Fundamentals Nursing Prep U Chapter 22 Nurse Leader, Manager, and Care Coordinator
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."
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
The new graduate nurse is evaluating the effectiveness of her assigned nurse mentor. Which characteristic should the new graduate recognize as being inappropriate for the nurse mentor to role model?
Advising the new graduate to consult her before making decisions regarding client care
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
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 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
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 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.
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
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 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
A nurse manager is implementing the function of directing in his or her role on the unit. Which action by the nurse manager demonstrates this role?
Helping manage unit flow with client care if there is a staff call-out
The designated charge nurse on the telemetry unit organizes and facilitates the unit meetings; however, during most of the meetings, another registered nurse runs the show and influences staff decisions just by her charisma and personality. Her power to lead is defined by which of the following terms?
Implied
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
Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses?
Laissez-faire
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.
Which is a task that the nurse can delegate to the unlicensed assistive personnel (UAP)?
Obtaining intake and output on a client with a foley catheter
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 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 recognizes that a new mother is having difficulty breastfeeding her baby. The nurse provides assistance by demonstrating various positions 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 illustrates Lewin's stage of refreezing?
The new mother attempts to breastfeed the baby again using the techniques recently acquired and is successful.
When a staff member has successfully completed the activities delegated by the nurse manager, the result is usually that the staff member is more
committed
A nurse working in a physician's office uses the managerial function known as "organizing." What is involved in this function?
resources
A nurse arranges all the resources available to teach a teenage girl how to manage her asthma. Which role is this nurse performing?
Organizing role
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."
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
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
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 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 staff nurse works on a surgical unit where the nurse leader allows the staff to make all decisions and direct themselves. The staff nurses fill out the work schedule and sometimes there are days where the unit is short staffed. The staff nurse feels the unit needs better leadership. The nurse leader is practicing which of the following leadership styles?
Laissez-Faire
A nurse is successful in promoting change on his nursing division. This nurse would be considered a
Leader
A nurse manager tells her 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 her staff. This action involves goal setting. What leadership style is noted with the implementation of goal setting?
Participative leadership
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
The nurse manager is aware that nurses in the operating room are concerned about a proposed change in their working hours. Which of the following is the nurse manager's best approach in addressing this problem and the nurses?
Relate the proposed change to the group's existing beliefs and values.
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 leadership
A nurse manager demonstrates an autocratic leadership style but does not understand why there is high turnover in the unit. What behaviors does the nurse exhibit that negatively impact the unit due to this leadership style? Select all that apply.
• The manager makes decisions without seeking the input from staff • Staff have limited opportunities to express creativity in care delivery
A nurse manager of a physician's office uses the laissez-faire style of leadership with the staff. Which nursing actions reflects 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 nurse is working at a facility that is applying for Magnet® Recognition. The nurse recognizes that research supports Magnet® hospitals as having which direct effect on client care?
Better patient outcomes
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 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.
A nurse manager is reviewing an employee's contribution to the nursing division annually. This process is
Performance appraisal
The primary responsibility of the nurse manager is to
create plans and budgets
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 registered nurse is delegating activities to UAPs on a hospital unit. Which activities could this nurse normally delegate? (Select all that apply.)
• Giving a bed bath to a patient • Taking routine vital signs • Transferring a patient to another floor
Which of the following attributes would be characteristic of a nurse mentor? Select all that apply.
• Supportive • Resourceful • Demonstrates leadership abilities • Experienced licensed professional
In a nursing unit, the RN delegates nursing tasks to the nursing assistant. Keeping in mind the delegation guidelines, which of the following statements denotes the right direction for the nursing assistant?
"Dispose of the disconnected IV set."
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 and unlicensed assistive personnel (UAP) are working together in the emergency room. Which task would the nurse avoid delegating to the UAP?
Assessing a rash on the arm
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 nurse plans the nursing activities for the shift. Which of the following activities should the nurse assign to the nursing assistant?
Assist a client to ambulate and sit on a bedside chair.
In the hospital setting, a nurse is responsible for overseeing the quality and financial outcomes of patient care while working collegially with health care providers. What type of professional nursing practice is this considered?
Case management
A nurse manager and the charge nurse have two employees who disagree with the accomplishment of client care. The manager determines a mutually agreed-upon time to discuss this situation with all the members involved. This activity is called what?
Conflict resolution
A nurse manager of a hospital unit is working within a decentralized management structure. Which nursing action best exemplifies this type of system?
Decisions are made by those who are most knowledgeable about the issue.
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
Maggie Brown, RN, is the designated charge nurse on the telemetry unit. She organizes and facilitates the unit meetings, in addition to making assignments and performing staff evaluations. Maggie's power to lead is defined by which of the following terms?
Explicit
The nurse manager has recently promoted a staff nurse to the charge nurse position. Which type of power does the charge nurse now have?
Explicit power
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 chief nursing officer (CNO) wants to encourage nurses in the hospital to become clinical nurse leaders (CNL) and is reviewing a roster of nurses working on the medical-surgical unit. Which nurse should the CNO recognize as being qualified to take the CNL examination?
Jane Doe, MSN, RN; nurse manager; 7 years of nursing experience; supportive; engaged in community service activities
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
A nurse manager is changing the policy for scheduling staff on a critical care unit. The schedules will be changed and an announcement was made regarding this to the staff. Based on Lewin's change theory, in what stage of change is the manager participating?
Moving
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 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
The registered nurse (RN) is preparing to delegate tasks to an unlicensed assisted personnel (UAP) for a client who recently had a stroke. Which task would be inappropriate for the RN to delegate to the UAP?
Obtaining vital signs
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.
The nurse manager for a surgical unit is planning a significant change in how the unit functions. She plans to include some things that will help the staff overcome any resistance to the change. Which of the following might help overcome resistance to Megan's planned change?
Provide incentives, such as time off.
A nurse manager best demonstrates effective leadership characteristic by which action?
Sharing a vision for the unit and enlisting support
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
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.
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
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.
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.
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
Which of the following nursing models results in greater continuity of care?
Primary nursing
The proficient nurse wants to become a more effective leader. Which step will be appropriate for the nurse to take?
Promote a healthy work environment and become a nurse mentor.
A nurse in an intensive care unit places a request with the nurse manager to modify her work schedule. The nurse desires to return to college and advance her nursing degree. Which of the following illustrates that the nurse manager approaches the situation using a transformational leadership style?
She rearranges the nurse's schedule in a manner that will allow her to attend college.
An RN is working on a medical-surgical unit with an experienced licensed practical/vocational nurse (LPN/LVN). Which tasks are appropriate for the RN to delegate to the LPN/LVN? (Select all that apply.)
• Administer oral aspirin and lisinopril to the client with hypertension. • Insert a nasogastric tube in a client with absent bowel sounds. • Reinforce a post-surgical abdominal dressing.
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.
A nurse manager values group satisfaction and tries to motivate the staff to be the best nurses possible. In which style of leadership is the group satisfaction and motivation the primary benefit?
Democratic
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 new nursing graduate 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. What is the first step that the nurse needs to take to resolve the time management issue?
Identify which nursing interventions are priority.
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 must provide care to her clients and her employees under the constraints of her resources. This involves maintaining the financial constraints of her division. What term best describes this scenario?
Resource management
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
A nurse manager helps staff nurses who are resistant to change with use of a new medication administration system by doing which of the following actions?
• Describe the evaluation process with use of the new system. • Discuss potential decrease in medication errors with the new system. • Encourage feedback by the nursing staff with use of the new system.
