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Chapter “01: “Leading, “Managing, “and “Following
Yoder-Wise: “Leading “and “Managing “in “Nursing, “8th “Edition
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 ―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.
ANS: ― 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, ―every ―voice ―counts, ―and ―therefore, ―all ―levels ― of ― staff ―would ―be ―involved ―in
―decision ―making.
TOP: ―AONE ―competency: ―Communication ―and ―Relationship-Building
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.
ANS: ― D
Placing ―the ―nurse ―on ―unpaid ―leave ―may ―threaten ―the ―nurse‘s ―capacity ―to ―meet ―physiologic
―needs―and ― demotivate ―the ― nurse. ― Unsatisfactory ―coverage ― of ― shifts ― on ― short ― notice ―could
― affect ―patient ―care ―and ―threaten ―the ―needs ―of ―staff ―to ―feel ―competent. ―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.
TOP: ―AONE ―competency: ―Communication ―and ―Relationship-Building
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.
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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.
ANS: ―C
For ―resolution ―of ―conflict, ―one ―should ―address ―the ―interests ―and ―involvement ―of
―participants ―in―the ―conflict ―by ―examining ―the ―real ―issues ―of ―all ―parties.
TOP: ―AONE ―competency: ―Communication ―and ―Relationship-Building
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 ―negation ―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.
ANS: ―B
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.
TOP: ―AONE ―competency: ―Communication ―and ―Relationship-Building
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
ANS: ―A
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. ― Leaving ―the ―RNs ―alone ―for ―a ―period ―of ―time ―before
―implementation ―does―not ―provide ―opportunity ―to ―explore ―different ―perspectives ―and ―values.
―Avoiding ―discussion ―until ―the ―team ―changes ―may ―not ―promote ―adoption ―of ―the ―change
―until ―there ―is ―opportunity ―to ―explore ―perspectives ―and ―values ―related ―to ―the ―change.
―Hiring ―of ―the ―assistants ―demonstrates ―lack ―of ―empathy ―for ―the ―perspectives ―of ―the ―RN
―staff.
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―there ―is ―little ―turnover ―among ―your ―LPN ―and ―nursing ―assistant ―(NA) ―staff
―members, ―but ―they ―are ―not ―very ―motivated ―to ―go ―beyond ―their ―job ―descriptions ―in ―their
―work. ―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 ―LPNs ―and ― NAs.
b. Allow ―the ―LPNs ―and ―NAs ―greater ―decision-making ―power ―within ―the ―scope ―of
―their―positions ―in ―the ― institution.
c. Hire ―additional ―staff ―so ―that ―there ―are ―more ―staff ―available ―for ―enhanced
―care,―and―individual ―workloads ―are ―lessened.
d. Ask ―the ―director ―of ―nursing ―to ―increase ―job ―security ―for ―night ―staff ―by ―having
―them―sign ―contracts ―that ― guarantee ―work.
ANS: ―B
Hygiene ―factors ―such ―as ―salary, ―working ―conditions, ―and ―security ―are ―consistent ―with
―Herzberg‘s ―two-factor ―theory ―of ―motivation; ―meeting ―these ―needs ―avoids ―job
―dissatisfaction. ―Motivator ―factors ―such ―as ―recognition ―and ―satisfaction ―with ―work ―promote
―a ―satisfying ―and ―enriched ―work ―environment. ―Transformational ―leaders ―use ―motivator
―factors ―liberally ―to ―inspire―work ―performance ―and ―increase ―job ―satisfaction.
TOP: ―AONE ―competency: ―Communication ―and ―Relationship-Building
7. The ―nurse ―manager ― wants ―to ―increase ―motivation ― by ―providing ―motivating ―factors ―for
― thenurse―on ―the ―unit. ―What ―action ―would ―be ―appropriate ―to ―motivate ―the ―staff?
a. Collaborate ―with ―the ―human ―resource/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.
ANS: ―C
Complexity ―theory ―suggests ―that ―systems ―interact ―and ―adapt ―and ―that ―decision ―making
―occurs―throughout ―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. ―This ―principle ―is ―the ―foundation ―of ―shared ― governance.
TOP: ―AONE ―competency: ―Communication ―and ―Relationship-Building
8. 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 ―of ―volunteers ―to
―take ―the―lead ―in ―mentoring ―and ―teaching ―others ―how ―to ―implement ― it.
ANS: ―D
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