chapter 10

A staff nurse is talking with a clinical nurse leader and asks, "What exactly do you do?" Which statement by the clinical nurse leader wouid be appropriate?

"I collaborate with health care teams to promote client care."

Before the RN delegates any nursing intervention they must consider 5 factors

(1) stability of the patient's condition (2) complexity of the activity (3) potential for harm (4) predictability of the outcome (5) other patient needs

what are the characteristics of a magnet facility?

- decentralized-decision making - self-governance at the unit level - respect and acknowledgement of autonomous practice

what do the 14 characteristics, Forces of Magnetism identify?

- quality patient care - excellent nursing care - innovations in nursing

what is are the 5 roles of management? *POSDC*

1. plan 2. organizing 3. staffing 4. directing 5. controlling

what are the new 5 model components of a magnet facility?

1.Transformational leadership 2.Structural empowerment 3.Exemplary professional practice 4.New knowledge, innovation, and improvements 5.Empirical quality results

how long is magnet status retained for?

4 years, then the hospital reapplies

As professionals, nurses generally respond well to this style of leadership?

Democratic leadership

This leadership is most effective when all staff are clinical experts with a deep understanding of both clinical and administrative processes?

Laissez-faire

This leadership is used when a leader wants the problem to be solved completely by team members

Laissez-faire

A nurse manager is changing the policy for scheduling staff on a critical care unit. The schedules will be changed and an announcement was made regarding this to the staff. Based on Lewin's change theory, in what stage of change is the manager participating?

Moving

What does PEARLA stand for?

P - presence E - empathy A - acknowledgement R - reflect L - listen A - ask questions

what is a powerful tool used for conflict engagement?

PEARLA

A nurse is using time management techniques when planning activities for patients. Which nursing action reflects effective time management? a. The nurse asks patients to prioritize what they want to accomplish each day b. The nurse includes a "nice to do" for every "need to do" task on the list c. The nurse "front-loads" the schedule with "must-do" priorities d. The nurse avoids helping other nurses if scheduling does not permit it

a

A nurse who is newly hired to manage a busy pediatric office is encouraged to use a transactional leadership style when dealing with subordinates. Which activities best exemplify the use of this type of leadership? Select all that apply. a.The manager institutes a reward program for employees who meet goals and work deadlines. b.The manager encourages the other nurses to participate in health care reform by joining nursing organizations. c.The manager promotes compliance by reminding subordinates that they have a good salary and working conditions. d.The manager makes sure all the employees are kept abreast of new developments in pediatric nursing. e.The manager works with subordinates to accomplish all the nursing tasks and goals for the day. f.The manager allows the other nurses to set their own schedules and perform nursing care as they see fit.

a, c

A nurse is a servant leader working in an economically depressed community to set up a free mobile health clinic for the residents. Which actions by the leader BEST exemplify a key practice of servant leaders? Select all that apply a. The nurse motivates coworkers to solicit funding to set up the clinic. b. The nurse sets only realistic goals that are present oriented and easily achieved. c. The nurse forms an autocratic governing body to keep the project on track. d. The nurse spends time with supporters to help them grow in their roles. e. The nurse first ensures that other's lowest priority needs are served. f. The nurse prizes leadership because of the need to serve others.

a, d, f

conflict engagement

address conflict in the workplace (rather than avoiding conflict)

laissez-faire leadership

allows the group to function more or less on its own

After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to:

assess whether the desired results have occurred.

A charge nurse in a busy hospital manages a skilled nursing unit using an autocratic style of leadership. Which leadership tasks BEST represent this style of leadership? Select all that apply. a.The charge nurse polls the other nurses for input on nursing protocols. b.The charge nurse dictates break schedules for the other nurses. c.The charge nurse schedules a mandatory in-service training on new equipment. d.The charge nurse allows the other nurses to divide up nursing tasks. e.The charge nurse delegates nursing responsibilities to the staff. f.The charge nurse encourages the nurses to work independently.

b, c, e

when the manager is implementing mechanisms for ongoing evaluation they are fulfilling which role?

controlling

A nurse is asked to act as a mentor to a new nurse. Which nursing action is related to this process? a. The nurse mentor accepts payment to introduce the new nurse to his or her responsibilities b. The nurse mentor hires the new nurse and assigns duties related to the position d. The nurse mentor makes it possible for the new nurse to participate in professional organizations e. The nurse mentor advises and assists the new nurse to adjust to the work environment of a busy emergency department

d

A nurse manager of a busy cardiac unit observes disagreements between the RNs and the LPNs related to schedules and nursing responsibilities. At a staff meeting, the manager compliments all the nurses on a job well done and points out that expected goals and outcomes for the month have been met. The nurse concludes the meeting without addressing the disagreements between the two groups of nurses. Which conflict resolution strategy is being employed by this manager? a.Collaborating b.Competing c.Compromising d.Smoothing

d, resolves conflict by complimenting the parties involved and focusing on agreement rather than disagreement is using smoothing to reduce the emotion in the conflict

A nurse manager values group satisfaction and tries to motivate the staff to be the best nurses possible. In which style of leadership is the group satisfaction and motivation the primary benefit?

democratic

when the manager is leading others in achieving goals within the constraints of the current fiscal and workforce shortage scenarios they are fulfilling which role? (toughest role)

directing

which situations require autocratic leadership?

emergency situations

democratic leadership

equality between the leader and followers

autocratic leadership

leadership style in which the leader assumes complete control over the decisions and activities of the group

quantum leadership

leadership that moves beyond the traditional modes

transactional leadership

maintaining control by rewarding good behavior and punishing negative or detrimental behavior

do transactional leaders inspire nurses to participate?

no, transactional leaders minimize employees thinking and involvement

In a centralized management structure who makes decisions?

senior managers

which situations is democratic leadership not good for?

situations where a rapid response is needed because democratic takes long

when the manager is hiring, orienting, scheduling to facilitate team building they are fulfilling which role?

staffing

In a decentralized management structure who makes the decisions?

those who are most knowledgeable

delegation

transfer of responsibility while retaining accountability for the outcome

this type of leadership pushed a hospital to achieve magnet status

transformational leadership

what are the 3 stages of change?

unfreezing: change is recognized moving: change is initiated refreezing: change is operational

Quantum leadership is effective for which scenarios?

unpredictable events and changing environments present themselves

conflict management

work through conflicts in a way that minimizes negative effects and promotes positive consequences

magnet status facilities do what?

attract and retain well-qualified nurses who promote quality patient care

decentralized decision-making process

autonomous, accountable professional nursing practice; a characteristic of a democratic leadership style and the heart of a self-governance model of unit organization

A new nurse manager at a small hospital is interested in achieving Magnet status. Which action would help the hospital to achieve this goal? a. Centralizing the decision-making process b. Promoting self-governance at the unit level c. Deterring professional autonomy to promote teamwork d. Promoting evidence-based practice over innovative nursing practice

b

A nurse manager who is attempting to institute the SBAR process to communicate with health care providers and transfer patient information to other nurses is meeting staff resistance to the change. Which action would be most effective in approaching this resistance? a.Containing the anxiety in a small group and moving forward with the initiative b.Explaining the change and listing the advantages to the person and the organization c.Reprimanding those who oppose the new initiative and praising those who willingly accept the change d.Introducing the change quickly and involving the staff in the implementation of the change

b

when a manager is acquiring, managing, and mobilizing resources to meet both clinical and financial objectives what role are they fulfilling?

organizing

A nurse manager reviews an employee's contribution to the nursing division annually. This process is:

performance appraisal.

transformational leadership

person creates revolutionary change and commits to the personal and professional growth of self and others

implied power

power obtained by force of a person's personality

explicit power

power obtained by virtue of a person's position

organizations use transactional leadership to

recognize employees' progress in meeting pre-established goals and work deadlines.

A nurse manager is attempting to update a health care provider's office from paper to electronic health records (EHR) by using the eight-step process for planned change. Place the following actions in the order in which they should be initiated: a. The nurse devises a plan to switch to EHR. b. The nurse records the time spent on written records versus EHR. c. The nurse attains approval from management for new computers. d. The nurse analyzes all options for converting to EHR. e. The nurse installs new computers and provides an in-service for the staff. f. The nurse explores possible barriers to changing to EHR. g. The nurse follows up with the staff to check compliance with the new system. h. The nurse evaluates the effects of changing to EHR.

b, f, d, c, a, e, h, g

An RN on a surgical unit is behind schedule administering medications. Which of the RN's other tasks can be safely delegated to a UAP? a. The assessment of a patient who has just arrived on unit b. Teaching a patient with newly diagnosed diabetes about foot care c. Documentation of a patient's I & O on the flow chart d. Helping a patient who has recently undergone surgery out of bed for the first time

c What they can delegate are assistance with basic care activities (bathing, grooming, ambulation, feeding) and things like taking vital signs, measuring intake and output, weighing, simple dressing changes, transfers, and post mortem care.

When a manager identifies problems, developing goals, objectives, and related strategies to meet the demands of the clinical site they are in what role?

planning