Chapter 10- Leadership, Managing and Delegation

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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. 220

The registered nurse (RN) is preparing to delegate tasks to an unlicensed assistive personnel (UAP) for a client who recently had a stroke. Which task would be inappropriate for the RN to delegate to the UAP?

Feeding 227

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 218-219

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

performance appraisal. 220

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." 227

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 216-217

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 216-217

The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive person (UAP). Which task is appropriate for the UAP to complete?

Bathing a combative client 227-233

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 218

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?

Democratic 218

A nurse can improve one's skill with time management by taking which action?

Evaluating success with accomplishment of goals in client care 226

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-fair 219

Which of these statements regarding a nurse manager role is accurate?

To effectively manage the nursing unit, the nurse manager should also be a leader. 221

Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses?

Laissez-faire 219

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. 221

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 228

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 most accurately described as what?

Conflict resolution 222

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 226-227

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. 223

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. 226

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 223

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 225

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 222-232

The nurse is caring for an older adult client who states the need to use the restroom. Which safety intervention must the nurse perform first?

Assess the need for assistance with ambulation. 778

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 218

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. 223

A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check clients' blood glucose levels. The nurse manager informs the group that this is a new policy on the unit and that discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating?

Autocratic 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 220

Which action by the nurse manager demonstrates the function of directing?

Helping manage unit flow with client care if there is a staff call-out 221

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 219

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 219

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 225

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 227-228

A nurse manager best demonstrates effective leadership characteristic by which action?

Sharing a vision for the unit and enlisting support 215

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 222

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 228

The nurse recognizes that a new mother is having difficulty breastfeeding. The nurse demonstraties 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. 223

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?

The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end. 222

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. 220

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 223-225

Which are examples of personal leadership skills necessary for nurse leaders? Select all that apply.

-Communication -Problem solving -Self-evaluation 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.

-Giving a bed bath to a client -Taking routine vital signs -Transferring a client to another floor 227-228

A staff nurse who has been working as a clinical manager is demonstrating strong leadership qualities on the unit. Which behaviors and competencies by the nurse would be recognized by senior management as indicators of strong leadership during evaluation? Select all that apply.

-When delegating tasks to unlicensed assistive personnel, the nurse supervises, guides care, and evaluates outcomes. -The nurse has achieved certification in the field of professional practice and belongs to that professional practice. -The nurse has recognized an error in practice and performance and is managing a task force to change policy. 216

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 220

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 227

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 ensurethat the deadline is met?

Offer 2 days of paid vacation 220

Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status?

Staff nurses are developing innovative solutions to problems. 220

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." 223

Conflict has emerged on a nursing unit due to the perception by new graduates 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. 222

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 216

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 216-217

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 222-232

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 227

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 219


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