Leadership/Management EAQ's

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?

"A leader has a formal position." 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.

A registered nurse as a leader is teaching novice leadership skills to a newly appointed leader. Which statements made by the new leader indicate effective learning? Select all that apply.

"I should resolve conflict." "I should deal with difficult people." "I should learn how to work in groups. Novice leadership skills include resolving conflict, dealing with difficult people, and learning how to work in groups. These skills contribute to future leadership success and can create skills that lead to some expertise. Ensuring that operations run smoothly is a skill of a manager. A manager will ensure that well-developed formulas are applied to situations.

The leader is teaching a nursing student about systems theory. Which statement by the student nurse indicates the need for further teaching? Select all that apply.

"Systems theory accounts for unpredictability." "Systems theory focuses on the effect of random events." Systems theory tends not to account for unpredictability and random events. In contrast, chaos theory focuses on unpredictability and random events. Systems theory involves open as well as closed systems. It is viewed as inputs, throughputs, and outputs. A system theory involves a system that consists of structure, technology, people, and environment.

The registered nurse is teaching a group of student nurses about the role of the nurse as a leader. Which statement by a student nurse indicates effective learning

"The goal of the nurse manager is to develop a shared vision of the future with direct care nurses." The goal of a nurse manager as a leader is to develop a shared vision of the future with direct care nurses. The nurse manager ensures that the day-to-day elements of the workplace are being performed correctly. The nurse executive has a plan for identification of charge nurses and should be aware of information on succession planning. The primary goal of the nurse executive is leadership within the workplace.

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?

"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

The nurse leader working in a 50-bed surgical unit accrued 765 client days in November and 189 of the clients were discharged during the month. What is the average length of stay for November? Record your answer using a whole number. _____ days

4 The formula for average length of stay is number of client days divided by the number of discharges. 765/189 = 4 days.

Four nurse leaders are performing Gardner's tasks. Which nurse leader is implementing Gardner's task of "serving as symbol"?

A Gardner's task of "serving as symbol" includes the representation of the nursing profession, values, and beliefs of the organization to clients, their families, and other community groups. Therefore nurse leader A implements Gardner's task of "serving as symbol." Being honest and keeping promises to clients and families in the nursing profession indicates the implementation of Gardner's task of "developing trust" by nurse leader B. Nurse leader C implements Gardner's task of "managing" by assisting clients and their families with planning, priority setting, and decision making. Nurse leader D implements Gardner's task of "managing" by ensuring that the organizational systems work on the client's behalf.

Four nurse leaders are performing Gardner's tasks of leading and managing. Which nurse leader is implementing Gardner's task of managing?

A Gardner's task of managing involves assisting other executives and corporate leaders with planning, priority setting, decision making, and ensuing human and material resources are available to meet their health needs. Therefore nurse leader A is implementing Gardner's task of managing. Gardner's task of envisioning goals involves assisting staff in formulating their vision of enhanced clinical and organizational performance; this is being done by nurse leader B. Nurse leader C is implementing Gardner's task of motivating by inspiring clients and their families to achieve their visions. Nurse leader D is implementing Gardner's task of developing trust by sharing the organizational information with the team.

The nurse leader is teaching about the role of followers to the nursing staff. Which statement made by the nursing staff is true regarding the followers' traits? Select all that apply.

A follower demonstrates collaborative behavior in daily practice. A follower cooperates with the leader and peers to reach the team goal. A follower demonstrates collaborative and cooperative behavior with staff, to help reach the team goals. Enforcing the policy mandates or contracts and maximizing the results from existing resources are the responsibilities of a manager. Demonstrating a positive feeling at the workplace is the duty of a leader.

Which factors are associated with transformational leadership? Select all that apply.

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

A nurse manager is helping staff reach optimal functioning to enhance organizational functions. Which Gardner's task is reflected in this leadership behavior?

Achieving workable unity Achieving workable unity is one of Gardner's tasks for leading and managing. Nurse managers should help staff reach optimal functioning to enhance organizational functions. Nurse managers enact motivation by relating to and inspiring staff to achieve the mission of the organization and the associated vision. Affirming values is involved in assisting the staff in explaining organizational values and strengthening staff members to be more attuned to the organization. Envisioning goals involves creating a vision of how systems support client care objectives and assisting in enhancing the vision of clinical and organization performance.

The nurse executive is seeking to improve client care by helping multidisciplinary leaders achieve optimal functioning. Which behavior related to Gardner's tasks of leading is the executive exhibiting?

Achieving workable unity The leader in an executive position helps multidisciplinary leaders achieve optimal functioning by applying Gardner's task of achieving workable unity. Managing involves helping other executives and corporate leaders with planning, priority setting, and decision making. Affirming values involves helping other organizational leaders in the expression of community and organizational values. Developing trust involves assisting and representing nursing and executive views openly and honestly.

A nurse is helping a client determine and articulate personal values about health problems. The nurse also explains the effect of these problems on lifestyle adjustments. Which Gardner's task of leadership is the nurse leader applying?

Affirming values Values are the connecting thoughts and inner driving forces that give purpose, direction, and precedence to life priorities. According to the Gardner's tasks of leadership, helping the client sort out and articulate personal values that are related to health problems is affirming values. It also involves explaining the effect of these problems on lifestyle adjustments. Explaining includes teaching and interpreting information to promote well-being in the client. Managing involves assisting the client with planning, priority setting, and decision making. This also includes ensuring that organizational systems work on behalf of the client. Motivating includes inspiring clients or family members to achieve their vision.

The nurse observes a dispute between staff members due to differences in perspective concerning nursing practices. Which approaches of the nurse as a leader would be appropriate in building up negotiation "loop-backs" to resolve the conflict? Select all that apply.

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

A nurse manager in a cancer care facility finds that the nursing care team is demotivated due to consecutive deaths of two terminally ill cancer clients. Which action of the nurse manager would help renew the team's energy?

Arranging a notice board in the unit and posting photos or messages reflecting achievements of the team A good leader keeps the team's spirits high by helping them renew their energy levels. The nurse manager may post motivating messages or photos on the notice board to motivate the team members. Counseling the team members may not help in motivating them as there could be further similar incidences in the unit. Shifting the team to another nursing unit with less likelihood of deaths may make the team members emotionally weak. The reason for the team members to be low in energy is unlikely to be their emotional attachment to the clients; keeping them emotionally detached may not help motivate them for client care.

Why does the leader ask the direct care nurse, "Do you block cooperative efforts to resolve issues?"

Avoidance in conflict management style means that conflict is postponed. Often people do this when they have far more important issues pressing, when they have to gather more information, or when people need to cool down. Therefore the question asked by the leader to the direct care nurse, "Do you block cooperative efforts to resolve issues?," indicates that the direct care nurse may be using avoidance. Competing means perusing one's own needs and goals at the expense of others. When a direct care nurse uses competing, often the leader may ask "Are you surrounded by people who agree with you all the time and who avoid confronting you?" Negotiating is similar to trading, and if the direct care nurse practices this often, the leader may ask "Do you ignore large, important issues while trying to work out creative, practical compromises? Accommodation in conflict management style means neglecting our own needs, goals, and concerns in favor of satisfying those of others. With regular use of accommodation by a direct care nurse, the leader may ask "Do you think people are using you?"

The nurse leader is promoted to nurse manager and has a plan of implementing an effective client counseling center in the outpatient department. The nurse gathers data from different healthcare providers and compares methods. Which type of quality improvement does the nurse implement?

Benchmarking Benchmarking is a process of conducting a widespread search to identify the best method, which helps to identify desired standards of quality performance. Risk management involves analyzing problems and minimizing losses after an occurrence of an adverse event. Quality management refers to a philosophy that defines a healthcare culture emphasizing customer satisfaction, innovation, and employee involvement. Performance improvement involves individual performance appraisal.

While having a group discussion in an organization, one of the team members criticizes an idea of another team member. Which strategy should the leader apply to resolve the issue?

Brainstorming Brainstorming can be an effective method of generating a large volume of creative and innovative ideas. The leader should apply this strategy to encourage ideas of all the team members, irrespective of any criticism, to resolve the issue. The purpose of focus group strategy is to explore issues, identify problems, and generate information. Delphi technique is a decision-making strategy that involves systematically collecting and summarizing opinions and judgments on a particular issue from followers. Nominal group technique strategy allows group members the opportunity to provide input into the decision-making process.

The hospital management is planning a study that compares the benefits and harms of a particular method to the benefits and harms of alternative methods when treating clients with chronic disorders. Which approach does the nurse manager follow to improve client care?

Comparative effectiveness research (CER) CER is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. Diffusion of innovations describes how innovations spread through society in different stages of decision, implementation and confirmation. PBE is a research methodology that helps inform practice decisions by examining outcomes in the real world. In PAR, the members of the community being studied are integral members of the research team and are involved in identifying the questions and addressing the issues in the research project.

Hospital management has replaced some equipment to provide more effective treatment. The nurse, as a leader, wants the team to support and implement this change successfully. Which actions of the nurse leader are effective in this situation? Select all that apply.

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

A medical care facility is seeking to establish an orthopedic center of excellence. The nurse manager teaches direct care nurses about opportunities available to them in the process. Which task would a direct care nurse be eligible for?

Conducting a literature review In an orthopedic center, the direct care nurse is eligible for participating on the council to conduct a literature review on topics related to orthopedic product lines, innovative orthopedic joint replacement procedures, and programs related to the orthopedics evidence-based practices for joint replacement. The other activities such as developing a budget, conducting a needs assessment, and forming an advisory committee are not the responsibilities of a direct care nurse. The members responsible for developing budget are assistant vice president of client care services and orthopedic product line manager/nurse manager. The Director of Nursing, orthopedic product line manager, and strategic planning and marketing director are responsible for conducting a needs assessment. The members responsible for formation of an advisory committee are the client satisfaction director, physician champion, vice president of client care services, orthopedic staff across the continuum of care, director of rehabilitation services, and vice president of medical affairs.

Which type of leadership theory explains the effectiveness of leadership and depends on the match between a leader's style and the demands of a situation?

Contingency Model Fiedler developed the Contingency Model, which explains that the effectiveness of the group depends on an appropriate match between a leader's style and the demands of a situation. Path-Goal theory was developed by House and Mitchell and explains the personal characteristics of followers and environmental demands. The Two-factor theory was developed by Herzberg for motivation in leadership. Normative-Decision Making Model is a problem solving approach developed by Vroom and Yetton.

The nursing leader stated, "The reimbursed cost is less than the full charge for a service in the hospital." Which type of health reimbursement does the nurse leader describe?

Contractual allowance When the reimbursed cost is less than the full charge for a service in the health organization, a contractual allowance or discount exists. Offering rewards and incentives to high performing organizations is value-based purchasing. In cost-based reimbursement, all allowable costs are calculated and used as the basis for payment. In a prospective payment system, the third-party payer decides in advance what will be paid for a service or episode of care

Which group discussion technique involves a large number of respondents who may be participating in the discussion remotely?

Delphi technique The Delphi technique includes the feedback of anonymous people who may not physically convene. These participants may be located throughout the country or the world. In the case of focus groups, the interaction is face to face. Brainstorming involves listing all ideas without critique or discussion. In the nominal group technique, participants are asked to not talk to each other as they write down their ideas to solve a predefined problem or issue.

Which action would a nurse leader specifically take to promote a health care climate where curiosity, reflection, and change are embraced?

Empowering staff to be life-long learners and risk takers A nurse leader who empowers staff to be life-long learners and risk takers is promoting a health care environment where questioning the status quo, reflecting on processes and advocating for change when appropriate is welcome and encouraged. The nurse leader should serve as coach, maintain a good relationship with the team, and collaborate with the team to problem solve, but these actions are not specific to creating a culture of curiosity, reflection and change.

Which behavior of the nurse as a leader would be considered a smart trust action according to Covey?

Focusing first on developing character Covey's smart trust actions help leaders develop high trust in a low-trust world. Focusing first on developing one's character is a smart trust action of a leader. Leading a balanced life, engaging in self-renewal, and seeing life as an adventure are Covey's characteristics of leadership.

The chief operating officer conducts an interview for the position of nurse leader and asks about Kotter's eight-step model. Which attribute cited by the nurse relating to helping build the momentum is correct?

Forming a powerful coalition The formation of a powerful coalition may help build the momentum and support individuals through the change experience. Removing obstacles may keep one alert for barriers in structure. A culture with continuous improvement may be created by building on the changes. The changes in the culture are anchored with the recognition of the people who helped make the changes.

Which question asked by a nurse leader establishes and maintains a human rapport with staff?

How are your children? Establishing interpersonal relationships and understanding each other's feelings by asking questions such as "how are your children" ensure establishing and maintaining human rapport. Questions such as "how is your daily work going?", "can you tell me some daily obstacles you run into?", and "do you support changes made by the organization?" indicate a professional relationship and do not indicate establishing of human rapport.

Which question related to quality of decisions would the nurse leader consider while assessing the degree of conflict resolution?

How creative are the resulting plans? The question about the creativity of resulting plans should be considered while assessing quality of decisions. The willingness of the people to work together, development of understanding, and generation of the mutual respect and concern for each other are related to quality of relationships.

The nurse manager noticed that one of the staff nurses is giving excuses for performing one task on time but ignoring another assigned task. What does the nurse manager do in this situation?

Identify the reason for procrastination. Sometimes nurses procrastinate, so the nurse manager should identify the reason for this behavior and provide the solution to break the task down into manageable pieces so that they can finish the task in time. The nurse manager should not recommend not performing the task, but instead should motivate the nurse to complete the work assigned. Planning to reward the nurse for accomplishing each of the smaller tasks is beneficial; he should not punished. Another technique for this situation is to advise the nurse to select the least attractive element of the task to do first, so that the rest will seem easy.

What are the attributes of a nurse leader? Select all that apply.

Identifying the needs of others Using critical-thinking skills in making decisions Using focused energy and stamina to accomplish a vision A nurse leader should possess attributes such as identifying the needs of others. A nurse leader should also use critical-thinking skills in making decisions and focused energy and stamina to accomplish a vision. Accepting responsibility willingly and performing follow up on the consequences of actions taken are the responsibilities of a follower.

A nurse leader is educating student nurses in helping clients to perform their difficult self-care activities. Which key idea from a Source of Power is this statement referring to?

Information power Information power arises from one's possession of selected information that is needed by others. Information power is involved when a leader teaches student nurses to help clients in performing their difficult self-care activities. Position power is possessed by virtue of one's position within an organization or a group. Coercive power arises from fear of someone's real or perceived fear of another person. A referent power is involved when a student nurse is granted association with a powerful person.

A direct care nurse performs exceedingly well on a cancer project. As a result, the managerial team decides to promote the nurse to a managerial position. Which actions by the nurse would justify the decision of the panel? Select all that apply.

Inspiring new ideas Establishing short-term goals Demonstrating positive feelings Maximizing results from existing resources The leader provides new ideas with a long-term effect on the progress of the organization. He/she should also provide a positive atmosphere by giving an equal importance to the followers. Providing short-term goals and maximizing results from existing resources are the job responsibilities of a manager. The willingness to lead and follow peers is the quality of a good follower.

In evaluating risks, what does the nurse understand is the responsibility of risk managers?

Involving perspectives from numerous disciplines Involving perspectives from numerous disciplines helps to discover underlying problems that a single discipline might miss. Risk managers should use multiple data sources, multiple data collection techniques, and multiple perspectives to collect and interpret data accurately. Both qualitative and quantitative data should be assessed and analyzed for implementing actionable plans to prevent adverse events.

The nurse leader mentors the staff on types of conflict. Which statement of the leader describes intrapersonal conflict?

It arises due to imbalances between the nurse's personal and professional priorities. Intrapersonal conflict arises due to imbalance between the nurse's personal and professional priorities. The conflict due to a difference in opinions with others causes interpersonal conflicts. Organizational conflicts arise from a discord between policies and procedures. Organizational conflict also arises from hierarchical structure and role differentiation among employees.

When a bedridden client complains that he or she is thirsty, the nurse leader says, "I want to make you comfortable. Here is a glass of water, please take it." Which communication skill is the nurse leader using to make caring visible?

Making explicit her or his positive intent The nurse is making explicit her or his positive intent by explaining the purpose and by showing what he or she is doing in the client's best interest. Listening actively indicates acknowledging and reflecting back the person's feelings in a nonjudgmental way. Expressing appreciation refers to giving the personal gift of positive reward. Showing caring nonverbally can be done by using a facial expression, intonation, posture, eye contact, and body language to mirror the client's feelings. Test-Taking Tip: On a test day, eat a normal meal before going to school. If the test is late in the morning, take a high-powered snack with you to eat 20 minutes before the examination. The brain works best when it has the glucose necessary for cellular function.

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?

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.

"In today`s workplace, female-male collaboration should provide efficacious models for the future." Which statements support this saying? Select all that apply.

Men and women must learn to work together. Women and men bring separate perspectives to resolving problems. Men and women must learn to work together and value the contributions of others and the differences they bring to any situation. Not all male managers make decisions on limited data. Women and men bring separate perspectives to resolve problems, which can help them function more effectively as a team on the nursing unit. Women may be better at collaborating and getting others to collaborate in accomplishing a task; men reportedly seem to be better at deciphering what needs to be done. Women are perceived to have a more participative management style; however, this does not mean that all male managers use an authoritative management model.

The nurse is relating to and inspiring the client who has a psychiatric disorder to achieve the client outcomes. Which of Gardner's leadership tasks is reflected in the nurse's actions?

Motivating When the nurse relates to and inspires the client with a psychiatric disorder to achieve the client outcomes, the nurse is motivating according to Gardner's leadership tasks. Gardner's leadership task of envisioning goals involves envisioning client's outcomes for single clients/families. Gardner's leadership task of serving as symbol involves representing the nursing profession and values and beliefs of the organization to clients and families and other community groups. Gardner's leadership task of achieving workable unity involves assisting clients and families in achieving optimal functioning to benefit the transition to enhanced health functions.

The nurse leader asks the team members not to talk to each other while writing their ideas for solving a predefined problem. Which type of group decision-making style does the nurse leader follow?

Nominal group technique In the nominal group technique, team members are asked to write their ideas for problem solving without talking to each other in order to avoid comments and elaboration of the ideas. Focus groups explore issues and generate information in identifying problems. The brainstorming method is used to generate a large volume of creative options. The Delphi technique involves collecting and summarizing opinions and judgments on a particular issue from respondents, such as expert panels, interviews, surveys, or questionnaires.

While having a group discussion in a decision-making process, the leader has asked the team members to silently write down their ideas. The merits of each idea were discussed, and the best one was chosen based on highest ranking. Which strategy is involved in this scenario?

Nominal group technique The nominal group technique has group members silently provide written input into the decision-making process. Choosing the ideas based on highest ranking is done after discussing the merits of the ideas. This technique allows equal participation among members and minimizes the problem of dominance. The focus group strategy is used to identify problems or to evaluate the effects of an intervention during a face-to-face discussion but not through writing the ideas. The brainstorming strategy is applied during a decision-making process to generate innovative ideas in spite of having criticism from team members. The Delphi technique is used to achieve consensus among team members by reconsidering and judging the opinions.

The nurse as a leader teaches staff about organizational disciplines to support change and evolution. Which statement of the nurse is relevant in the context of maintaining self-awareness and using reflection?

Personal mastery fosters openness in the face of change. Personal mastery fosters openness by maintaining self-awareness and using reflection. Team learning promotes the team thinking together to share ideas, knowledge, and perspective. System thinking considers the organization as a complex entity; this helps in seeing the movement of the organization. Shared vision creates a common viewpoint to understand the direction of movement of the organization.

A staff nurse states "I am sorry, I am responsible for the situation" while communicating to the nurse leader. Which communication pattern is the staff nurse using?

Placation Placation means to appease. By saying "I am sorry, I am responsible for the situation," the staff nurse is taking the blame. An irrelevant pattern is used when someone is trying avoid a situation or ignore his or her feelings. Congruence is used when matching inner feelings with words. While blaming others for any situation, attribution of blame is applied.

Which behavior from the nurse leader exhibits charismatic leadership qualities?

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

Which qualities of a leader indicate a transformational approach to leadership? Select all that apply.

Possessing charismatic behavior Possessing intellectually stimulating behavior Having inspirational and motivational behavior The leader who has a transformational approach to leadership possesses charismatic behavior, intellectually stimulating behavior, and inspirational and motivational behavior. The transformational leader follows an inspirational and motivational approach. The leader who uses the transactional leadership approach has a punitive nature and gives rewards to followers contingently

While reviewing the work of a team, the nurse observes a conflict among the members. How should the nurse build in consultation before and feedback after the negotiations in a conflict resolution?

Providing a forum for open discussion Providing a forum for open discussion will help to build in consultation before and feedback after the negotiations. Examining the real issues of all parties will help to focus on interests in conflict resolution. Providing the necessary resources to those involved to offer support will help to impart motivation, skills, and resources in conflict resolution. Allowing a "cooling off" period before reconvening if resolution fails will help build in "loop-backs" to negotiation in conflict resolution

Which type of behavior by the registered nurse results in a low-to-stable level of commitment?

Punitive Punitive behavior is a type of transactional leadership behavior that results in a low-to-stable level of commitment as an organizational outcome. Charismatic, inspirational, and intellectual stimulation are transformational leadership behaviors that result in increased commitment as an organizational outcome.

The nurse manager threatens a staff nurse about being penalized for poor performance in the unit. Which type of leader behavior did the staff nurse experience?

Punitive Punitive behavior is experienced in transactional leadership; this occurs when the nurse manager aims at punishing the staff nurse by penalizing for poor performance. Charismatic behavior and intellectual stimulation are seen in transformational leadership. Laissez-faire behavior is the hands-off style in which the manager allows a high degree of autonomy and self rule.

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?

Rehabilitation Tertiary care includes rehabilitation. Chronic care and health maintenance are considered primary care, and prevention of disease complications is classified as secondary care.

The nurse, as a leader, takes care of himself or herself to promote the nurse's ability to care for the staff. Which of Gardner's tasks of leadership is the nurse applying in practice?

Renewing Leaders generate energy within and among others. When a nurse engages in self-care to enhance his or her ability to care for the staff, the nurse is applying renewing, one of Gardner's tasks of leadership. Affirming values involves assisting the client to sort out and articulate personal values in relation to health problems. Developing trust involves keeping promises given to clients or families. Serving as symbol indicates representing the nursing profession and the values and beliefs of the organization to clients or families.

A nurse encourages employees to implement a Magnet Recognition Program in the organization. The nurses think beyond their own personal needs and are clear about the group outcomes. Which leadership quality according to Gardner's tasks is reflected in the activity of the nurse?

Representing the group According to Gardner's Tasks of Leadership, encouraging employees to implement a Magnet Recognition Program shows that the nurse is representing the group. Trust develops when leaders are clear when providing direction and refrain from misdirecting others in their thinking and actions. The leader may serve as a symbol by becoming involved in public relations events, for example. The nurse as leader can achieve workable unity between and among parties by avoiding, diminishing, or resolving conflicts.

The nurse notes a conflict between staff members during a meeting. Which principle should the nurse follow, as a leader, to put the focus on mutual interest?

Responding expediently to the issues Responding expediently to issues will help put the focus on interest in a process of conflict resolution. Providing a forum for open discussion will help build in consultation before and feedback after the negotiations. Reviewing with all parties the likely consequences of not proceeding will help build in "loop-backs" to negotiation. Working with staff or clients after the conflict to learn from the situation will help build in consultation before and feedback after the negotiations.

A nurse manager receives a complaint from a client that a particular staff member had been rude when providing care. The nurse, rather than punishing the staff member, listens to his or her side of the story and then talks to the client to clarify the misunderstanding. Which leadership theory is reflected in this scenario?

Situational-contingency theory Situational-contingency theory encourages an adaptive leadership style to focus on the issue being faced. The nurse manager understands the situation and makes a decision based on the complete information obtained. Trait theory explains a set of leadership traits that influence others toward a common goal. Two-factor theory involves application of hygiene factors and motivational factors to avoid and promote job enrichment. Expectancy theory refers to a perceived probability of fulfilling a particular need based on experience.

The student nurse is assisting the registered nurse (RN) in collecting feedback from superiors and peers. The questions they are asking address comments to the RN about his or her work quality that affects the environment and overall productivity. Which theory does the student nurse think the RN is applying practically as a leader?

Style theory Style theory measures the achievement of satisfactory performance. It requires supervisors to pursue an effective relationship with their followers. Therefore leaders need to obtain feedback from their followers, peers, and superiors. Trait theory involves the leader using self-awareness of his/her traits. It is useful in self-development as well as in seeking employment that matches the traits. Transformational theory includes a process in which the leader attends to the needs of the followers. This interaction raises the followers to higher levels of morality. Situational-contingency theory involves leaders considering the challenge of a situation

Which action of the registered nurse (RN) represents his or her leadership ability?

Supervising the tasks assigned to unlicensed nursing personnel The nurse as a leader should supervise the tasks assigned to unlicensed nursing personnel to ensure the client's safety. Pursuing higher professional courses can help in self-growth but does not indicate leadership. Performing home visits and modifying a diet chart indicates the role of the nurse.

The registered nurse, while teaching a group of nursing students about the characteristics of a good team player, states, "A good team player should work with determination and refuse to stop until the goal has been accomplished." Which characteristic is the registered nurse describing?

Tenacity Tenacity means giving your all with determination and refusing to stop until the goal has been accomplished. Selflessness is a characteristic that involves putting the other members of the team ahead of oneself. Dependability involves the nurse following through and doing what he or she agreed to do. Collaboration involves each person bringing something to the project that adds value to the team and supports the creation of synergy.

Which critical factors would the nurse say are associated with situational-contingency theory? Select all that apply.

The ability of the leader to reward followers The degree of trust and respect between leaders and followers The task structure about goals and the complexity of the problems being faced Situational-contingency theory considers three factors to be critical. It includes the ability of the leader to reward followers in terms of power and position. It is also comprised of the degree of trust and respect between leaders and followers. The task structure about goals and the complexity of problems faced is a critical factor. Environmental demands and the personal characteristics of followers are contingent variables.

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?

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.

The nurse as a leader is using a transactional leadership style. Which effect on followers often results from this style of leadership?

The followers will correct errors in a reactive manner. Transactional leadership depends on the power of the organizational position and the formal authority to reward or punish the employees. Transactional leadership often results in followers correcting errors in a reactive manner. Increased self-worth is a typical effect of transformational leadership on followers. Likewise, a transformational leadership style fosters a sense of being valued and a feeling that the work is challenging and meaningful.

What would the nurse describe as "leadership" in nursing practice?

The use of individual traits to interpret the environment in an emerging situation to execute a plan Leadership is defined as the use of abilities and traits by an individual to interpret the environment in an emerging situation to execute a defined plan. In followership, each member contributes optimally and follows a peer who leads in the setting. The ability to plan, direct, control, and evaluate other members in situations with a pre-established outcome is management. Collaboration is the transfer of responsibility for the performance of a task while retaining the accountability for the outcome.

Which example would the nurse consider to be a part of systems thinking theory?

To focus on the needs of all residents in a long-term care facility The systems thinking theory would describe the need to focus on all the residents in a long-term facility care facility. Transformational theory is associated with promoting employee development. Leaders obtain feedback from peers and staff according to the style theory. Organizational behavior modification theory believes in avoiding situations that cause discomfort.

Which objective is associated with creating urgency in Kotter's eight-step model?

To generate open dialogue about external and internal realities The attribute of creating urgency is associated with generating open dialogue about external and internal realities. Short-term targets are created for creating short-term wins. Honoring the people who help complete the task anchors the changes in the culture. A culture created with continuous improvement builds on the change.

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

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

A nurse leader has resolved a conflict within the team. Which further action of the nurse leader prevents the same conflict in the future?

Working with the team members after the conflict The nurse leader should work with the team members or staff after resolving the conflict to learn from the situation and to prevent repetition of the conflict in the future. The nurse leader should teach the importance of unity within the team rather than punishing the responsible member. Separating the member responsible for the conflict does not prevent repetition of the conflict. The nurse leader should supervise the team but should not ask another person to do it.