Ch. 10
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?
Better patient outcomes
A nurse informs the client that the client has no choice and must take a bath in the morning. What type of leadership does this exemplify?
Directive leadership
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.
Giving a bed bath to a client Taking routine vital signs Transferring a client to another floor
A nursing facility has recently implemented new policies regarding nurse-to-patient ratios. The nursing staff seems very resistant to the change. How can the nurse manager help the staff accept the change?
Hold a unit meeting to discuss how the changes will benefit staff.
A nurse manager is educating the staff on new forms of charting. Within the education session, the manager sets a goal for complete use of the charting. Through goal setting, the manager is acting as:
a leader.
Which of these statements regarding a nurse manager role is accurate?
To effectively manage the nursing unit, the nurse manager should also be a leader.
The proficient nurse wants to become a more effective leader. Which step would be most appropriate for the nurse to take to achieve this goal?
Promote a healthy work environment and become a nurse mentor.
The older client tells the nurse that the client needs to use the restroom. Which safety intervention must the nurse perform first?
Assess the need for assistance with ambulation.
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?
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.
Which are examples of personal leadership skills necessary for nurse leaders? Select all that apply.
Communication Problem solving Self-evaluation
The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task?
The stability of the patient's condition, potential for harm, and complexity of the activity
Two nurses have requested that the nurse manager allow them to plan in-service education with creative, new education techniques. Which leadership style would be best for the nurse manager to use to get the new project completed?
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 ensurethat the deadline is met?
Offer 2 days of paid vacation.
The nurse manager is concerned about the large number of teenage mothers being seen in the obstetrics clinic. How can the nurse manager use the transformational leadership style to address the concern?
Enlist volunteers to help develop a community outreach project that will educate teenagers on methods to prevent pregnancy.
How should a nurse leader best address nurses' resistance to a change in the shift-scheduling protocol on their hospital unit?
Explain the benefits of the change and elicit honest feedback.
The nurse recognizes that a new mother is having difficulty breastfeeding. The nurse demonstraties 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?
The new mother attempts to breastfeed the baby again using the new techniques and is successful.
Which statement by a registered nurse (RN) represents appropriate delegation to a nursing assistant?
"Dispose of the disconnected IV set."
A staff nurse is talking with a clinical nurse leader and asks, "What exactly do you do?" Which statement by the clinical nurse leader wouid be appropriate?
"I collaborate with health care teams to promote client care."
A nurse leader on a unit allows the staff to make all decisions and direct themselves, including filling out the work schedule. The nurse leader is practicing which leadership style?
Laissez-faire
When communicating with an employee, the nurse manager must:
communicate congruently.
A nurse is successful in promoting change on the nursing division. This nurse would be considered a:
leader.
The nurse is conducting an in-serve on change theories. Which example should the nurse include in the presentation illustrating Lewin's three stages of change?
A need for a safer intravenous therapy pump is identified. New intravenous therapy pumps are purchased and training for staff nurses is provided. Intravenous therapy pumps are placed on the nursing unit for client care.
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?
Autocratic
The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive person (UAP). Which task is appropriate for the UAP to complete?
Bathing a combative client
The nurse is delegating care to an unlicensed assistive personnel (UAP). Which intervention would be most important for the nurse to perform independently?
Assess the client with difficulty breathing
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?
Autocratic
In a nursing unit, the RN delegates nursing tasks to the nursing assistant. Keeping in mind the delegation guidelines, which statement denotes the right communication for the nursing assistant?
"Dispose of the disconnected IV set."
The new nurse is evaluating the effectiveness of the assigned nurse mentor. Which characteristic should the new nurse recognize as being inappropriate for the nurse mentor to role model?
Advising the new nurse to consult the nurse mentor before making decisions regarding client care
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.
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?
Conflict resolution
A nurse manager best demonstrates effective leadership characteristic by which action?
Sharing a vision for the unit and enlisting support
Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status?
Staff nurses are developing innovative solutions to problems.
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?
Administer a dose of digoxin that is two hours behind schedule.
Two new nurses are requesting the same preceptor for unit orientation and say they'll be unhappy if they do not receive their choice of preceptor. The nurse manager sets up a meeting with the two new nurses to come to a resolution regarding the preceptor. Which conflict resolution style is the nurse manager using?
Collaborating
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?
Assessing oxygen (O2) saturation
On a medical unit, the nurses complain that they have no voice in the decisions that are made in the operation of the unit. The nurses state they are always told by the nurse manager to perform tasks instead of being asked. Which of these best describes the leadership style of the nurse manager?
Autocratic
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?
Autocratic leadership
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?
Avoiding
How might one define leadership?
Leadership is the process of guiding, educating, motivating, and directing others.
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?
The interdisciplinary health care team collectively developing plans of care for clients
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?
Obtaining an admission weight for the client utilizing the client's bed scale
Conflict has emerged on a nursing unit due to the perception by new graduates 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.
A nurse is in charge of a large group of employees on a busy surgical floor. Today's care must be completed early due to a special event involving most of the employees. Which management style would work best in this situation?
Authoritarian
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
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?
Collaborating
The nurse manager in a critical care unit actively listens to the staff and engages the staff to offer decisions regarding problem solving and implementing these decisions. What type of managerial mindset does this manager exhibit?
Collaborative mindset
The nurse manager is concerned about staff being upset about the frequency of taking clients' vital signs and holds a meeting. The staff are allowed to make suggestions to amend the new policy and vote on which policy will be implemented. The nurse manager then makes the decision to implement the policy that is best. What types of leadership style(s) are being used by the nurse manager? Select all that apply
Directive Participative
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?
Democratic
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?
Democratic
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 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?
Laissez-faire
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?
Laissez-faire
Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses?
Laissez-faire
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)?
Obtaining vital signs every 4 hours
Which nursing model results in the greatest continuity of care?
Primary nursing
The nurse manager for a surgical unit is planning a significant change in how the unit functions. Which action by the nurse manager would be most effective in helping overcome resistance to the planned change?
Provide incentives for adopting the change, such as time off.
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
A charge nurse on a medical-surgical unit is asked by the nurse manager to serve as a mentor to another staff nurse who is less experienced. Which of these would best describe this role?
The charge nurse is providing support for the staff nurse in new responsibilities.
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.
A nurse manager of a physician's office uses the laissez-faire style of leadership with the staff. Which nursing actions reflect this management style? Select all that apply.
The nurse manager allows self-scheduling. The nurse manager allows dominant staff members to direct the group activities. Manager and staff work independently, making task accomplishment difficult.
The registered nurse (RN) wants to delegate a task to an unlicensed assistive personnel (UAP) but is unsure if the task can be delegated. What is the best resource for the RN to use in determining if the task is appropriate?
The nurse practice act or facility's policy and procedures
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?
Unfreezing
After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to:
assess whether the desired results have occurred.
A nurse leader is working with a client with hypertension who needs to learn about a low-sodium diet. The nurse recognizes that the client is in the unfreezing stage of Lewin's Change theory with which client statement?
"I understand why I need to eat a low-sodium diet."
Two nurse managers working on different units in a hospital are planning for a major change to occur on both units. One nurse manager reports to the other having identified a key power player on the unit. Which description most applies to a key power player in this context?
A regular employee who is a natural leader
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?
Democratic
A nurse manager reviews an employee's contribution to the nursing division annually. This process is:
performance appraisal.
An inner-city hospital is seeing a declining client census. The nurse managers begin to strategically plan to determine ways to increase their client population. In the implementation of these strategies, they also evaluate their success and failure and renew their plan. This activity is:
problem solving.
To help staff nurses who are resistant to change adapt to the use of a new medication administration system, the nurse manager should take which action?
Describe the evaluation process with use of the new system. Discuss the potential for a decrease in medication errors with the new system. Encourage feedback by the nursing staff with use of the new system.
A nurse can improve one's skill with time management by taking which action?
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?
Laissez-faire
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?
The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end.
