Theory Leadership

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The postpartum nurse is delegating tasks to an unlicensed health care worker. Which task should the nurse delegate? Evaluation of a postpartum client's lochia Vital signs on a client 4 hours after delivery Assessment of a postpartum client's episiotomy Assisting the postpartum client to breastfeed for the first time

Evaluating the client's lochia, assessing the client's episiotomy, and helping the client breastfeed for the first time would involve assessment, teaching, or evaluation and should not be delegated. The only task that does not require any of these is taking vital signs 4 hours after delivery.

Which actions make the nurse a transformational leader? Gaining higher education degrees Introducing a vision for the future nurses Implementing client-centered care effectively Correcting errors of the followers in a reactive manner

A transformational leader creates and shares a vision or goal for future nurses. Gaining higher education does not indicate leadership. Effective implementation of client-centered care indicates professionalism but not leadership. A transformational leader corrects the errors of followers by coaching and mentoring, not by using a reactive manner.

What is the most important skill of the nurse leader? Priority setting Time management Clinical decision making Clinical care coordination

The most important leadership skill for a nursing student is clinical care coordination. Priority setting, time management, and clinical decision-making are secondary components included in clinical care coordination.

While auditing unit documents, a nurse finds some omissions. Which term best describes when the nurse meets with the staff to discuss the findings and communicates ways to achieve the desired goals? Leadership Followership Management Decision making

The process of guiding, planning, and controlling others in a situation where communication is shared to improve clinical processes and outcomes is referred to as management. Leadership can be defined as a process of identifying a goal or target, motivating other people to act, and providing support and motivation to achieve goals. Followership is the process of following the leader or the manager to ensure the best clinical decision making and actions taken to achieve organizational outcomes. Decision making is a process of making crucial decisions.

Which internal factors affect the decision-making process of a leader? Select all that apply. Time Values Interest Resources Knowledge

Values, interests, and knowledge are the internal factors that affect the decision-making process of a leader. Time and resources are the external factors that affect decision making of a leader.

After determining that the nurses on the psychiatric unit are uncomfortable caring for clients who are from different cultures than their own, the nurse manager establishes a unit goal that by the next annual review the unit will have achieved what? Increased cultural sensitivity Decreased cultural imposition Decreased cultural dissonance Increased cultural competence

Cultural competence encompasses sensitivity as well as knowledge, desire, and skill in caring for those who are different from one's self. The nurses are already somewhat sensitive to those from different cultures and now must move forward in their ability to care for these clients. The nurses are not imposing their culture on the clients; they are avoiding them. There is no clashing of cultures in this situation.

The new unit manager is doing an annual performance evaluation on a nursing assistant (NA) hired 1 year ago. Several nurses have complained about this NA's skill level, even for basic care tasks. Which action by the manager is the best? Ask if the NA has ever been evaluated before now. Remind the NA of the skills and tasks within the job description. Send the NA to the skills practice and evaluation lab. Show the NA documentation of prior poor performance.

There are several sources of performance weaknesses, including unclear expectations, lack of feedback, educational needs, need for additional supervision and direction, and personal characteristics. The manager should ask the NA how things are going and lead into the discussion of the poor performance by asking if the NA has ever been evaluated before and what the results of that evaluation were. Because the manager is new, he or she may be unfamiliar with how the outgoing manager evaluated new employees. The other action may need to occur, but the manager needs to know the NA's evaluation history first.

A nurse encourages employees to implement a Magnet Recognition Program in the organization. The nurses think beyond their own personal needs and are clear about the group outcomes. Which leadership quality according to Gardner's tasks is reflected in the activity of the nurse? Developing trust Serving as a symbol Representing the group Achieving workable unity

According to Gardner's Tasks of Leadership, encouraging employees to implement a Magnet Recognition Program shows that the nurse is representing the group. Trust develops when leaders are clear when providing direction and refrain from misdirecting others in their thinking and actions. The leader may serve as a symbol by becoming involved in public relations events, for example. The nurse as leader can achieve workable unity between and among parties by avoiding, diminishing, or resolving conflicts.

A nurse leader is setting priorities for achieving success by using the simplest and fastest method of communication. Which rules and responsibilities does the nurse fulfill by this action? Maintaining balance Building self-confidence Generating self-motivation Maintaining a positive attitude

An effective leader maintains work-life balance in his or her own life, as well as facilitating balance for followers. Making communication as efficient as possible is one way of helping to maintain this balance. Self-confidence can be established by performing honest self-appraisal on a regular basis. Spending time on the needs of the followers and offering frequent and lavish praise will help build self-motivation. A positive attitude can be maintained by consistently having answers to the question asked by others, knowing where the organization is going, and taking the initiative to get the group to its goal.

The registered nurse delegates the following task to an unlicensed assistive personnel: "Mr. Smith in room 408 is very unsteady on his feet. Each time you are in the room, please make sure the call light is in reach and his bed alarm is turned on." Four hours later, the nurse asks the aide if Mr. Smith is doing all right and goes on break. While at dinner, Mr. Smith falls and breaks his hip. When reviewing this incident, the nurse determines which part of the delegation process was not done correctly? Right circumstance Right directions and communication Right supervision and evaluation Right task

C. Right supervision and evaluation The problem with delegation in this case is that the nurse never evaluated the job done by the nurse's assistant, so the right supervision and evaluation is missing. Placing a call light in reach and ensuring that a bed alarm is on are tasks that a nurse's aide should be qualified to do; nothing in the question indicates that this was a new aide or one not familiar with the equipment. The patient does not have any unusual circumstances that would make the aide the wrong person to do this job. The directions are clear.

The nurse leader is teaching the staff that the health care provider continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining? Cultural diversity Cultural sensitivity Cultural imposition Cultural competence

Cultural competence is the process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of a client, individual, family, or community. Cultural diversity describes a vast range of cultural differences among individuals or groups. Cultural sensitivity describes the affective behaviors in individuals such as the capacity to feel, convey, and react to ideas, habits, and customs or traditions unique to a group of people. Cultural imposition is defined as the tendency of an individual or group to impose their values, beliefs, and practices on another culture for various reasons.

The nursing manager said, "Nurse leaders must also be excellent change managers." Which statement supports this? Nurse leaders ensure a change that will support only staff. Nurse leaders are only coordinators to bring a change in the system. Nurse leaders can only support clients in changing their behaviors to improve care. Nurse leaders will ensure that the disruption and chaos of change does not affect client care.

During change, nurse leaders keep the delivery of safe and effective care at the center of their attention to ensure that the disruption and chaos of change do not affect clients. By supporting a transparent and evidence-based environment, the nurse leader ensures a culture that will support both clients and staff during the change process. Nurse leaders play the roles of both coach and coordinator, facilitating the changes needed at a system, unit, or team level. Nurse leaders not only support clients in changing their behavior but also must foster innovation and promote change in the workplace that advance client safety and improves client outcomes.

Which statement is true regarding leadership? Having the title of chief executive officer indicates a good leader. Leadership is an earned honor and an action-oriented responsibility. Playing an administrative role can automatically place the title of leader on an individual. Strengthening the mission of an organization purely depends on the leader himself or herself.

Leadership is an earned honor, right, and privilege and an action-oriented responsibility that requires a time commitment. Having a title such as chief executive officer or chief nursing officer does not guarantee that a person will be a good leader. Administrative or management roles do not automatically confer the title of leader on an individual. Strengthening the mission of organization depends on both a good leader and follower.

What is the role of the nurse executive as a leader? Orientation Empowerment Employee selection Financial accountability

The role of the nurse executive as the leader is to empower followers or to share the authority with the followers by asking them to actively participate in the given task. Orientation of the employee, employee selection, and financial accountability indicates the role of a nurse manager as leader.

A nurse and health care provider are talking in the hallway about a patient's condition. The health care provider says that the patient needs an x-ray. Which action by the nurse is most appropriate? Document the order and facilitate the patient having the x-ray. Explain that you will call x-ray when the health care provider inputs the order. Inform the health care provider that verbal orders are prohibited now. Repeat the order to the health care provider and document it in the chart.

Verbal orders should only be taken during an emergency situation or when it is physically difficult for the physician to write or put in the order himself or herself, such as during a sterile procedure. Because neither is the case here, the nurse should explain that as soon as the order is properly put into the system, he or she will facilitate the study. The nurse should not document the order or say that verbal orders are prohibited because there are circumstances in which they are still appropriate.


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