Ch, 10 leading, managing and delegating

The nurses who provide care on a medical unit are skeptical about the planned change from a traditional opioid cupboard to a computerized medical supply and management system. Which statement best demonstrates mistrust about the benefits of this proposed change?

"I've heard those machines don't even cut down on medication errors like they say they do.

The nurse has just graduated with a bachelor of science degree in nursing and is eager to find a mentor at this early stage in her career which of the following individuals is most likely to be an appropriate mentor for the nurse

An experienced nurse who was a preceptor in a previous clinical placement

Conflict has emerged on a nursing unit because new graduates have found that some of the more experienced nurses are manipulating the client assignment to ensure a lighter workload during night shifts. How should the manager of the unit best address this conflict?

Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible

what is a general rule RN should not delegate

Assessment planning evolution steps of the nursing process

which of the following nursing care tasks is acceptable for a graduate nurse to delegate to unlicensed assistive personnel (UAP)

Assisting a client with ambulation

A nurse manager makes all the decisions for staff activities what type of leader ship is demonstrated by this action

Autocratic

A nurse strives to establish trusting interpersonal relationships with clients, peers, subordinance, and superiors to facilitate call achievement and personal growth of all participants which type of skills is this nurse demonstrating

Communication skills

What type of leader shares decisions and activities with group participants

Democratic

which of the following tasks could the nurse safely delegate to unlicensed assistive personnel

Documentation of client's I&O on a flow sheet

planned change #7

Evaluate the effects of change by comparing them with objectives stated in the plan for change

A nurse can delegate the initial or ongoing assessment of the patient to an unlicensed assistant as long as the primary nurse reviews the documentation within 24 hours.

False

According to Lewin's change theory, the process of initiating change after a careful process of planning is known as "unfreezing."

False

Transactional leadership theory views an organization and its members as interconnected and collaborative.

False

A senior student has been elected president of the student nurses association which of the following qualities is essential to being a nursing leader

Flexibility

planned change #2

Identify a problem to be solved through change. Analyze the symptoms and reach a conclusion. Note resistance to barriers to change

the nursing student is working to improve his time management. which of the following would assist the nursing student to accomplish his goal

Identify priorities for the day Evaluate time management at the end of the day Establish a reasonable time line

planned change #6

Implement the selected course of action to effect change.

Explicit power refers to power vested in the position (e.g., unit manager), whereas __________ power refers to the power to influence as a leader.

Implied

Which attributes should be characteristic of a nurse mentor? Select all that apply.

Is supportive Is resourceful Demonstrates leadership abilities Is an experienced, licensed professional

A head nurse assumes the leadership role when directing and supervising coworkers. which of the following are attributes of a leader

Philosophical charismatic dynamic

conflict management and engagement PEARLA approach

Presence Empathy Acknowledgement Reflect or Reframe Listen openly Ask questions

Which type of skills is not needed for nursing leader ship

Technical skills

The registered nurse (RN) has received orders to perform an unsafe practice on a client. The RN voices concern with the physician who gave the order, but the physician refuses to change the order. Whom should the nurse consult next regarding the order?

The charge nurse

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?

The client acknowledges the need to lose weight

In Lewin's classic theory of change, what happens during unfreezing

The need for change is recognized

A nurse leader is described as charismatic motivational and passionate communications are open and honest and the nurse is willing to take risks what type of leader ship is the nurse practicing

Transformational

planned change is purposeful, systematic effort to alter or bring about change, what occurs next after alternative solutions to a problem are determined and analyzed

a course of action is chosen is chosen from among the alternatives

A nurse is described as a "quantum leader" which action characterizes this type of leadership

a nurse conducts a blind survey to evaluate her leadership skills

what is conflict management

a process to work through conflicts in a way that minimizes negative effects and promotes positive consequences

what is planned change

a purposeful, systematic effort to bring about change through intervention

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?

administering a dose of digoxin 2 hours behind schedule

A nurse working on leadership skills should keep in mind which of the following accurate statements regarding leaders

all nurse leaders began as inexperienced nurses

what can the RN delegate to the UAP

assistance with basic care activities bathing grooming ambulation feeding vital signs measuring intake and output weighing simple dressing changes transfers post mortem care

Autocratic leadership involves the leader

assuming complete control over the decisions and activities of the group.

what is the significance of magnet recognition

attract and retain top talent improve care, safety, and satisfaction foster a collaborative culture advance nursing standards and practice

Directive or authoritarian leadership, also known as _______________ leadership, involves the leader assuming control over the decisions and activities of a group.

autocratic

The nurse is caring for a client who had a sudden episode of vomiting, which produced 900 mL of frank blood. The nurse directed and delegated to colleagues in order to notify the physician. She started intravenous fluids, and provided physical and emotional support for the client. Different situations call for different leadership styles. Which of the following leadership styles did the nurse display in this situation

autocratic

In general, how do most people view change

by how they are affected personally

The process of transforming or modifying something

change

change theory refreezing

change becomes operational

change theory moving

change that is initiated after a careful process of planning

Transformational leaders are often described described as

charismatic, challenging, and passionate about their vision. They communicate openly and honestly, show concern for others, and are willing to take risks.

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?

collaborating

A nurse believes in listening to clients and coworkers more than talking to them, allowing more personal control for all involved. This is a quality of which of the following managerial mindsets

collaborative

What are the four basic types of skills needed for nursing leader ship

communication problem solving management self evaluation

Magnet® status recognizes an institution for creating an environment that supports three approaches toward nursing services: self-governance at the unit level, acknowledgment of professional autonomy, and a ______________ decision-making process.

decentralized

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?

delegate bathing and vital signs tasks

A nurse who transfers responsibility for the performance of an activity to another nurse, while retaining accountability for the outcome, is using the process of _______________ nursing care

delegating

what type of leadership can a graduate nurse working in a magnet hospital expect

democratic

planned change #3

determine and analyze alternative solutions to problems

There is a perception in a long-term care facility that the older adult residents are experiencing falls more often than in the past an audit of incident reports has confirmed this and the nursing leader ship has recognized the need to make changes to reduce the incidence of falls how should the leaders proceed with this planned change place the following steps in the correct order

determine and analyze different solutions to the problem choose a new protocol that is likely to reduce falls develop a plan for implementing the change Implement the change in nursing practice take measures to ensure that nursing practice does not revert

During a staff meeting, the nurse is discussing new quantum leadership. The nurse explains that in this type of leadership change is viewed as which of the following

dynamic and constantly unfolding

To adequately direct client care and maintain effective decision making, the nurse manager requires knowledge of what?

economics

The nurse is having an exceptionally busy shift on an obstetrical unit. which of the following tasks is the nurse justified in delegating to an unlicensed care provider

emptying a clients foley catheter bag and reporting the volume to the nurse

A nurse manager has encountered resistance to a planned change. what is one way the nurse can overcome the resistance

encourage open communication and feedback

The nurse is a manager on an orthopedic unit. The unit changed to a new computer documentation system three days ago. One of the night nurses has called in sick every shift since the new system started. The nursing manager is aware that this situation has to do with resistance to change. which of the following are common reasons why people resist change

feel threatened fear increased responsibility lack of understanding see no benefits to the change

conflict resolution compromising

for this technique to be effective, both patient must be willing to relinquish something of equal value

a nurse manager has directed a registered nurse who is out of school for one year to become a member of the institution's policy and procedure committee. A goal in the nurse manager's delegation is to assist the nurse to what

grow in her profession

What are the tasks that should be performed by a registered nurse

initial and ongoing assessments diagnosis plan of care evaluation of client progress supervision and education evaluation of nursing care delivered to the patient

a nurse is considering the delegation of administering medications to an unskilled assistant. what is the first question the nurse must ask herself before doing so

is the delegated task permitted by law

which of the following is a characteristic of mentorship

it is a link to a protege with common interests

The ANA which is committed to monitoring the regulation, education, and use of NAPs recommends adherence to which one of the following principles

it is the nursing profession that determines the scope of nursing practice.

A leader who relinquishes power to the group in such a way that an outsider could not identify the leader is said to be practicing ________________ leadership.

laissez-faire

Nurse managers must have

leadership qualities delegation skills flexible knowledgeable

what is transactional leadership

leadership style based on maintaining control by rewarding good behavior and punishing negative or detrimental behavior

laissez-faire leadership

leadership style in which the leader relinquishes all power to the group

which of the following statements accurately describes recommended guidelines for overcoming resistance to change

list the advantages of the proposed change for members of the group if possible, introduce change gradually

A student nurse has just graduated with a baccalaureate degree in nursing. what type of nursing leadership will this nurse be expected to provide

nursing care of the individual client

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?

participative leadership

Democratic leadership is also called

participative leadership, it is characterized by equality among the leader and other participants. decisions and activities are shared

planned change #5

plan for making the change

what is implied power

power obtained by force of a person's personality that might enable that person to have more power to influence others than designated leaders

What is explicit power

power obtained by virtue of a person's position

what should the RN consider before delegating care

qualifications & capabilities stability of patient complexity of activity potential for harm predictability of the outcome patient needs

Planned change: an 8 step process #1

recognize symptoms that indicate a change is needed and collect data

planned change #4

select a course of action for possible alternatives

Nurses with varying levels of experience possess leadership skills. A graduate nurse walks out of the nurse manager's office after a meeting. The graduate nurse reflects on the positive and negative feedback that she received from the manager regarding her three months working on the unit. What nursing leadership skill is best illustrated by the graduate nurse in this scenario? A) Self-evaluation skills B) Communication skills C) Problem-solving skills D) Management skills

self evaluation skills

In which of the following conflict resolution strategies is the conflict rarely resolved

smoothing

what technique involves complimenting all parties in an attempt to prevent emotional outbursts and focus on agreement

smoothing approach

planned change #8

stabalize the change

what is conflict engagement

teaches skills to help nurses perform well in the face of conflict instead of finding a work-around to avoid conflict

when comparing team nursing with functional nursing, what characteristics is found

team nursing focuses on individual client care.

The scope of practice of the RN is governed by

the board of registered nurses

change theory unfreezing

the need for change is recognized

conflict resolution strategies avoiding

there is awareness of the conflict situation, but the patient involved decide to either ignore the conflict, or avoid, or postpone its resolution

which of the following statements accurately describes the use of power by change agents

they are often accomplished professional women

conflict resolution collaborating

this is a joint effort to resolve the conflict with a win-win solution, all parties set aside previously determined goals, determine a priority goal

Magnet® status recognizes an institution for creating an environment that supports three approaches toward nursing services: self-governance at the unit level, acknowledgment of professional autonomy, and a decision-making process.

true

what is transformational leadership

type of leadership in which the person creates revolutionary change and commits to the personal and professional growth of self and others

A nurse is attempting to change the method for documenting client care in a hospital setting. which of the following should be considered before planning change

what is amenable to change how does the group function as a unit is the group ready for change are the changes major or minor