NSG 441 Leadership Exam 1

philosophy

A system of beliefs and values

What Followers Want:

Respect Control of decisions that affect them Rewards and recognition Balance of life Professional development

functional structure

An organizational structure composed of all the departments that an organization requires to produce its goods or services.

service-line structure

Most common structure in healthcare, particularly magnet hospitals. Clinical services are organized around patients with specific conditions

Leadership Theories

Trait, Style, Situational-Contingency, and transformational.

OB modification

an operant approach to organizational behavior. Follows a three-step ABC model: A= antecedent analysis of clear expectations and baseline data collection B= behavioral analysis and determination C= consequence analysis, including reinforcement strategies -Luthans

The Five Domains of Emotional Intelligence

-Having self-awareness -Managing emotions -Motivating self -Being empathetic -Handling relationships

Five Operational Roles of a Manager

1. establishes objectives and goals and communicates them to persons who are responsible to attain them. 2. organizes and analyzes the activities, decisions, and relations, dividing them into manageable tasks 3. motivates and communicates with people responsible for jobs through teamwork 4. Analyzes, appraises, and interprets performance, communicates results to staff and superiors. 5. Develops people, including self

Complexity Science Users

Develop networks Encourage nonhierarchical interaction among workers Become a leadership "Tag" Focus on emergence Think systematically

Followership

The optimal use of personal attributes in a team situation, while acquiescing to a peer who is leading or managing, to ensure the best clinical decision making and actions are taken to achieve clinical or organizational outcomes.

Nonlinear (complex) change

refers more to a web. In other words, everything is connected; pulling on one piece moves other pieces so that a new pattern appears. Most change in health care is complex because it involves many people and clinical and organizational changes.

economic factors

uninsured therapy/diagnostic costs personnel costs

demographic factors

where clients live vs. access to care aging client population/workforce income uninsured/underinsured

Covey's Eight Characteristics of Effective Leaders

- engage in lifelong learning - service oriented - concerned with the common good - radiate positive energy - believe in other people - lead balanced lives and see life as an adventure - synergistic, or see things as greater than the sum of parts - engage in self-renewal

Attributes of Effective Leaders and Managers

-use focused energy and stamina to accomplish a vision -use critical-thinking skills in decision making -trust personal intuition and then back up intuition with facts -accept responsibility willingly and follow up on the consequences of actions taken -identify the needs of others -deal with people skillfully: coach, communicate, counsel -Demonstrate ease in standard/boundary setting -Examine multiple options to accomplish the objective at hand flexibly -Are trustworthy and handle information from various sources with respect for the source -Motivate others assertively toward the object at hand. -Demonstrate competence or are capable of rapid learning in the arena in which change is desired.

Bleich's Tasks of Management

1. Identify systems and processes that require responsibility and accountability and specify who owns the process. 2. Verify minimum and optimum standards/specifications and identify roles and individuals responsible to adhere to them. 3. Validate the knowledge, skills, and abilities of available staff engaged in the process; capitalize on strengths; and strengthen areas in need of development. 4. Devise and communicate a comprehensive big picture plan for the division of work, honoring the complexity, and variety of assignments made at an individual level. 5. Eliminate barriers/obstacles to work effectiveness. 6. Measure the equity of workload, and use data to support judgments about efficiency and effectiveness. 7. Offer rewards and recognition to individuals and teams. 8. Recommend ways to improve systems and processes. 9. Use a social network to engage others in decision making and for feedback, when appropriate or relevant.

Which statements below reflect traits emotionally intelligent nurses display as credible leaders? Select all that apply. -Awareness of the individual, family, or community - Enhanced organizational skills -Investment in relationships - Adoption of group behaviors -Commitment to self-growth

All of these EXCEPT adoption of group behaviors Rationale: Emotionally intelligent nurses are credible as leaders because they possess awareness of the individual, family, or community being cared for; have enhanced organizational skills resulting from investment in relationships; and a commitment to self-growth. Adoption of group behaviors would not yield a credible leader if the behaviors were negative or ineffective.

Which trend is influencing healthcare organizations today? Select all that apply. -An aging population -Decreasing personnel costs -Rapidly escalating drug costs -Reduced number of underinsured and uninsured -Decreased consumer attention to disease prevention -Patients demanding increased participation with providers

An aging population, rapidly escalating drug costs, patients demanding increased participation with providers

A new nurse sees a flyer for a workshop on Healthcare relationship building and recognizes that relationship building with those in current leadership positions is challenging for her. She decides to attend. By making the decision to attend what is the new nurse demonstrating? A. social awareness B. self-management C. strengths-based learning D. personal leadership

B. Self-Management

When caring for a patient who had a hip replacement that morning, a nurse is providing what level of care? A. primary B. secondary C. tertiary D. essential

B. secondary

Gardner's Tasks of Leadership

Envisioning goals Affirming values Motivating Managing Achieving workable unity Developing trust Explaining Serving as a symbol Representing the group Renewing

Motivational Theories

Hierarchy of needs Two-factor theory Expectancy theory OB modification

Roles of Leader, Manager, and Follower

Leader: interacts with peers Manager: interacts with persons being supervised, administrators, supervisors, regulating agencies Follower: interact with follower and peers ROLES R- responsibilities O-Opportunities L-Lines of communication E-Expectations S-Support

Trait Theories

Leaders have a certain set of physical and emotional characteristics that are crucial for inspiring others toward a common goal. Some theorist believe that traits are innate and cannot be learned; others believe that leadership traits can be developed in each individual sometimes referred to as "The Great Man Theory" Key researchers: Aristotle and Stogdill

Third-Party Financing Organizations

Medicare Medicaid Private health insurance

shared governance

a method that aims to distribute decision making among a group of people

mission statement

a statement of the organization's purpose - what it wants to accomplish in the larger environment

Systems Theory

a theory stating that an organization is a managed system that changes inputs into outputs attempts to explain productivity in terms of a unifying whole as opposed to a series of unrelated parts. Systems can be either closed (self-contained) or open (interacting with both internal and external forces). In systems theory, a system is described as comprising four elements: structure, technology, people, and their environment. Systems theorists focus on the interplay among these elements in a framework of (1) inputs—resources such as people, money, or materials; (2) throughputs—the processes that produce a product from the inputs; and (3) outputs—the product of inputs and throughputs.

vision statement

expresses what the organization should become, where it wants to go strategically

Style Theories

focus on what leaders do in relational and contextual terms. The achievement of satisfactory performance measures requires supervisors to pursue effective relationships with their subordinates while comprehending the factors in the work environment that influence outcomes Sometimes referred to as "group and exchange" theories. Key researchers: Shartle, Stogdill, and Likert

Two-factor theory

hygiene factors, such as working conditions, salary, status and security, motivate workers by meeting safety and security needs and avoiding job dissatisfaction. Motivator factors, such as achievement, recognition, and the satisfaction of the work itself, promote job enrichment by creating job satisfaction. -Herzberg

organizational culture

the reflection of the norms or traditions those identified as "heroes" mutually reinforcing vs. conflict producing lived experience of staff and clients

Chaos Theory

theory that suggests universe filled with unpredictable and random events organizations must be self-organizing and adapt readily to change in order to survive. Organizations, therefore, must accept that change is inevitable and unrelenting. When one embraces the tenets of chaos theory, one gives up on any attempt to create a permanent organizational structure. Using creativity and flexibility, successful managers will be those who can tolerate ambiguity, take risks, and experiment with new ideas that respond to each day's unique situation or environment. They will not rest upon a successful transition or organizational model because they know the environment within which it flourished is fleeting. The successful nurse leaders will be those individuals who are committed to lifelong learning and problem solving.

Linear (planned) change

typically deals with predictable changes such as determining how to educate all staff on the use of a new piece of equipment.

Three Stages of Change

unfreezing, experiencing the change, refreezing

leadership

use of individual traits and abilities to interpret an emerging situation and to address the situation in the absence of a script or defined plan.

AONE Domains of the Nurse Manager

-Leader within: creating the leader in yourself -Science: managing the business -Art: leading the people

A graduate nurse is reflecting on his or her own personal values while searching for employment. What kind of organization will be the best fit for the graduate nurse? A. An organization with similar beliefs to the graduate nurse. B. An organization with a philosophy statement matching the graduate nurse's values. C. An organization with a philosophy of nursing that contrasts the graduate nurse's values. D. An organization with different beliefs that the graduate nurse, which will promote professional growth.

B. An organization with a philosophy statement matching the graduate nurse's values

Which statement is true regarding complexity theory? A. complexity theory is used to predict the health and illness trajectory of critically ill patients. B. Nurses can understand the dynamic nature of health care processes using complexity theory. C. The need for additional staff can be justified based on complexity theory. D. Complexity theory is used to explain the relationships among leading, managing, and following.

B. Nurses can understand the dynamic nature of health care processes using complexity theory.

Which best demonstrates the concept of followership? A. Completing the tasks associated with your patient assignment without deviation with the intent of receiving praise from your manager. B. Preparing for a committee meeting by reviewing the agenda and supplemental materials, so that you can be an active participant in the meeting. C. Assessing a clinical situation and following a set of guidelines in order to delegate tasks to unlicensed personnel. D. Administering medications to patients in conjunction with other nursing actions in order to make effective use of your time.

B. Preparing for a committee meeting by reviewing the agenda and supplemental materials, so that you can be an active participant in the meeting.

Which term defines a healthcare organization's reason or purpose for being, identifies its customers, and identifies the types of services offered? A. vision statement B. values statement C. mission statement D. philosophy statement

C. Mission statement

To maximize the coordination of care, provide seamless transitions, and improve quality of care, organizations are increasingly turning to which organizational structure? A. academic medical centers B. public health institutions C. accountable care organizations D. proprietary, investor-owned organizations

C. accountable care organizations

A family of five people presented to a hospital after the flooding of their urban home. These family members are classified as... -poverty victims -displaced persons -indirect victims -mass casualties

Displaced persons Rationale: Displaced persons are those who have to evacuate their home, school, or business as a result of a disaster. An indirect victim may be a family member or friend of the victim or a first responder. A mass casualty event is one in which 100 or more individuals are involved. Poverty is not considered a disaster classification.

Which statement describes trait theory? -Leaders have a certain set of characteristics that inspire others. - Leaders motivate others through the hierarchy of human needs. - Leaders attend to the needs and motives of followers. - Leaders respond to patient and organization problems differently.

Leaders have a certain set of characteristics that inspire others. Rationale: Trait theory states that leaders have a certain set of physical and emotional characteristics that inspire others. The hierarchy of needs theory states that leaders motivate other through the hierarchy of human needs. In transformational leadership, leaders attend to the needs and motives of followers. In complex adaptive leadership, leaders respond to patient and organization problems differently.

Situational-Contingency theories

Three factors are critical: 1. the degree of trust and respect between leaders and followers. 2. the task structure denoting the clarity of goals and the complexity of problems faced 3. the position power in terms of where the leader was able to reward followers and exert influence Consequently, leaders were viewed as able to adapt their style according to the presenting situation. The Vroom-Yetton model was a problem-solving approach to leadership. Path-Goal theory recognized two contingent variables: 1. the personal characteristics of followers and 2. environmental demands. On the basis of these factors, the leader sets forth clear expectations, eliminates obstacles to goal achievements, motivates and rewards staff, and increases opportunities for follower satisfaction based on effective job performance. Researchers: Fiedler, Vroom and Yetton, House and Mitchell

Role Theory

roles within organizations affect an individual's interactions with others Acquisition of these roles is time-dependent and varies based on individual experiences and value systems. For effective communication to take place, role expectations for performance must be understood by all individuals involved. -Kahn, Wolfe, Quinn, Snoek, and Rosethal

Management

the act of any individual who guides others through a series of routines, procedures, or practice guidelines.

Which describes a NA-TECH (natural technological) type of disaster? -A flood covering crops and recreational areas of a geographic area. -A terrorism attack causing major interruption of communication technologies -A tornado resulting in flood and destruction of electrical systems for a community. -A nuclear accident at a power plant causing evacuation of people in an urban community.

- A tornado... Rationale: A natech disaster is a natural disaster that creates or results in a widespread technological problem. A flood covering crops and recreational areas of a geographic area does not mention a technological problem, and a terrorism attack and a nuclear accident are not natural disasters.

Drucker's Seven Foundational Management Concepts

-management of personnel including salaries, wages, job descriptions, and objectives -decentralization as much as possible -productivity linked to scientific management -Manager development needed to ensure professional growth -use of information and data analysis in decision making -marketing services - long-range planning for future

matrix structure

An organizational structure that simultaneously groups people and resources by function and by product.

Which agency has a mission to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all? -American Red Cross -National Institute of Health -Federal Emergency Management Agency -Centers of Disease Control and Prevention

Federal Emergency Management Agency Rationale: FEMA's mission is to support citizens and first responders to ensure that as a nation everyone works together to build, sustain, and improve the capacity to prepare for, protect against, respond to, recover from, and mitigate all. The other agencies may be peripherally involved in national disasters, but it is not their primary focus.

for-profit organizations

goal is to make a profit pay investors/shareholders

The leadership role of professional nurses in the united states has evolved in the 21st century. Which factor most describes the nurse's leadership role in shaping the healthcare environment? - nurses remaining neither powerful nor political -nurses providing education to patients and families -nurses influencing health care through political action -nurses exercising power to create a strong voice for nursing.

nurses exercising power to create a strong voice for nursing Rationale: in the 21st century, nurses must exercise their power to create a strong voice for nursing in shaping an evolving healthcare environment. Nurses providing education to patients influences the patients to charge behavior to promote optimal health. in the 19th century, women were viewed as neither powerful nor political. nurses can influence health care through politics, but this is not the only way to do so.

not-for-profit organization

paying and non-paying clients reinvest in organization

Hierarchy of Needs

People are motivated by a ____, beginning with physiologic needs and then progressing to safety, social, esteem, and self-acutalizing needs. In this theory, when the need for food, water, air, and other life-sustaining elements is met, the human spirits reaches out to achieve affiliation with others, which promotes the development of self-esteem, competence, achievement, and creativity. Lower-level needs will always drive behavior before higher-level needs will be addressed -Maslow

Elements of Role Theory

Role acquisition refers to how one takes on a new role. This aspect focuses on how to perform and what is expected. Role clarity refers to distinguishing the role from that of others. This aspect of role development refers to such tasks as seeing how the role of a staff nurse in hospital A differs from the role of a staff nurse in hospital B. It can also relate to what differences exist between serving as a charge nurse as opposed to a staff nurse or nurse manager. Many people think of this aspect as a clarification of "whose job is what." Role performance relates to how the role is actually enacted. Legal and organizational parameters are established by law and the employer, but the insight of the role is derived from the individual. So, when differences of opinion arise between two staff members about what to do next or how to approach a problem, in part these differences may derive from how an individual believes he or she must perform his or her role.

Which statement describes complex adaptive leadership theory? - Leaders attend to the needs and motives of followers. - Leaders have a certain set of traits that inspire others. - Leaders motivate others through the hierarchy of human needs. - Leaders respond to patient and organization problems differently.

- Leaders respond to patient and organization problems differently. Rationale: In complex, adaptive leadership, leaders respond to patient and organization problems differently. In transformational leadership, leaders attended to the needs and motives of followers. Trait theory states that leaders have a certain set of traits that inspire others. The hierarchy of needs theory states that leaders motivate others through the hierarchy of human needs.

Nature of Change

-Is a natural social process of altering things. -Involves individuals, groups, organizations, and society. -Is constant and unavoidable. -Occurs at different speeds at both a personal and organizational level -Varies from high complexity to low complexity

Which statement is accurate regarding the difference between leading and managing? - A leader functions without the use of a predesigned plan, whereas a manager focuses on situations where the outcomes are known or preestablished. -A leader relies on control in situations with known outcomes, whereas a manager inspires trust through honest communication. - A leader imitates established protocols, whereas a manager originates new ideas to address emerging situations. - A leader administers policies adhering to processes for efficiency, whereas a manager innovates in the midst of complex, uncharted circumstances.

A leader functions without the use of a predesigned plan, whereas a manger focuses on situations where the outcomes are known or preestablished. Rationale: Leading is required when the unknown presents itself, necessitating the use of principles to improvise solutions and help others cope, thrive, and function in the situation. Managing is the ability to plan, direct, control, and evaluate others in situations where the outcomes are known or preestablished. A manger relies on control, whereas a leader inspires trust. The manager imitates, whereas the leader originates. The manager administers; the leader innovates.

Which phase of the community response to disaster includes medical personnel contributing long hours of volunteer work helping unfamiliar people after a disaster? A-Honeymoon phase B-Heroic phase C-Reconstruction phase D-Disillusionment phase

B -Heroic phase Rationale: The heroic phase of a community's reaction to a disaster involves people feeling the need to rush to help people survive the disaster. Medical personnel may volunteer to work long hours without sleep and in dangerous conditions to care for patients. During the honeymoon phase, people who have survived the disaster get together to talk about their experiences. People begin to look to the future during the reconstruction phase and during the disillusionment phase people recognize that many things are different, and much needs to be done to adjust to the current situation.

Nurses were long viewed by physicians, legislators, the media, and others as powerless because nurses... A. declined to participate in political activities in the earliest years of the profession in the United States. B. as women were subject to control by medicine and other paternalistic groups; women had limited legal rights in late 19th-centruay America. C. and nursing leaders in the mid-20th century did not wish to be viewed by those outside of nursing as pushy or demanding. D. were subject to nursing practice acts that limited their ability to take political action.

B. As women were subject to control by medicine and other paternalistic groups; women had limited legal rights in the late 19th-century America.

The nurse manager of the emergency department needs to hire a nurse for an open position. The nurse manager interviews the applicants and contacts the selected candidate to offer the open position. What organizational philosophy does this illustrate? A. Shared governance B. Selective decentralization C. Centralized decision making D. Decentralized decision making

C. Centralized decision making Rationale: Centralized decision making means that decisions are made at the top level, and the decision-making authority is vested solely in the nurse manager in this scenario. Shared governance is a process that promotes decision making and accountability for practice through empowerment and collaboration. Executives use selective decentralization, where power for decision making is concentrated in functional areas. Decentralized decision making means that decision making is diffused through the organization.

regulatory organizations

Centers for Medicare and Medicaid Services (CMS) U.S. Food and Drug Administration Occupational Health and Safety Administration Boards of Nursing state licensing authorities require quality management activities and set quality standards

Which is the purpose of the staging area in a disaster plan? A-a triage area outside the hospital, supplying first aid and transport to medical facilities. B- A stage for entertainment to cheer up disaster victims C-To provide sheltered area for displaced victims to sleep, eat, and bathe D-to act as command station for disaster responders to report to and get assignments

D Rationale: The staging area is the onsite command station. Dispatch responders should report to this area and check-in. This allows everyone to be accounted for and to gather assignments. The other options are not appropriate uses for the staging area in a disaster.

An uninsured child's family does not meet the income-related eligibility requirement to receive Medicaid, and the family cannot afford to buy private insurance. Which option might the nurse recommend? A. The child might be eligible for Medicare part D. B. The family might get less expensive care at a teaching hospital. C. The family should be directed to an Independent Practice Association (IPA) D. The child might be eligible to receive coverage through the Children's Health Insurance Plan (CHIP)

D. CHIP

A new nurse works on a busy med-surg unit. While the charge nurse keeps the unit organized and running smoothly, the nurse notices that another experienced nurse is the nurse to whom most of the other nurses ask questions and seek information. How does the new nurse view this experienced nurse? A. a formal leader B. a positional leader C. an official leader D. an informal leader

D. an informal leader

Role and Function of Management

Focus on completing the work that must be done. Self-manage and manage others. Values and respects people and incorporates integrity. Help the person develop realistic goals. Courage to know when to stand and advocate for patient, staff, or improvements in care. Serve as a change agent as well as to understand effects of role and functions

The most effective leaders help followers thrive within the healthcare organization by demonstrating which behavior? -Fostering professional growth - Guiding towards a common goal - Providing clear and concise direction -Setting the tone within the organization

Fostering professional growth Rationale: Effective followers need leaders who foster professional growth. Effective followers then influence the leader by providing intelligent and experience-driven suggestions for solutions. Guiding toward a common goal, providing clear and concise direction, and setting the tone within the organization are traditional leader behaviors but are not specific to helping effective followers thrive.

The nurse manager of a large medical-surgical unit wants to ensure brief and concise daily communication exchange that engages team members to identify any important needs or safety issues. Which strategy should the nurse manager use to communicate in this way? - Email -Huddle - Newsletter -Staff meeting

Huddle Rationale: the nurse manager of a large unit would implement the huddle as a daily brief and concise communication exchange that engages team members to identify any important needs or safety issues. Emails can become lost within the team's electronic mailboxes, not be identified as urgent or important, or may go unread. Newsletters, in either paper or electronic form, will not be identified by the team as urgent or important and there is no way to ensure that they are read. Daily staff meetings would not be feasible.

Managing Intergenerational Workforce

Millennials (18-26yo): prefer dependable manager Generation X (27-39yo): prefer supportive manager Baby Boomers (Over 40 yo): prefer supportive manager Examples of managing different generations: •maintaining an open door policy for employees (especially younger generations who desire to be heard) •focusing on each individual •being mindful of inclusion of all •individual goals/advancement •work/life balance, benefits •recognition and respect •opportunities for growth and development as well as, •providing motivational opportunities for all generational groups.

The new graduate nursing orientation program supports professional development throughout the nurse's career. Which theorist developed this approach? - Robert Kelley - Patricia Benner - Dorothea Orem - Ida Jean Orlando

Patricia Benner Rationale: Patricia Benner developed a novice-to-expert theory that addresses how nurses progress throughout their careers. Robert E. Kelley decided that the world of business needed to pay attention to followers; he stated leaders do not live and thrive without followers. Dorothea Orem places the nurse in an active, participatory role within the career and specifically holds the nurse accountable for the care needs identified as lacking. Ida Jean Orlando requires nurses to incorporate their ideas and feelings and to investigate any assumptions they have about patients.

Accrediting bodies

center for medicare and Medicaid Services The Joint Commission American Osteopathic Association

social factors

client participation health promotion customer service expectancy

The nurse manager is coaching a new graduate nurse about role performance on the clinical unit. Which types of power are effective when coaching a new employee to improve role performance? Select all that apply. -expert -position -reward -coercive -information -connection

expert, position, information Effective coaching makes use of expert power, position power, and information power. Expert power is based on expertise and credibility. The new employee needs knowledge and skills of the nurse manager to identify role performance expectations with position power. Information power stems from the nurse manager's possession of critical information needed by the new employee. Coercive power is derived from someone's perceived fear of another person and is not a positive motivating tool in coaching. in this situation, the nurse managers i the power figure; the manager is not using connection with a powerful figure. reward powers i being able to provide rewards for favor and is not illustrated in this scenario.

The key for renewal is the release of human energy and talent. Leaders know that which elements are required for renewal to occur? Select all that apply. - focused energy - staff recognition - development of trust - conflict management - personal well-being

focused energy and personal well-being Rationale: Focused energy and personal well-being are essential for the release of human energy and talent; according to Gardner, the task of renewing. Staff recognition is important and helps build confidence in the team. Developing trust in one of Gardner's tasks of leading and managing and is important to help keep staff aware of the organizational decisions and initiatives., but it is not involved in renewal. The skill of conflict management is essential for mangers to master to keep the lines of communication open and for the team to grow.

Expectancy Theory

individuals' perceived needs influence their behavior. In the work setting, this motivated behavior is increased if a person perceives a positive relationship between effort and performance. Motivated behavior is further increased if a positive relationship exists between good performance and outcomes or rewards, particularly when these are valued. -Vroom

emotional intelligence

possession of social skills, interpersonal competence, psychological maturity, and emotional awareness devoted to helping people work well together.

Complexity Theory

promotes the idea that the world is full of systems that interact and adapt through relationships. Nurses must be flexible and dynamic to be in tune with the everchanging systems of people, health care, public policy and human relationships

Transactional Leadership

leadership based on an exchange process in which followers are rewarded for good performance and punished for poor performance Advantages: motivates through rewards for desired work, monitors performance and focuses on problems, reactive to problems Effects on Followers: Fulfills the contract or gets punished, does the work and gets paid, errors are corrected in a reactive manner Effects on Organizational Outcomes: work is supervised and completed according to rules, deadlines are met, limited job satisfaction, low to stable level of commitment

Transformation Leadership

leadership that generates awareness and acceptance of a group's purpose and mission and gets employees to see beyond their own needs and self-interests for the good of the group Advantages: challenges the process, brings people together, empowers others, models the way, attends to personal things Effects on Followers: shares the vision, has increased self-worth, challenging and meaningful work, coaching and mentoring happen, feels valued Effects on Organizational Outcomes: increased loyalty, commitment, job satisfaction, morale, and performance

Transformational Theories

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. The leader is a role model who inspires followers through displayed optimism, provides intellectual stimulation, and encourages follower creativity. Bass, Bennis and Nanus, Tichy and Devanna

Bleich's Tasks of Followership

1. Demonstrate individual accountability while working within the context of organizational systems and processes; do not alter the process for personal gain or shortcuts. 2. Honor and implement care to the standards and specifications required for safe and acceptable care/service. 3. Offer knowledge, skills, and abilities to accomplish the task at hand. 4. Collaborate with leaders and managers; avoid passive-aggressive or nonassertive responses to work assignment. 5. Include evidence-based feedback as part of daily work activities as a self-guide to efficiency and effectiveness and to contribute to outcome measurement. 6. Demonstrate accountability to the team effort. 7. Take reasonable risks as an antidote for fearing change or unknown circumstances. 8. Evaluate the efficiency and effectiveness of systems and processes that affect outcomes of care/service; advocate for well-designed work. 9. Give and receive feedback to others to promote a nurturing and generative culture.

The community health nurse is working in an emergency shelter with displaced families. Which clients have risk factors for posttraumatic stress disorder (PTSD)? (Select all that apply.) A- an 18-year-old client with a previous gunshot wound. B- A 50-year-old client who saw people die in the disaster C- A 23-year-old client experiencing extreme fear D- A 60-year-old client who had little social support before the event E- A 35-year-old client with a history of schizophrenia

A, B, C, and E Rationale: Risks for PTSD include living through dangerous events or traumas; having a history of mental illness; getting hurt; seeing people hurt or killed; feeling horror, helplessness, or extreme fear; having little or no social support after the event; and dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home.

You teach a community disaster preparedness class on how to find shelter during and after a disaster situation. This is an example of what kind of prevention? A-Primary B-Secondary C-Tertiary D-Disaster

A- Primary Rationale: Primary prevention occurs in the nondisaster and predisaster stages. Actions during these stages includes developing local, state, and federal disaster plans; conducting drill tests; training volunteers and health care providers; and providing educational programs. Secondary measures are those taken after the disaster has occurred and tertiary measures are aimed at rehabilitation. Disaster prevention is a broad term covering all types.

The Affordable Care Act brought about significant and dramatic changes in health care. Which entity emerged as a mechanism to meet the challenges of value-based payment models? A. Accountable care organizations B. Proprietary organizations C. third-party payers D. voluntary agencies

A. Accountable care organizations Rationale: Accountable care organizations (ACOs) emerged as a result of the Patient Protection and Affordable Care Act of 2010 as a mechanism to meet the challenges of value-based payment models. ACOs coordinate care and chronic disease management and improve the overall quality of care provided to Medicare patients. Proprietary organizations (or for-profit organizations) operate with the specific intent of earning a profit by providing healthcare services to individuals who can afford to pay for these services. Organizations such as private or public insurers who provide healthcare insurance coverage are known as third-party payers. Voluntary agencies (or not-for-profit) organizations are controlled by voluntary boards or trustees and provide care to a mix of paying and charity patients.

What is involved in systemic thinking? A. being able to consider the "big picture" beyond the needs of your unit. B. Considering what nursing tasks need to be completed before the next medication pass. C. Focusing on the number of patients each nurse is assigned, unrelated to patient acuity. D. Refusing to come to staff meetings on your day off.

A. Being able to consider the "big picture" beyond the needs of your unit.

Which term refers to a healthcare organization's goal that is designed to identify the desired future of the organization. A. vision statement B. values statement C. mission statement D. philosophy statement

A. vision statement Rationale: a vision statement is a future-oriented, purposeful statement designed to identify the desired future of an organization. A values statement expresses the core values as part of a strategic plan. A mission statement defines a healthcare organization's reason or purpose for being, identifies its customers, and identifies the types of services offered. A philosophy statement is an explanation of the systems of beliefs that determine how a mission or a purpose is to be achieved.

Chemical warfare agents such as pulmonary agents and cyanides are classified as... A-weapons of mass destruction B- computer-based attack weapons C-recovery agents D- prevention medications

A. weapons of mass destruction Rationale: Weapons of mass destruction refer to any weapon that is designed or intended to cause death or serious bodily injury through release, dissemination, or impact of toxic or poisonous chemicals or their precursors. Chemical warfare agents are classified as nerve agents, vesicants, pulmonary agents, and cyanides.

Triple Aim in Healthcare

Access, Quality, and Cost of Care

Which healthcare organization is an institution providing general services under the ownership of the federal government and is financed as a nonprofit organization? A. Geriatric corporation B. Shriners burn hospitals C. Veterans Administration D. Academic medical center

C. Veterans Administration Rationale: Geriatric corporations provide long-term services under private ownership and are financed as nonprofits. Shriners burn hospitals are institutions providing specialty services under private ownership and are financed as nonprofits. Academic medical centers provide general services under private ownership and are financed as nonprofits.

Shared governance is the core of the philosophy of the organization. One nurse states, "With shared governance, I know the organization values my ideas, and I feel like I make a difference in the nursing practice in our organization." What does the nurse's statement illustrate? A. Power B. Centralization C. Empowerment D. Decentralization.

C. empowerment Rationale: The nurse's statement is an example of empowerment because the nurse recognizes his or her legitimate power and authority to make decisions regarding nursing practice. Power is not illustrated in the nurse's statement because the power is shared.

What element of a community disaster plan investigates the citizen's reliance on telephone systems or cell phones during disasters? A-Authority B-Logistical C-Rescue D-Communication

D. Communication Rationale: Communication is one of the biggest problems during a disaster. The reliance on telephone systems or cell phones should not be the only plan for communication during a disaster. Authority focuses on the people in charge, logistical includes focuses on storage of equipment and location of key responders, and search and rescue focuses on the search and rescue of victims.

The nurse at the disaster site is using the SMART triage system. What color triage tag would be provided to an ambulatory individual with a superficial cut on the left elbow and bruise to the right hand? A-Red B-Yellow C-Black D-Green

D. Green Rationale: Green is for the wounded or individuals with minor injuries who are able to walk and to wait several hours before receiving medical treatment. Red is for those with life-threatening injuries but have a high probability of survival, yellow is for those with systemic but non-life-threatening complications, and black is for the deceased or those with nonsurvivable injuries.

the spectrum of care services usually provided by a healthcare network include primary care, secondary care, and tertiary care. which is an example of secondary care? A. rehabilitation B. Health maintenance C. entry into a system D. prevention of disease complications

D. Prevention of disease complications Rationale: Prevention of disease complications is an example of the secondary type of care. Service organizations providing secondary care include home health care, ambulatory care centers, and nursing centers. Health maintenance and entry into a system are examples of primary care. Rehabilitation and long-term care are examples of tertiary care.

A new graduate nurse is considering employment opportunities. He wants to make sure he works for an organization with beliefs regarding nurse similar to his own for good work fit. What document would NOT provide him information to help him make his decision? A. organizational mission B. nursing philosophy C. organizational chart D. product line

D. product line Rationale: an organizations' culture is reflected in its mission statement. A philosophy of nursing describes the organization's beliefs about nursing, health, and patients. A review of the organizational chart typically demonstrates the level of empowerment and independence of nurses within the organizational structure focused on a specific service.

"Power in nursing" refers to the nurse's ability to: A. protest unfair working conditions through walkouts and strikes. B. demonstrate knowledge about organizational behavior. C. act on issues that influence nursing licensure but not patient care. D. use one's influence to create change in pursuit of goals

D. use one's influence to create change in pursuit of goals.