Chapter 10: Leadership, Managing and Delegating
The nurse is getting accustomed to the role of nurse manager. What are requirements for this nursing role? Select all that apply.
Creating schedules for the unit Managing the unit's operational budget Introducing methods to improve staff efficiency Evaluating the success of the unit policies
A nurse can improve his or her skill with time management by doing which of the following?
Evaluating success with accomplishment of goals in client care
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.
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
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
A nurse is considering applying for a leadership role on her medical unit. She asks her colleagues what they consider to be good personal leadership skills. Which of the following would be appropriate? Choose all that apply.
Communication Problem solving Self-evaluation
A nurse manager is reviewing an employee's contribution to the nursing division annually. This process is
Performance appraisal
A nurse manager has asked 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 the deadline is met?
Offer two days paid vacation.
A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check patients' blood glucose levels. The nurse manager informs the group this was a new policy on the unit, and discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating?
Autocratic
The case manager works in a facility that supports a participative leadership style. Which of the following 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 manager is trying to resolve a conflict between the day and night shifts. She 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 of the following types 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 of the following conflict resolution styles 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 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 informs the client that he has no choice and must take his 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.
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
The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive personnel member. Which task is appropriate for the unlicensed personnel member to complete?
Bathing a combative client
Which of the following attributes would be characteristic of a nurse mentor? Select all that apply.
Supportive Resourceful Demonstrates leadership abilities Experienced licensed professional
How might one define leadership?
Leadership is the process of guiding, educating, motivating, and directing others.
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.
The nurse and unlicensed assistive personnel (UAP) are working together to admit a client newly diagnosed with diabetes to a nursing unit. Which task would be inappropriate to delegate to the UAP?
Monitoring insulin requirements
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."
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 is working with a client with hypertension who needs to learn about a low-sodium diet. The nurse recognizes 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."
Which of the following nurse leaders most clearly exemplifies transformational leadership?
A leader who is dynamic, inspiring, and promotes change by the power of her convictions
A student has asked her nursing instructor about advanced practice roles. The student aspires to work independently in obstetrics and gynecology and work in a rural impoverished setting. Of the following advanced practice roles, which would be most suitable for the student?
Nurse midwife
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 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 she will begin to count caloric intake beginning with the next meal. The client also states intentions to begin an exercise program with friends. Which statement illustrates Lewin's stage of unfreezing?
The client acknowledges the need to lose weight.
Two new graduate nurses are requesting the same preceptor for unit orientation. Both new graduates have been very vocal about being unhappy if they do not receive their choice of preceptors. Which illustrates the nurses using a compromise approach to conflict resolution?
The nurses decide to share the preceptor. The preceptor will precept one nurse at the beginning of the orientation and precept the other nurse at the end of the orientation.
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 primary responsibility of the nurse manager is to ...
create plans and budgets
The new graduate nurse is having difficulty managing time required to care for a group of complex clients. Medications are several hours behind schedule and several nursing procedures have not be performed. How should the nurse resolve the time management issue? Place the following steps in order.
Identify which nursing interventions are priority. Evaluate the potential to successfully complete the nursing interventions. Identify which nursing interventions can be delegated to other members of the health care team. Establish a timeline to get the nursing interventions completed.
Karen Wolf, RN, is the charge nurse on the orthopedic unit. She 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 Karen contributes. Karen's style of leadership can be described as which of the following?
Laissez-faire
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
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
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
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 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
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.
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
The registered nurse (RN) is preparing to delegate tasks to an unlicensed assisted personnel (UAP). Which tasks would be appropriate for the RN to delegate to the UAP?
Assessing oxygen (O2) saturation
The registered nurse (RN) is preparing to delegate tasks to an unlicensed assisted personnel (UAP). Which tasks would be appropriate for the RN to delegate to the UAP?
Assessing oxygen (O2) saturation.
A registered nurse (RN) serves as the chair of the Nursing Practice Committee for the hospital. The meetings 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 chairman's leadership style could be termed what?
Laissez-faire
The new graduate 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. Of the following outstanding tasks, which nursing intervention should the nurse complete first?
Administer a dose of digoxin (lanoxin) that is two hours behind schedule.
Two staff nurses have voiced not wanting to assume care for any new postoperative surgical clients during the shift. How can the charge nurse resolve this conflict using the strategy of accommodation to address the immediate concerns of the two staff nurses?
Assign clients to one of the nurses and tell the nurse that it will be remembered in the future for a day off
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 staff nurse works on a medical unit where staff retention is very high. There is a 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 of the following leadership styles?
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
The nurse and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate to delegate to the UAP?
Initiating intravenous therapy
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.