and following yoder wise leading and managing in nursing
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Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 6th Edition
Chapter 01: Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 6th 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 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.
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.
REF: Page 8 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.
NURSINGTB.COM
,Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 6th Edition
REF: Page 10 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 her 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.
ANS: C
Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to address the
interests and involvement of participants in the conflict by examining the real issues of all
parties.
REF: Page 16 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.
It would now be best to:
a. Arrange another meeting in a week’s time so as to allow a cooling-off period.
b. Turn the dispute over to the director of nursing.
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
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-off” period is
recommended if resolution fails.
REF: Page 16 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 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 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.
NURSINGTB.COM
,Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 6th Edition
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.
REF: Page 7 | Page 15
TOP: AONE competency: Knowledge of the Health Care Environment
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.
REF: Page 9 | Page 10
TOP: AONE competency: Communication and Relationship-Building
7. As the nurse manager who wants to increase motivation by providing motivating factors, which
action would you select?
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.
NURSINGTB.COM
, Leading, Managing, and Following
Yoder-Wise: Leading and Managing in Nursing, 6th Edition
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.
REF: Pages 8-11 TOP: AONE competency: Communication and Relationship-Building
8. A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who
begins to complain loudly about the quality of care his mother is receiving. His behavior 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 behavior by the charge nurse best illustrates refined
leadership skills in an emotionally intelligent practitioner?
a. Reflect to gain insight into how the situation could be handled differently in the future.
b. Try to catch up with the angry family member to resolve the concern.
c. Discuss the concern with the patient after the family member has left.
d. Notify nursing administration of the situation.
ANS: A
Goleman suggests that emotional intelligence involves insight and being able to step outside
of the situation to envision the context of what is happening as well as being able to manage
emotions such as frustration effectively.
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 feel it is
insulting to be required to participate in a competency program. Which behavior by the staff
development coordinator is most appropriate in this situation?
a. Disregard staff concerns and continue with development of the program.
b. Inform the nurses that this program is a requirement for JCAHO accreditation.
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.
ANS: D
The manager role involves guiding others through a set of derived practices that are evidence-
based and known to satisfy preestablished outcomes such as participation in a competency
program. This involves engagement of staff through sharing of concerns and ideas. A close
analysis of the IOM report and the summary of the PPACA suggests that no health reform can
unfold without active nursing engagement. Each document emphasizes that nurses must lead,
NURSINGTB.COM
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