Chapter 10: Leadership, Managing and Delegating (SAMPLE QUIZ)
A typical day for the nurse manager includes the time she spends with other nurses, client, physicians, and ancillary staff. The most important skill she must have is the ability to A. Provide direct client care B. Maintain the unit's budget C. Communicate with all groups D. Plan for the future
C Explanation: Communication, a prerequisite to problem solving, is one of the fundamental skills of management.
A nursing facility has recently implemented new policies regarding nurse-to-patient ratios. The nursing staff seems very resistant to the change. How can the nurse manager help the staff accept the change? Institute the changes immediately and collectively to decrease anticipation anxiety. Use the laissez-faire leadership style to address staff concerns. Challenge staff's beliefs and values regarding providing quality patient care. Hold a unit meeting to discuss how the changes will benefit staff.
Hold a unit meeting to discuss how the changes will benefit staff. Explanation: Holding meetings allows open communication and opportunities for feedback. Listing the benefits of change to the individual and group also helps with buy-in. Laissez-faire leadership styles tend to increase conflicts and anxiety during times of change. Challenging staff beliefs will increase anxiety and create unpleasant work environments. Change should be instituted gradually, if possible. Reference: Chapter 10: Leadership, Managing and Delegating - Page 225
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? Quantum Autocratic Laissez-faire Democratic
Laissez-faire
A nurse manager best demonstrates effective leadership characteristic by which action?
Sharing a vision for the unit and enlisting support Explanation: The nurse leader on a nursing unit should have a vision for the unit and be able to share this with the staff in order to enlist support and cooperation among the staff. The nurse leader should already be a role model, rather than just demonstrating interest. This would be related more to someone who was developing leadership qualities. The nurse leader should be flexible, not rigid, and does not have to know all information about the unit; rather, the nurse leader needs to know what resources are available among the staff and other leadership in helping reach expected goals and outcomes. Reference: Chapter 10: Leadership, Managing and Delegating - Page 215
The nurse has recently been promoted to nurse manager on a pediatric unit and has decided to accept input from staff regarding changes they would like to see on the unit. Which type of leadership style is the nurse embodying? A. Democratic B. Quantum C. Laissez-faire D. Autocratic
A Explanation: Democratic leadership style involves sharing the decision making process and activities with others who have an interest. Autocratic leadership style involves assuming control over the decisions and activities of the group. Laissez-faire leadership style involves the leader relinquishing power or control to the group. Quantum leadership style involves seeing an organization and members as interconnected and collaborative. This style involves change as continually unfolding, and frequently incorporates technology. Reference: Chapter 10: Leadership, Managing and Delegating - Page 218 Add
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? A. "I'm an advanced practice nurse with a specific specialty area." B. "I collaborate with health care teams to promote client care." C. "I'm an administrator involved with client care." D. "My position is one of management."
B Explanation: A clinical nurse leader is a master's-prepared nurse who has earned the certified CNL credential and works collaboratively with the health care team to facilitate, coordinate, and oversee care provided to clients. This role is not considered an administrative or management role, but rather one of leadership in all health care settings. Clinical nurse specialists are advanced practice nurses with specialist education in a defined area of practice. Chapter 10: Leadership, Managing and Delegating - Page 227
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? Avoiding Competing Smoothing Collaborating
Collaborating Explanation: With the collaborating approach to conflict resolution, there is a joint effort to resolve the conflict with a win-win solution. All parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. With avoiding there is awareness of the conflict situation, but the parties involved decide to either ignore the conflict or avoid or postpone its resolution. Competing is an approach that results in a win for one party at the expense of the other. Smoothing is an effort to complement the other party and focus on agreement rather than disagreement, thus reducing the emotion in the conflict. The original conflict is rarely resolved with this technique. Reference: Chapter 10: Leadership, Managing and Delegating - Page 222-232
Which attributes should be characteristic of a nurse mentor? Select all that apply. A. Embraces disruptive conflict B. Is driven by financial reward C. Demonstrates leadership abilities D. Deconstructs health care networks E. Is an experienced, licensed professional F. Is resourceful G. Is supportive
G, C, E, F Mentors should demonstrate characteristics that will help the less experienced person grow in the profession. Mentors should be supportive, resourceful, experienced, respectable, and trustworthy leaders. Mentors do not receive financial compensation for their effort as preceptors typically do. Mentors should not embrace conflict that is disruptive to tasks. Mentors should build and use health care networks, not deconstruct them. Chapter 10: Leadership, Managing and Delegating - Page 228
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 A more experienced nurse working on the same unit The medical practice act website A nurse mentor or a nurse preceptor
The nurse practice act or facility's policy and procedures Explanation: The RN should consult the nurse practice act or the facility's policy and procedures. The nurse mentor or preceptor and the more experienced nurse are good resources, but may mistakenly give inaccurate information. The medical practice act is designed to govern physician practice and may not contain information on the task that is to be delegated. Reference: Chapter 10: Leadership, Managing and Delegating - Page 227
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? A. Democratic B. Autocratic C. Transformational D. Laissez-faire
A The democratic leadership style is characterized by a sense of equality among the leader and other participants and shared decision making. The autocratic leader assumes complete control over the decisions and activities of the group. Transformational leaders create intellectually stimulating practice environments, and challenge themselves and others to grow personally, to grow professionally, and to learn. In laissez-faire leadership, also called nondirective leadership, the leader relinquishes power to the group, such that an outsider could not identify the leader in the group. Chapter 10: Leadership, Managing and Delegating - Page 218
Two staff nurses have voiced not wanting to assume care for any new postoperative surgical clients during the shift. How can the charge nurse resolve this conflict using the strategy of accommodation to address the immediate concerns of the two staff nurses? Assign clients to one of the nurses and tell the nurse that it will be remembered in the future for a day off Decide how postoperative surgical clients should be assigned to the two nurses. Complement the nurses on how well they care for new postoperative surgical clients. Discuss incentives that can be given for agreeing to accept new postoperative surgical clients.
Assign clients to one of the nurses and tell the nurse that it will be remembered in the future for a day off Explanation: Accommodating involves one party making a conscious decision to let the other group win and may collect an "IOU" for use in the future, such as one nurse agreeing to be assigned the new clients in exchange for time off in the future. Transactional leadership involves providing incentives to motivate staff to achieve established goals. Smoothing is an effort to compliment the other party and focus on agreement rather than disagreement, thus reducing the emotion in the conflict. The charge nurse simply deciding how the postoperative surgical clients should be assigned to the two nurses is an example of avoiding, as the charge nurse is ignoring the requests of the two nurses and not making any effort to resolve the conflict. Reference: Chapter 10: Leadership, Managing and Delegating - Page 222
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 Explanation: Autocratic leadership will be most effective in this scenario. Autocratic leadership involves the leader assuming control over the decision and activities of the group. During code blue, a leader is needed to direct the actions needed and make quick decisions to positively affect the client. Laissez-faire leadership would ultimately lead to the demise of the client. Democratic leadership could possibly delay the client receiving life-sustaining measures and would be less effective than autocratic leadership. Transactional leadership would involve a reward system which would be unethical in this situation. Reference: Chapter 10: Leadership, Managing and Delegating - Page 216-217
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 Explanation: Magnet® hospitals have better patient outcomes than facilities without the recognition. Magnet® hospitals have higher nurse retention and job satisfaction scores, but these do not have a direct effect on client care. Magnet® hospitals have shorter, not longer, patient stays. Reference: Chapter 10: Leadership, Managing and Delegating - Page 220
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? A. Quantum B. Democratic C. Autocratic D. Laissez-faire
C Explanation: Autocratic leadership style involves assuming control over the decisions and activities of the group. Democratic leadership style involves sharing the decision making process and activities with others who have an interest. Laissez-faire leadership style involves the leader relinquishing power or control to the group. Quantum leadership style involves seeing an organization and members as interconnected and collaborative. This style involves change as continually unfolding, and frequently incorporates technology. Reference: Chapter 10: Leadership, Managing and Delegating - Page 216-217
Two new nurses are requesting the same preceptor for unit orientation. Both new nurses have been very vocal about being unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using a compromise approach to conflict resolution? A. The nurses agree to allow the preceptor to decide which nurse to precept. B. The nurses ignore each other's request for the preceptor. C. The nurses agree that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend. D. The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end.
C Explanation: Compromise involves both parties willingly relinquishing something of equal value. The nurses' decision to share the preceptor, with one having the preceptor at the beginning of the orientation and the other at the end, demonstrates compromise. The nurses ignoring each other's request illustrates avoidance. Allowing the preceptor to decide which nurse to precept encourages competition. Competition involves a win-lose approach to conflict. The nurses agreeing that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend illustrates accommodation. Accommodation involves one party deciding to let the other party win in exchange for something else of value. Chapter 10: Leadership, Managing and Delegating - Page 222
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? A. The unlicensed assistive personnel (UAP) taking vital signs for several nurses B. The dietitian completing a nutritional assessment for a registered nurse (RN) C. The nurse implementing the physician's written orders for client care D. The interdisciplinary health care team collectively developing plans of care for clients
D Explanation: Democratic or participative leadership style is characterized by a sense of equality among the leader and other participants. The interdisciplinary health care team collectively developing plans of care for clients is the only option that shows shared responsibility to achieve the same client outcome. The other answers are simply individual healthcare team members carrying out their assigned tasks. Chapter 10: Leadership, Managing and Delegating - Page 218-219
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. Explanation: Steps to enhancing time management include: establish goals, evaluate ability to meet goals and identify tasks that can be delegated, establish a timeline, evaluate success of the plan, and use the evaluation to make future plans. Goals were established in the stem of the question and therefore, the next step would be to delegate task. Reference: Chapter 10: Leadership, Managing and Delegating - Page 226-227
To adequately direct client care and maintain effective decision making, the nurse manager requires knowledge of what? Planning Assertiveness Economics Introspection
Economics Explanation: A knowledge of economics provides a foundation for effective decision making. A nurse manager needs to the skills, not knowledge, of introspection, planning, and assertiveness. Reference: Chapter 10: Leadership, Managing and Delegating - Page 221
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. A. The determination of a nursing diagnosis for a client with breast cancer B. Taking routine vital signs C. Administering medications to clients D. Planning education for a client with a colostomy E. Transferring a client to another floor F. Giving a bed bath to a client
Giving a bed bath to a client Taking routine vital signs Transferring a client to another flooR Explanation: The nurse should be familiar with guidelines for delegating nursing care. The nurse could delegate the following tasks to UAP: giving a bed bath to a client, taking routine vital signs, and transferring a client to another floor. The nurse could not delegate the administering of medications, planning client education for a client with a colostomy, or the determination of a nursing diagnosis. Reference: Chapter 10: Leadership, Managing and Delegating - Page 227-228
