NMNC4320 Leadership

Which action makes the nurse manager also the nurse leader? Implementing best management skills when hiring employees Having financial accountability associated with the organization Screening effectively to select the right employees for the organization Helping employees reach the highest level of their potential excellence

Helping employees reach the highest level of their potential excellence RATIONALE: The nurse leader helps employees reach their highest level of potential excellence and raises their level of expectations. To stand out as a nurse leader, the nurse manager would help with employee development. Implementation of management skills while hiring and financial accountability for an organization are roles of a nurse manager but not of a nurse leader. Effective employee selection indicates a nurse manager but not necessarily a nurse leader.

Which factors are associated with transformational leadership? Select all that apply. One, some, or all responses may be correct. A shared vision Increased self-worth of followers Doing the work and getting paid Coaching and mentoring by the leader Correction of errors in a reactive manner

A shared vision Increased self-worth of followers Coaching and mentoring by the leader RATIONALE: Transformational leadership involves sharing a vision with team members to accomplish goals. This type of leadership promotes self-worth in the followers through positive reinforcement. The leaders practicing transformational leadership facilitate coaching and mentoring of followers for skill enhancement. Transactional leadership involves arrangements in which the followers do the task and get paid for it. The mistakes that happen during the task are corrected in a reactive manner.

The nurse manager monitors employees' performance and takes punitive action when necessary. Which could be the expected organizational outcomes in this type of leadership? Select all that apply. One, some, or all responses may be correct. Increased loyalty Adherence to deadlines Increased performance Limited job satisfaction Low-to-stable levels of commitment

Adherence to deadlines Limited job satisfaction Low-to-stable levels of commitment RATIONALE: Monitoring performance and taking punitive action when performance standards are not met indicates a transactional style of leadership. With this leadership behavior, deadlines tend to be met; however, members have limited job satisfaction and low-to-stable levels of commitment. Increased loyalty and performance are the organizational outcomes in transformational leadership.

The nurse is explaining the nursing process to a student nurse. Which step of the nursing process would include interpretation of data collected about the client? Evaluation Assessment Implementation Diagnosis

Assessment RATIONALE: An actual or potential client health problem is based on the analysis and interpretation of the data previously collected during the assessment phase of the nursing process. Gathering data is included in the client's assessment. Nursing interventions are based on the earlier steps of the nursing process. The plan of care includes nursing actions to meet client needs. The needs first must be identified before nursing actions are planned. Diagnosis is formulation of a problem based on the gathering and interpretation of data collected about the client.

Which behavior on the part of the nurse helps develop trust among subordinates? Behaving with consistency Creating a "Hall of Honor" to post photos Being expedient in responding to the issues Taking time to celebrate individual accomplishments

Behaving with consistency RATIONALE: Behaving with consistency to make them believe in and count on the leader's intention will help develop trust among subordinates. Creating a "Hall of Honor" to post photos will help renew the spirits of employees. Being expedient in responding to the issues will help resolve conflict. Taking time to celebrate individual accomplishments will help renew the spirits of employees.

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

Clinical care coordination RATIONALE: The most important leadership skill for the nurse leader is clinical care coordination. Priority setting, time management, and clinical decision-making are secondary components included in clinical care coordination.

Which skill would be most associated with the effective nurse leader? Recognizing her or his own limitations Delegating work appropriately Displaying confidence in her or his knowledge base Respecting the rights, beliefs, wishes, and values of clients

Delegating work appropriately RATIONALE: The effective nurse leader would be able to delegate work appropriately. Entry level nursing competencies may require the nurse to recognize her or his own limitations and display confidence in her or his knowledge base. Entry level nursing competencies are also related to respecting the rights, beliefs, wishes, and values of clients.

A discussion between a group of team members results in a conflict in an organization. The nurse leader uses an adaptive style to address the conflict. Which theory of leadership is the nurse applying in practice? Trait theory Two-factor theory Hierarchy of needs Situational-contingency theory

Situational-contingency theory RATIONALE: Situational-contingency theory considers the challenge of a situation and encourages an adaptive style of leadership. Trait theory holds that self-awareness of traits is required to inspire others to achieve a goal. The two-factor theory of leadership posits that both hygiene and motivator factors are required for inspiring work performance. The hierarchy of needs theory of leadership holds that motivation is achieved by providing individuals with a hierarchy of needs.

An organization having poor work flow was suffering financial losses. A team member introduced creative solutions that were publicly recognized by leadership. Which leadership theory is at work in this scenario? Trait theory Style theory Transformational theory Situational-contingency theory

Transformational theory RATIONALE: Transformational leadership refers to a process by which the leader attends to the needs and motives of subordinates to motivate. A creative initiative by an employee and an optimistic attitude of a leader toward subordinates indicates successful effects of transformational theory. Trait theory explains that a set of leadership traits influences others to work toward a common goal. Style theory involves task behaviors and relationship behaviors that determine leadership effectiveness. Situational-contingency theory considers the challenge of a situation and develops an adaptive leadership style to resolve the issues.

The nursing team is providing care for a client. The team leader develops client care plans and coordinates care among the team members. Which member of the team acts as a team leader? Charge nurse Registered nurse (RN) Licensed practical nurse (LPN) Unlicensed assistive personnel (UAP)

Registered Nurse (RN) RATIONALE: The RN acts as a team member by creating a care plan for the client and coordinating care among the team members. The RN works directly with the client, family, and health care team members. The charge nurse assigns tasks to the other health care professionals if the RN is absent. The LPN provides care to the client under the supervision of RN. The UAP are team members who provide care to the client under the supervision of the RN.

The nurse who lacks confidence in her performance in a new position is worried about an upcoming review with the nursing director. Which type of power would the nursing director hold in this scenario? Expert power Position power Coercive power Referent power

Coercive power RATIONALE: The nursing director holds coercive power. Coercive power arises from someone's real or perceived fear of another person and may be caused by a lack of confidence in performance in a new position or about an upcoming review with the nursing director. Expert power is based on one's reputation for expertise and one's credibility. Position power is achieved by virtue of one's position within an organization or status within a group. Referent power is granted by association with a powerful person.

The transformational leader demonstrates charismatic behavior and the careful consideration of the value of every individual in the organization. Which might be the expected organizational outcomes with this type of leadership? Select all that apply. One, some, or all responses may be correct. Increased loyalty Deadlines met Increased performance Low-to-stable levels of commitment Work supervised and completed according to the rules

Increased loyalty Increased performance RATIONALE: Charismatic behavior and individual consideration are the behaviors of transformational leadership. A leader displaying this behavior would increase the loyalty and performance level of the followers. In transactional leadership, deadlines are typically met but followers have low-to-stable levels of commitment and the work needs to be supervised and completed according to the rules.

Which behavior from the nurse leader exhibits charismatic leadership qualities? Using a shared vision as a core of leadership Encouraging innovation and creativity in solving a problem Encountering a situation with the transactional leadership style Possessing an inspirational quality that makes team members attracted to her or him

Possessing an inspirational quality that makes team members attracted to her or him RATIONALE: Charismatic behavior is seen in the transformational leadership style; this inspiring quality attracts team members. By sharing a vision, the leader is not attracting team members; therefore, this may not be a charismatic leadership behavior. Encouraging innovation and creativity in problem-solving will exhibit a quality of intellectual stimulation and is a transformational leadership behavior. Charismatic behavior is not seen in the transactional leader.

The nurse leader is promoting successful dialogue within the health care team. Which actions of the nurse leader are responsible for this success? Select all that apply. One, some, or all responses may be correct. Serving as a facilitator Encouraging the sharing of ideas Discouraging the sharing of fears Reacting to changed proposals honestly Assigning different tasks to team members

Serving as a facilitator Encouraging the sharing of ideas Reacting to changed proposals honestly RATIONALE: Serving as a facilitator, encouraging the sharing of ideas, and reacting honestly to the changed proposals establish a common goal. The nurse leader would perform these actions to promote dialogue within the team. The nurse leader would encourage the sharing of fears to promote dialogue. Assigning different tasks to members of the team is not an example of team "dialogue."

Which statement reflects the concept of "referent power" to the nurse? The nurse leaders share their power with the direct care nurses in client care. The nurse manager hires the student nurse she advised to work in the agency after graduation. The nurse manager is perceived positively by the student nurse who received an exemplary grade. The direct care nurses demonstrate great skill in teaching clients who have difficulty with self-care activities.

The nurse manager hires the student nurse she advised to work in the agency after graduation. RATIONALE: Referent power is granted by a powerful person having an association. Managers hiring student nurses to work in the agency is considered a use of referent power. The use of empowerment involves the nurse leader sharing power sources. In reward power, the instructor positively perceives the exemplary grades achieved by the student nurse. The direct care nurse who demonstrates good skills in teaching clients who have difficulty with self-care activities is an example of information power.

A client engages in angry outbursts and places excessive demands on the staff. An unlicensed health care worker tells the nurse, "I've had it. I am not putting up with that behavior. I'm not going in there again." Which is the correct response by the nurse? "You need to try to be patient. The client is going through a lot right now." "I'll talk with the client. Maybe I can figure out the best way for us to handle this." "Just ignore it and get on with your work. I'll assign someone else to take a turn." "The client is frightened and taking it out on the staff. Let's think of approaches we can take."

"The client is frightened and taking it out on the staff. Let's think of approaches we can take." RATIONALE: The correct response interprets the client's behavior without belittling the unlicensed health care worker's feelings; it encourages the unlicensed health care worker to get involved with plans for future care. Telling the unlicensed health care worker to be patient recognizes the client's feelings, but it does not address the unlicensed health care worker's feelings or help the unlicensed health care worker cope with the client's behavior. The nurse would not assume the unlicensed health care worker has nothing to contribute and that only the nurse can deal with the problem. Saying "Just ignore it" does not help the unlicensed health care worker understand the client's behavior, nor does it demonstrate an understanding of the client's feelings.

Hospital management has replaced some equipment to provide more effective treatment. The nurse leader wants the team to support and implement this change successfully. Which actions of the nurse leader are effective in this situation? Select all that apply. One, some, or all responses may be correct. Conducting a dialogue with the team members Encouraging the team members to develop new skills Inspiring the team members to increase competency in different areas Becoming knowledgeable about the change implemented in the organization Instructing one-half of the team to use the old equipment and the other half to use the new equipment

Conducting a dialogue with the team members Encouraging the team members to develop new skills Inspiring the team members to increase competency in different areas RATIONALE: Dialogue allows the team members with different perspectives to come together and find common goals. Discussing the new equipment, developing new skills, and increasing competency in different areas ensure effective action of the leader to bring a change in an organization. Simply gaining knowledge about the change does not allow the team to support the change. The nurse leader would instruct the whole team to implement the change effectively.

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 do not affect client care.

Nurse leaders will ensure that the disruption and chaos of change do not affect client care. RATIONALE: 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 improve client outcomes.

The nurse manager regularly analyzes herself or himself and her or his performance, focusing on developing leadership qualities such as assertiveness, confidence, and task knowledge. Which leadership theory would the manager most likely subscribe to? Style theory Trait theory Transformational theory Situational-contingency theory

Trait theory RATIONALE: Trait theory describes a set of physical and emotional characteristics of a leader that inspires others toward a common goal. Assertiveness, confidence, and task knowledge are among the traits attributed to strong leaders according to trait theory. Style theory focuses on what leaders do in relational and contextual terms. According to transformational theory, leadership refers to a process by which the leader considers the needs of the followers to raise the motivation and morality to higher levels. Situational-contingency theory explains that leadership effectiveness relies on a leader's task at hand, his/her interpersonal skills, and the favorableness of the situation.

Which theory related to leadership is a nontraditional theory that has emerged from the physical and social sciences? Expectancy theory Complexity theory Motivational theory Management theory

Complexity theory RATIONALE: Complexity theory is a nontraditional theory emerging from the work of the physical sciences and, more recently, social sciences. Expectancy theory posits that motivational behavior is increased by rewarding good and innovative performance; it is not rooted in the physical sciences. Motivational and management theories are traditional theories of leadership.

Which theory states that leaders should expand and respond to a dynamic change rather than prescribing and approaching change as a lock-step, pre-prescribed method? Role theory Chaos theory Complexity theory Organizational theory

Complexity theory RATIONALE: Complexity theory states that the leaders should expand and respond to engaging dynamic change and focus on relationships rather than on prescribing and approaching change as a lock-step, pre-prescribed method. Role theory is a framework used to understand how individuals perform within organizations. Chaos is the theoretical construct defining the seemingly random yet deterministic characteristics of complex organizations. Organizational theory is the systematic analysis of how organizations and their component parts act and interact.

Which actions would the nurse leader avoid to implement changes effectively? Answering tough questions raised by the staff Asking the staff what is not working well for them Maintaining a rigid boss-employee relationship with the staff Asking questions of the staff related to daily functions

Maintaining a rigid boss-employee relationship with the staff RATIONALE: To effectively implement change, a leader nurse would establish and maintain rapport with staff. Maintaining a rigid boss-employee relationship should be discouraged. Answering tough questions faced by the staff will promote a good work culture of helping. Asking the staff about what is not working well for them helps identify problems and solve them. Asking questions of the staff related to daily functions will promote a friendly environment and help track their work.

The nurse observes a dispute between staff members due to differences concerning nursing practices. Which approaches of the nurse leader would be appropriate in building up negotiation "loop-backs" to resolve the conflict? Select all that apply. One, some, or all responses may be correct. Providing a forum for open discussion Using negotiation procedures and processes Allowing a cooling-off period if the resolution fails Informing of the full consequences of failing to resolve the issues Using political skills to facilitate communication before confrontation

Using negotiation procedures and processes Allowing a cooling-off period if the resolution fails RATIONALE: The principle of conflict resolution through building in the "loop-backs" to negotiation includes a cooling-off period after the failure of a resolution. It also includes reviewing the possible consequences to the members for not resolving the issues. For building in consultation before and after the negotiations, an open forum for discussion is provided. The open forum also includes the use of political skills for facilitating communication before confrontation.

After the completion of training under the newly appointed transactional leader, the nurse manager intends to judge the performance of the new leader through interaction with the staff. Which type of statements would the manager expect to receive when asking about the outcome of training? Select all that apply. One, some, or all responses may be correct. "We fulfill the task to avoid punishment." "We are paid only after our work is satisfactorily completed." "We have learned much due to coaching provided by the leader." "We have completed many challenging and meaningful assignments." "We tend to minimize errors; otherwise, they get corrected in a reactive manner."

"We fulfill the task to avoid punishment." "We are paid only after our work is satisfactorily completed." "We tend to minimize errors; otherwise, they get corrected in a reactive manner." RATIONALE: The transactional leader believes in punishment to accomplish a task. With the transactional leader, incentives and punishments are clearly defined for the staff. The followers might have been paid only if the work is satisfactorily completed. The followers minimize errors under a transactional leader; otherwise, they are corrected in a reactive manner. Transformational leadership may include coaching and mentoring. Challenging and meaningful assignments are part of transformational leadership.

The nurse manager oversees an inexperienced nursing staff. The manager inspires followers through displayed optimism, by providing intellectual stimulation, and by encouraging follower creativity. Which leadership theory is most closely aligned with the manager's approach? Two-factor theory Expectancy theory Transformational theory Situational-contingency theory

Transformational theory RATIONALE: Transformational theory refers to a process in which the leader is receptive to the needs and motives of followers and helps stimulate motivation. Inspiring followers through displayed optimism, providing intellectual stimulation, and encouraging follower creativity are applied in transformational theory. Two-factor theory involves application of hygiene factors and motivational factors to develop motivation. Expectancy theory describes expectancy as the perceived probability of satisfying a need based on experience. Situational-contingency theory is applied to address the challenge of a given situation and encourages an adaptive leadership style to resolve any issues that may arise.