Leadership EAQs

The change will not affect your treatment A nurse leader ensures the changes made by the federal government or organization will not cause harm or financial burden to the client. Therefore a nurse leader should support the client by saying that the changes will not affect treatment. Follow-up visits are based on the client's condition, not on the changes made on the insurance policies. Increased duration and decreased effectiveness of the treatment indicates harm to the client and will not be caused by a Medicare policy change.

A client is concerned about not receiving treatment due to a Medicare policy change. What is the accurate response of a nurse as a leader?

To work on the plan implemented by the primary nurse In the primary nursing model, the associate nurse has to take charge if the primary nurse is absent and should implement the plan according to the primary nurse's specifications. The associate nurse has no right to change a plan or to implement a new plan. Waiting for the primary nurse to implement the plan would not be appropriate. Soliciting the help of the primary care provider will not be appropriate in this situation because the associate nurse should work on the plan implemented by the primary nurse.

A client with cardiac failure is admitted to the hospital. The primary nurse is unable to attend to the client. The nurse leader appoints the associate nurse in providing care to the client. Which strategy does the associate nurse implement in providing care to the client?

Assigning individual duties to different nurses and nursing students for different tasks In the functional model of nursing, different types of duties are assigned to different people and they work independently. A single nurse cares for a single client during the entire work period with the case method model of nursing. Assigning responsibility to a registered nurse for coordinating a group of nursing students is a type of team nursing. In primary nursing, a registered nurse is assigned to work autonomously as the client's primary nurse throughout their stay. Test-Taking Tip: Recall the different responsibilities of the nurses as per the models of nursing.

A hospital is planning to implement the functional model of nursing. Which action performed by a nurse leader would be effective under this model?

Time-management skills are important for stress reduction Symptoms such as anxiety and frequent errors in work indicate mental stress. The direct care nurse should develop time-management skills to help manage the stress. Practicing yoga would help to reduce physical stress. Taking more continuing educational courses may increase mental stress. Communicating feelings helps to reduce emotional/spiritual stress. Test-Taking Tip: Read the stem carefully. The symptoms provided in the stem indicate mental stress. Now suggest an answer that would help to manage this type of stress.

A leader observes the direct care nurse making more frequent errors and being anxious. Which advice provided by the leader to the direct care nurse would help to manage the stress?

The leader should provide specific feedback for positive performance The leader should elicit feedback from peers, followers, and higher authority Providing specific feedback for positive performance is an important aspect of expectancy theory, not situational-contingency theory. Obtaining feedback from the peers, followers, and higher management is central to style theory, not situational-contingency theory. The critical factors that should be present in an effective leader based on situational-contingency theory are presenting a task structure that has clarity of goals, developing trust and respect between leaders and followers, and providing rewards to followers for excellent work. STUDY TIP: Remember that intelligence plays a vital role in your ability to learn. However, being smart involves more than just intelligence. Being practical and applying common sense are also part of the learning experience.

A newly promoted nurse manager is studying the critical factors that are needed to be an effective leader according to situational-contingency theory. Which statement by the nurse manager indicates the need for further study? Select all that apply.

The members are talking and discussing with one another while writing down their ideas As per the nominal group technique, members are asked not to talk and discuss anything while writing down their ideas. This may be because a period of silence may lead to the generation of ideas. If a member "passes" because of exhausting his or her list of ideas, this can be an effective way to help make decisions. When ranking options, this gives everyone the chance to choose what they think is a priority. The option that receives the highest ranking by the majority is chosen as the solution. If members are asked to share ideas by displaying them on a flip chart, it avoids comments and elaboration during this phase. Test-Taking Tip: Choose the best answer for questions asking for a single answer. More than one answer may be correct, but one answer may contain more information or more important information than another answer.

A nurse leader implements the nominal group technique while making decisions about a critical issue but is unable to find a proper solution. What could be the reason for the failure of technique?

Explaining the reason behind the change Providing the opportunity for dialogue and feedback Giving information that addresses the listener's self-interest While communicating and explaining the rules of the hospital, listeners should be informed about the reason and values behind the changes. This may help them understand and reinforce the changes effectively. Opportunities for dialogue and feedback should be provided to analyze what was missed and which areas need improvement. Presenting the message in a manner that stimulates the self-interest of the listener may help in effective communication by better attracting the attention of the listener. The message for delivery should be strategically planned. Providing all or too much information can temporarily paralyze the listener and divert energy away from key responsibilities. The use of complex terms, concepts, or ideas may also prevent the learner from hearing the message and lead to ineffective communication. Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation or client. All options likely relate to the situation, but only some of the options may relate directly to the situation.

A nurse leader wants to communicate and explain changes to hospital rules to team members. Which approaches should the nurse leader follow for effective communication? Select all that apply.

Emphasizing the good qualities of the staff and giving positive direction for growth The principle of non-maleficence states that one should not do harm. Therefore the approach towards this while evaluating the performance of staff includes emphasizing the staff's good qualities and giving positive direction for growth. Fulfilling the commitment of promotion to a preceptor position within the unit is the principle of fidelity. Acknowledging the right of individuals to make decisions and to live by these decisions is respect for others. The principle of justice is used while deciding which staff members are to be promoted or recommended for development opportunities.

A nurse leader wants to implement the principle of non-maleficence while evaluating the staff. What is an effective way to perform this action?

Information power The information power of the nurse's colleague is being utilized to provide education to clients about use of glucose-monitoring devices. Position power is utilized when a person holds a position of authority within the organization. Reward power involves a person's ability to reward someone for desired actions or outcomes. Coercive power involves using fear to influence people.

A nurse working in a medical unit finds that diabetic clients have a knowledge deficit regarding use of glucose-monitoring devices. The nurse requests that a colleague who works in the outpatient diabetic counseling department provide health teaching to the clients. Which type of power does the nurse's colleague hold?

Organizing a group of colleagues to address organizational problems An individual can become an effective leader when he or she mainly focuses on the well-being of the others. Therefore organizing the group of colleagues and addressing organizational problems indicates his or her leadership ability. Treating all clients equally irrespective of race and economic status indicates that the nurse is implementing justice in the profession but not leadership. Following the orders of the primary healthcare provider effectively indicates professionalism but not leadership. Maintaining confidentiality about the client's health indicates that the nurse is adhering to Health Insurance Portability and Accountability Act (HIPPA) rules and regulations. Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options.

A senior nurse is teaching about leadership qualities to a new nurse. Which action of the new nurse represents his or her leadership quality?

Taking an active role in the work of change Bringing everyone together to move toward a goal Encouraging people by giving attention to personal things that are important

According to Kouzes and Posner, what key practices in transformational leadership would a nurse teach? Select all that apply.

Setting program priorities Capital budgeting Developing cash budget negotiating and revising analysis of variance The first step in the budgeting process is gathering information and planning, which includes setting priorities for programs. The second step is developing units and departmental budgets, including capital budgeting. The third step is developing cash budgets to know the actual cost of the programs that are included. The fourth step is negotiating and revising, which is very important to present a standard budget that should be acceptable. Evaluating is the final step, which includes analysis of variance, after which the critical performance reports are generated.

Arrange the following steps of the budgeting process performance in chronological order.

Analyze the mission and culture Assess strengths, weaknesses, opportunities Analyze the future environment the marketer is likely to face Determine objectives and goals Formulate the core marketing stratgey Establish benchmarks While implementing strategic marketing planning, the first step is to analyze the mission and culture to which the strategy is contributing. The next step is to assess strengths, weaknesses, opportunities, and threats (SWOT analysis) presented by the external environment. This is followed by analyzing the future environment the marketer is likely to face. Determining the objectives and goals for the relevant planning period should be performed next. To achieve the specified goals, the core marketing strategy needs to be formulated after the objective has been determined. The final step is to establish the benchmarks to measure interim and final achievements.

Arrange the steps in the order that a nurse leader would implement while following the strategic marketing planning process.

Style theory In style theory, it is important for leaders seek feedback from followers, peers, or higher authorities in order to understand their style. These leaders are employee-centered and tend to foster an effective, productive work environment. Two-factor theory involves leaders using motivational factors to inspire work performance. When applying the hierarchy of needs, leaders understand factors that affect staff performance and creativity, such as the need for safety and security. In situational-contingency theory, leaders adapt easily to new situations and provide appropriate action based on the people involved. STUDY TIP: You have a great resource in your classmates. We all have different learning styles, strengths, and perspectives on the material. Participating in a study group can be a valuable addition to your nursing school experience.

During a status meeting for a research project, the project leader asks the team members for feedback. What leadership theory is represented by the action of the leader?

To inspire followers The primary role of a leader is to inspire the followers by actively participating in the task along with the followers. It also involves changing the workplace to increase work satisfaction. The other roles of a leader are to provide training to the followers, to share views about the task with the followers, and to increase the feeling of self-worth in the followers. All these are reflected in the concept of transformational leadership.

During an interview for a nurse manager position, the panel asks the nurse about the primary role of a leader. Which answer provided by the nurse would be most appropriate?

A successful manager should take risks A successful manager should tolerate uncertainty A successful manager should experiment with ideas for a unique situation A successful manager shows positive qualities in his or her work such as taking risks, tolerating uncertainty, and experimenting with new ideas for a unique situation or environment. A willingness to work as a leader, as well as to follow peers where appropriate, is a quality of any good employee depending on the situation; it is not specific to the role of a manager. Exerting the power to communicate through various channels is the trait of a follower. Test-Taking Tip: Be alert with the options; therefore, try to be smart enough to differentiate between the qualities of a manager, leader, and follower to provide the right answer.

During an interview for the position of manager in the healthcare industry, the candidate is asked about the important qualities of a successful manager. Which responses would be appropriate? Select all that apply.

Vaccinating children in school The nurse as a community leader has the unique opportunity to work with schools, city or county governments, and other community entities. The nurse as a community leader formulates a vision for improving the health of the community through disease prevention and health promotion. Therefore administering vaccines by Nurse leader D to the children in school to prevent disease indicates that the nurse is performing the role of the community nurse leader. Scheduling the client for a surgery may not be done in a community; therefore this action of Nurse leader A does not indicate the role of the community nurse leader. Assisting the client in positioning him or her on a bed can be done wherever possible, such as in client's home or healthcare facility. Therefore this action by Nurse leader B does not indicate the role of the community nurse leader. Teaching the student nurse to administer an intramuscular medication can be done in a healthcare facility also, therefore this action by Nurse leader C does not indicate the role of the community nurse leader. Test-Taking Tip: Chart/exhibit items present a situation and ask a question. A variety of objective and subjective information is presented about the client in formats such as the medical record (e.g., laboratory test results, results of diagnostic procedures, progress notes, healthcare provider orders, medication administration record, health history), physical assessment data, and assistant/client interactions. After analyzing the information presented, the test taker answers the question. These questions usually reflect the analyzing level of cognitive thinking.

Four nurse leaders are performing different tasks. Which nurse leader's action indicates the role of the community nurse leader?

Identifiy Assemble Collect data to measure Establish Select Collect data to evaluate The quality improvement process starts with identifying the needs that are most important to the consumer of healthcare services. It further proceeds with assembling an inter-professional team to review the identified consumer needs and services. Then the data are collected to measure the current status of these services. The quality improvement process proceeds with establishing measurable outcomes and quality status. Then selection and implementation of a plan is done to meet the outcomes. Finally, the data are collected for evaluation of the plan implementation and achievement of outcomes.

How would the nurse arrange the steps in the quality improvement process to help the leader to minimize errors and achieve satisfaction on the part of the consumer of healthcare services?

An environment that is rapidly changing and dynamic "Quantum theory" lays its foundation on an environment that is rapidly changing. It does not focus on a single event. Hygienic factors in the environment are an aspect of the two-factor theory. The nurse leader, through the transformational theory, provides intellectual stimulation. An environment that develops trust between followers and leaders are aspects of the situational-contingency theory.

The chief operating officer (COO) discusses the performance of a newly appointed leader with the nursing staff. The team communicates that the practical approach of the leader fulfills the quantum theory. What type of work environment does the COO understand that the leader creates at the workplace?

Knowledge persuasion Decision Implementation Confirmation Gaining knowledge is the first step of the innovation-decision process, followed by persuasion, decision, implementation, and, finally, confirmation.

The leader asks the student nurse to arrange the steps of the innovation-decision process in the chronological order that would be useful for individual change. What sequence organized by the student nurse shows effective learning?

Creativity Experience Group process A situation with unpredictable results requires creativity, experience, and group process. Enthusiasm is an important quality of a follower but it would be a secondary factor to be considered in this situation. Independent decision making would not be appropriate to this situation. Rather, the leader should seek expert opinion and involve key stakeholders.

The leader encounters a situation where the nursing outcomes are unpredictable. Which attributes or approaches should the leader utilize to navigate this situation? Select all that apply.

Assisting clients to accomplish optimal functioning Assisting clients to accomplish optimal functioning is a behavior of Gardner's task of Achievable Work Unity. It is applied in practice to benefit the transition to enhanced health functions. Relating to and inspiring clients to achieve their vision and enhance health functions is the motivating task as described by Gardner. Providing self-care to improve the ability to care for staff, clients, and families is the renewing task as described by Gardner. Representing nursing and the unit in task forces and shared governance councils involves the executive position of Gardner's task of developing trust. Test-Taking Tip: Multiple-choice questions can be challenging because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.

The leader has planned to assist staff in order to achieve workplace unity. Which of Gardner's tasks would the leader apply in practice?

22 The formula is client days for a given time period divided by the number of days in the time-period. There are 31 days in July, so 679/31 = 21.9. Therefore, the ADC is 21.9, rounded to 22.

The leader nurse is calculating the average daily census (ADC) in a 40-bed medical surgical unit, which accrued 679 client days in the month of July. What is the ADC on this unit? Record your answer using a whole number. ____________

Role conflict Role conflict is easier to recognize because the employees know what is expected from them, but they are either unwilling or unable to meet the requirements. Role theory provides an appreciable framework for the development and evaluation of staff. Role ambiguity in the workplace creates an environment for misunderstanding and hinders effective communication. Individuals do not have a clear understanding of what is expected of their performance or how they are evaluated. Role acquisition is enhanced by the use of clear position descriptions and evaluation standards.

The leader nurse noticed that a staff nurse is unable to meet the responsibilities assigned, though the staff nurse is aware of the working requirements. What is the staff nurse experiencing?

I will call your daughter Did you take your medicine this morning when i was late It is important as a nurse to show visible caring to the client. When the student says "I will call your daughter" and "Did you take your medicine this morning when I was late" there is no indication of visible caring, therefore these statements indicate ineffective learning. The student nurse should say "I will call your daughter for you" and "I hope that someone assisted you with your medications this morning; I am sorry that I was late." By saying "I really admire your courage," the nurse expresses appreciation, which shows caring. "I can imagine this might feel scary for you" shows that the nurse is listening to the client actively, which also reflects care. By saying "I want to make you comfortable. Here's a blanket," the nurse shows his/her clear communication and positive intention, which also reflects visible caring for the client.

The leader teaches the student nurse about the way to make caring visible to a client who has undergone a hip replacement surgery. Which statements made by the student nurse to the client indicate ineffective learning? Select all that apply.

Communicating in a simple language with followers Giving a chance to the followers to express their views Ensuring proper eye contact while communicating with followers An effective leader should use the simplest and fastest method to communicate with followers. An effective leader should give a chance to the followers to express their views, as followers have many questions to ask. Proper eye contact ensures effective communication; therefore an effective leader should maintain proper eye contact while communicating with followers. An effective leader should use critical thinking to decide the actions to be performed but should not instruct the followers. An effective leader should communicate the clear boundaries with followers.

The nurse is learning about the rules of leaders. Which actions of the nurse indicate effective implementation of these rules in the profession? Select all that apply.

Maslow's theory Maslow's theory prioritizes the needs of the client and, if applying Maslow's theory, the nurse leader would provide for safety needs of the client first. Role theory is associated with an appreciable framework for the development and evaluation of staff. Complexity theory explains that change is an ongoing experience through which a system is adjusted. Situational leadership theory analyzes an individual's knowledge and the work-related task before delegation.

The nurse leader finds that a client with a severe vitamin B12 deficiency is extremely fatigued and tends to fall. Which theory does the student nurse think that the nurse leader would find appropriate for prioritizing the need of the client?

OVID EBSCO OVID and EBSCO are search platforms for a variety of databases including CINAHL and MEDLINE. PubMed is an abstract database of the National Library of Medicine, providing access to over 15 million citations from 1950s to the present. PsycINFO is an abstract database of the behavioral sciences and mental health literature from 1800s to the present. MEDLINE is the largest component within PubMEd, indexing over 5200 journals according to medical subject headings. Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation or client. All options likely relate to the situation, but only some of the options may relate directly to the situation.

The nurse leader is monitoring a student nurse who is accessing various databases. Which search platform should the nurse leader suggest to access a variety of databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE? Select all that apply.

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 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?

Offering rewards and recognition to individuals and teams Offering rewards and recognition to individuals and teams is a management task, not a task of followership. Demonstrating accountability to the team effort; offering knowledge, skills, and abilities to achieve the task at hand; and taking reasonable risks as a preventive measure when fearing change or unknown circumstances are implementations of Bleich's tasks of followership. Test-Taking Tip: Chart/exhibit items present a situation and ask a question. A variety of objective and subjective information is presented about the client in formats such as the medical record (e.g., laboratory test results, results of diagnostic procedures, progress notes, healthcare provider orders, medication administration record, health history), physical assessment data, and assistant/client interactions. After analyzing the information presented, the test taker answers the question. These questions usually reflect the analyzing level of cognitive thinking. In a clinical exam, you may be expected to select instruments, arrange instruments, and/or perform some other task. Acquaint yourself with the physical facility. If the required procedures are not clear to you, ask for clarification.

The nurse manager is evaluating different Bleich's tasks of followership performed by members of the nursing team. Which team member's action indicates incorrect implementation of Bleich's tasks of followership?

Rehabilitation

The nurse manager orders the direct care nurse to assist in providing tertiary care to a client. Which type of treatment would the direct care nurse be involved in?

When facing trivial issues When the other person's solutions appear better When harmonious relationships have to be preserved Appropriate reasons for accommodating to resolve conflict include when the issues are trivial or not important, when the other person's ideas or solutions are better, or when harmonious relationships have to be preserved. Avoiding defensiveness is not an appropriate reason to accommodate when resolving conflict. Gathering more information is not an appropriate reason to accommodate when resolving conflicts, unless that additional information has shown that the nurse has made a mistake.

The nurse resolves a conflict with another nurse by using accommodation. In what situations is accommodation appropriate for resolving conflict? Select all that apply.

Being sensitive to nonverbal communication Providing the opportunity for dialogue and feedback Presenting information that addresses the listener's self-interest The nurse should be sensitive to nonverbal communication because it may require interpretation of key points in complex situations. The nurse should provide the opportunity for dialogue and feedback. The nurse should present information that addresses the listener's self-interest. The nurse should plan the message and should not give too much information, which will paralyze the listener and divert energy away from key responsibilities. The nurse should use face-to-face communication as the primary communication mechanism rather than e-mail or texting. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

The nurse, as a leader, is planning to provide information about personal hygiene to a group of clients. Which communication methods should the nurse use to talk to the clients? Select all that apply.

Emotions and personality The staff nurse may be experiencing distress and pent up emotions and may not be able to receive another message. Distractions most commonly come through sensory perceptions, such as poor lighting or background noise, including music, ringing phones, and interruptions by others. Poor planning may not be the cause in this situation. A difference in perception arises because of differences in the way two individuals see the world.

The nursing leader is giving a demo on using computerized provider order entry (CPOE) to a newly hired nurse for automatic dose calculation. The nurse leader observed that the staff nurse was not concentrating on the instructions and seemed distressed. After completing the demo, the nurse leader asked the staff nurse to operate the CPOE, but the nurse misused the system. Which communication barrier does the nurse leader suspect to be the reason?

"it will identify medication errors." An electronic medication administration record will generate reports to track medication errors with the visibility of near misses. The electronic medication administration record will be accessible to multiple users. It will increase the accuracy of charge capture between administration time and the time when the drug is dispensed. It will improve the accuracy of pharmacokinetic monitoring.

The nursing leader is teaching the newly hired nurse about the use of an electronic medication administration record. Which statement of the newly hired nurse indicates effective learning?

Veracity Veracity concerns telling the truth and demands involved, giving all the facts of a situation truthfully, and then assisting employees to make appropriate decisions. Justice is the principle of treating all persons equally and fairly and it often arises in times of short supplies for resources. Nonmaleficence states that one should do no harm. Respect for others acknowledges the right of individuals to make decisions and to live by these decisions. Test-Taking Tip: You have at least a 25 percent chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

The nursing manger wants to transfer a nurse to the intensive care unit (ICU) and describes the roles and responsibilities of the position in detail to the nurse. After disclosing all details, the nurse manager inquires about the nurse's decision. Which type of principle is the nurse manger following?

Role discrepancy Role discrepancy is the development of gaps between role expectations and the role performances that may lead to discomfort and frustration of the team. In role exploration, the new nurse leader will be happy, excited, and is confident in exploring the new roles involved in the leadership position. Role negotiation is a strategy that is helpful during conflicting role expectations. When nurse leaders have been in their positions for several years and have internalized their roles, it is referred to as role internalization. Test-Taking Tip: Multiple-choice questions can be challenging because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.

The nursing staff of a unit is frustrated and uncomfortable with the newly appointed nurse leader. Which role transition process is involved?

Inspiring the student nurse to take active participation The leader should inspire and motivate his or her followers to complete the task successfully. Therefore inspiring the student nurse to participate actively in the program explores the leadership ability of the registered nurse (RN). Leaving the student nurse on his or her own to make a decision does not help the student nurse to grow in his or her profession. The leader should not demand his or her followers to do things as this does not indicate effective leadership ability. Reporting the student nurse to other higher level healthcare professionals does not indicate leadership ability. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

The registered nurse (RN) finds that a student nurse is unwilling to participate in a community health literacy program conducted for clients with diabetes mellitus . Which action of the RN portrays his or her leadership ability?

Supporting the team Motivating the other nurse Using skills to expand social networks Supporting the team describes the interpersonal competence which is a characteristic of emotional intelligence of leadership. Motivating others promotes emotional self-control and using skills to expand social networks describe the handling of relationships. To follow the rules of organization and expertise in technical skills are the nursing professional aspects.

The registered nurse (RN) is evaluating the student nurse in the aspect of leadership qualities. Which behaviors of the student nurse express emotional intelligence in leadership? Select all that apply.

"A leader has a formal position." A leader does not necessarily have a formal position to indicate that he or she is a leader; rather, leadership refers to the performance. Leaders are those medical professionals who can intervene with courage when needed. Leaders are also able to organize a group of colleagues to solve an organizational problem. A nursing medical professional becomes a leader after promotion. Test-Taking Tip: Have confidence in your initial response to an item because it more than likely is the correct answer.

The registered nurse is teaching a group of nursing students about leadership principles. Which statement made by a nursing student indicates the need for further teaching?

Encouraging and developing the leadership of the new nurse Effective leadership is responsible for achieving an effective workplace, and therefore succession of the leadership is an important consideration. This can be done by encouraging and developing the leading skills of the new nurse and supporting current leaders to implement their roles effectively. Discouraging the new nurse does not result in succession of the leadership and effects the growth of the organization. Therefore actions such as asking the nurse to stop leading immediately or asking the nurse to act as a leader after the senior nurse retires do not indicate effective leading ability. The senior nurse, as a leader, should guide the nurse to focus on both professional work and leadership. STUDY TIP: Regular exercise, even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you now may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it at home, the YMCA, or a health club can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, the exercise routine should be done without the mental connection to school; time for the mind to unwind is necessary, too.

The senior nurse finds that a novice nurse is mainly emphasizing leadership activities in a healthcare facility. Which action of the senior nurse indicates effective leading ability?

Accept responsibility for one's mistakes Give credit to others where credit is due Use business card when introducing yourself to new contacts Accepting responsibility for one's mistakes and then learning from them is a power strategy for a nursing leader. Giving credit to others where credit is due and using business cards when introducing yourself to new contacts, as well as collecting the business cards of those you meet when networking, are power strategies for a nursing leader. Developing the ability to take constructive criticism gracefully and learning to let destructive criticism "roll off your back" is a power strategy for nursing leaders. Learning to be comfortable with conflict and ambiguity as they are the normal states of the human condition, rather than being uncomfortable with conflict and ambiguity is a power strategy for the nursing leader. Test-Taking Tip: A psychological technique used to boost your test-taking confidence is to look into a mirror whenever you pass one and say out loud, "I know the material, and I'll do well on the test." Try it; many students have found that it works because it reduces "test anxiety."

What are the power strategies for nursing leaders? Select all that apply.

Generate an open dialogue about external and internal realities. Develop a core group of change advocates. Create a vision for change. Communicate the change vision regularly and consistently. Keep an alert for barriers in structure and processes. Report differences and honor the people who implement According to the Kotter's eight-step change model, the first step towards creating a vision and fostering major organizational transformation is creating urgency. Generating open dialogue about external and internal realities will impact the need to change. The next step is forming a powerful coalition. Developing a core group of change advocates will help build momentum as well as support individuals through the change experience. Next, creating a vision for change may involve lots of small alterations, and may or may not be a larger or inspiring vision. Communicating the change vision to people is the next step. People tend to pay attention to what is reinforced, so communicating regularly and consistently is required to sustain the effort. The next step is removing obstacles. This includes having alerts for barriers in the structure and processes that limit the ability to change and removing these barriers. The last step is to report the changes and honor the people who helped make it happen, in order to inspire others.

What is the correct order of steps that should be followed by a leader to create a vision and foster major organizational transformation?

Empowerment 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.

What is the role of the nurse executive as a leader?

Modeling behavior Giving timely feedback Providing appropriate advice The mentor should model professional and desired behavior and give timely feedback and appropriate advice to make the aspiring leader an effective leader. The mentor should not criticize, but rather coach the new aspiring leader to develop a personal leadership style. Noting the mistakes without feedback does not help an aspiring leader become an effective leader.

Which actions can the mentor take to develop effective leadership qualities in the aspiring leader? Select all that apply.

Providing self-care to enhance the ability to care for clients, families, staff, and the organization When the nurse as a leader provides self-care to enhance his or her ability to care for clients, families, staff, and the organization, it indicates Gardner's task of renewing in an executive position. Representing nursing and executive views openly and honestly indicates Gardner's task of developing trust. Assisting other organizational leaders in the expression of community and organizational values indicates Gardner's task of affirming values. When the nurse assists other executives and corporate leaders with planning, priority setting, and decision making, it indicates Gardner's task of managing.

Which behavior of the nurse as a leader indicates Gardner's task of renewing at an executive level?

Inspiring a shared vision Improving interpersonal skills Being able to motivate the nursing staff Having a shared vision helps effective transformational leaders and their teams become inspired and committed to a shared goal. Being an effective transformational leader depends on one's interpersonal skills; improving these can help in interactions with the staff. The ability to motivate the nursing staff is also important for a transformational leader because this helps one reach desired goals and improve performance. Acquiring a mentor is not a requirement of transformational leadership. Upgrading one's self-knowledge is beneficial for a nurse leader in decision making.

Which characteristics should a nurse focus on to become an effective transformational leader? Select all that apply

Delphi technique The Delphi technique is a decision-making strategy that involves systematic collection and summarization of opinions and judgments on a particular issue from respondents in order to achieve consensus among the team members and the leader. The purpose of a focus group strategy is to explore issues, identify problems, and generate information. Brainstorming strategy can be an effective method for generating a large volume of creative and innovative ideas irrespective of criticism. Normal group technique strategy gives opportunity to the group members to provide input into the decision-making process. Test-Taking Tip: You have at least a 25 percent chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

Which decision-making strategy involves systematic collection and summarization of opinions and judgments on a particular issue from the respondents?

Number of staff Leader competency Nurse education level While implementing any change in an organization, the number of staff should be considered to avoid administrative burdens and duplication of endeavors for that change. Effective leadership abilities and nurses' educational levels are essential for successful implementation and good understanding about the change. The financial status and place at which the organization is located do not affect the change; therefore these factors may not be considered while implementing the change.

Which internal factors should be considered while implementing any change in an organization? Select all that apply.

Work individually The core competency of a nurse leader is to work in interdisciplinary teams, but not individually. Utilizing informatics, providing client centered care, and employing evidence-based practice are the core competencies of a nurse leader.

Which is excluded from the competencies of nurse leader?

Expectancy theory Expectancy theory focuses on the motivations for good behavior. Good behavior is increased if a positive relationship exists between good performance and outcomes or rewards. Style theory focuses on pursuing effective relationships between the leader and subordinates while comprehending the factors in the work environment that influence outcomes. Two-factor theory promotes job enrichment by creating job satisfaction. Transformational leadership refers to a process whereby the leader attends to the needs and motives of followers so that the interaction raises each to high levels of motivation and morality. Test-Taking Tip: Use your knowledge and practical skills to eliminate the wrong options. Read each of the answer options carefully and eliminate the choices one by one. Incorrect options would sound confusing

Which leadership theory is being followed in a hospital if the nurse leader tells newly hired team members that they will be appreciated and rewarded if they perform well?

Functional model The functional model of nursing is a method of providing client care by which each licensed and unlicensed staff member performs specific tasks for a large group of clients. Team nursing is a small group of licensed and unlicensed personnel, with a team leader, responsible for providing client care to a group of clients. Primary nursing is a model of client care delivery whereby one registered nurse functions autonomously as the client's main nurse throughout the entire hospital stay. Case management is a model of delivering client care based on client outcomes and cost containment.

Which model of nursing is focused on the task-oriented approach to client care?

Recognition Achievement Recognition and achievement are motivating factors that transformational leaders use to inspire work performance. According to two-factor theory, organizations need both hygiene and motivator factors to recruit and retain staff. Salary, security, and working conditions are hygiene factors that should be in place for work to be accomplished.

Which motivator factors to inspire work performance are in accordance with the two-factor theory? Select all that apply.

Focusing on the needs of all the residents in a long-term care facility Knowing about the complications of emergency department overcrowding in an urban setting Focusing on the needs of all residents in a long-term care facility and knowing about the complications of emergency department overcrowding in an urban setting are actions that indicate effective implementation of the "Big Picture" principle by helping the nurse envision his/her work beyond the immediate tasks. Focusing on analyzing morale, working relationships, team work, and the number of clients indicates effective implementation of "Using Measurable versus Nonmeasurable Data Systems" principle of systems thinking theory. Identifying and understanding the relationships of clients, families, communities, and local economies indicates effective implementation of "Recognizing the Dynamic, Complex, and Interdependent Nature of Systems" principle. Recognizing the long-term effects of actions on the organization or client care indicates the "Balancing Short-Term and Long-Term Objectives" principle of systems thinking theory.

Which nursing actions indicate effective implementation of systems thinking theory principle with respect to "thinking of the Big Picture"? Select all that apply.

Flexibility Ability to listen to others Ability to share information and ideas In order to collaborate effectively, the nurse should be flexible, must be willing to listen to others, and must share information and ideas with others. The nurse manager should plan a thoughtful response, consider others' perspective first, and not react hastily. The nurse manager should not share his or her own anger or frustration with other staff. Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation. All options likely relate to the situation, but only some of the options may relate directly to the situation.

Which skills would be essential for an effective nurse manager to develop and improve collaboration with others? Select all that apply.

The nurse manager hires the student nurse she advised to work in the agency after graduation Referent power is granted by a powerful person having an association. Therefore 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 considered to be an example of information power.

Which statement reflects the concept of "referent power" to the nurse?

Situational-contingency theories Situational-contingency theories, which are leadership theories, hold that leadership effectiveness depends on a leader's interpersonal skills. The hierarchy of needs explains that people are motivated first by physiological needs and safety, then by social and self-actualizing needs. Transformational leadership is a process through which the leader attends to the needs and motives of followers. OB modification theory says that the leader should use positive reinforcement to motivate followers and avoid situations that cause discomfort.

Which theory emphasizes that leadership effectiveness depends on the executive nurse's interpersonal skills?

Quantum theory Quantum theory states that leaders must embrace uncertainty and understand behaviors before changing them. Therefore quantum leaders represent change catalysts and innovators. Role theory is a collection of concepts that predict circumstances under which certain type behaviors are expected. Trait theory is a leadership theory in which leadership traits such as a certain set of physical and emotional characteristics are innate and cannot be learned. McGregor's Theory X describes the workforce motivation by assuming that people basically do not like their work and must be coerced by their manager to perform.

Which theory states that leaders act as change catalysts and innovators?

Complexity theory 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 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?

Great Man theory The trait theory is sometimes referred as the Great Man theory. According to this theory, the leadership traits such as a certain set of physical and emotional characteristics are innate and cannot be learned. Style theory focuses on what leaders do, but not on the leadership qualities. Two-factor theory focuses on motivation and job satisfaction based on hygiene factors and motivational factors. Situational-contingency theory focuses on the challenge of a situation and encourages an adaptive leadership style particular to that situation. Test-Taking Tip: If you are unable to answer a multiple-choice question immediately, eliminate the alternatives that you know are incorrect and proceed from that point. The same goes for a multiple-response question that requires you to choose two or more of the given alternatives. If a fill-in-the-blank question poses a problem, read the situation and essential information carefully and then formulate your response.

Which theory states that the leadership traits in an individual are born and not made?

Management 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. Test-Taking Tip: Recall the responsibilities and traits of each role and choose the answer that suits best to the scenario in the question.

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?

Managing Managing is the Gardner leadership task that involves assisting the client with planning, priority setting, and decision making. Explaining involves teaching and interpreting information to promote functioning of the client and well-being. Developing trust involves keeping promises to clients and families and being honest in role performance. Envisioning goals involves envisioning client outcomes for client or families.

While serving as a leader, the nurse assists the client with planning, priority setting, and decision making. Which of Gardner's leadership tasks is the nurse putting into practice?