,
Managers, And Followers At The Point-Of-Care, Unit, Institutional, And Even
Societal Levels.
DIF: Cognitive Level: Understand REF: Page 7 TOP: Nursing Process: Evaluation
12. You Walk Into A Patient‘S Room And Find Him Yelling At The Licensed
Practical Nurse. The Patient Is Obviously Very Upset, And After You Speak With
Him Regarding His
Behaviour, N R I G B
You
, Determine That He Has Not Slept ufor S
thren
e N i tg Hts B e o
c a u Se Of Unrelieved Pain Levels. The
Licensed Practical Nurse Is Very Upset With Him And Calls Him An ―Ugly, Old Man.‖ You
Acknowledge
Her Feelings And Concerns And Then Suggest That The Patient‘S Behaviour Was
Aggressive But Is Related To Lack of Sleep And To Pain. You Ask, ―Can Both You And
ws
The Patient Together Determine Triggers For The Pain And Effective Approaches To
Controlling His Pain?‖ This Approach Demonstrates:
a. Lack Of Empathy And Understanding For The Licensed Practical Nurse.
b. Concern With Placating The Patient.
c. Leadership Behaviour.
d. Management Behaviour.
ANSWER: C
The Situation Between The Patient And The Licensed Practical Nurse Is Complex,
Involving Unrelieved Symptoms And Aggressiveness Toward A Staff Member. Health Care
Is Now Delivered In A Collaborative, And Most Often, An Interdisciplinary Manner,
Whereby Select Leadership/Management Roles (E.G., First-Line Nurse Leaders) Serve
As Conduits For Information And Care Coordination. Providing Engaged, Collaborative
Guidance And Decision Making In A Complex Situation For Which There Is No
Standardized Solution Reflects Leadership.
DIF: Cognitive Level: Apply REF: Page
7 TOP: Nursing Process: Implementation
13. Which Category Is Unique To Management But Is Not Part Of Leadership?
a. Initiating Change
b. Personal Qualities
c. Developing People
d. Information Management
ANSWER: D
Information Management Is A Category Of Management Only. Developing People Is A
Category Of Solely Leadership, Not Management. Initiating Change And Personal
Qualities Are Categories Of Both Management And Leadership.
DIF: Cognitive Level: Understand REF: Page
5 TOP: Nursing Process: Assessment
14. Chart Audits Have Revealed Significant Omissions Of Data That Could Have
Legal And Funding Guidelines. 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.
ANSWER: B
The Process Of Guiding Other People To Meet Established Goals, Outcomes, And
Procedures Is Management. This Can Require Collaborative Decision Making To
Determine How Best To Reach Predetermined Goals And Follow Established Practices.
ws
N R I G B .c m
DIF: Cognitivelevel: Apply U S N RTE F : P ao
ge s 6–
7 TOP: Nursing Process: Implementation
, 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 Such Situations. What Role Are You Assuming
Through This Action?
a. Manager
b. Leader
c. Follower
d. Laissez Faire
ANSWER: A
Management Is The Process Of Getting The Job Done And Ensuring That People
Have The Necessary Resources To Get The Job Done. Referral To A Social Worker
Alleviates Demand On Nurse Staff Time And Is Consistent With Hospital Procedures.
DIF: Cognitive Level: Apply REF: Page
6 TOP: Nursing Process: Implementation
16. After A Meeting With Members Of The Family Of A Dying Patient, The Nursing Manager
Discusses With You The Family‘S Desired Approach To Care, And You Support The
Manager‘S Decision. Your Actions Indicate That You Are Acting In What Role?
a. Leadership
b. Management
c. Followership
d. Evidence-Informed
ANSWER: C
Followership Is Engaging With Other People Who Are Leading Or Managing By
Contributing To The Work That Needs To Be Done. By Accepting And Implementing
The Desired Approach To Care Direction Given By The Manager In Response To
Your Concerns, You Are Demonstrating Followership.
DIF: Cognitive Level: Analyze REF: Page
7 TOP: Nursing Process: Implementation
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 Beginning
To Distance Themselves From The Family. After Inviting The Concerns Of Staff, You
Explain That The Organization Values Patient-Centred Care And Suggest That
Evidence Indicates 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-
Centred In These Situations. In This Situation, You Are Taking On Which Role?
a. Leadership
b. Management
c. Follower
d. Visionary
ANSWER: A Nur I
ws
S Gn b t
.C M O
ws
Leadership Is The Process Of Engaging And Influencing Others. Strong Leaders Are
Associated With Words Such As Visionary, Energetic, Inspirational, And Innovative;
They Go Beyond
The Status Quo To Make A Difference For Others. As A Leader, You Engage Other
People In Decision Making That Moves Them Toward A Goal With A Reasonable
