Ch. 10 Coursepoint- Leadership, Managing and Delegating
A nurse is part of a group working at an acute care facility. The group wants to implement strategies toward achieving magnet status for the facility. When describing their plan to the organization, which information would they include as a benefit to the organization? Select all that apply.
-Collaborative practice -Improved client safety -Retention of highly talented individuals -Financial growth of the organization
Which nurse leader most clearly exemplifies transformational leadership?
A leader who is dynamic and inspiring and promotes change by the power of the leader's convictions
The nurse has recently been promoted to nurse manager on an oncology unit and has decided to be the sole decision maker regarding issues that concern the unit. Which type of leadership style is the nurse embodying?
Autocratic
A nurse manager of a hospital unit is working within a decentralized management structure. Which nursing action best exemplifies this type of system?
Decisions are made by those who are most knowledgeable about the issue.
A nurse can improve one's skill with time management by taking which action?
Evaluating success with accomplishment of goals in client care
Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses?
Laissez-faire
The nurse manager notices a trend in nurses routinely arriving to work late. How can the nurse use the transactional leadership style to get nurses to arrive to work on time?
Monitor time clock reports on a monthly basis and enter all nurses who have not been tardy into a raffle for a paid day vacation.
The nurse and unlicensed assistive personnel (UAP) are working together to admit a client newly diagnosed with diabetes to a nursing unit. Which task would be inappropriate to delegate to the UAP?
Monitoring insulin requirements
The case manager works in a facility that supports a participative leadership style. Which action should the nurse recognize as an example of democratic leadership style?
The interdisciplinary health care team collectively developing plans of care for clients
The registered nurse (RN) wants to delegate a task to an unlicensed assistive personnel (UAP) but is unsure if the task can be delegated. What is the best resource for the RN to use in determining if the task is appropriate?
The nurse practice act or facility's policy and procedures
After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to:
assess whether the desired results have occurred.
The primary responsibility of the nurse manager is to:
create unit plans and budgets.
A nurse is successful in promoting change on the nursing division. This nurse would be considered a:
leader
The nurses who provide care on a medical unit are skeptical about the planned change from a traditional narcotic cupboard to a computerized medical supply and management system. Which statement best demonstrates mistrust about the benefits of this proposed change?
"I've heard those machines don't even cut down on medication errors like they say they do."
Which are examples of personal leadership skills necessary for nurse leaders? Select all that apply.
-Communication -Problem solving -Self-evaluation
Which attributes should be characteristic of a nurse mentor? Select all that apply.
-Is an experienced, licensed professional -Is supportive -Is resourceful -Demonstrates leadership abilities
Two nurse managers working on different units in a hospital are planning for a major change to occur on both units. One nurse manager reports to the other having identified a key power player on the unit. Which description most applies to a key power player in this context?
A regular employee who is a natural leader
The new nurse is evaluating the effectiveness of the assigned nurse mentor. Which characteristic should the new nurse recognize as being inappropriate for the nurse mentor to role model?
Advising the new nurse to consult the nurse mentor before making decisions regarding client care
On a medical unit, the nurses complain that they have no voice in the decisions that are made in the operation of the unit. The nurses state they are always told by the nurse manager to perform tasks instead of being asked. Which of these best describes the leadership style of the nurse manager?
Autocratic
The nurse is working at a facility that is applying for Magnet® Recognition. The nurse knows that compared with other hospitals, Magnet® hospitals have which direct effect on client care?
Better patient outcomes
Two staff nurses on a unit disagree with one another over certain key aspects of providing client care. The nurse manager of the unit arranges a meeting with the charge nurse and the two staff nurses at a mutually agreed-upon time to discuss this situation. This activity is mostaccurately described as what?
Conflict resolution
Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status?
Staff nurses are developing innovative solutions to problems.
A charge nurse on a medical-surgical unit is asked by the nurse manager to serve as a mentor to another staff nurse who is less experienced. Which of these would best describe this role?
The charge nurse is providing support for the staff nurse in new responsibilities.
A nurse manager is educating the staff on new forms of charting. Within the education session, the manager sets a goal for complete use of the charting. Through goal setting, the manager is acting as:
a leader
The new nurse is having difficulty managing the time required to care for a group of complex clients and is several hours behind in completing nursing interventions. Which intervention should the nurse complete first?
Administer a dose of digoxin that is two hours behind schedule.
A nurse is in charge of a large group of employees on a busy surgical floor. Today's care must be completed early due to a special event involving most of the employees. Which management style would work best in this situation?
Authoritarian
Two new nurses are requesting the same preceptor for unit orientation and say they will be unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using an accommodating approach to conflict resolution?
The nurses agree for one nurse to obtain the preceptor for orientation in exchange for that nurse working each weekend.
A nurse leader is working with a client with hypertension who needs to learn about a low-sodium diet. The nurse recognizes that the client is in the unfreezing stage of Lewin's Change theory with which client statement?
"I understand why I need to eat a low-sodium diet."
The nurse and unlicensed assistive personnel (UAP) are working together in the emergency room. Which task should the nurse avoid delegating to the UAP?
Assessing a rash on the arm
A client is received into the emergency department after getting shot in the chest. The client is hemorrhaging profusely and is in hypovolemic shock. The nurse calls a code blue. What type of leadership style will be most effective during the management of the code?
Autocratic leadership
The proficient nurse wants to become a more effective leader. Which step would be mostappropriate for the nurse to take to achieve this goal?
Promote a healthy work environment and become a nurse mentor.
The nurse is advising a client about health problems related to being overweight. The client acknowledges the need to lose weight. The nurse provides education on how to count calories in food and the importance of daily exercise. The client states an intention to begin counting calories with the next meal. The client also states an intention to begin an exercise program with friends. Which statement associated with this scenario illustrates Lewin's stage of unfreezing?
The client acknowledges the need to lose weight.
In a nursing unit, the RN delegates nursing tasks to the nursing assistant. Keeping in mind the delegation guidelines, which statement denotes the right communication for the nursing assistant?
"Dispose of the disconnected IV set."
Two nurses have requested that the nurse manager allow them to plan in-service education with creative, new education techniques. Which leadership style would be best for the nurse manager to use to get the new project completed?
Laissez-faire
A nurse aspires to work independently in obstetrics and gynecology in a rural, impoverished setting. Which advanced practice role would be most suitable for this nurse?
Nurse midwife
A nurse manager has asked the staff to create a plan to improve patient outcomes. In the past, the staff have not met deadlines. How can the nurse manager use transactional leadership style to ensure that the deadline is met?
Offer 2 days of paid vacation.
Which statement by a registered nurse (RN) represents appropriate delegation to a nursing assistant?
"Dispose of the disconnected IV set."
Two nurses are having a disagreement over who will take the next admission to the unit. The nurse manager asks one of the nurses to take the admission and explains that this will be considered a personal favor. Which style of conflict resolution did the nurse manager display?
Accommodating
The chief nursing officer (CNO) wants to encourage nurses in the hospital to become clinical nurse leaders (CNL) and is reviewing a roster of nurses working on the medical-surgical unit. Which nurse should the CNO recognize as being qualified to take the CNL examination?
An RN with an MSN who is a nurse manager, has 7 years of nursing experience, is supportive, and is engaged in community service activities
The nurse is delegating care to an unlicensed assistive personnel (UAP). Which intervention would be most important for the nurse to perform independently?
Assess the client with difficulty breathing
To adequately direct client care and maintain effective decision making, the nurse manager requires knowledge of what?
Economics
A nurse leader on a unit allows the staff to make all decisions and direct themselves, including filling out the work schedule. The nurse leader is practicing which leadership style?
Laissez-faire
A nurse is caring for a client with pneumonia. Which task is most appropriate for the nurse to delegate to an experienced unlicensed assistive personnel (UAP)?
Obtaining vital signs every 4 hours
The nurse manager for a surgical unit is planning a significant change in how the unit functions. Which action by the nurse manager would be most effective in helping overcome resistance to the planned change?
Provide incentives for adopting the change, such as time off.
The nurse manager of a medical-surgical unit is planning to make changes, because the unit is understaffed. What is the first action the manager takes to plan the change for the unit?
Recognize the symptoms that indicate a change is needed and collect data
The nurse manager is aware that nurses in the operating room are concerned about a proposed change in their working hours. Which is the nurse manager's best approach to addressing this problem and the nurses?
Relate the proposed change to the group's existing beliefs and values.
A nurse manager best demonstrates effective leadership characteristic by which action?
Sharing a vision for the unit and enlisting support
The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task?
The stability of the patient's condition, potential for harm, and complexity of the activity
A staff nurse is talking with a clinical nurse leader and asks, "What exactly do you do?" Which statement by the clinical nurse leader would be appropriate?
"I collaborate with health care teams to promote client care."
A registered nurse is delegating activities to unlicensed assistive personnel (UAP) on a hospital unit. Which activities could this nurse normally delegate? Select all that apply.
-Taking routine vital signs -Giving a bed bath to a client -Transferring a client to another floor
The nurse is conducting an in-serve on change theories. Which example should the nurse include in the presentation illustrating Lewin's three stages of change?
A need for a safer intravenous therapy pump is identified. New intravenous therapy pumps are purchased and training for staff nurses is provided. Intravenous therapy pumps are placed on the nursing unit for client care.
The nurse manager calls a staff into a unit meeting to discuss patient satisfaction. During the meeting, several staff members assume control. The nurse manager does not intervene to regain control of the group. Which type of leadership style is the nurse embodying?
Laissez-faire
The charge nurse on a postoperative surgical unit is responsible for making client assignments for staff nurses. Two staff nurses have voiced not wanting to assume care for any new postoperative surgical clients during their shifts. How can the charge nurse resolve this conflict using the strategy of compromise to address the immediate concerns of the two staff nurses?
Approach both nurses to discuss incentives that can be given for agreeing to accept new postoperative surgical clients.
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
The nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and physicians is exhibiting what style of leadership?
Democratic
The registered nurse (RN) and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate for the RN to delegate to the UAP?
Initiating intravenous therapy
A registered nurse serves as the chair of the Nursing Practice Committee for the hospital. The meetings of this committee do not have a planned agenda; members of the committee who are interested in a particular topic feel free to suggest it and then to lead the subsequent discussion. This chair's leadership style could be most accurately termed what?
Laissez-faire
The nurse recognizes that a new mother is having difficulty breastfeeding. The nurse demonstrates various positions in which to hold the baby while feeding. The nurse also educates the mother on ways to ensure proper latching. The new mother attempts to breastfeed the baby again using the new techniques and is successful. Which statement in this scenario illustrates Lewin's stage of refreezing?
The new mother attempts to breastfeed the baby again using the new techniques and is successful.
Following a myocardial infarction (heart attack), a client begins to recognize the need to increase exercise, eat a low-fat diet, and implement relaxation techniques. According to Lewin, this client is in which stage of the change process?
Unfreezing
A nurse manager reviews an employee's contribution to the nursing division annually. This process is:
performance appraisal.
An inner-city hospital is seeing a declining client census. The nurse managers begin to strategically plan to determine ways to increase their client population. In the implementation of these strategies, they also evaluate their success and failure and renew their plan. This activity is:
problem solving.
The nurse is working to enhance time management skills and has to administer pain medications to several patients, obtain vital signs, and assist clients with bathing. What should the nurse do next?
Delegate bathing and vital signs tasks.
A staff nurse works on a medical unit where staff retention is very high. There is a sense of equality between the leader and the staff nurses. The unit decisions and activities are shared between the leader and the group. The designated nurse leader practices which leadership style?
Democratic
The nurse manager is concerned about the large number of teenage mothers being seen in the obstetrics clinic. How can the nurse manager use the transformational leadership style to address the concern?
Enlist volunteers to help develop a community outreach project that will educate teenagers on methods to prevent pregnancy.
A nurse manager is trying to resolve a conflict between the day and night shifts. The nurse manager wants to convince the involved persons to set aside their differences, determine a priority common goal having to do with improved client care, and accept mutual responsibility for achieving this goal. The nurse manager is using which type of conflict resolution?
Collaborating
The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which conflict resolution style does the nurse manager display?
Collaborating
The charge nurse on the orthopedic unit believes in giving the staff as much power as possible. The nurses are allowed, among other things, to create their own work schedules, provide dates and times for unit meetings, and create the agendas, to which the charge nurse contributes. The charge nurse's style of leadership can be described as which?
Laissez-faire
The home health nurse is caring for a noncompliant client who has been diagnosed with type 2 diabetes. Which nursing interventions would be effective in helping the client change behaviors? Select all that apply.
-Encourage participation in a diabetes support group. -Include the client in creating a list of benefits for exercising. -Set short-term goals for modifying eating habits.
Conflict has emerged on a nursing unit because new graduates have found that some of the more experienced nurses are manipulating the client assignment to ensure a lighter workload during night shifts. How should the manager of the unit best address this conflict?
Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible.
