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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
|t heory, |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 a| nd |Relationship-Building
3. A |grievance |brought |by |a |staff |nurse |against |the |unit m
| anager |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 m
| anager |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 i| n |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 |a lso |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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