Leadership Exam 1 Ch. 1, 2, 3, 5, 6, 8, 9,
10, 11, 15, 16, 23, 24, 25, 26, 27, 28, 29
(Yoder-Wise: Leading and Managing in
Nursing, 7th Edition Newest
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A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults.
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She is 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 in making
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this change?
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a. Leverage the hierarchical management position to get unit staff involved in assessment
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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 community environment
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d. Hire a geriatric specialist to oversee and control the project
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b) Engage involved staff at all levels in the decision-making process
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A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who
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has called in sick five times in the past month. He tells the manager that he very much
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wants to come to work when scheduled but must often care for his wife, who is undergoing
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treatment for breast cancer. According to Maslows need hierarchy theory, what would be
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the best approach to 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 nurses dilemma and let the charge nurse know that this nurse may
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be calling in frequently in the future
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d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off
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around his wife's treatments.
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d. Work with the nurse, staffing office, and other nurses to arrange his scheduled
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days off around his wife's treatments
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A grievance brought by a staff nurse against the unit manager requires mediation. At the
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first mediation session, the staff nurse repeatedly calls the unit managers actions unfair,
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and the unit manager continues to reiterate the reasons for her actions. What would be the
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best 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 so as to clarify issues
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c. Ask each party to examine her 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
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c. Ask each party to examine her own motives and issues in the conflict
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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 weeks 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 managers actions and end the dispute.
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b) Elevate the next negation session to the next manager, one level above (new)
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b. Turn the dispute over to the director of nursing (old)
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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 walk patients. The RNs on the staff
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have always practiced in a primary nursing-delivery system & are very resistant to this
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idea. What would be the best initial strategy for 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 is
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implemented
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c. Dropping the idea and trying for the change in a year or so when some of the present
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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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a. Exploring the values and feelings of the RN group in relationship to this change
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As the RN charge nurse on the night shift in a small long-term care facility, youve found that
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there is little turnover among your LPN and nursing assistant (NA) staff members, but they
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are not very motivated to go beyond their job descriptions in their work. Which of the
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following 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 & bonuses for extra work for the night
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LPNs and NAs
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b. Allow the LPNs and NAs greater decision-making power within the scope of their
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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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b. Allow the LPNs and NAs greater decision-making power within the scope of their
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positions in the institution
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The nurse manager wants to increase motivation by providing motivating factors for the
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nurse 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-site daycare
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service
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b. Provide a hierarchical organizational structure
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c. Implement a model of shared governance
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d. Promote the development of a flexible benefits package.
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c. Implement a model of shared governance
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A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member
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who begins to complain loudly about the quality of care his mother is receiving. His
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behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The
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family member rejects any attempt to intervene therapeutically to resolve the issue. He
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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
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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
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d. Notify nursing administration of the situation.
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a. Reflect to gain insight into how the situation could be handled differently in the
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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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units, the staff development coordinator overhears RN staff complaining that they feel it is
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insulting to be required to participate in a competency program. What behavior by the staff
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development coordinator is most appropriate in this situation?
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a. Disregard staff concerns and continue with development of the program.
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b. Inform the nurses that this program is a requirement for JCAHO accreditation.
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c. Schedule a meeting with the chief nurse executive to apprise her of the situation.
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d. Facilitate a meeting so nurses can articulate their values and concerns about a
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competency program.
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d. Facilitate a meeting so nurses can articulate their values & concerns about a
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The nurse manager has been asked to implement an evidence-based approach to teach
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ostomy patients self-management skills postoperatively. The program is to be
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implemented across the entire facility. What illustrates effective leadership in this
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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-based & is more familiar
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c) You decide to implement the approach at a later date because of feedback from the RNs
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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 the lead in
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mentoring and teaching others how to implement it.
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d) An RN who is already familiar with the new approach of volunteers to take the
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lead in mentoring and teaching others how to implement it.
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You overhear a new graduate RN telling a nurse colleague that leadership and
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management belong to the unit manager, not to her. As a nursing colleague, what do you
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know to be true in regard to the statement?
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a) The statement is correct. Leadership is not the role of the staff nurse.
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b) The new graduate would benefit from further understanding of her role as a professional,
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whose influence may affect the decision making of patients, colleagues, and other
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professionals.
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c) The new graduate has been influenced by nurse leaders and managers who leave for
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other positions.
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d) The general perception is that nurse leaders and managers are not satisfied in their jobs.
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b) The new graduate would benefit from further understanding of her role as a
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professional, whose influence may affect the decision making of patients,
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colleagues, and other professionals
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The charge nurse walks into Mr. Smith's room and finds him yelling at the LPN. He is
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obviously very upset. The charge nurse determines that he has not slept for three nights
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because of unrelieved pain levels. The LPN is very upset and calls Mr. Smith an "ugly, old
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man." The charge nurse acknowledges the LPN's feelings and concerns and then
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suggests that Mr. Smith's behavior was aggressive but was related to lack of sleep and to
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pain. The charge nurse asks, "Can you, together with Mr. Smith, determine triggers for the
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pain and effective approaches to controlling his pain?" This situation is an example of
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what?
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a) Lack of empathy and understanding for Miss Jones
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b) Concern with placating Mr. Smith
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c) Leadership behavior
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d) Management behavior
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c) Leadership behavior
AD
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You walk into Mr. Smiths room and find him yelling at the LPN, Miss Jones. He is obviously
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very upset and after you speak with him regarding his behavior, you determine that he has
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not slept for three nights because of unrelieved pain levels. The LPN is very upset with Mr.
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Smith and calls him an ugly, old man. You acknowledge her feelings and concerns and
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then suggest that Mr. Smiths behavior was aggressive but is related to lack of sleep and to
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pain. You say to Miss Jones, Can you both, together with Mr. Smith, determine triggers for
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the pain and effective approaches to controlling his pain? This approach demonstrates:
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a. Lack of empathy and understanding for Miss Jones
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b. Concern with placating Mr. Smith
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c. Leadership behavior
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d. Management behavior
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After assessing an older adult patient in long-term care who has been slowly deteriorating
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for weeks, the nurse manager calls the family and asks them to come in, as the patient is
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dying. What is the most likely basis for the nurse manager's request?
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a. An established clinical pathway
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b. Confirmatory scientific evidence
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c. Unit protocol
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d. Experience
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d. Experience
