Ch 10: Leadership, Managing and Delegating

When communicating with an employee, the nurse manager must: a) communicate congruently. b) be agreeable. c) reserve time to be attentive. d) be aware of surroundings.

a) communicate congruently.

A nurse arranges all the resources available to teach a teenage client how to manage asthma. Which role is this nurse performing? a) Planning b) Organizing c) Directing d) Controlling

b) Organizing

After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to: a) ask the staff members for other solutions. b) plan to monitor the supply cabinets. c) assess whether the desired results have occurred. d) make an appointment with the chief nursing officer.

c) assess whether the desired results have occurred.

A staff nurse is talking with a clinical nurse leader and asks, "What exactly do you do?" Which statement by the clinical nurse leader would be appropriate? a) "I'm an administrator involved with client care." b) "My position is one of management." c) "I collaborate with health care teams to promote client care." d) "I'm an advanced practice nurse with a specific specialty area."

c) "I collaborate with health care teams to promote client care."

The nurse is working at a facility that is applying for Magnet® Recognition. The nurse knows that compared with other hospitals, Magnet® hospitals have which direct effect on client care? a) Higher nurse retention b) Longer patient stays c) Better patient outcomes d) Improved job satisfaction scores

c) Better patient outcomes

A nurse manager of a hospital unit is working within a decentralized management structure. Which nursing action best exemplifies this type of system? a) Senior managers make all the decisions. b) Nurses are not intimately involved in decisions involving client care. c) Decisions are made by those who are most knowledgeable about the issue. d) Nurse managers are not accountable for clients, staffing, supplies, or budgets.

c) Decisions are made by those who are most knowledgeable about the issue.

The charge nurse on a unit receives a report that a licensed practical nurse (LPN) is taking clients' narcotics and hiding them in the nurses' lounge. The charge nurse disregards the report and continues to work on a scheduled task. Which conflict resolution style is the charge nurse using? a) Collaborating b) Compromising c) Avoiding d) Accommodating

c) Avoiding

The registered nurse (RN) is preparing to delegate tasks to an unlicensed assistive personnel (UAP). Which task would be appropriate for the RN to delegate to the UAP? a) Assessing oxygen (O2) saturation b) Calculating fluid volume resuscitation c) Monitoring intracranial pressure (ICP) d) Measuring intravenous therapy intake

a) Assessing oxygen (O2) saturation

A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check clients' blood glucose levels. The nurse manager informs the group that this is a new policy on the unit and that discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating? a) Autocratic b) Democratic c) Laissez-faire d) Transformational

a) Autocratic

A staff nurse works on a medical unit where staff retention is very high. There is a sense of equality between the leader and the staff nurses. The unit decisions and activities are shared between the leader and the group. The designated nurse leader practices which leadership style? a) Autocratic b) Democratic c) Laissez-faire d) Transformational

Democratic

A client is received into the emergency department after getting shot in the chest. The client is hemorrhaging profusely and is in hypovolemic shock. The nurse calls a code blue. What type of leadership style will be most effective during the management of the code? a) Autocratic leadership b) Laissez-faire leadership c) Democratic leadership d) Transactional leadership

a) Autocratic leadership

The nurse is delegating care to an unlicensed assistive personnel (UAP). Which intervention would be most important for the nurse to perform independently? a) Assess the client with difficulty breathing b) Obtain a postprandial blood sugar reading c) Measure the client's blood pressure d) Assist the client with turning in bed

a) Assess the client with difficulty breathing

The older client tells the nurse that the client needs to use the restroom. Which safety intervention must the nurse perform first? a) Assess the need for assistance with ambulation. b) Ask the unlicensed assistive personnel (UAP) to help the client to the restroom. c) Offer the bedpan to keep the client safe. d) Ask a family member to help the client to the restroom.

a) Assess the need for assistance with ambulation.

A registered nurse serves as the chair of the Nursing Practice Committee for the hospital. The meetings of this committee do not have a planned agenda; members of the committee who are interested in a particular topic feel free to suggest it and then to lead the subsequent discussion. This chair's leadership style could be most accurately termed what? a) Decentralization b) Democratic c) Laissez-faire d) Autocratic

c) Laissez-faire

The nurse is advising a client about health problems related to being overweight. The client acknowledges the need to lose weight. The nurse provides education on how to count calories in food and the importance of daily exercise. The client states an intention to begin counting calories with the next meal. The client also states an intention to begin an exercise program with friends. Which statement associated with this scenario illustrates Lewin's stage of unfreezing? a) The client acknowledges the need to lose weight. b) The client also states an intention to begin an exercise program with friends. c) The client states an intention to begin counting calories with the next meal. d) The nurse provides education on how to count calories in food and the importance of daily exercise.

a) The client acknowledges the need to lose weight.

Two staff nurses on a unit disagree with one another over certain key aspects of providing client care. The nurse manager of the unit arranges a meeting with the charge nurse and the two staff nurses at a mutually agreed-upon time to discuss this situation. This activity is most accurately described as what? a) Conflict resolution b) Problem solving c) Delegation d) Client protection

a) Conflict resolution

The nurse has recently been promoted to nurse manager on a pediatric unit and has decided to accept input from staff regarding changes they would like to see on the unit. Which type of leadership style is the nurse embodying? a) Quantum b) Autocratic c) Democratic d) Laissez-faire

c) Democratic

Which statement by a registered nurse (RN) represents appropriate delegation to a nursing assistant? a) "Discontinue the IV solution." b) "Dispose of the disconnected IV set." c) "Inspect the site for thrombophlebitis." d) "Check the infusion rate."

b) "Dispose of the disconnected IV set."

The new nurse is having difficulty managing the time required to care for a group of complex clients and is several hours behind in completing nursing interventions. Which intervention should the nurse complete first? a) Perform a dressing change to an abdominal abscess that is three hours behind schedule. b) Administer a dose of digoxin that is two hours behind schedule. c) Obtain discharge orders for a client who is ready to be transferred to a long-term nursing facility. d) Complete a medication reconciliation form on a client who has recently been admitted to the hospital.

b) Administer a dose of digoxin that is two hours behind schedule.

The nurse has recently been promoted to nurse manager on an oncology unit and has decided to be the sole decision maker regarding issues that concern the unit. Which type of leadership style is the nurse embodying? a) Quantum b) Autocratic c) Democratic d) Laissez-faire

b) Autocratic

The nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and physicians is exhibiting what style of leadership? a) Laissez-faire b) Democratic c) Autocratic d) Transactional

b) Democratic

A nurse is successful in promoting change on the nursing division. This nurse would be considered a: a) guide. b) leader. c) manager. d) specialist.

b) leader.

The nurse manager notices a trend in nurses routinely arriving to work late. How can the nurse use the transactional leadership style to get nurses to arrive to work on time? a) Allow the nursing staff to develop a plan to decrease tardiness within the unit. b) Emphasize the importance of arriving to work on time during a monthly unit meeting. c) Monitor time clock reports on a monthly basis and enter all nurses who have not been tardy into a raffle for a paid day vacation. d) Generate a report of nurses who routinely arrive to work late and set an example by firing the nurse who has been tardy the most.

c) Monitor time clock reports on a monthly basis and enter all nurses who have not been tardy into a raffle for a paid day vacation.

A nurse manager reviews an employee's contribution to the nursing division annually. This process is: a) interpreting quality indicators. b) employee's job satisfaction survey. c) performance appraisal. d) reward and development survey.

c) performance appraisal.

Two new nurses are requesting the same preceptor for unit orientation. Both new nurses have been very vocal about being unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using a compromise approach to conflict resolution? a) The nurses ignore each other's request for the preceptor. b) The nurses agree to allow the preceptor to decide which nurse to precept. c) The nurses agree that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend. d) The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end.

d) The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end.

Which of these statements regarding a nurse manager role is accurate? a) The nurse manager's main role in the nursing unit is to manage the unit budget. b) To effectively manage the nursing unit, the nurse manager should also be a leader. c) A healthy work environment is not within the scope of the nurse manager's role. d) The nurse manager will decide on the financial targets for the nursing unit.

b) To effectively manage the nursing unit, the nurse manager should also be a leader.

Following a myocardial infarction (heart attack), a client begins to recognize the need to increase exercise, eat a low-fat diet, and implement relaxation techniques. According to Lewin, this client is in which stage of the change process? a) Prizing b) Unfreezing c) Moving d) Refreezing

b) Unfreezing

The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which conflict resolution style does the nurse manager display? a) Avoiding b) Competing c) Collaborating d) Smoothing

c) Collaborating

The nurse is working to enhance time management skills and has to administer pain medications to several patients, obtain vital signs, and assist clients with bathing. What should the nurse do next? a) Bathe clients. b) Obtain vital signs. c) Delegate bathing and vital signs tasks. d) Administer pain medications.

c) Delegate bathing and vital signs tasks.

A nurse on a telemetry unit is admitting a client and has an unlicensed assistive person (UAP) helping with the admission process. Which task can the nurse delegate to the UAP? a) Gathering information about the client's medical history and any allergies b) Listing the client's home medications on a medication reconciliation form c) Obtaining an admission weight for the client utilizing the client's bed scale d) Determining what heart rhythm the client is in based on telemetry reading

c) Obtaining an admission weight for the client utilizing the client's bed scale

A nurse manager is trying to resolve a conflict between the day and night shifts. The nurse manager wants to convince the involved persons to set aside their differences, determine a priority common goal having to do with improved client care, and accept mutual responsibility for achieving this goal. The nurse manager is using which type of conflict resolution? a) Avoiding b) Competing c) Compromising d) Collaborating

d) Collaborating

A registered nurse is delegating activities to unlicensed assistive personnel (UAP) on a hospital unit. Which activities could this nurse normally delegate? Select all that apply. a) The determination of a nursing diagnosis for a client with breast cancer b) Giving a bed bath to a client c) Planning education for a client with a colostomy d) Taking routine vital signs e) Administering medications to clients f) Transferring a client to another floor

b) Giving a bed bath to a client d) Taking routine vital signs f) Transferring a client to another floor

The charge nurse on the orthopedic unit believes in giving the staff as much power as possible. The nurses are allowed, among other things, to create their own work schedules, provide dates and times for unit meetings, and create the agendas, to which the charge nurse contributes. The charge nurse's style of leadership can be described as which? a) Democratic b) Laissez-faire c) Autocratic d) Transformational

b) Laissez-faire

A nurse manager tells the staff that they need to increase response time to client requests by five minutes, beginning tomorrow. The time to begin this activity has been established by the manager and the staff. This action involves goal setting. What leadership style is noted with the implementation of goal setting? a) Directive leadership b) Participative leadership c) Shared governance d) Institutional governance

b) Participative leadership

Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status? a) Nursing administration is in control of all decision-making. b) Staff nurses are developing innovative solutions to problems. c) Most client outcomes have improved but are not at target range. d) There is a decreased rate of retention among the nursing staff.

b) Staff nurses are developing innovative solutions to problems.

A nurse manager best demonstrates effective leadership characteristic by which action? a) Being very structured and rigid with the unit flow b) Knowing all information about the unit processes c) Indicating an interest in becoming a role model d) Sharing a vision for the unit and enlisting support

d) Sharing a vision for the unit and enlisting support

A nurse is caring for a client with pneumonia. Which task is most appropriate for the nurse to delegate to an experienced unlicensed assistive personnel (UAP)? a) Assessing for shortness of breath b) Instructing the client about the need to alternate activity with rest c) Obtaining vital signs every 4 hours d) Administering nebulizer treatments as needed

c) Obtaining vital signs every 4 hours

The case manager works in a facility that supports a participative leadership style. Which action should the nurse recognize as an example of democratic leadership style? a) The nurse implementing the physician's written orders for client care b) The unlicensed assistive personnel (UAP) taking vital signs for several nurses c) The dietitian completing a nutritional assessment for a registered nurse (RN) d) The interdisciplinary health care team collectively developing plans of care for clients

d) The interdisciplinary health care team collectively developing plans of care for clients

The nurse recognizes that a new mother is having difficulty breastfeeding. The nurse demonstrates various positions in which to hold the baby while feeding. The nurse also educates the mother on ways to ensure proper latching. The new mother attempts to breastfeed the baby again using the new techniques and is successful. Which statement in this scenario illustrates Lewin's stage of refreezing? a) The nurse also educates the mother on ways to ensure proper latching. b) The nurse recognizes that a new mother is having difficulty breastfeeding. c) The nurse demonstrates various positions in which to hold the baby while feeding. d) The new mother attempts to breastfeed the baby again using the new techniques and is successful.

d) The new mother attempts to breastfeed the baby again using the new techniques and is successful.

A nurse can improve one's skill with time management by taking which action? a) Allowing the flow of the day to control how time is managed b) Setting priorities without involving clients or their families c) Starting each day as a new day without considering the previous day d) Evaluating success with accomplishment of goals in client care

d) Evaluating success with accomplishment of goals in client care

The nurse manager calls a staff into a unit meeting to discuss patient satisfaction. During the meeting, several staff members assume control. The nurse manager does not intervene to regain control of the group. Which type of leadership style is the nurse embodying? a) Quantum b) Autocratic c) Democratic d) Laissez-faire

d) Laissez-faire

A nurse manager has asked the staff to create a plan to improve patient outcomes. In the past, the staff have not met deadlines. How can the nurse manager use transactional leadership style to ensure that the deadline is met? a) Ask politely. b) Demand efficiency. c) Give extensions as needed. d) Offer 2 days of paid vacation.

d) Offer 2 days of paid vacation.