Ch, 10 leading, managing and delegating
The nurses who provide care on a medical unit are skeptical about the planned change from a traditional opioid 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.
The nurse has just graduated with a bachelor of science degree in nursing and is eager to find a mentor at this early stage in her career which of the following individuals is most likely to be an appropriate mentor for the nurse
An experienced nurse who was a preceptor in a previous clinical placement
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
what is a general rule RN should not delegate
Assessment planning evolution steps of the nursing process
which of the following nursing care tasks is acceptable for a graduate nurse to delegate to unlicensed assistive personnel (UAP)
Assisting a client with ambulation
A nurse manager makes all the decisions for staff activities what type of leader ship is demonstrated by this action
Autocratic
A nurse strives to establish trusting interpersonal relationships with clients, peers, subordinance, and superiors to facilitate call achievement and personal growth of all participants which type of skills is this nurse demonstrating
Communication skills
What type of leader shares decisions and activities with group participants
Democratic
which of the following tasks could the nurse safely delegate to unlicensed assistive personnel
Documentation of client's I&O on a flow sheet
planned change #7
Evaluate the effects of change by comparing them with objectives stated in the plan for change
A nurse can delegate the initial or ongoing assessment of the patient to an unlicensed assistant as long as the primary nurse reviews the documentation within 24 hours.
False
According to Lewin's change theory, the process of initiating change after a careful process of planning is known as "unfreezing."
False
Transactional leadership theory views an organization and its members as interconnected and collaborative.
False
A senior student has been elected president of the student nurses association which of the following qualities is essential to being a nursing leader
Flexibility
planned change #2
Identify a problem to be solved through change. Analyze the symptoms and reach a conclusion. Note resistance to barriers to change
the nursing student is working to improve his time management. which of the following would assist the nursing student to accomplish his goal
Identify priorities for the day Evaluate time management at the end of the day Establish a reasonable time line
planned change #6
Implement the selected course of action to effect change.
Explicit power refers to power vested in the position (e.g., unit manager), whereas __________ power refers to the power to influence as a leader.
Implied
Which attributes should be characteristic of a nurse mentor? Select all that apply.
Is supportive Is resourceful Demonstrates leadership abilities Is an experienced, licensed professional
A head nurse assumes the leadership role when directing and supervising coworkers. which of the following are attributes of a leader
Philosophical charismatic dynamic
conflict management and engagement PEARLA approach
Presence Empathy Acknowledgement Reflect or Reframe Listen openly Ask questions
Which type of skills is not needed for nursing leader ship
Technical skills
The registered nurse (RN) has received orders to perform an unsafe practice on a client. The RN voices concern with the physician who gave the order, but the physician refuses to change the order. Whom should the nurse consult next regarding the order?
The charge nurse
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 Lewin's classic theory of change, what happens during unfreezing
The need for change is recognized
A nurse leader is described as charismatic motivational and passionate communications are open and honest and the nurse is willing to take risks what type of leader ship is the nurse practicing
Transformational
planned change is purposeful, systematic effort to alter or bring about change, what occurs next after alternative solutions to a problem are determined and analyzed
a course of action is chosen is chosen from among the alternatives
A nurse is described as a "quantum leader" which action characterizes this type of leadership
a nurse conducts a blind survey to evaluate her leadership skills
what is conflict management
a process to work through conflicts in a way that minimizes negative effects and promotes positive consequences
what is planned change
a purposeful, systematic effort to bring about change through intervention
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?
administering a dose of digoxin 2 hours behind schedule
A nurse working on leadership skills should keep in mind which of the following accurate statements regarding leaders
all nurse leaders began as inexperienced nurses
what can the RN delegate to the UAP
assistance with basic care activities bathing grooming ambulation feeding vital signs measuring intake and output weighing simple dressing changes transfers post mortem care
Autocratic leadership involves the leader
assuming complete control over the decisions and activities of the group.
what is the significance of magnet recognition
attract and retain top talent improve care, safety, and satisfaction foster a collaborative culture advance nursing standards and practice
Directive or authoritarian leadership, also known as _______________ leadership, involves the leader assuming control over the decisions and activities of a group.
autocratic
The nurse is caring for a client who had a sudden episode of vomiting, which produced 900 mL of frank blood. The nurse directed and delegated to colleagues in order to notify the physician. She started intravenous fluids, and provided physical and emotional support for the client. Different situations call for different leadership styles. Which of the following leadership styles did the nurse display in this situation
autocratic
In general, how do most people view change
by how they are affected personally
The process of transforming or modifying something
change
change theory refreezing
change becomes operational
change theory moving
change that is initiated after a careful process of planning
Transformational leaders are often described described as
charismatic, challenging, and passionate about their vision. They communicate openly and honestly, show concern for others, and are willing to take risks.
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
A nurse believes in listening to clients and coworkers more than talking to them, allowing more personal control for all involved. This is a quality of which of the following managerial mindsets
collaborative
What are the four basic types of skills needed for nursing leader ship
communication problem solving management self evaluation
Magnet® status recognizes an institution for creating an environment that supports three approaches toward nursing services: self-governance at the unit level, acknowledgment of professional autonomy, and a ______________ decision-making process.
decentralized
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 nurse who transfers responsibility for the performance of an activity to another nurse, while retaining accountability for the outcome, is using the process of _______________ nursing care
delegating
what type of leadership can a graduate nurse working in a magnet hospital expect
democratic
planned change #3
determine and analyze alternative solutions to problems
There is a perception in a long-term care facility that the older adult residents are experiencing falls more often than in the past an audit of incident reports has confirmed this and the nursing leader ship has recognized the need to make changes to reduce the incidence of falls how should the leaders proceed with this planned change place the following steps in the correct order
determine and analyze different solutions to the problem choose a new protocol that is likely to reduce falls develop a plan for implementing the change Implement the change in nursing practice take measures to ensure that nursing practice does not revert
During a staff meeting, the nurse is discussing new quantum leadership. The nurse explains that in this type of leadership change is viewed as which of the following
dynamic and constantly unfolding
To adequately direct client care and maintain effective decision making, the nurse manager requires knowledge of what?
economics
The nurse is having an exceptionally busy shift on an obstetrical unit. which of the following tasks is the nurse justified in delegating to an unlicensed care provider
emptying a clients foley catheter bag and reporting the volume to the nurse
A nurse manager has encountered resistance to a planned change. what is one way the nurse can overcome the resistance
encourage open communication and feedback
The nurse is a manager on an orthopedic unit. The unit changed to a new computer documentation system three days ago. One of the night nurses has called in sick every shift since the new system started. The nursing manager is aware that this situation has to do with resistance to change. which of the following are common reasons why people resist change
feel threatened fear increased responsibility lack of understanding see no benefits to the change
conflict resolution compromising
for this technique to be effective, both patient must be willing to relinquish something of equal value
a nurse manager has directed a registered nurse who is out of school for one year to become a member of the institution's policy and procedure committee. A goal in the nurse manager's delegation is to assist the nurse to what
grow in her profession
What are the tasks that should be performed by a registered nurse
initial and ongoing assessments diagnosis plan of care evaluation of client progress supervision and education evaluation of nursing care delivered to the patient
a nurse is considering the delegation of administering medications to an unskilled assistant. what is the first question the nurse must ask herself before doing so
is the delegated task permitted by law
which of the following is a characteristic of mentorship
it is a link to a protege with common interests
The ANA which is committed to monitoring the regulation, education, and use of NAPs recommends adherence to which one of the following principles
it is the nursing profession that determines the scope of nursing practice.
A leader who relinquishes power to the group in such a way that an outsider could not identify the leader is said to be practicing ________________ leadership.
laissez-faire
Nurse managers must have
leadership qualities delegation skills flexible knowledgeable
what is transactional leadership
leadership style based on maintaining control by rewarding good behavior and punishing negative or detrimental behavior
laissez-faire leadership
leadership style in which the leader relinquishes all power to the group
which of the following statements accurately describes recommended guidelines for overcoming resistance to change
list the advantages of the proposed change for members of the group if possible, introduce change gradually
A student nurse has just graduated with a baccalaureate degree in nursing. what type of nursing leadership will this nurse be expected to provide
nursing care of the individual client
A nurse manager tells the staff that they need to increase response time to client requests by five minutes, beginning tomorrow. The time to begin this activity has been established by the manager and the staff. This action involves goal setting. What leadership style is noted with the implementation of goal setting?
participative leadership
Democratic leadership is also called
participative leadership, it is characterized by equality among the leader and other participants. decisions and activities are shared
planned change #5
plan for making the change
what is implied power
power obtained by force of a person's personality that might enable that person to have more power to influence others than designated leaders
What is explicit power
power obtained by virtue of a person's position
what should the RN consider before delegating care
qualifications & capabilities stability of patient complexity of activity potential for harm predictability of the outcome patient needs
Planned change: an 8 step process #1
recognize symptoms that indicate a change is needed and collect data
planned change #4
select a course of action for possible alternatives
Nurses with varying levels of experience possess leadership skills. A graduate nurse walks out of the nurse manager's office after a meeting. The graduate nurse reflects on the positive and negative feedback that she received from the manager regarding her three months working on the unit. What nursing leadership skill is best illustrated by the graduate nurse in this scenario? A) Self-evaluation skills B) Communication skills C) Problem-solving skills D) Management skills
self evaluation skills
In which of the following conflict resolution strategies is the conflict rarely resolved
smoothing
what technique involves complimenting all parties in an attempt to prevent emotional outbursts and focus on agreement
smoothing approach
planned change #8
stabalize the change
what is conflict engagement
teaches skills to help nurses perform well in the face of conflict instead of finding a work-around to avoid conflict
when comparing team nursing with functional nursing, what characteristics is found
team nursing focuses on individual client care.
The scope of practice of the RN is governed by
the board of registered nurses
change theory unfreezing
the need for change is recognized
conflict resolution strategies avoiding
there is awareness of the conflict situation, but the patient involved decide to either ignore the conflict, or avoid, or postpone its resolution
which of the following statements accurately describes the use of power by change agents
they are often accomplished professional women
conflict resolution collaborating
this is a joint effort to resolve the conflict with a win-win solution, all parties set aside previously determined goals, determine a priority goal
Magnet® status recognizes an institution for creating an environment that supports three approaches toward nursing services: self-governance at the unit level, acknowledgment of professional autonomy, and a decision-making process.
true
what is transformational leadership
type of leadership in which the person creates revolutionary change and commits to the personal and professional growth of self and others
A nurse is attempting to change the method for documenting client care in a hospital setting. which of the following should be considered before planning change
what is amenable to change how does the group function as a unit is the group ready for change are the changes major or minor