Leadership Test 2

The nurse manager wishes to use written communication to convey a message to the Chief Nurse Executive (CNE) that will probably result in the CNE having a negative response. Which option reflects an indirect message type? a. "The nurses under my supervision have strong commitment to patient-centered care and to safety. They have a long history of minimal medication errors. It is my sad duty today to inform you that we have experienced 5 critical errors this week." b. "We have experienced 5 critical medication errors on my units this week." c. "The nursing staff I supervise have committed 5 medication errors this week, even though they have a long history of attention to detail and minimal error." d. "Please call me in regard to the 5 critical medication errors made by my nurses this week."

Answer: a. "The nurses under my supervision have strong commitment to patient-centered care and to safety. They have a long history of minimal medication errors. It is my sad duty today to inform you that we have experienced 5 critical errors this week." Feedback: Indirect messages start with general comments with the bad news buried at the end. Choice (b) is a direct statement. Choice (c) is a direct statement, followed by additional information. Choice (d) is a direct request for the CNE to call in regard to the main message of the statement.

A nurse serving as committee chair realizes that an important message she delivered in a previous meeting was misunderstood by the group. Who is responsible? a. Both the committee chair and the group members share responsibility for the misunderstanding. b. If the words were clearly spoken, it was the group's responsibility to decode the message properly. c. It was the committee chair's responsibility to encode the message with appropriate gestures and expressions. d. The committee chair would be responsible for the poorly delivered transmission.

Answer: a. Both the committee chair and the group members share responsibility for the misunderstanding. Feedback: The communication process consists of six steps: ideation, encoding, transmission, receiving, decoding, and response. Encoding is the manner in which the message (ideation, which is the message, the idea, and the thought to be communicated) is conveyed. The manner may be something other than verbal, such as a written message or a visual or spoken cue.

A group of physicians come into conflict with the nursing staff regarding the time at which morning vital signs are recorded. Which technique might be used that respects the professionalism of both parties? a. Collaboration b. Competing c. Accommodating d. Avoiding

Answer: a. Collaboration Feedback: Collaboration implies mutual attention to the problem because the talents of all parties are used. Competing implies that one group has power over another. Accommodating requires that one group try to make the situation better by cooperating, and the issue generally does not get resolved. Avoiding occurs when one of the parties withdraws from the situation in order to avoid the conflict.

The nurse manager has discovered that many staff nurses do not have a good understanding of the resources available to patients after discharge. This lack of knowledge is likely to reduce the effectiveness of which critical issue(s) in healthcare? Select all that apply. a. Collaboration b. Coordination c. Conflict d. Empowerment e. Organizational performance

Answer: a. Collaboration; b. Coordination; e. Organizational performance Feedback: Collaboration and coordination require that the nurse be aware of the resources available for the care of the patient. Organizational performance depends on collaboration and coordination at all levels in the organization. This lack of knowledge is more likely to increase conflict. Empowerment is a sense within one's self. The empowered nurse or patient would find a way to solve problems.

A decision has been made that the unit will no longer offer both 8- and 12-hour shifts. All nurses are required to work 12-hour shifts, which causes concern among nurses with school-age children at home. Which type of conflict will this decision most likely create? a. Competing role b. Organizational c. Intergroup d. Interpersonal

Answer: a. Competing role conflict Feedback: Competing role conflicts, a type of individual conflict, occur when the same person fills the roles of nurse, student, spouse, and parent, all of which exert a pull on that individual's time, energy, and attention. Organizational conflicts, also referred to as intergroup conflicts, are the result of an incompatibility of expectations produced by the system and perceived professional standards and responsibilities. An example of intergroup conflicts is nurse/nurse conflicts that result when differing values toward the philosophy of nursing are held by nurses who work together. Interpersonal conflicts occur between two people

Which e-mail message is appropriate to send in a professional situation? a. I am sending this e-mail to request your attendance at the Infection Control committee meeting tomorrow at 10:00. b. I AM SENDING THIS E-MAIL TO REQUEST YOUR ATTENDANCE AT THE INFECTION CONTROL COMMITTEE MEETING TOMORROW AT 10:00. c. Sending this to request attendance at the Inf Control committee meeting tom at 10:00. d. I am sending this e-mail to reqest your attendance at the Infection Control comittee meeting tomorow at 10:00.

Answer: a. I am sending this e-mail to request your attendance at the Infection Control committee meeting tomorrow at 10:00. Feedback: Choice (a) is a message in correct form. E-mail messages should be written in sentence case. Types of abbreviations in choice (c) can cause confusion with the message. Is this sender asking for the recipient to come to the meeting or asking for permission to attend the meeting? Spelling should be carefully checked in professional communications.

The nurse manager is studying ways to improve communication skills. Which factor(s) can have a negative effect on successful communication? Select all that apply. a. Overusing reassuring statements b. Using nonverbal feedback c. Using selective listening d. Making quick inferences

Answer: a. Overusing reassuring statements; c. Using selective listening; d. Making quick inferences Feedback: Overusing reassuring statements makes the receiver suspicious about the message. Nonverbal feedback can be a good method of encouraging effective communication. Smiling, eye contact, and nodding of the head are all nonverbal feedback strategies. In this strategy, one hears only what one wants to hear. This can be a very destructive strategy. This is the same as jumping to a conclusion and is a detrimental strategy.

Which is the first step a nurse should take when confronted by a hostile co-worker? a. Trying to get yourself under control b. Reporting the hostility to the nurse manager c. Telling the co-worker that he or she is inappropriate d. Calling security

Answer: a. Trying to get yourself under control Feedback: The first action is to get yourself under control. While reporting the co-worker's hostility to the nurse manager may be necessary, this is not the first action the nurse should take. The nurse should be under control when this report occurs. Telling the co-worker that he or she is inappropriate is likely to escalate the situation and is not a good choice. There is no evidence that it is necessary to call security at this point.

The staff of a medical-surgical unit is in disagreement about holiday scheduling. The nurse manager knows that this is which type of conflict? a. Intergroup b. Intragroup c. Interpersonal d. Intrapersonal

Answer: b. Intragroup conflict Feedback: Intergroup conflict occurs between two or more groups. Intragroup conflict occurs within one group. Interpersonal conflict occurs between two or more people. Intrapersonal conflict occurs within one individual.

In dealing with a conflict on a unit, the nurse manager tells one of the staff nurses, who is not moving towards resolution, that a decision has been made and that there will be no more discussion of the topic. Which tactic has the manager implemented? a. Competition b. Avoidance c. Accommodation d. Collaboration

Answer: c. Accommodation Feedback: Accommodation occurs when one of the parties tries to make the situation better by cooperating. The use of power to stop the conflict is using the competition technique. Avoidance is when one of the conflicting parties withdraws from the situation to avoid the conflict. Collaboration is when all parties in the conflict work together to reach an acceptable solution.

Which technique would be most useful in teaching health care profession students about collaboration? a. Requiring a class in each curriculum that includes information about other disciplines b. Using common textbooks c. Having joint classes in the same classroom d. Encouraging students to read about other disciplines

Answer: c. Having joint classes in the same classroom Feedback: Having multiple disciplines in class learning about one another, as they learn the required academic material, is a good way to foster collaboration. While the other options may be useful in teaching healthcare profession students about collaboration, they are not the most useful.

A group of six experienced and respected nurses from various areas of the hospital were asked to be part of a task force to recommend changes to the staffing policies. After a series of meetings, the group had made little progress. What is the likely reason that the group was nonproductive? a. The group members did not have enough interest in the problem to maintain motivation. b. The group members felt they would not be provided adequate resources to address the problem properly. c. The group members had their own hidden agendas that were unexpressed and that distracted them from problem solving. d. The group members recognized that they would not have any real influence on hospital policy.

Answer: c. The group members had their own hidden agendas that were unexpressed and that distracted them from problem solving. Feedback: There is no evidence that there was a lack of interest in the project. The group is meeting, but no progress is being made. There is no evidence that choice (b) is a concern. The usual reason for a nonproductive group consisting of competent people is that individuals have unexpressed feelings and motivations that cause them to fight among themselves or even to withdraw from a constructive solution. This is often referred to as a hidden agenda, or the real reason that a group member is not participating with the group to solve the immediate problem. There will be no constructive group effort if hidden agendas remain concealed. There is no evidence that choice (d) is the situation. The group has been asked to be a part of this task force.

A nurse manager has asked a small group of unit nurses to meet to discuss a specific patient complaint. Which behavior used by the nurse manager is most likely to result in a defensive (negative) environment? a. The nurse manager actively listens to each nurse's description of the events in question. b. The nurse manager encourages members of the group to problem-solve. c. The nurse manager gives advice on how the problem could have been avoided. d. The nurse manager shows empathy as the nurses express hurt feelings.

Answer: c. The nurse manager gives advice on how the problem could have been avoided. Feedback: A supportive communication climate is characterized by a leader who listens; is empathetic; offers acceptance of individuals; exhibits a shared, problem-solving attitude; is open; and values equality in the workplace. A defensive climate is characterized by a leader who may be controlling, punishing, evaluating, and advice-giving, and who insists on being right. The followers, however, are submissive or hostile, and communication usually is nonproductive.

A conflict between a nurse and a physician has reached the point where mediation is required. Which should the nurse expect to occur during the mediation process? a. Compromising with the physician's point of view b. Expecting the physician to compromise with the nurse's point of view c. Having a neutral third party decide who is right in the conflict d. Having a neutral third party act as a negotiator

Answer: d. Having a neutral third party act as a negotiator Feedback: The nurse would expect having a neutral third party act as a negotiator during the mediation process. When going into mediation, there is no expectation that either party will have to agree with the other party's point of view. The neutral third party in this case will not make a decision.

A nurse manager who tells the staff to "come to me with any problem" but then keeps the office door closed is using what type of communication? a. Metacommunication b. Upward communication c. Diagonal communication d. Intrasender conflict

Answer: d. Intrasender conflict Feedback: Metacommunication is the context in which the message is delivered. This manager delivers the message in the correct context and manner, but then does not follow through with the meaning of the message. Upward communication occurs from staff to management or from lower management to middle or upper management. Diagonal communication involves individuals or departments at different hierarchical levels. When a verbal message is incongruent with the nonverbal message, it results in intrasender conflict. This manager has sent a clear verbal message, but then sends the opposite nonverbal message (keeping the door closed). This may be the result of the leader saying what is expected, but communicating nonverbally what is desired.

The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problem? a. Upward communication b. Downward communication c. Authority communication d. Lateral communication

Answer: d. Lateral communication Feedback: Upward communication occurs from staff to management or from lower management to middle or upper management. Downward communication is communication, generally directive, given from an authority figure or manager to staff. In this case, one set of employees (nursing) does not have authority over another (occupational therapy). Lateral communication occurs between individuals or departments of the same hierarchical level.

The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions is use of which strategy? a. Getting positive attention b. Knowing the context of the instruction c. Follow-up communication d. Verifying through feedback

Answer: d. Verifying through feedback Feedback: The manager would call the subordinate by name to get attention. The manager should plan the context of the information, but asking the subordinate to repeat the information is not related to context. Choice (c) would not give the manager immediate feedback about the subordinate's understanding. Making sure the receiver has understood the request is verifying through feedback.

A nurse manager informs the nursing staff at a unit meeting, "Due to the current critical staff shortage on our unit, no additional vacation time will be granted until further notice." What aspect of this message is least important to conveying the meaning? a. Facial expression b. Movement of hands c. Tone of voice d. Words chosen

Answer: d. Words chosen Feedback: Words become far less important than the tone of the message and the accompanying body language.

The nurse manager is trying to determine whether the nursing staff is functioning as a team or a group. Which characteristic would lead the manager to decide that the nurses are functioning as a team? a. They have clear goals and purpose. b. They are not very well organized. c. No one emerges as a leader. d. There is no evaluation of the work done.

a. They have clear goals and purpose. Feedback: This is a characteristic of a team. A functioning team is organized. Teams have leader and follower responsibilities. Functioning teams use evaluation.

Several staff nurses are considered effective followers. Which characteristic would these staff nurses most likely demonstrate? a. Use of expertise, sharing, collaboration b. Passivity, critical thinking c. Do their work with enthusiasm, don't like to make decisions, and support the leader d. Need clear direction and do as they are told

a. Use of expertise, sharing, collaboration Feedback: Following requires use of expertise, development of expertise, sharing, understanding of problems and others, effective communication, and collaboration. Alienated followers might use critical thinking but usually are passive. Choice (c) answers are characteristics of "yes" people. Choice (d) answers are characteristics of "sheep."

A novice nurse has been asked to use a different leadership style and is quite uncomfortable with the suggestion. Which leadership approach has this nurse likely been asked to try? a. Direct b. "Hands-off" approach c. Participative d. Dictatorial

b. "Hands-off" approach Feedback: Less experienced nurses who are developing their own leadership styles are generally more comfortable providing direct leadership. This style is more controlling than other styles. The less experienced nurse is more comfortable with a direct leadership style. The "hands-off" approach is not as controlling as the direct style and this nurse needs to develop self-confidence and trust before feeling comfortable with it. Leadership approaches that are direct and dictatorial as well as participative, with the leader as the central figure, are more comfortable for the new RN in a team leader role.

The team leader is successful when working with team members. Which action is most likely to be characteristic of this leader? a. Dictating to other members on a day-to-day regime b. Filling in for regular staff during times of need c. Scheduling staff with few changes d. Providing rigid criteria to keep the team on task

b. Filling in for regular staff during times of need Feedback: The leader who dictates actions to other members is not supporting the growth and independence of the team. This can cause conflict between the leader and members of the team. Guiding the team from within is an effective way to accomplish what needs to be done. Team leaders who approach the position with an attitude of being different from team members or above the team members will not be successful. Flexibility is an essential team leader skill. The successful team leader must also assist the team to stay on task and provide an environment where all team members are active in planning.

The nurse has decided to accept the invitation to join a nursing work team because the nurse wants to get to know the nurses on the team. According to McClelland, what is this nurse's motivation? a. Need for achievement b. Need for affiliation c. Need for esteem d. Need for power

b. Need for affiliation Feedback: Motivation related to need for achievement occurs when the person challenges one's self to achieve a set of goals. This nurse's motivation is social interaction, which is a need for affiliation. Need for esteem is part of Maslow's hierarchy. This nurse is not demonstrating a need for esteem. There is no indication that this nurse has the need to obtain and exercise power.

The team members have begun to work together on the project, and the leader feels the group is becoming more cohesive. At what developmental stage is this team? a. Performing b. Norming c. Forming d. Storming

b. Norming Feedback: Performing occurs when work is getting done and the team feels positive about the progress. Norming occurs when the team members begin to work together and team cohesion develops. Forming is the initial stage of team development, when the team is learning about one another. Storming is the second stage when some members may be unwilling to work as a team and others will be restless with the need to get through team building and on to the task at hand.

A staff nurse develops an innovative documentation system for postoperative patients. The nurse manager grants the staff nurse paid leave to develop one for medical patients. Which type of power is the nurse manager using? a. Referent b. Reward c. Expert d. Information

b. Reward power Feedback: Reward power is the ability to reward others if they comply. Referent power comes from others recognizing that an individual has special qualities and is admired. With expert power, the expert is able to produce sound advice and direction. Information power is the ability to access information.

Critical assumptions related to self-directed work teams (SDWTs) include which options? Select all that apply. a. There is little difference between these teams and the traditional "team approach" to the provision of nursing care. b. Team members are responsible for fulfilling their portion of the care. c. Managers relinquish control. d. Roles within the team are changeable. e. Teams work within established performance measures.

b. Team members are responsible for fulfilling their portion of the care.; c. Managers relinquish control.; d. Roles within the team are changeable.

A nurse manager needs to solve a conflict between the staff nurses and the physical therapy department. Which type of power would be most useful to the manager in this situation? a. Information b. Reward and punishment c. Connection and referent d. Legitimate

c. Connection and referent power Feedback: Connection power is based on an individual's formal and informal links to influential or prestigious persons within and outside an area or organization. Referent power is based on admiration and respect for an individual. Information power is based on access to valued data. Reward power is based on the inducements the manager can offer group members in exchange for cooperation and contributions that advance the manager's objectives. Punishment power, or coercive power, is based on the penalties that a manager might impose on an individual or a group. Legitimate power stems from the manager's right to make a request because of the authority associated with job and rank in an organizational hierarchy.

A team has been chosen for a particularly difficult task. At the first team meeting, the leader has the members decide on a team name. At the second meeting, the leader distributes coffee mugs that bear that name. What is this leader trying to accomplish? a. Support of tolerance for different ideas b. A "trial-run" of the team's ability to function c. Creating a feeling that the team is unified d. Identifying the members who are team players

c. Creating a feeling that the team is unified Feedback: These actions would not be helpful in meeting this goal. While choice (b) may be an indication of how the team will function, it is probably not the reason the exercise was done. When a task is particularly difficult or long in duration, it is important to establish a feeling that "we are all in this together." This is the probable reason for this leader's actions. While this may be an unintended result of these actions, it is probably not the primary reason they were done.

A nurse has been assigned to lead a steering committee for a larger project. If given a choice, the leader should pick which team for this committee? a. Fifteen people who volunteered for the committee b. Eight people assigned to the committee c. Six people who volunteered for the committee d. Twelve people assigned to the committee

c. Six people who volunteered for the committee Feedback: Fifteen people are too many for most committees. Eight is a nice size for a committee, but it would be better if the members were volunteers. Six is a small group of volunteers, which is the best choice for a leadership committee. This group in choice (d) is too large, and it would be better if they were volunteers.

A team is focusing on sharing the meaning and mission of a project. This team is exhibiting which stage in the process of team building? a. Communicating b. Claiming c. Initiating d. Visioning

d. Visioning Feedback: Communicating, or letting go, is the last stage. Claiming is the third stage, when the focus is on doing the work. Initiating is the first stage, when team members get to know one another. Visioning, with the focus on sharing meaning and mission, is the second stage of team building. At this time, the team will identify assumptions, which can provoke anxiety, but this will help the team members understand each other's work.