Leadership

A hospital management team has conducted a randomized controlled trial to decrease the occurrence of ventilator-associated pneumonia .The trial was successful and had positive outcomes. The nurse manager, in collaboration with other hospital management staff, conducted the same trial in another hospital, but the results were different. Which research strategy implementation would the nurse manager consider to be beneficial in preventing dramatic differences in trial results? 1 Evidence-based practice (EBP) Correct2 Practice-based evidence (PBE) 3 Client-centered outcomes research 4 Comparative effectiveness research (CER)

PBE is a research methodology that helps inform practice. It uses an observational cohort study design that compares clinically relevant interventions, includes diverse study participants, uses heterogeneous practice settings, collects data on a broad range of health outcomes, and includes frontline clinicians in study development. EBP is the integration of the best research evidence with clinical expertise and the client's unique values and circumstances in making decisions about the care of individual clients. Client-centered outcomes researchers conduct research to provide information about the best available evidence to help clients and their providers make decisions that are more informed. CER is the generation and synthesis of evidence that compares the benefits and harms of alternative methods.

While providing the feedback to student nurses, the registered nurse provides specific information about positive performance. Which type of theory is the registered nurse applying practically as a leader? 1 Trait 2 Style Correct3 Expectancy 4 Two-factor

According to the expectancy theory, satisfying individual needs influences the behavior of those individuals. Therefore, when the nurse provides specific feedback about positive performance, the nurse is applying expectancy theory as a leader. Trait theories are based on self-awareness of traits and the seeking of employment that matches those traits. Style theories focus on what leaders do in relational and contextual terms. Two-factor theory holds that both hygiene and motivator factors are needed to recruit and retain staff.

What are the desired attributes of the nurse as a leader? Select all that apply. Correct1 Identifying the needs of followers 2 Avoiding the use of personal intuition over facts Correct3 Motivating others assertively towards the objective 4 Focusing on a single option to accomplish the objective Correct5 Using a critical thinking approach while making a decision

A desired attribute of a nurse as a leader includes the identification of others' needs. The nurse should assertively motivate others towards the objective. A critical thinking approach is the desired attribute to make decisions in nurse leadership. The nurse should rely on personal intuition as well as facts. While accomplishing any objective, multiple options should be discussed before making decisions.

Which objective is associated with creating urgency in Kotter's eight-step model? 1 To create short-term targets 2 To honor the people who helped complete a task 3 To create a culture with continuous improvement Correct4 To generate open dialogue about external and internal realities

The attribute of creating urgency is associated with generating open dialogue about external and internal realities. Short-term targets are created for creating short-term wins. Honoring the people who help complete the task anchors the changes in the culture. A culture created with continuous improvement builds on the change.

Which actions of a nurse as a leader demonstrate a hands-off approach in practice? Select all that apply. Correct1 The nurse leader avoids making conscious decisions. 2 The nurse leader avoids acting in situations beyond his or her control. Correct3 The nurse leader chooses to do nothing when an intervention is indicated. 4 The nurse leader chooses not to act upon a problem considered to be nonsignificant. 5 The nurse leader avoids responding to strict mandates imposed by an official in a higher position of authority.

A hands-off approach may signify that the leader does not make a conscious decision while solving a problem. Moreover, he or she chooses not to act when an intervention is indicated. In a situation beyond the leader's control, he or she not taking any action is an example of the purposeful inaction approach. In such an approach, the leader may consider the problem to be nonsignificant. After strict mandates imposed by higher officials, the nurse leader may avoid any action. However, this is not considered part of the hands-off theory.

A nurse is helping a client determine and articulate personal values about health problems. The nurse also explains the effect of these problems on lifestyle adjustments. Which Gardner's task of leadership is the nurse leader applying? 1 Explaining 2 Managing 3 Motivating Correct4 Affirming values

Values are the connecting thoughts and inner driving forces that give purpose, direction, and precedence to life priorities. According to the Gardner's tasks of leadership, helping the client sort out and articulate personal values that are related to health problems is affirming values. It also involves explaining the effect of these problems on lifestyle adjustments. Explaining includes teaching and interpreting information to promote well-being in the client. Managing involves assisting the client with planning, priority setting, and decision making. This also includes ensuring that organizational systems work on behalf of the client. Motivating includes inspiring clients or family members to achieve their vision.

A nurse leader wants to communicate and explain changes to hospital rules to team members. Which approaches should the nurse leader follow for effective communication? Select all that apply. 1 Providing all the information related to the topic Correct2 Explaining the reason behind the change Correct3 Providing the opportunity for dialogue and feedback 4 Using complex terms while addressing a diverse group Correct5 Giving information that addresses the listener's self-interest

While communicating and explaining the rules of the hospital, listeners should be informed about the reason and values behind the changes. This may help them understand and reinforce the changes effectively. Opportunities for dialogue and feedback should be provided to analyze what was missed and which areas need improvement. Presenting the message in a manner that stimulates the self-interest of the listener may help in effective communication by better attracting the attention of the listener. The message for delivery should be strategically planned. Providing all or too much information can temporarily paralyze the listener and divert energy away from key responsibilities. The use of complex terms, concepts, or ideas may also prevent the learner from hearing the message and lead to ineffective communication.

The senior nurse finds that a novice nurse is mainly emphasizing leadership activities in a healthcare facility. Which action of the senior nurse indicates effective leading ability? 1 Asking the new nurse to stop doing it Correct2 Encouraging and developing the leadership of the new nurse 3 Asking the new nurse to act as a leader after he or she retires 4 Suggesting the new nurse mainly focuses on the profession rather than on leadership

Effective leadership is responsible for achieving an effective workplace, and therefore succession of the leadership is an important consideration. This can be done by encouraging and developing the leading skills of the new nurse and supporting current leaders to implement their roles effectively. Discouraging the new nurse does not result in succession of the leadership and effects the growth of the organization. Therefore actions such as asking the nurse to stop leading immediately or asking the nurse to act as a leader after the senior nurse retires do not indicate effective leading ability. The senior nurse, as a leader, should guide the nurse to focus on both professional work and leadership.

What should a nurse manager as a leader do to provide a non-threatening and positive environment to the group members? Select all that apply. 1 Ask indirect and close-ended questions Correct2 Encourage group members to actively participate Correct3 Create an environment conducive to solving problems Correct4 Protect the members and their suggestions from attack 5 Encourage the attempts of members to monopolize the discussion

Encouraging group members to actively participate may help elicit different ideas from different members. An environment conducive to solving problems helps in keeping the group focused on tasks and strategies. Protecting members and their suggestions from attack should be done for a healthy discussion and to create a non-threatening environment. Asking direct and close-ended questions may not help involve members who are not actively involved in the discussion. Encouraging the attempts of members to monopolize the discussion may not encourage more passive individuals to contribute to the discussion.

While providing feedback to nurse practitioners, the registered nurse uses the extinction approach to handle negative behaviors. Which theory of leadership is the registered nurse applying in this scenario? 1 Hierarchy of needs 2 Transactional theories 3 Transformational theories Correct4 Organizational behavior modification (OB Mod) theory

Extinction is purposefully ignoring negative behavior. According to the OB Mod theory, the nurse as the leader should ignore negative behaviors as a form of non-reinforcement. A leader employs the hierarchy of needs by developing an awareness of what motivates subordinates, beginning with physiologic needs and progressing to safety, social, esteem, and self-actualizing needs. Leaders using the transactional theory of leadership reward or punish subordinates while providing feedback. Transformational theories of leadership involve motivating subordinates by generating enthusiasm and promoting scholarship.

A nurse leader changes the work schedule after a team member asks for more flexibility in the schedule. Which theory outlines this nurse leader's approach? 1 Maslow's theory Correct2 Herzberg's theory 3 Great Man theory 4 McGregor theory X

Herzberg's theory (also known as the two-factor theory) states that hygienic factors, such as working conditions, motivate an employee by meeting that employee's safety and security needs and also help to avoid job dissatisfaction. Therefore changing the working schedule of the nurse executive as per his or her convenience may help to create job satisfaction. Maslow's theory states that employees are motivated by the hierarchy of human needs. The Great Man theory (also known as the trait theory) states that leaders have certain physical and emotional characteristics that help in motivating workers to achieve the common goal. McGregor's theory X states that employees are inherently lazy and unhappy with their jobs and must be coerced to perform.

The registered nurse is interviewing for a management position and wants to present a powerful image. What can the nurse focus on when preparing for the interview? Select all that apply. Correct1 Conveying positive body language Correct2 Appearing well groomed and well dressed Correct3 Showing confidence in work and abilities 4 Communicating a conservative, safe philosophy 5 Demonstrating an ability to work independently without the need for collaboration

Positive body language, appearing well groomed and well dressed, and conveying self-confidence are essential for establishing a powerful image. An effective leader should always be ready to take risks rather than maintaining a conservative, safe philosophy. A successful leader should also be comfortable collaborating and utilizing the assistance of others.

A senior nurse finds that the nurse leader is implementing Gardner's task of "achieving workable unity" effectively. Which action of the nurse leader supports the senior nurse's finding? 1 Being honest and keeping promises to clients 2 Representing the values of organization to clients Correct3 Developing conflict resolution skills effectively 4 Inspiring the team members to achieve their vision

Gardner's task of "achieving workable unity" can be implemented by inculcating the unity in the team. This can be achieved by developing the conflict resolution skills effectively. The nurse leader implements the Gardner's task of "developing trust" by being honest and keeping promises to clients. The nurse leader implements Gardner's task of "affirming values" by representing the value of organization to clients. The nurse leader implements the Gardner's task of "motivating" by inspiring the team members to achieve their vision.

According to Kouzes and Posner, which key practices are involved when a leader takes an active role in the work of change and creative thinking about new solutions? Select all that apply. 1 Inspiring 2 Enabling Correct3 Modeling Correct4 Challenging 5 Encouraging

Modeling the way and challenging the process are two of the key practices described by Kouzes and Posner in their work on transformational leadership. Modeling the way means that a leader must take an active role in the work of change. Challenging the process involves questioning the methods and finding new solutions to old problems. Inspiring involves sharing vision or bringing everyone together to march towards a goal that is desirable and achievable. Enabling others to act, which includes empowering people to believe that their extra effort will have rewards and will make a difference. Encouraging involves giving attention to personal things that are important to people, such as saying "thank you" for a job well done..

The nurse is relating to and inspiring the client who has a psychiatric disorder to achieve the client outcomes. Which of Gardner's leadership tasks is reflected in the nurse's actions? Correct1 Motivating 2 Envisioning goals 3 Serving as symbol 4 Achieving workable unity

When the nurse relates to and inspires the client with a psychiatric disorder to achieve the client outcomes, the nurse is motivating according to Gardner's leadership tasks. Gardner's leadership task of envisioning goals involves envisioning client's outcomes for single clients/families. Gardner's leadership task of serving as symbol involves representing the nursing profession and values and beliefs of the organization to clients and families and other community groups. Gardner's leadership task of achieving workable unity involves assisting clients and families in achieving optimal functioning to benefit the transition to enhanced health functions.

The nurse manager implements a change in the back care routine provided to bedridden clients to help prevent pressure ulcers. The nurse manager observes a decrease in the incidences of pressure ulcers in the unit and appreciates the efforts of the team members who implemented the change. Which step of Kotter's eight-step change model is reflected in this scenario? 1 Creating urgency 2 Removing obstacles 3 Creating a vision for change Correct4 Anchoring the changes in the culture

Recognizing the change and appreciating the team members who implemented the change help anchor the change in the work culture, which is the final step in Kotter's eight-step change model. Creating urgency involves initiating dialogue around the need for a change. The nurse should be aware of the hassles in the change and remove the obstacles as and when they arise. Creating a vision for change involves creating a strategy, determining values, and practicing vision speech before communicating with the team members.

The registered nurse, as a leader, is teaching about leadership roles to a group of nurse practitioners. Which statement made by a nurse practitioner indicates effective learning? 1 "I should identify recurring problems." 2 "I should have persistent and vigilant behavior in self and others." Correct3 "I should use experience and knowledge to judge reasonable risks." 4 "I should communicate in a way that maintains esprit de corps in the face of repetitive work tasks."

Leadership is the use of individual traits and abilities in relationships with others. It is the ability to interpret the environment and act in the absence of a defined plan. The nurse, as a leader, should use experience and knowledge to judge reasonable risks. The key traits of management include identifying recurring problems, having persistent and vigilant behavior in self and others, and communicating in a way that maintains esprit de corps in the face of repetitive work tasks.

The leader has planned to assist staff in order to achieve workplace unity. Which of Gardner's tasks would the leader apply in practice? Correct1 Assisting clients to accomplish optimal functioning 2 Relating to and inspiring clients to achieve their vision 3 Providing self-care to enhance the ability to care for staff, clients, and families 4 Representing nursing and the unit in task forces and shared governance councils

Assisting clients to accomplish optimal functioning is a behavior of Gardner's task of Achievable Work Unity. It is applied in practice to benefit the transition to enhanced health functions. Relating to and inspiring clients to achieve their vision and enhance health functions is the motivating task as described by Gardner. Providing self-care to improve the ability to care for staff, clients, and families is the renewing task as described by Gardner. Representing nursing and the unit in task forces and shared governance councils involves the executive position of Gardner's task of developing trust.

The transformational leader demonstrates charismatic behavior and the careful consideration of the value of every individual in the organization. What might be the expected organizational outcomes with this type of leadership? Select all that apply. Correct1 Increased loyalty 2 Deadlines are met Correct3 Increased performance 4 Low-to-stable levels of commitment 5 Work is supervised and completed according to the rules

Charismatic behavior and individual consideration are the behaviors of transformational leadership. A leader displaying this behavior would increase the loyalty and performance level of the followers. In transactional leadership, deadlines are typically met but followers have low-to-stable levels of commitment and the work needs to be supervised and completed according to the rules.

A staff member is planning to start a new job but is worried about the impact it might have on future growth opportunities. The nurse leader is helping the staff member understand all the implications. Which ethical principle is the nurse manager as a leader following? 1 Justice 2 Veracity Correct3 Paternalism 4 Non-maleficence

Paternalism is assisting people to make decisions when they do not have sufficient data or expertise. Helping the staff member understand all effects of a possible career change and how the potential change could impact his or her future growth reflects the leader nurse following paternalism .Justice is the principle of treating all persons equally and fairly. By following veracity, the nurse manager tells the truth and demands that the truth be told completely. The principle of non-maleficence states that one should do no harm to others.

Which statement reflects the concept of "referent power" to the nurse? 1 The nurse leaders share their power with the direct care nurses in client care. Correct2 The nurse manager hires the student nurse she advised to work in the agency after graduation. 3 The nurse manager is perceived positively by the student nurse who received an exemplary grade. 4 The direct care nurses demonstrate great skill in teaching clients who have difficulty with self-care activities.

Referent power is granted by a powerful person having an association. Therefore managers hiring student nurses to work in the agency is considered a use of referent power. The use of empowerment involves the nurse leader sharing power sources. In reward power, the instructor positively perceives the exemplary grades achieved by the student nurse. The direct care nurse who demonstrates good skills in teaching clients who have difficulty with self-care activities is considered to be an example of information power.

Why does the leader ask the direct care nurse, "Do you block cooperative efforts to resolve issues?" Correct1 The direct care nurse uses avoidance often. 2 The direct care nurse uses competing often. 3 The direct care nurse uses negotiation often. 4 The direct care nurse uses accommodation often.

Avoidance in conflict management style means that conflict is postponed. Often people do this when they have far more important issues pressing, when they have to gather more information, or when people need to cool down. Therefore the question asked by the leader to the direct care nurse, "Do you block cooperative efforts to resolve issues?," indicates that the direct care nurse may be using avoidance. Competing means perusing one's own needs and goals at the expense of others. When a direct care nurse uses competing, often the leader may ask "Are you surrounded by people who agree with you all the time and who avoid confronting you?" Negotiating is similar to trading, and if the direct care nurse practices this often, the leader may ask "Do you ignore large, important issues while trying to work out creative, practical compromises? Accommodation in conflict management style means neglecting our own needs, goals, and concerns in favor of satisfying those of others. With regular use of accommodation by a direct care nurse, the leader may ask "Do you think people are using you?"

The registered nurse is teaching a group of student nurses about the role of the nurse as a leader. Which statement by a student nurse indicates effective learning? 1 "The nurse manager has a plan for identification of charge nurses." 2 "The nurse executive need not be aware of information on succession planning." 3 "The primary goal of the nurse executive is leadership within and outside the workplace." Correct4 "The goal of the nurse manager is to develop a shared vision of the future with direct care nurses."

The goal of a nurse manager as a leader is to develop a shared vision of the future with direct care nurses. The nurse manager ensures that the day-to-day elements of the workplace are being performed correctly. The nurse executive has a plan for identification of charge nurses and should be aware of information on succession planning. The primary goal of the nurse executive is leadership within the workplace.

The senior leader instructs the direct care nurses about asking the right question in PICOT (patient population, intervention, comparison, outcome, and time frame) format. During the discussion, the leader discussed factors such as complication rate, satisfaction, nursing diagnosis, and nursing quality indicator. What do these factors indicate in the PICOT format? 1 Time Correct2 Outcome 3 Comparison 4 Intervention/interest area

Outcome means the result. There are multiple strategies to measure outcome, such as complication rate, satisfaction, a nursing diagnosis, and a nursing quality indicator. Time indicates short-term or long-term interventions. Comparison means to compare a new intervention with the one already in the practice, such as a treatment. Intervention/interest area indicates an intervention or a specific area of interest such as postoperative complications or the experience of postoperative pain.

Which of Gardner's tasks involves anticipating client outcomes for single clients or families and helping them formulate their vision of future well-being? 1 Explaining 2 Motivating 3 Affirming values Correct4 Envisioning goals

Envisioning goals is one of Gardner's tasks of leading. It involves anticipating client outcomes for single clients/families and helping clients formulate their vision of future well-being. Explaining involves teaching and providing information to promote client/family functioning and well-being. Motivating involves relating to and inspiring clients and their families to achieve their vision. Affirming values involves helping the client/family explain personal values in relation to health problems and their effect on lifestyle.

During a feedback session, the nursing staff communicates that a recently appointed nurse is using "empowerment theory." Which statement of the nursing team members most supports this position? Select all that apply. Correct1 "He/she can share power with others." 2 "He/she demonstrates successive planning." Correct3 "He/she encourages others to provide input into decisions." 4 "He/she regularly ensures that everything is correct at the workplace." Correct5 "He/she provides considerable information about the decision-making process."

Empowerment theory suggests that power be shared with others in the organization. Through the practical application of this theory, the direct care nurse could be given an opportunity to provide input while making a decision. This theory also includes sharing considerable information in the decision-making process. Successive planning may not be demonstrated through empowerment theory. Empowerment theory may not include ensuring everything is correct at the workplace.

Which are the organizational outcomes of transformational leadership? Select all that apply. Correct1 Increased loyalty 2 Met deadlines 3 Limited job satisfaction Correct4 Increased commitment Correct5 Increased performance

Transformational leadership refers to an inspiring vision to change the structure of the organization for the employees. It helps create an emotional engagement with the employees. The organizational outcomes of transformational leadership are increased loyalty, increased commitment, and increased performance. On the other hand, transactional leadership refers to a management making decisions with little or no input from the subordinates. The organizational outcomes of transactional leadership are project completion within deadlines and limited job satisfaction.

"In today`s workplace, female-male collaboration should provide efficacious models for the future." Which statements support this saying? Select all that apply. Correct1 Men and women must learn to work together. 2 Male managers make decisions on limited data. 3 Women are better at deciphering what needs to be done. 4 Male managers have a more participative management style. Correct5 Women and men bring separate perspectives to resolving problems.

Men and women must learn to work together and value the contributions of others and the differences they bring to any situation. Not all male managers make decisions on limited data. Women and men bring separate perspectives to resolve problems, which can help them function more effectively as a team on the nursing unit. Women may be better at collaborating and getting others to collaborate in accomplishing a task; men reportedly seem to be better at deciphering what needs to be done. Women are perceived to have a more participative management style; however, this does not mean that all male managers use an authoritative management model.

Which task followed by the executive nurse is a leadership development task? 1 Maintaining balance Correct2 Having a clear vision 3 Listening to constituents 4 Maintaining a positive attitude

Having a clear vision and seeing beyond where one is and where one is going is a leadership development task. Maintaining balance, listening to constituents, and maintaining a positive attitude are rules for a leader.

The nurse leader teaches the student nurse about the quality assurance (QA) process. Which statement made by the student nurse indicates ineffective learning? 1 "The goal is to improve quality." Correct2 "The major task is staff development." 3 "The focus is on discovery and correction of errors." 4 "The outcomes are set by the QA team with input from staff."

Staff development is the major task of the quality improvement process while the goal of the QA process is to improve quality. The focus of the QA process is on discovery and correction of errors. The outcomes of the QA process are set by the QA team with input from staff.

The registered nurse (RN) is delegating a task to an unlicensed nursing professional (UNP). Which client care is appropriate for the UNP to achieve a proper outcome in the care? Correct1 Client A 2 Client B 3 Client C 4 Client D

Client A needs assistance in oral care and personal hygiene which can be performed by an unlicensed nursing professional (UNP). Client B is undergoing bladder irrigation and needs monitoring for the presence of blood clots; this care should be done by an LPN to achieve a proper outcome. Client C requires wound care for ulcers which can be completed by an LPN under the guidance of a registered nurse. In client D, the task of tracheostomy care should be performed by an LPN for an effective outcome. The skill of performing tracheostomy care cannot be delegated to a UNP.

The nurse leader monitors the direct care nurse administering pain medication to the client. The leader tells the client "I will come back in 30 minutes to check your pain level." Which right of the client does the leader fulfill if the leader returns within 30 minutes? Correct1 Fidelity 2 Veracity 3 Beneficence 4 Confidentiality

Fidelity addresses the nurse keeping promises or commitments. Veracity is concerned with telling the truth and demands that the truth be conveyed completely. Beneficence states that good actions should be promoted and is the basic obligation for assisting others. Confidentiality involves maintaining the privacy of the client's health records.

The nurse organizes a meeting of health care team members after finding no improvement in the condition of a client recovering from major surgery. Which statement made by the nurse during the discussion signifies transformational leadership? Correct1 "My active participation will also be required moving forward." 2 "I will supervise and direct all treatment procedures." 3 "My increased efforts will lead to positive outcomes in the client." 4 "The previous treatment plan was correct but failed because of the client's weak condition."

Transformational leadership refers to an inspiring vision to change the structure of the organization for the employees which creates an emotional engagement with the employees. It requires a leader to show active participation in the ongoing treatment along with the team members. A transformational leader should share vision and bring the team together to achieve the goal. The most important quality of a transformational leader is to entrust and empower others to take extra efforts for effective treatment. A transformational leader should look critically at the previous treatment and bring new ideas to achieve the positive outcome of the treatment.

The nurse leader is promoted to nurse manager and has a plan of implementing an effective client counseling center in the outpatient department. The nurse gathers data from different healthcare providers and compares methods. Which type of quality improvement does the nurse implement? Correct1 Benchmarking 2 Risk management 3 Quality management 4 Performance improvement

Benchmarking is a process of conducting a widespread search to identify the best method, which helps to identify desired standards of quality performance. Risk management involves analyzing problems and minimizing losses after an occurrence of an adverse event. Quality management refers to a philosophy that defines a healthcare culture emphasizing customer satisfaction, innovation, and employee involvement. Performance improvement involves individual performance appraisal.

The leader is devising a strategy to connect individuals, groups, and organizations to attune them toward a common goal. Which political strategy is the leader pursuing? 1 Negotiating Correct2 Building coalitions 3 Adopting an empowering attitude 4 Fostering collegiality and collaboration

Developing coalitions is a political strategy that involves groups of individuals or organizations joining together temporarily around a common goal. It is often focused on an effort to effect change. Negotiating is a very important skill for organizational and political power to make trade-offs. An empowering attitude helps in the exercise of power among colleagues while educating others regarding nurses and nursing. To act collegially and collaboratively in the work place, development of a sense of unity and mutual respect is required.

In evaluating risks, what does the nurse understand is the responsibility of risk managers? 1 Using a single data source to interpret data Correct2 Involving perspectives from numerous disciplines 3 Using only quantitative methods in gathering data 4 Analyzing qualitative data for actionable plans to prevent adverse events

Involving perspectives from numerous disciplines helps to discover underlying problems that a single discipline might miss. Risk managers should use multiple data sources, multiple data collection techniques, and multiple perspectives to collect and interpret data accurately. Both qualitative and quantitative data should be assessed and analyzed for implementing actionable plans to prevent adverse events.

The chief operating officer (COO) discusses the performance of a newly appointed leader with the nursing staff. The team communicates that the practical approach of the leader fulfills the quantum theory. What type of work environment does the COO understand that the leader creates at the workplace? 1 An environment that promotes hygienic factors Correct2 An environment that is rapidly changing and dynamic 3 An environment that provides intellectual stimulation 4 An environment that develops trust between followers and leaders

Quantum theory lays its foundation on an environment that is rapidly changing. It does not focus on a single event. Hygienic factors in the environment are an aspect of the two-factor theory. The nurse leader, through the transformational theory, provides intellectual stimulation. An environment that develops trust between followers and leaders are aspects of the situational-contingency theory.

The nurse leader working in a 50-bed surgical unit accrued 765 client days in November and 189 of the clients were discharged during the month. What is the average length of stay for November? Record your answer using a whole number. _____ days 4

The formula for average length of stay is number of client days divided by the number of discharges. 765/189 = 4 days.

Which nurse has the following authorizations: change plans whenever necessary; function as part of the interprofessional team by communicating, planning, and implementing care directly to the client; and assess the cohort risks? 1 Nurse manager Correct2 Clinical nurse leader (CNL) 3 Licensed practitioner nurse (LPN) 4 Advanced practice registered nurse (APRN)

A CNL is a nurse who has successfully completed the CNL certification examination. A CNL functions as part of the interprofessional team by communicating, planning, and implementing care directly with healthcare professionals. A CNL has the authority to access the cohort group as well as change the plan of care wherever required. Nurse managers are involved in managing a team of nurses and other staff. LPNs are trainers and work under a registered nurse, gain experience, and learn the basics of nursing. The APRN perspective is supported by in-depth education in physiology, physical assessment, pharmacology, and a broad healthcare systems perspective.

The nurse manager sends the nursing team to perform a pediculosis screening at an elementary school and stays behind to catch up on administrative work. Which leadership quality does the manager fail to demonstrate in this instance? 1 Willingness to grow 2 Sharing of the reward Correct3 Leading by example 4 Having a clear vision

An effective leader actively leads members toward a mutual goal as a team, rather than simply sending them to do the job. Willingness to grow as a leader is demonstrated in activities like reading about new ideas and approaches and experimenting with new concepts to enhance their abilities. An effective leader shares the rewards of success by recognizing the positive contributions of each team member. Effective leaders with a clear vision see beyond where they are and see where they are going.

The mental health nurse is facilitating a therapy group. How can the nurse further develop trust among the members of the group? 1 By discussing the importance of their trusting one another 2 By revealing some personal data as an example of trusting behavior 3 By having group members reveal some personal information about themselves Correct4 By reminding group members about the need for confidentiality within the group

Members must feel comfortable discussing things in the group; there must be an understanding that what is discussed in the group will remain in the group. Talking about trust does little to foster it. Revealing personal data about one's self or having group members reveal information will not establish trust and may increase anxiety because the members may feel that their turn for exposure will come whether they want it or not.

The leader is teaching a nursing student about systems theory. Which statement by the student nurse indicates the need for further teaching? Select all that apply. Correct1 "Systems theory accounts for unpredictability." Correct2 "Systems theory focuses on the effect of random events." 3 "Systems theory involves open as well as closed systems." 4 "Systems theory is viewed as inputs, throughputs, and outputs." 5 "A system consists of structure, technology, people, and environment."

Systems theory tends not to account for unpredictability and random events. In contrast, chaos theory focuses on unpredictability and random events. Systems theory involves open as well as closed systems. It is viewed as inputs, throughputs, and outputs. A system theory involves a system that consists of structure, technology, people, and environment.

The registered nurse (RN) is teaching a student nurse about the qualities of a transactional leader. Which statement made by the student indicates effective learning? Correct1 "I will penalize team members for poor performance." 2 "I will motivate employees by articulating an inspirational vision." 3 "I will encourage employees to transcend their own self-interests." 4 "I will challenge the process that involves new solutions to old problems."

A transactional leader is responsible for penalizing a nurse executive for poor performance. This type of leader influences followers to fulfill their contracts or get penalized. Motivating employees by articulating an inspirational vision is the behavior of a transformational leader. Encouraging employees to transcend their own self-interests to increase job satisfaction is the behavior of a transformational leader. Challenging the process that involves new solutions to old problems is the behavior of a transformational leader.

A nurse leader is teaching the nursing staff about preparing objectives. Which statements by a member of the nursing staff indicate effective learning? Select all that apply. Correct1 "I will specify the target to be achieved." Correct2 "I will not include unrealistic and unattainable goals." Correct3 "I will provide the level of accomplishment for the end result." 4 "I will include statements such as 'in the future' in the objective." 5 "I will not indicate specific teams working toward the goals."

An effective objective should be a S.M.A.R.T. goal, i.e., it should be specific, measurable, agreed upon, realistic, and time bound. Therefore it is important to include statements that specify the target that needs to be achieved. As the objective needs to be realistic, developing unrealistic and unattainable points should be avoided. By providing the level of accomplishment for the end result, the objective is being measured. Statements like "in the future" should be excluded from the objective, because they do not provide a specific timeframe. The teams working toward goals should be specified.

Which statement is true regarding the framework of delegation related to the Hersey's Situational Leadership Model? Select all that apply. 1 Single factor influences the effectiveness of a leader 2 Ability relates to the individual's attitude and commitment Correct3 Willingness relates to the individual's attitude towards the task Correct4 Ability to diagnose performance is a core competency of a situational leader 5 Willingness is the sole factor that must be assessed to determine the readiness of the follower

Hersey's Situational Leadership Model serves as a foundation for delegation decision making. Willingness is the individual's attitude and commitment towards the task. The ability to diagnose the performance and commitment of others is a core competency of Hersey's Situational Leadership Model. Multiple factors such as assessment of personality characteristics and readiness level of an individual influence the effectiveness of a leader. Willingness, not ability, relates to attitude and commitment. Willingness and ability are the two factors that are assessed when determining the level of follower's readiness.

Which qualities of a nurse leader can move the organization in a forward direction to continue delivering the best possible care? Select all that apply. Correct1 Supporting the followers effectively 2 Implementing the care plan of the client effectively 3 Gaining knowledge on new technologies in the practice Correct4 Nurturing the followers with right knowledge and direction 5 Pursuing higher educational degrees in professional courses

The nurse leader should serve to better the organization and to deliver the best possible care. Continual learning is essential to keep the organization moving forward. This can be done by supporting and nourishing the followers to make them future leaders. Effective implementation of the client's care plan indicates professionalism but not leadership. Gaining knowledge on new technologies and pursuing degrees in higher professional courses do not indicate leadership quality.

Which point should the nurse exclude when developing strategies to project a powerful image? Correct1 Using authoritative language 2 Maintaining good body posture 3 Making good eye contact with clients 4 Ensuring that clothing and hair are appropriate to the situation

The nurse should treat people with courtesy and respect. The use of authoritative language does not help in developing a powerful image. The nurse should also maintain good body posture because it conveys self-confidence. Good eye contact helps in developing trust. Appropriate dress and hair help convey a powerful image.

A nurse manager in a surgical unit finds that many clients are developing urinary tract infections post-operatively and wants to discuss the measures to prevent it with the team. Which action of the nurse manager reflects good communication practice? Correct1 Calling the team for a brief meeting 2 Texting every team member about the problem 3 Sending a detailed email about preventive measures 4 Requesting the nursing supervisor for a seminar to address all the nursing staff

Communication is a very important aspect of any leader. Solving a client care-related issue such as increasing incidences of urinary tract infections may require discussion with team and input form the team members to arrive at any decision. Therefore a face-to-face meeting with the team would be the best communication practice. Texting or sending emails to the team members would not facilitate feedback. Addressing all the nursing staff of the facility would not be needed, as the issue is limited to the surgical unit.

Which action of the clinical nurse is consistent with Gardner's task of "achieving work unity"? Correct1 Helping clients accomplish optimal functioning 2 Relating to and inspiring clients to achieve their vision 3 Providing self-care to enhance the ability to care for staff, clients, and families 4 Representing nursing and the unit on task forces and shared governance councils

Helping clients accomplish optimal functioning is a behavior of Gardner's task of "achieving work unity." It is applied in practice to benefit the transition to enhanced health functions. Relating to and inspiring clients to achieve their vision and enhancing health functions is involved in Gardner's task of "motivating." Providing self-care to improve the ability to care for staff, clients, and families is the Gardner's task of "renewing." Representing nursing and the unit on task forces and shared governance councils is involved in Gardner's task of "representing."

Which actions should a nurse leader avoid in order to implement changes effectively? 1 Answering tough questions raised by the staff 2 Asking the staff what is not working well for them Correct3 Maintaining a boss-employee relationship with the staff 4 Asking questions of the staff related to daily functions

To effectively implement change, a leader nurse should establish and maintain rapport with staff. Therefore maintaining a rigid boss-employee relationship should be discouraged. Answering tough questions faced by the staff will promote a good work culture of helping. Asking the staff about what is not working well for them helps identify problems and solve them. Asking questions of the staff related to daily functions will promote a friendly environment and help track their work.

What would the nurse consider to be the two contingent variables of path-goal theory? Select all that apply. 1 Intellectual stimulation Correct2 Environmental demands 3 Feedback from followers 4 Reinforcement strategies Correct5 Personal characteristics of followers

Environmental demands and personal characteristics of followers are two contingent variables of path-goal theory. Intellectual stimulation is a characteristic of transformational theories of leadership. Feedback from followers is a characteristic of the style theories of leadership. Reinforcement strategies are included in the Organizational Behavior Modification theory of leadership.

The staff nurses complain the unit is disorganized and that there is no proper guidance from the nurse leader in regards to client services. Which type of leadership does the unit experience? 1 Directive 2 Autocratic Correct3 Laissez-faire 4 Participative

Laissez-faire is a hands-off style of leadership in which the nurse leader allows the staff nurses a high degree of autonomy and self-rule. In a directive style of leadership, the nurse leader sets clear objectives and rules for the nursing staff. Autocratic leadership occurs when the nurse leader places control within the position over a particular work area. Participative leadership is the type of leadership in which the nursing staff participates in the decisions made by the nurse leader.

A discussion between a group of team members results in a serious conflict in an organization. The nurse, as a leader, accepts the challenge of the situation and uses an adaptive style. Which theory of leadership is the nurse applying in practice? 1 Trait theory 2 Two-factor theory 3 Hierarchy of needs Correct4 Situational-contingency theory

Situational-contingency theory takes into account the challenge of a situation and encourages an adaptive style of leadership. Trait theory holds that self-awareness of traits is required to inspire others to achieve a goal. The two-factor theory of leadership posits that both hygiene and motivator factors are required for inspiring work performance. The hierarchy of needs theory of leadership holds that motivation is achieved by providing individuals with a hierarchy of needs.

The registered nurse assigned a task to a licensed practical nurse. The task was not successfully completed by the deadline. Which action by the registered nurse would be characteristic of a transactional leader? 1 Provides training Correct2 Punishes the nurse 3 Motivates the nurse 4 Offers ideas to the nurse

The transactional leader often reacts by punishing subordinates if the task is not fulfilled. He or she is not concerned with offering the training, motivation, and ideas to the medical professional. These activities are typical of transformational leaders.

The nursing leader stated, "The reimbursed cost is less than the full charge for a service in the hospital." Which type of health reimbursement does the nurse leader describe? Correct1 Contractual allowance 2 Value-based purchasing 3 Cost-based reimbursement 4 Prospective payment system

When the reimbursed cost is less than the full charge for a service in the health organization, a contractual allowance or discount exists. Offering rewards and incentives to high performing organizations is value-based purchasing. In cost-based reimbursement, all allowable costs are calculated and used as the basis for payment. In a prospective payment system, the third-party payer decides in advance what will be paid for a service or episode of care.

Which theory of nursing leadership involves the traditional organizational hierarchy playing a less significant role as the "keeper of high-level knowledge?" 1 Style theory 2 Thinking theory 3 Motivation theory Correct4 Complexity theory

Complexity theory involves the traditional organizational hierarchy playing a less significant role as "keeper of high-level knowledge." Style theory focuses on the achievement of an effective and productive work environment through employee-centered leadership. Thinking theory recognizes the dynamic, complex, and interdependent nature of systems. Motivation theory identifies and describes the forces that motivate people.

What is the key element of success for a nurse manager as a leader? Correct1 Including the direct care nurses in decision making 2 Allocating different nurses for specific tasks effectively 3 Leading a team with a limited number of team members 4 Resolving the financial issues of the organization effectively

Involving the direct care nurses in decision making is an essential element of success for a nurse manager as a leader. An effective leader should lead a team either with limited or many team members. Allocating different nurses or resources for specific tasks and resolving the financial issues of the organization are the jobs of a nurse manager.

After oral surgery the dentist writes a prescription for pain medication for an 18-month-old child. Which medication does the nurse question? 1 Acetaminophen 2 Codeine Correct3 Oxycodone/aspirin 4 Morphine

Oxycodone/aspirin (Percodan) is a combination drug that contains aspirin as well as oxycodone. Aspirin should not be given after surgery because it affects platelets, prolonging bleeding. In addition, it should not be given to children because it is associated with Reye syndrome. It is available only in tablet form, which is difficult to administer to a toddler. Acetaminophen (Tylenol), codeine, and morphine are not contraindicated for a child who has undergone oral surgery.

A nurse manager receives a complaint from a client that a particular staff member had been rude when providing care. The nurse, rather than punishing the staff member, listens to his or her side of the story and then talks to the client to clarify the misunderstanding. Which leadership theory is reflected in this scenario? 1 Trait theory 2 Two-factor theory Incorrect3 Expectancy theory Correct4 Situational-contingency theory

Situational-contingency theory encourages an adaptive leadership style to focus on the issue being faced. The nurse manager understands the situation and makes a decision based on the complete information obtained. Trait theory explains a set of leadership traits that influence others toward a common goal. Two-factor theory involves application of hygiene factors and motivational factors to avoid and promote job enrichment. Expectancy theory refers to a perceived probability of fulfilling a particular need based on experience.

Which type of behavior by the registered nurse results in a low-to-stable level of commitment? Correct1 Punitive 2 Charismatic 3 Inspirational 4 Intellectual stimulation

Punitive behavior is a type of transactional leadership behavior that results in a low-to-stable level of commitment as an organizational outcome. Charismatic, inspirational, and intellectual stimulation are transformational leadership behaviors that result in increased commitment as an organizational outcome.

Which principle of systems thinking theory involves the nurse focusing on the needs of all residents in a long-term care facility? Correct1 Thinking of the big picture 2 Balancing short-term and long-term objectives 3 Using non-measurable data systems 4 Recognizing the dynamic, complex, and interdependent nature of systems

Thinking of the big picture involves the nurse understanding the needs of the hospital as a whole or focusing on the needs of all residents in a long-term care facility. This application of the principle helps the nurse envision the context of the needs beyond the tasks. Balancing short-term and long-term objectives may involve the nurse considering the decision of the client about termination of clinical treatment in order to have a better quality outcome. Using measurable versus non-measurable data systems involves analyzing intangible data such as morale and working relationships and tangible data such as the number of clients in the work unit. Recognizing the dynamic, complex, and interdependent nature of systems involves understanding the connection of clients with their families and friends and how those together are connected to communities and cultures.

The nurse leader is monitoring a student nurse who is accessing various databases. Which search platform should the nurse leader suggest to access a variety of databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE? Select all that apply. Correct1 OVID Correct2 EBSCO 3 PubMed 4 PsycINFO 5 MEDLINE

OVID and EBSCO are search platforms for a variety of databases including CINAHL and MEDLINE. PubMed is an abstract database of the National Library of Medicine, providing access to over 15 million citations from 1950s to the present. PsycINFO is an abstract database of the behavioral sciences and mental health literature from 1800s to the present. MEDLINE is the largest component within PubMEd, indexing over 5200 journals according to medical subject headings.

The nurse manager threatens a staff nurse about being penalized for poor performance in the unit. Which type of leader behavior did the staff nurse experience? Correct1 Punitive 2 Charismatic 3 Laissez-faire 4 Intellectual stimulation

Punitive behavior is experienced in transactional leadership; this occurs when the nurse manager aims at punishing the staff nurse by penalizing for poor performance. Charismatic behavior and intellectual stimulation are seen in transformational leadership. Laissez-faire behavior is the hands-off style in which the manager allows a high degree of autonomy and self rule.

When a bedridden client complains that he or she is thirsty, the nurse leader says, "I want to make you comfortable. Here is a glass of water, please take it." Which communication skill is the nurse leader using to make caring visible? 1 Listening actively 2 Expressing appreciation 3 Showing caring nonverbally Correct4 Making explicit her or his positive intent

The nurse is making explicit her or his positive intent by explaining the purpose and by showing what he or she is doing in the client's best interest. Listening actively indicates acknowledging and reflecting back the person's feelings in a nonjudgmental way. Expressing appreciation refers to giving the personal gift of positive reward. Showing caring nonverbally can be done by using a facial expression, intonation, posture, eye contact, and body language to mirror the client's feelings.

The nurse manager finds that there is an increased infection rate in the unit due to an increased number of client visitors. The nurse believes that a change in the visitor policy could help reduce the infection rates. The leader is initiating an open dialogue about external and internal realities among the team members. Which attribute of Kotter's eight-step model is involved in this action by the nurse manager? Correct1 Creating urgency 2 Creating short-term wins 3 Forming a powerful coalition 4 Communicating the change vision

The nurse leader generating an open dialogue regarding the need for a change in visitor policy reflects the attribute of creating urgency in Kotter's eight-step model. Creating short-term wins involves setting short-term targets; success meeting these targets helps motivate the team to accomplish future tasks. Forming a powerful coalition involves the leader helping to build momentum and support individuals through the change experience.

Which qualities should a nurse who is promoted to leader of a unit possess? Select all that apply. Correct1 Having adaptability to hospital rules Correct2 Encouraging the newly appointed nurses 3 Penalizing the nurses for poor performance 4 Doubting the healthcare staff performances Correct5 Being aware about the events of organization Correct6 Collaborating with the staff for decision making

As a leader, the nurse should be able to adapt to the rules of the hospital to perform accordingly. A nurse leader should motivate or encourage the newly appointed staff to reach the desired goals. A nurse leader should also be aware of any organization events; this helps in managing the team effectively. Collaboration with the staff and allowing them to participate in decision making helps to reduce medical errors and improves job satisfaction. Penalizing the nurses for poor performance is the duty of the nurse manager. Incredulity or doubting the staff performance may reduce job satisfaction instead of motivating nurses to improve their performance.

The registered nurse (RN) is caring for a client who was admitted to the hospital due to severe diarrhea. The RN assigns the unlicensed assistive personnel (UAP) to check on the client hourly and perform hygiene care as needed. Which concept best explains this situation? 1 Leadership Correct2 Delegation 3 Supervision 4 Assignment

Delegation involves transfer of responsibility for the performance of tasks and skills for the ultimate outcome. Here the registered nurse (RN) is delegating a task to the unlicensed assistive personnel (UAP). Supervision involves directing, guiding, and influencing the outcome of an individual who performs the task. Assignment mostly happens in professional staff members such as RNs because it involves transferring responsibility and accountability.

Which characteristic of a manager should the nurse leader exclude while addressing the complex issues of the hospital? Correct1 Developing a vision 2 Budgeting the target goal 3 Organizing and planning to address the issue 4 Addressing the complex issue on a priority basis

Developing a vision in solving a complex issue is the characteristic of a leader, not a manager. Budgeting the target goal, organizing and planning the issue, and addressing complex issues first are the characteristics of a manager.

Which individual would be an appropriate member of a critical incident stress debriefing (CISD) team for a group of staff nurses? Select all that apply. Correct1 Staff nurse 2 Organization chaplain 3 Organization media representative Correct4 Physician trained in critical debriefing Correct5 Advanced practice mental health nurse

The critical incident stress debriefing (CISD) team includes a peer member of the group being debriefed. For this group, the CISD team would include a staff nurse. The team may include a physician trained in critical debriefing. The team leader would be someone with a background in mental or behavioral health. This role would be appropriate for the advanced practice mental health nurse. The chaplain and the media representative are not identified as being appropriate for the CISD team.

Which action makes a nurse manager also a nurse leader? 1 Implementing best management skills when hiring employees 2 Having financial accountability associated with the organization 3 Screening effectively to select the right employees for the organization Correct4 Helping employees reach the highest level of their potential excellence

A nurse leader helps employees reach their highest level of potential excellence and raises their level of expectations. Therefore, to stand out as a nurse leader, a nurse manager should help with employee development. Implementation of management skills while hiring and financial accountability for an organization are roles of a nurse manager but not of a nurse leader. Effective employee selection indicates a nurse manager but not necessarily a nurse leader.

The nurse is learning about the rules of leaders. Which actions of the nurse indicate effective implementation of these rules in the profession? Select all that apply. Correct1 Communicating in a simple language with followers Correct2 Giving a chance to the followers to express their views 3 Instructing followers to decide the actions to be performed 4 Avoiding communicating the clear boundaries with followers Correct5 Ensuring proper eye contact while communicating with followers

An effective leader should use the simplest and fastest method to communicate with followers. An effective leader should give a chance to the followers to express their views, as followers have many questions to ask. Proper eye contact ensures effective communication; therefore an effective leader should maintain proper eye contact while communicating with followers. An effective leader should use critical thinking to decide the actions to be performed but should not instruct the followers. An effective leader should communicate the clear boundaries with followers.

Which question asked by a nurse leader establishes and maintains a human rapport with staff? Correct1 "How are your children?" 2 "How is your daily work going?" 3 "Can you tell me some daily obstacles you run into?" 4 "Do you support changes made by the organization?"

Establishing interpersonal relationships and understanding each other's feelings by asking questions such as "how are your children" ensure establishing and maintaining human rapport. Questions such as "how is your daily work going?", "can you tell me some daily obstacles you run into?", and "do you support changes made by the organization?" indicate a professional relationship and do not indicate establishing of human rapport.

The nurse leader sent a team of followers to conduct a community health session. The session was completed successfully. Which action of the nurse indicates leadership quality? 1 Expecting praise from the followers 2 Asking for rewards from the followers Correct3 Giving rewards to the followers responsible for the success 4 Asking the followers to give a presentation on the health session

Followers expect rewards from leaders in appropriate situations. Giving rewards for good performance can motivate and instill interest in the followers. Therefore the nurse as a leader should reward the followers for the success. Expecting praise from the followers does not indicate leadership quality. Even though the nurse leader is responsible for the success, he or she should not ask for rewards from followers; this does not indicate professionalism. Asking the followers to give a presentation on the health session indicates professionalism, but does not explore the leadership ability of the nurse.

A nurse manager proposes to change a protocol regarding the care of postoperative clients. However, the nursing staff openly expresses their resistance to the change and wants to continue with the original protocol. Which behavioral pattern in response to change best describes the nursing staff? Correct1 Laggards 2 Rejectors 3 Early majority 4 Late majority

Laggards value their traditional practices and may openly express their resistance to the change. Rejectors actively resist the change and may use sabotage to avoid the change. An early majority may prefer a conventional approach but accept the change gradually. A late majority is openly resistant to change and does not accept the change until all others have accepted it.

The nurse manager shares experiences faced during the journey to leadership with other staff members. Which statement made by the nurse appropriately describes the barriers faced during the leadership journey? Select all that apply. Correct1 "It requires time commitment." Correct2 "The title doesn't guarantee good leadership." 3 "It requires a mentor who offers advice and criticism." 4 "It requires sharing rewards with the other team members." 5 "It requires the leaders to take responsibility for an activity with a low outcome achievement."

Leadership requires commitments to be fulfilled within a time frame. It is a false assumption to think that the leadership position and the title are equivalent in nurse leadership; it should be considered an earned honor and an action-oriented responsibility. The development of leadership requires the selection of a guide who can offer advice and criticism; however this is not considered a leadership barrier. Sharing rewards also comes under the development of leadership. Leadership development involves leaders accepting the responsibilities for low outcomes achievement, but this may not be considered a barrier in leadership.

The nurse manager is evaluating different Bleich's tasks of followership performed by members of the nursing team. Which team member's action indicates incorrect implementation of Bleich's tasks of followership? Correct1 A 2 B 3 C 4 D

Offering rewards and recognition to individuals and teams is a management task, not a task of followership. Demonstrating accountability to the team effort; offering knowledge, skills, and abilities to achieve the task at hand; and taking reasonable risks as a preventive measure when fearing change or unknown circumstances are implementations of Bleich's tasks of followership.

Which behavior is an example of the nurse's role as an executive in the Gardner task of leadership? 1 Helping staff achieve optimal functioning to benefit transition 2 Representing nursing and the organization on assigned boards Correct3 Representing the organization and client care services on councils 4 Assisting the staff with planning, priority setting, and decision making

Representing the organization and client care services on councils are activities of an executive position, according to Gardner's task of leadership. Representing nursing and the organization on assigned boards are management activities, per Gardner's task of leadership. Helping the staff achieve optimal functioning to benefit transition is part of the management position, per Gardner's task of leadership. Assisting the staff with planning, priority setting, and decision making refers to the management position as per Gardner's task of leadership.

The behaviors of four nurses are described in the table. Which nurse is exhibiting the management-level behavior according to Gardner's tasks? 1 A 2 B 3 C Correct4 D

Sharing organizational information openly and being honest in the performance as leader reflectsthe management-level behavior of Gardner's task of developing trust. Representing the values and beliefs of an organization and client care services to internal and external constituents describes Gardner's task of serving as symbol at the executive level. Assisting multidisciplinary leaders to achieve optimal functioning to benefit client care and collaborative care is also an executive-level task. A leader representing a nursing unit on task forces, total quality initiatives, and shared governance councils reflects the Gardner's task of representing the group in a clinical position.

The nurse leader is involved in the planning of initiation of a healthcare organization. What is the correct sequence of events for strategic planning? Incorrect 1. Develop protocols to standardize client care. Incorrect 2. Assess rates of healthcare costs and available diagnostic services. Incorrect 3. Develop client care questionnaires regarding the level of satisfaction met through the care provided. Incorrect 4. Prepare a budget and develop the short-term and long-term objectives.

Strategic planning to set up an organization includes four phases. The first step is to assess the internal and external environments that include economic factors such as rates of healthcare costs and technological factors such as availability of diagnostic services. The second step is to set the goals that include developing protocols for standardizing client care. The third step is to identify the strategies to meet the goals such as preparing the budget and developing the short-term and long-term goals. The fourth step is to implement the specific plan of action prepared and evaluate the strategic plan such as developing client questionnaires regarding the care provided.

The nurse manager is promoting a nurse who has the qualities to become a team leader. What responsibilities are allotted to a team leader? Select all that apply. 1 To assign work to an associate nurse 2 To take care of the client 24 hours a day Correct3 To be prepared for daily changes in team membership 4 To assign the delivery of client care only to the technical personnel Correct5 To evaluate the quality of care for the clients assigned to his or her team

The team leader must face the challenge of changing team membership on a daily basis. The team leader plans the care, delegates the work, and follows up with members to evaluate the quality of care for clients assigned to his or her team. The associate nurse is a registered nurse who will provide care to the client according to the primary nurse's specification; therefore a team leader may not be responsible for assigning work to associate nurse. The primary nurse is accountable for the client's care 24 hours a day from admission through discharge. The team leader can assign the professional, technical, and ancillary personnel to deliver client care.

The nurse manager is evaluating a primary nurse who is working with a hospitalized adolescent client with the diagnosis of conduct disorder. Which intervention by the primary nurse should the nurse manager question? 1 Discussing unit rules 2 Giving the client choices 3 Explaining the consequences of not following unit regulations Correct4 Encouraging the verbalization of negative feelings toward others

Verbalization of negative feelings to others may escalate and result in antisocial or acting-out behavior. The environment must be consistent and predictable to limit manipulative behavior. Allowing opportunities for choices provides opportunities for the client to have some control. Consequences for unacceptable behavior can motivate individuals to act appropriately.

The nurse leader is representing the nursing unit and the values and beliefs of the organization to staff members. Which leadership task does the nurse's behavior indicate according to Gardner's tasks of leadership? 1 Serving as a symbol in an executive position 2 Representing a group in an executive position Correct3 Serving as a symbol in a management position 4 Representing a group in a management position

When the nurse represents the nursing unit and the values and beliefs of the organization to staff, it indicates the nurse is serving as a symbol in a management position. When serving as a symbol in an executive position, the nurse represents client care services and the values and beliefs of the organization to both internal and external constituents. When representing a group in an executive position, the nurse as a leader serves on assigned boards, councils, and committees representing the organization and client care services. Representing a group in a management position, the nurse as a leader represents nursing and the organization on assigned boards, councils, and committees.

The nurse as a leader provides feedback to a recently recruited student nurse after checking performance reports that show a disregard for the Organizational Behavior Modification (OB Mod) theory. Which activity of a student nurse would the nurse leader mention during the feedback session? 1 Neglecting the needs of a client 2 Disregarding hygiene factors at the workplace Correct3 Discussing the past mistakes of a subordinate 4 Ignoring the submission of a feedback form about a leader's productivity

OB Mod theory uses positive reinforcement to promote constructive behavior in the workplace. It involves motivating the staff by avoiding certain situations that cause discomfort. Therefore discussing the past mistake of a subordinate only creates a negative environment in the workplace. Hygiene factors should not be disregarded according to two-factor theory. Neglecting the client's needs is unprofessional and goes against Maslow's theory. If the submission of the feedback form about the leader is ignored, it disregards style theory.

The nurse leader working in a 30-bed intensive care unit accrued 792 client days in January. What is the percentage of occupancy calculated by the leader nurse? Record your answer using a whole number. _____% 85

The formula is average daily census (ADC) (rounded) divided by the number of beds in the unit multiplied by 100. ADC equals the client days in a given time period divided by the number of days in the time period. Therefore 792/30 = 25.5. Therefore the percentage of occupancy is 25.5/30 x 100 = 85%.

During an interview for a nurse manager position, the panel asks the nurse about the primary role of a leader. Which answer provided by the nurse would be most appropriate? Correct1 "To inspire followers" 2 "To provide training to the followers" 3 "To share views about the task with the followers" 4 "To increase the feeling of self-worth in the followers"

The primary role of a leader is to inspire the followers by actively participating in the task along with the followers. It also involves changing the workplace to increase work satisfaction. The other roles of a leader are to provide training to the followers, to share views about the task with the followers, and to increase the feeling of self-worth in the followers. All these are reflected in the concept of transformational leadership.

The nurse as a leader is sharing organizational information openly and honestly. Which of Gardner's tasks of leadership is the nurse manager applying in practice? 1 Renewing 2 Explaining Correct3 Developing trust 4 Affirming values

When the nurse leader shares organizational information openly and honestly, it indicates developing trust in a management position. The task of renewing in a management position involves providing self-care to enhance the ability to care for staff, families, and clients. The task of explaining in a management position involves teaching and interpreting information to promote organizational functioning. The task of affirming values in a management position involves helping staff interpret organizational values during change.

What are the attributes of a nurse leader? Select all that apply. Correct1 Identifying the needs of others 2 Accepting responsibility willingly Correct3 Using critical-thinking skills in making decisions Correct4 Using focused energy and stamina to accomplish a vision 5 Performing follow up on the consequences of actions taken

A nurse leader should possess attributes such as identifying the needs of others. A nurse leader should also use critical-thinking skills in making decisions and focused energy and stamina to accomplish a vision. Accepting responsibility willingly and performing follow up on the consequences of actions taken are the responsibilities of a follower.

A nurse leader is given an additional duty of nurse navigator. Which extra responsibilities does the nurse leader need to provide as a nurse navigator? Select all that apply. Incorrect1 Plan care for clients Correct2 Address barriers to care Correct3 Provide psychosocial support 4 Communicate effectively to facilitate care Correct5 Provide health education about the disease

A nurse navigator may help clients with serious chronic diseases by assessing, screening, diagnosing, treating, and follow-up care. The responsibilities of a nurse navigator include overcoming health system barriers and providing psychosocial support while treating the client. Providing health education about the disease, from prevention to treatment, is also the responsibility of a nurse navigator. Planning the client's care and communicating effectively are the responsibilities of a nurse leader and not a nurse navigator.

Which behavior of the nurse indicates management skills according to Gardner's task of achieving workable unity? 1 Assisting the client/family with planning, priority setting, and decision making 2 Assisting multidisciplinary leaders to achieve optimal functioning to benefit client care delivery 3 Assisting clients to achieve optimal functioning to benefit the transition to enhanced health functions Correct4 Assisting staff to achieve optimal functioning to benefit the transition to enhanced organizational functions

According to Gardner's task of achieving workable unity, the nurse in a management position helps the staff achieve optimal functioning to benefit transition to enhanced organizational functions. Assisting the client/family with planning, priority setting, and decision making is the clinical position of Gardner's task of managing. Assisting multidisciplinary leaders to achieve optimal functioning to benefit client care delivery is the executive position of Gardner's task of achieving workable unity. Assisting clients to achieve optimal functioning to benefit the transition to enhanced health functions is the clinical position of Gardner's task of achieving workable unity.

The nurse manager is assisting the nursing staff with planning, priority setting, and decision making. Which Gardner's task of leading is being applied in this practice? Correct1 Managing 2 Motivating 3 Affirming values 4 Developing trust

According to Gardner's tasks of leading, the nursing manager carries out the task of managing by assisting the staff with planning, priority setting, and decision making. Motivating involves inspiring and relating to staff to achieve the mission of the organization and the vision associated with organizational enhancement. Affirming values as a manager involves assisting the staff in interpreting organizational values and reinforcing every staff member's personal values to be more attuned with those of others. Developing trust as a manager involves sharing organizational information.

A nurse manager promotes a staff nurse to assistant manager of the medical unit as the staff nurse had expressed interest in taking on more responsibilities. Which type of ethical principle is exhibited by the nurse manager by this activity? 1 Fidelity 2 Autonomy 3 Paternalism Correct4 Beneficence

According to ethical principles, beneficence states that the actions one takes should promote good; it is the basic obligation to assist others. Therefore, by employing this principle, the nurse manager as a leader is encouraging employees to seek more challenges in clinical experiences and to take on additional responsibilities. Fidelity means fulfilling the promises or commitments made to others. Autonomy is the activity of addressing personal freedom and self-determination. Paternalism may be used to assist people in making decisions when they do not have sufficient data or expertise.

The nurse manager reviews the performance report of a direct care nurse and asks the nurse to focus on "emotional intelligence" in order to be promoted as the nurse leader. Which statement would the nurse leader most likely use while advising the nurse on areas for improvement? 1 "Try to balance short-term and long-term objectives." Correct2 "Try to be more sensitive to the experiences of others." 3 "Try to determine the type of information being shared." 4 "Try to engage in shaping policy and practices that affect client care."

Emotional intelligence is advising the nurse to be more sensitive to the experiences of others. The process of thinking systematically requires the nurse to balance short-term and long-term objectives. Under the "explaining" process of Gardner's tasks of leading/managing, the information type to be shared is determined. The involvement of the nurse in shaping the policies and practices of client care is an example of shared governance.

A medical care facility is seeking to establish an orthopedic center of excellence. The nurse manager teaches direct care nurses about opportunities available to them in the process. Which task would a direct care nurse be eligible for? 1 Developing a budget Correct2 Conducting a literature review 3 Conducting a needs assessment 4 Forming an advisory committee

In an orthopedic center, the direct care nurse is eligible for participating on the council to conduct a literature review on topics related to orthopedic product lines, innovative orthopedic joint replacement procedures, and programs related to the orthopedics evidence-based practices for joint replacement. The other activities such as developing a budget, conducting a needs assessment, and forming an advisory committee are not the responsibilities of a direct care nurse. The members responsible for developing budget are assistant vice president of client care services and orthopedic product line manager/nurse manager. The Director of Nursing, orthopedic product line manager, and strategic planning and marketing director are responsible for conducting a needs assessment. The members responsible for formation of an advisory committee are the client satisfaction director, physician champion, vice president of client care services, orthopedic staff across the continuum of care, director of rehabilitation services, and vice president of medical affairs.

An infant with a congenital heart defect is returned to the unit after cardiac catheterization. The nurse manager is observing a nurse newly assigned to the unit. Which nursing intervention should the nurse manager interrupt? 1 Offering fluids and foods as tolerated Correct2 Performing range-of-motion exercises 3 Monitoring the apical pulse for rate and rhythm 4 Assessing the pulses distal to the catheterization site

Range-of-motion exercises of the limb bearing the catheterization site might cause the dislodgement of a clot and result in hemorrhage. Intake should start with fluids and progress as tolerated. The apical pulse is monitored because a common complication after cardiac catheterization involves disturbances of cardiac rate and rhythm. The peripheral pulses are assessed because formation of thrombi is a complication of cardiac catheterization.

The student nurse is assisting the registered nurse (RN) in collecting feedback from superiors and peers. The questions they are asking address comments to the RN about his or her work quality that affects the environment and overall productivity. Which theory does the student nurse think the RN is applying practically as a leader? 1 Trait theory Correct2 Style theory 3 Transformational theory 4 Situational-contingency theory

Style theory measures the achievement of satisfactory performance. It requires supervisors to pursue an effective relationship with their followers. Therefore leaders need to obtain feedback from their followers, peers, and superiors. Trait theory involves the leader using self-awareness of his/her traits. It is useful in self-development as well as in seeking employment that matches the traits. Transformational theory includes a process in which the leader attends to the needs of the followers. This interaction raises the followers to higher levels of morality. Situational-contingency theory involves leaders considering the challenge of a situation.

A hospital administrator is evaluating the nursing teams of different units. Which team was found to be effective and will have positive outcomes? 1 Team A 2 Team B Correct3 Team C 4 Team D

Team C is found to be effective because it consists of a manager who collaborates with nursing staff in decision making. Here the leader with charismatic behavior motivates team members, which may help in improving the quality of the performance of the team members. The behavior of the followers of team C is effective, and they actively take part in problem solving, which is required for the development of their skills. Team A is ineffective because the leader and manager do not possess effective leadership and managerial behaviors. Team B demonstrates ineffective leadership behavior, which may lead to job dissatisfaction by the followers. Team D has ineffective managerial behavior, which may result in poor participation of the leader and the followers.

The nurse leader actively participates in the quality improvement process. Arrange the steps in a sequence that the nurse leader will follow while implementing the quality improvement process? Incorrect 1. Select a plan to meet the outcomes. Incorrect 2. Establish the outcomes and quality indicators. Incorrect 3. Identify the important needs of the consumer. Incorrect 4. Collect the data for evaluating the plan. Incorrect 5. Collect the data on the current status of the service. Incorrect 6. Collaborate with the interprofessional team to review needs..

The first step of the quality improvement process involves identifying the needs that are important to the consumer of healthcare services. Collaborating with the interprofessional team to review the needs that are identified is done to avoid bias. The next step is confirming the needs and collecting the data on the current position of the service that helps in the improvised plan. This is followed by implementing the process and establishing the outcomes for which quality indicators are required. Then the next step is to select and implement the plan to meet the outcomes and objectives of quality improvement. Evaluating the plan is the last step and is necessary for quality improvement.

The nurse manager enlists 10 direct care nurses for a project addressing the needs of the human immunodeficiency virus (HIV). The project successfully completes within the timeline. What would be the most essential factor for the success of the nursing manager? 1 Offering ideas to the direct care nurses 2 Providing training to the direct care nurses Correct3 Allowing the direct care nurse to share ideas 4 Promoting discipline among the direct care nurses

The most important element of success for the nursing manager is to allow the direct care nurses to share their ideas about the project and participate in decision making. This approach will increase their organizational commitment and increase the feeling of self-worth. The nurses will then be more likely to invest extra effort for successful completion of the project. The other factors necessary for successful completion of the project include providing ideas, training the nurses, and promoting discipline.

An obese client leads a sedentary lifestyle and complains of leg pain when walking long distances. A nurse leader is teaching the client different exercises that can relieve the pain and can be performed while working in an office or doing daily activities. Which of Gardner's leadership tasks is the leader nurse following? 1 Managing Correct2 Explaining 3 Motivating 4 Affirming values

The nurse leader is performing the explaining element of Gardner's leadership tasks. Explaining includes teaching and interpreting information to promote client functioning and well-being. Managing involves assisting the client with planning, priority setting, and decision making while ensuring the organizational systems work on the client's behalf. Motivating is inspiring clients to achieve their vision. Assisting clients in sorting out and articulating personal values in relation to health problems falls under the affirming values task.

The nurse, as a leader, is planning to provide information about personal hygiene to a group of clients. Which communication methods should the nurse use to talk to the clients? Select all that apply. 1 Giving abundant information Correct2 Being sensitive to nonverbal communication Correct3 Providing the opportunity for dialogue and feedback Correct4 Presenting information that addresses the listener's self-interest 5 Using primarily written methods, such as e-mail and text messages

The nurse should be sensitive to nonverbal communication because it may require interpretation of key points in complex situations. The nurse should provide the opportunity for dialogue and feedback. The nurse should present information that addresses the listener's self-interest. The nurse should plan the message and should not give too much information, which will paralyze the listener and divert energy away from key responsibilities. The nurse should use face-to-face communication as the primary communication mechanism rather than e-mail or texting.

The nurse manager is explaining how intramuscular (IM) injection techniques are an example of the theory of diversion of innovation. Which statement made by the nurse manger is accurate? 1 The use of the dorsogluteal site is recommended. 2 The IM injection is used to deliver short acting antibiotics. 3 The technique of IM injection will be taught in the final nursing program. Correct4 The use of IM injections for pain management has decreased with the use of intravenous and epidural routes.

The practice of administering IM injections for pain management to adults in acute care settings has virtually disappeared with the use of intravenous and epidural routes. The use of the dorsogluteal site is no longer recommended. IM injections are used to deliver long acting antibiotics such as immunoglobulins, vaccines, and hormonal agents. Nurses learn this technique in their initial nursing program but may never subsequently alter their practices.

The nurse leader taught the student nurse the principles of quality management and quality improvement. Which statement made by the student nurse indicates ineffective learning? Correct1 "Managers define the quality." 2 "Decisions should be based on data." 3 "Quality improvement focuses on outcomes." 4 "Manager and workers must be committed to quality improvement."

The quality is defined by the clients, not by the managers. All the decisions should be based on the data and not on the theory. Quality improvement focuses on outcomes. Quality improvement is based on the work commitment of both the manager and the workers.

Which statement is true regarding leadership theories? 1 Trait theory is sometimes referred to as the group and exchange theory of leadership. 2 Hierarchy of needs theory focuses on what leaders do in relational and contextual terms. Correct3 Expectancy theory states that leaders should provide specific feedback about positive performance. 4 Organizational Behavior Modification theory states that leaders use motivator factors to inspire staff.

According to the expectancy theory of leadership, the nurse as a leader should provide specific feedback about positive performance. This increases motivation and performance in subordinates. Trait theory is sometimes referred as the Great Man theory. Style theory focuses on what leaders do in relational and contextual terms. Organizational Behavior Modification theory states that leaders should uses positive reinforcement to motivate followers.

The nurse leader is focused on recognizing the dynamic, complex, and interdependent nature of systems in an organization. Which nursing action indicates an effective implementation of this principle of systems thinking theory? 1 Focusing on the measuring of morale, working relationship, team work, and the number of clients 2 Recognizing the consequences of actions taken on the long-term effect of the organization or client care Correct3 Identifying and understanding the relationships between clients, families, communities, and local economies 4 Focusing on the needs of all the residents in a long-term care facility or the complications of emergency department overcrowding

Identifying and understanding the relationship of client, families, communities, and local economies indicates recognizing the dynamic, complex, and interdependent nature of systems related to systems thinking theory. Measuring morale, working relationships, team work, and the number of clients helps focus on both measurable and non-measurable data. Recognizing the consequences of actions taken on the long-term effect of the organization or client care is an example of balancing short-term and long-term objectives principle of systems thinking theory. Focusing on the needs of all the residents in a long-term care facility and thinking of emergency complications is an example of the thinking of the "big picture" principle of systems thinking theory.

A hospital wants to implement the primary nursing model on the premises. Which challenges are likely to be faced by the management? Select all that apply. 1 Lack of client rapport Correct2 Lack of nurse availability Correct3 Lack of experienced nurses 4 Decrease in cost for management 5 Lack of communication with healthcare providers

In the primary nursing model, a single nurse cares for a client while that client is in the hospital. This model requires a nurse to be available 24 hours a day, but it is not possible for any nurse to work for that whole time period. A nurse may not be specialized in all fields and may not have enough experience to care for all types of clients; this may become a challenge for management. If a single nurse cares for a client, that client may be more comfortable, which will increase client rapport. This model becomes more costly as a nurse may charge more for working so many hours for a client. In this model there will be increased communication with the healthcare provider; this may be an advantage for management.

A client who was in an accident is admitted to the hospital. Which decision making approach by the nurse leader indicates the 'satisficing' approach? 1 Informing the client's family members Correct2 Providing preliminary care to the client 3 Waiting for the primary healthcare provider to initiate treatment 4 Thinking of pros and cons and then performing the action

In the satisficing approach to decision making, the nurse makes a quick decision by selecting an acceptable solution, even if it isn't the best one. Therefore the nurse leader makes a decision to provide preliminary care to the client, which meets the objective of treating the client minimally. Informing the client's family members may be the next step after providing preliminary care. Waiting for the primary healthcare provider to treat the client would not be an effective decision for the nurse leader to make as it may lead a serious condition in the client. Thinking of pros and cons and then performing an action indicates 'optimizing approach' of decision making.

The nurse leader has implemented a change in documentation of nursing care. The nurse leader finds that the licensed practitioner nurse (LPN) is resistant to change and is not participating in the change process. Which approach made by the nurse leader would be appropriate in dealing with the LPN? 1 To ignore the resistance displayed by the LPN 2 To instruct the LPN to comply with the change or lose his/her employment Correct3 To confront the LPN and encourage verbalization of feelings regarding the change 4 To calm the LPN by stating that the documentation is done by the registered nurse

The appropriate strategy to manage resistance to change is to confront the LPN and encourage him or her to verbalize feelings regarding the change. Ignoring the resistance may lead to overall poor performance by the LPN. Threatening loss of employment may produce additional resistance. Calming the LPN is done to overcome the resistance at that particular situation but may not improve the overall performance of the LPN.

When a client with cancer reaches an incurable last stage, the nurse explains the situation to the client and calls the client's family members to provide support. Which need of the client does the nurse prioritize here? 1 Safety need Correct2 Belonging need 3 Self-esteem need 4 Self-actualization need

The client at an incurable stage of cancer might need the support of loved ones for emotional support. Therefore the belonging need is fulfilled through this action. Safety needs may not be the top priority of the client at this stage. Self-esteem needs may be fulfilled through recognition and personal growth. Self-actualization needs may not be a priority for the client.

Which initiatives for leaders and managers are set forth in the Institute of Medicine's core relevance report "The Future of Nursing?" Select all that apply. Correct1 Created state coalitions focused on nursing 2 Reinforced the disparities that occur within healthcare 3 Supported the concept of shared governance in nursing 4 Focused on outcomes, accreditation processes, and nurse's roles Correct5 Provided a framework for considering how nurses could determine staffing requirements

The core relevance report "The Future of Nursing" created state coalitions focused on nursing and provided a framework for considering how nurses could determine staffing requirements. The core relevance report "Crossing the Quality Chasm" reinforced the disparities that occur within healthcare. The concept of shared governance was supported by the core relevance report "Keeping Patients Safe." The focus on outcomes and accreditation processes and nurses' roles is developed by the core relevance emphasis on membership-based organization related to quality measurement and reporting from the National Quality Forum.

Four nurse leaders are performing different tasks. Which nurse leader's action indicates the role of the community nurse leader? 1 A 2 B 3 C Correct4 D

The nurse as a community leader has the unique opportunity to work with schools, city or county governments, and other community entities. The nurse as a community leader formulates a vision for improving the health of the community through disease prevention and health promotion. Therefore administering vaccines by Nurse leader D to the children in school to prevent disease indicates that the nurse is performing the role of the community nurse leader. Scheduling the client for a surgery may not be done in a community; therefore this action of Nurse leader A does not indicate the role of the community nurse leader. Assisting the client in positioning him or her on a bed can be done wherever possible, such as in client's home or healthcare facility. Therefore this action by Nurse leader B does not indicate the role of the community nurse leader. Teaching the student nurse to administer an intramuscular medication can be done in a healthcare facility also, therefore this action by Nurse leader C does not indicate the role of the community nurse leader.