Nursing Leadership & Management Final

A novice nurse has been trying to apply the nursing process to each client interaction. What should

The weakness of the nursing process, like the traditional problem-solving model, is in not requiring clearly stated objectives. Goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured. Assessment and diagnosis often cannot be performed at the same time. Ethics should always be considered, of course, but this variable is not identified as enhancing the overall effectiveness of the nursing process. Evaluation is recommended as an ongoing, iterative process that is not reserved for when all outcomes have been met. Indeed, it is impossible to determine whether outcomes have been met without performing evaluation

The nurse-manager who seeks to exemplify emotional intelligence should:

Theorists studying emotional intelligence posit that the ability to regulate the emotions of self and others is key to effective leadership. Emotional intelligence does not involve removing emotion from decision making; conversely, it does not claim that emotion should trump reason. Management of emotions is not the same as manipulating the emotions of others, which is unethical.

Which statements demonstrate a characteristic of a critical thinker? Select all that apply.

A critical thinker displays persistence, empathy, and assertiveness. Trying a new approach shows persistence. Considering the client's participation shows empathy. Speaking to the care provider on the client's behalf shows assertiveness. Concluding that there is no solution to a problem reflects an inability to think outside the box. Stating, "It's important that we not give up; our clients deserve it" shows persistence and empathy.

Which statements concerning autonomy are true? Select all that apply.

A form of personal liberty, autonomy is also called freedom of choice or accepting the responsibility for one's choice. The legal right of self-determination supports this moral principle. The use of progressive discipline recognizes the autonomy of the employee. The employee, in essence, has the choice to meet organizational expectations or to be disciplined further. If the employee's continued behavior warrants termination, the principle of autonomy says that the employee has made the choice to be terminated by virtue of his or her actions, not by that of the manager. Ethical situations always differ, so it is impossible to state that one particular principle always overrides another.

The nurse-manager oversees the care of several dozen nurses. With which nurse should the manager rev

HIPAA states that a client's privacy and confidentiality must be maintained. Confirming a new client's presence on a unit can be problematic because the identity of the person speaking cannot be confirmed. Communicating by telephone with other members of the care team is acceptable provided efforts are taken to protect the client's privacy from others who may overhear. Documentation can be completed in any setting provided it is guarded from view of unauthorized persons. There is no prohibition against initiating contact for referrals.

A manager is trying to get in the habit of creating a daily list of tasks. The manager should

The daily list should be flexible. changeable. leave some time for the unexpected. and include appropriate short-term goals.

The manager is leading a team to develop a unit-level philosophy statement. What guideline should th

The unit philosophy will be congruent with the organizational philosophy. Vision and mission are istinct from philosophy statements. The statement should transcend any one particular manager and does not necessarily have to align with other organizations.

A nurse leader has set a goal of becoming a more transformational leader. What outcome will best ind

Transformational leadership is characterized by empowering others and instilling them with vision. Transactional leadership is more management-oriented and includes functions around rewarding performance and allocating resources. Transactional and transformational leadership can both result in loyalty and respect.

The nurse who manages an ambulatory clinic is well known as being a visionary leader who is skilled

Transformational leadership is characterized by the presence of a vision. Transformational leaders impart this to others, creating a collective purpose. The traditional manager, concerned with the day-to-day operations, was termed a transactional leader. Transactional leaders are not typically known as being visionaries. Bureaucratic leaders are focused on functions and processes, not vision. The basic premise of interactional theory is that leadership behavior is generally determined by the relationship between the leader's personality and the specific situation; vision is not a central focus.

What action by the nurse-manager in a health organization best demonstrates transformational leaders

Transformational leadership often involves the communication of a vision and empowering employees to share in it. Functions involving performance review, scheduling, and licensure are more consistent with a transactional role. Taking responsibility is a trait of effective transformational and transactional leadership.

For which client would right to die laws most likely apply?

Typically right to die laws apply only to patients who are at least 18 years old with the capacity to make medical decisions with a terminal disease expected to result in death within 6 months. Depression and pain are not normally considered to be terminal diseases and suicidal ideation in and of itself does not mean that this legislation would apply.

Nurses on a hospital unit have been informed that a change to the documentation system is being prop

Unfreezing occurs when the change agent convinces members of the group to change or when guilt. anxiety. or concern can be elicited. Thus. people become discontent and aware of a need to change. In this case. dissatisfaction with the current documentation system creates a powerful impetus for change. This factor is likely more significant than the support of the leader-manager and influential nurse or the fact that similar institutions have made a change.

A society that highly values social equity and equality is likely to support a health-care system wh

Values strongly influence the formation of health-care policy. A society that values equality of access and social equity is likely to create a health-care system in which each citizen has similar access to services. In many cases. the roles of the free market and the private sector are eclipsed by government. which provides or coordinates services accessible to all. This type of system may or may not be cost-effective. depending on numerous variables.

The manager of a clinic is considering a change in the scheduling of vacation time in which nurses w

Weaknesses are those internal attributes that challenge an organization in achieving its objectives. In this case. possible intimidation within the culture of the unit would be considered an internal attribute that could complicate the proposed system. Threats are also potential confounding factors. but these are external. not internal. factors. Strengths and opportunities are positive attributes.

The nurse-manager has been approached by three different families in recent weeks, all of whom have

Democratic leadership involves the use of awards and feedback. The Great Man theory posits that leadership is an inherent trait, not a learned trait; the manager's actions do not point to this. There is no reason to believe that a commendation may discourage the nurse's peers. Accusations of favoritism are unlikely, provided the manager's commendation is evidence-based.

A nurse intends to enroll in graduate school and has informed a colleague of this intention. What re

In the precontemplation stage. the individual has no intention of changing in the foreseeable future. Exploring the possibility of making a change would suggest the contemplation stage. and transitioning to movement characterizes the preparation stage.

What characteristic of a health-care organization most clearly suggests that is an aged organization

A history of suppressing innovation is a hallmark of aged organizations. Age alone does not constitute an aged organization; well-established organizations can stay "fresh" and avoid becoming aged by promoting positive change and innovation. Many factors can contribute to being overtaken in size or in attractiveness to new graduates. These phenomena do not necessarily mean that it has become an aged organization.

When applying the principles of advocacy a nurse-manager should:

Advocacy is helping others to grow and self-actualize. The manager must be an advocate for clients, subordinates, and the nursing profession. Advocacy is not limited to leaders. It is simplistic to claim that the needs of subordinates always trump those of the organization; every situation is different.

Frequent turnover in leadership at a health-care organization has meant that change has often occur

Change by drift is unplanned or accidental. Change by drift is not necessarily the result of a threat. Even though change by drift happens "organically." this does not mean that it is necessarily a democratic process.

The nurse-manager is faced with a difficult decision in a situation that involves the manager's values...

Every person has a value system, and this cannot be simply "set aside." Awareness and reflection are necessary to make good decisions in the context of one's own values. Intuition and values are not counterpoints, and prioritizing intuition does not negate the importance of values. Values influence every decision to varying degrees, and it is impractical to defer every value-laden decision to someone else

Which is a true statement about planning?

Every plan should be flexible because unexpected events are inevitable. It is impossible to identify every aspect of the plan at the outset because circumstances are always changing. Short- and long-range plans should be complementary and integrated. not separate. The philosophy should form the foundation of objectives and goals.

A nurse has repeatedly witnessed a physician being dismissive of clients' reports of pain and anxiety and recognizes that the best action would be to addess the behavior with the physician but the nurse suspects that these concern would be dismissed. What phenomenon is this nurse experiencing?

Moral Outrage

A state Nurse Practice Act is an example of which source of law?

Statutes are the only laws made by official enactment by the legislative body. A Nurse Practice Act is an example of a "law that governs." As a statute a Nurse Practice Act is not a form of constitutional administrative or judicial law.

The leader-manager of several inpatient units is participating in fiscal planning. During this proce

The manager's responsibility is to monitor all aspects of the unit's budget in the unit under his or her leadership. However . the leader-manager does not have primary responsibility for budgeting . which usually lies with a chief financial officer. There is often minimal participation by subordinates in fiscal planning . and it is often not possible to control variations in the census.

The unit manager has created a decision grid in order to assist with a difficult staffing decision...

A decision grid allows one to visually examine the alternatives and compare each against the same criteria. This assists with the decision-making process, but it cannot guarantee that the decision will be completely objective. A decision grid is not a tool for tracking the outcomes of a decision. Decision grids are not synonymous with project planning tables

A novice nurse-manager is frequently late for appointments. This manager's colleagues are likely to

A lack of punctuality suggests that one does not value other people's time. Chronic lateness is likely to cause resentment among colleagues. not a recognition of the manager's needs for more support.

Which leadership role is most closely associated with advocacy?

A leadership role associated with advocacy is to create a climate where advocacy and its associated risk taking are valued. Management functions include giving subordinates and clients adequate information to make informed decisions and seeking appropriate consultation when advocacy results in intrapersonal or interpersonal conflict. Workplace safety is more closely aligned with a management role than a leadership role.

A nurse failed to supervise a confused client and the client fell while transferring to the bathroom

A malpractice suit requires evidence of actual injury to the offended party. The fact that this client was unharmed would likely jeopardize the suit regardless of the client's role or the standard of care. Even if the event was foreseeable the absence of injury removes a key criterion of malpractice.

A health-care organization has adopted a new philosophy statement. What observation best shows that

A philosophy is being implemented if it is evident in the care that clients and families receive. Displaying the philosophy prominently. aligning it with vision and mission. and collaboratively creating the philosophy do not guarantee that the philosophy is actually being implemented.

A nurse is integrating the code of ethics when making a decision about the best response to a challe

A professional code of ethics is a set of principles, established by a profession, to guide the individual practitioner. It is not, however, a decision-making model or a tool for clarifying one's own values. Codes of ethics are not legally binding documents.

Which response is most characteristic of a servant leader?

A servant leader always thinks before reacting. This leader also chooses words carefully so as to not damage those being led, provides directions toward goal achievement, and finds asking for input more important than personally providing solutions. Speed is not a priority within servant leadership.

The nurse-manager is on a team that is performing a SWOT analysis of the staffing system at a commun

After identifying the issue. SWOT analysis begins with identifying strengths. which are the internal attributes that help an organization achieve its objectives. The "S" does not denote stakeholders or strategizing. It is important to identify the rationale for a change. but this is not a component of the SWOT model of analysis.

A nurse is considering applying for a management job that will require the nurse to make many difficult...

An individual's comfort level with risk has a major bearing on that person's ability and willingness to make difficult decisions. It also affects the outcomes of decisions. The nursing process can have application in the decision-making process, but it is not among the most common decision-making models in management situations. A focus on pleasing other people may make it difficult to arrive at a decision when there are not ideal options available. Quick thinking can be beneficial when making some decisions, but people who are more methodical thinkers are not necessarily at a disadvantage. Quick thinking does not always lead to wise decisions.

A nurse-manager has recognized that unproductive socialization is making it difficult to complete ea

Appointments will discourage unproductive socialization since time will be allotted and a schedule maintained. Open-door policies and impromptu meetings encourage socialization. Requesting a transfer would be an extreme measure that should be reserved for more entrenched or unsolvable problems. An outright ban on socialization is excessive and likely to cause resentment.

Which statement is true concerning political action of nurses?

As a whole the nursing profession has not yet recognized the full potential of collective political activity. Political action is not contrary to ethical practice and may in fact support it. The ANA is not the main venue for political action among nurses which can take many forms. Nurses can speak to many aspects of health care and the nursing profession not only consumer issues.

Even after a lengthy discussion concerning the ramifications a client wants to leave the hospital a,

As advocate for this client it is important to make sure the client is informed of the ramifications of leaving AMA however it is a client's right to refuse treatment. However this does not mean that the nurse is obliged to actively encourage the client to leave which would be inappropriate. The nurse should dialogue with the client about the risks of leaving but avoid making the decision for the client or coercing the client to stay.

The clinic leader tends to make decisions independently and closely supervises and controls the prac

Authoritarianism is associated with decision making that does not involve others and strong control. Democratic leadership emphasizes broad participation in decision making, and a laissez-faire approach highly permissive with low control. A contingency approach emphasizes the need for flexibility in leadership, not high control and centralized decision making.

A nurse is distressed by some of the examples of substandard care in the workplace and is considerin

Before taking action it is important for the nurse to consider the possible ramifications of whistleblowing which could be serious. This must precede efforts such as hiring a lawyer or contacting the media. Depending on the circumstances, it may be inadvisable to dialogue with the manager before whistleblowing.

A nurse feels strongly that a proposed piece of legislation would be contrary to the interests of cl

Collective action is generally considered to be more effective than individual action. E-mails are easy to ignore and are less effective than personalized letters. Addressing the issue on social media may make more people aware of the issue, but it may or may not result in action change. Media outlets normally initiate interest in news interviews; they rarely respond to people's requests to be interviewed.

An older adult client has been admitted to the hospital with pneumonia and has been placed on a crit

Critical pathways are one means of standardizing care for clients with similar diagnoses. Pathways do not necessarily reduce the client's costs. Care is standardized . but this does not mean that administrative costs and documentation are always reduced.

The manager at a long-term care facility has intervened in a conflict between two staff members abou

Directing entails human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals. Evaluation is not one of the five specific functions in the management process.

A nurse has been asked to stay after a shift and work overtime because three nurses have called in sick

Duty-based reasoning is an ethical framework stating that some decisions must be made because there is a duty to do something or to refrain from doing something. In this case, it could be construed that the nurse has a duty to care for clients that supersedes social activities. Duty-based reasoning would not prioritize the effect on relationships over the nurse's moral duty. Precedents would not necessarily indicate what the nurse's duty is. Duty-based reasoning emphasizes the nurse's own duty, not that of colleagues.

Which nurse is experiencing moral distress?

Each of the listed situations has an ethical element. However, moral distress occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action. A nurse who lacks the time and energy to give clients what they need is likely to experience moral distress. Issues of respect, honesty, and confidentiality require ethical decision making, but they do not directly involve a disconnect between the desire and the ability to do the right thing.

A leader is applying the principles of emotional intelligence? What outcome indicates successful app

Emotional intelligence (EI) refers to the ability to use emotions effectively and is required by leader-managers in order to enhance their success. Holding one's emotions in check can be unhealthy; EI does not demand this. EI does not require that emotions dominate decision making or that the expression of emotion is the marker of success.

A nurse is facing an ethical dilemma about whether to report a colleague's offensive comment an act

Ethical dilemmas involve being forced to choose between two or more undesirable alternatives. Ethical dilemmas are often not amenable to being solved with empirical data; they involve values and beliefs, not only facts. Most ethical dilemmas do not involve a breach of the law; legal issues often have a more clear and unambiguous response. Even though ethical dilemmas are difficult to manage, this does not mean that there is no possibility of a realistic solution.

A registered nurse has admitted to the manager that she obtained her license on false pretenses and

Following a complaint the board of nursing completes an investigation. The facility may or may not pursue a lawsuit and is more likely to focus solely on dismissal. This would be more likely to be handled administratively by the board of nursing than criminally by the court system. A ban from the profession would be more likely than a fine.

A nurse has been hired to oversee a day surgery clinic. What action will best ensure good outcomes f

For managers and leaders to function at their greatest potential, the two roles must be integrated. This helps ensure positive outcomes for all. Authoritative leadership is generally not preferred in the 21st century because it has poorer results than more contemporary models. Charisma can be beneficial in a leadership position, but it is not among the major traits of successful leadership and management. A focus on finances with all employees is not normally necessary and is not linked to high-level outcomes.

A nurse-manager has identified the following objective for the care on the unit: At least 95% of ne

For objectives to be measurable. they should have certain criteria. There should be a specific time frame in which the objectives are to be completed. and the objectives should be stated in behavioral terms. be objectively evaluated. and identify positive outcomes rather than negative outcomes. It is appropriate for an objective to include references to documentation and it may or may not be appropriate to expect 100% compliance. depending on many factors. The rationale is not normally included in an objective statement.

In which situation would the nurse be justified in overriding a client's right to confidentiality?

Health-care managers are required by law to report certain cases, such as drug abuse in employees, elder abuse, and child abuse. This is considered a justifiable violation of confidentiality. The manager is obliged to respect client confidentiality around disclosing pregnancy, acknowledging a hospital admission, or not wanting to know diagnostic results.

The novice nurse can reduce the likelihood of being sued for malpractice by

It has been shown that despite technical competence nurses who have difficulty establishing positive interpersonal relationships with patients and their families are at greater risk for being sued. Relationship building is a skill that consequently has the potential to reduce a nurse's risk of a lawsuit. Many malpractice suits originate in lower acuity settings, such as long-term care, so practicing in such an environment may not necessarily reduce the nurse's risk of a lawsuit. It is unrealistic and unnecessary to perform all interventions with a witness and there is no evidence that this would reduce the risk of a lawsuit. Lifelong learning is beneficial but is not noted to reduce the nurse's risk of a lawsuit

What is the primary reason for documenting nursing interventions as soon as possible after an active

It is important to document nursing interventions as soon as possible after an activity is completed. Waiting until the end of the workday to complete necessary documentation increases the risk of inaccuracies and incomplete documentation. It is true that this is an established nursing principle and that it shows professionalism and good time management. but the primary rationale is client safety.

A charge nurse has discovered that a medication error was made on the previous shift. What is the nu

It is the responsibility as manager to immediately document the error according to hospital policy. Because policies concerning such situations vary, it is vital to know and follow established policies. It is not generally appropriate to make such a note on the client's chart. Speaking to another nurse or manager is not a sufficient response, although this may be one part of the follow-up process.

The nurse is caring for a client who has health insurance that is a form of managed care. What are l

Key principles of managed care include the use of primary care providers as gatekeepers . a focus on prevention . a decreased emphasis on inpatient hospital care . the use of clinical practice guidelines for providers . selective contracting . capitation . utilization review . the use of formularies to manage pharmacy care . and continuous quality monitoring and improvement. The client's choice of health-care providers is often limited.

A nurse was 20 minutes late returning from a scheduled lunch break and a colleague's break was conse

Laissez-faire leadership is generally understood to be a "hands off" approach. The manager using this approach would likely allow the two nurses to self-manage this event and reach a solution independently. Requiring a meeting would be a more authoritarian or autocratic approach. Punishing the nurse and requiring an apology would be a strongly autocratic approach.

When participating in fiscal planning . a leader should perform what role?

Leaders are visionary; the other roles of assessing needs . monitoring budget control . and documenting needs are management-related.

Which statement regarding the characteristics of a good leader is true?

Leaders may be deceitful and trustworthy, greedy and generous, and cowardly and brave. To assume that all good leaders are good people is foolhardy and makes us blind to the human condition. It is only when we recognize and manage our failings that leaders achieve greatness. No one can be brave in each and every situation. Many good leaders have strong charisma, but this is not always the case.

The nurse-manager is addressing a nurse's suspected breach of client confidentiality in a social med

Legal and ethical issues, such as violations of confidentiality, are categorized within the controlling function. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals. Staffing functions consist of recruiting, interviewing, hiring, and orienting staff. Directing entails human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration.

The nurse-manager is creating a list in order to promote efficiency and productivity. What is the ma

Lists must be based on the relative priority of tasks. Lists generally focus on short-term priorities more than longer term goals. The list should not be longer than what can be realistically accomplished in 1 day; otherwise. it demotivates instead of assists. There is no particular benefit to keeping each day's list similar to every other days.

The manager is using a decision package to set funding priorities for a hospital unit. What type of

Managers must rejustify their program or needs every budgeting cycle in zero-based budgeting. Using a decision package to set funding priorities is a key feature of only zero-based budgeting . not flexible . operating . or capital budgets.

A nurse-manager set a goal early in the year take better control of time management. Upon achieving

Managing time appropriately reduces stress and increases productivity. However. a manager is unlikely see a direct relationship between time management and increased knowledge. influence. and learning.

Which statement concerning the role of the most powerful individuals in organizational decision maki

Not only does the preference of the powerful influence decisions of others in the organization but the powerful are also able to inhibit the preferences of the less powerful. Powerful people in organizations are more likely to have decisions made that are congruent with their own preferences and values. Powerful people tend to make decisions on their own rather than delegating them. Often, the effect on others is not prioritized as highly as it should be.

Which statements accurately describe the implications of a Good Samaritan law for a registered nurse

Nurses are not required to stop and provide emergency services as a matter of law although most health-care workers feel ethically compelled to do so. Good Samaritan laws suggest that health-care providers are typically protected from potential liability if they volunteer their nursing skills away from the workplace (generally limited to emergencies) provided that actions taken are not grossly negligent and if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. Good Samaritan laws vary between jurisdictions.

Which action should the nurse prioritize when trying to prevent malpractice claims?

Nurses can reduce the risk of malpractice claims by practicing within the scope of the Nurse Practice Act. Nurses should purchase their own liability insurance and understand the limits of their policies. Although this will not prevent a malpractice suit, it should help to protect a nurse from financial ruin should there be a malpractice claim. Asking for assistance when needed is prudent nursing practice but staying within the scope of practice is a more important guideline. Similarly good nurse-client relationship has been shown to reduce the likelihood of malpractice but this is a less significant guideline than staying in the scope of practice which is paramount

Which statement about time management is true?

Nurses who are self-aware and have clearly identified personal goals and priorities have greater control over how they spend their time. Most people have misperceptions about how they spend their time. Writing down goals is always necessary and creating an accurate time inventory requires more than 1 day.

What initiative is most likely to promote open communication between clients and practitioners?

One way to promote open communication between clients and practitioners is involving health-care consumers as active members of the health-care team. Pursuing client safety initiatives prevent medical injury by promoting the creation of cultures of client safety in health-care organizations, establishing a federal leadership locus for advocacy of client safety and health-care quality and building an evidence-based information and technology system impacts client safety.

One of the most commonly used tools in health-care organizations is SWOT analysis. What is the defin

Opportunities are external conditions that promote achievement of organizational objectives. Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

The interdisciplinary team is considering whether to apply the principle of paternalism in the care

Paternalism can be invoked when a client is unable to make sound decisions for himself or herself. Consequently the client's ability to make decisions underlies the question of whether acting paternalistic is justified or not? The presence or absence of social and family support does not justify or rule out paternalism. Likewise the particulars of the client's prognosis do not determine whether it is appropriate to be paternalistic. The client's competence decides whether the care team is justified in stepping in to act in the client's "best interest."

Which ethical principle is demonstrated when an adult child is legally given the right to make medic

Paternalism is when one individual assumes the right to make decisions for another. Justice requires that a person seek fairness, treat "equals" equally and treat "unequals" according to their differences. Fidelity involves the need to keep promises. Beneficence involves actions that are taken in an effort to promote good.

What actions by the nurse-manager are consistent with relationship age leadership? Select all that a

People skills, transparent communication, cooperation, and valuing staff knowledge are all characteristics of the relationship age leader. Promoting competition is characteristic of an industrial age leader.

Which factor is the greatest contributor to the resistance encountered with organizational change?

Perhaps the greatest factor contributing to the resistance encountered with change is a lack of trust between the employee and the manager or the employee and the organization. Although the other options may increase resistance. employee distrust is the primary barrier to change.

Which statement regarding nursing policies and procedures is most important to their successful appl

Policies and procedures should be evidence-based. It is unrealistic to expect 100% compliance. 100% of the time. A policy that is created by staff representatives but which is not evidence-based is not appropriate because it may be unsafe. Ongoing. cyclical review should be implemented.

To decrease overtime, the manager of a surgical unit offers nurses who get their work finished on ti

Principal agent theory suggests that followers may have an informational (expertise or knowledge) advantage over the leader as well as their own preferences, which may deviate from that of the principal. This may lead to a misalignment of goals. To influence the agent, the principal offers an incentive that corrects excessive overtime. This action is performance-based, so it would be difficult to characterize it as favoritism. Servant leadership prioritizes the interests of others; creating incentives to address the misalignment of goals is not central to servant leadership. Quantum leadership is a holistic

A leader-manager has recognized the need to be more consistent with time management? What skill shou

Priority setting is perhaps the most critical skill in time management because all actions taken are some type of relative importance. It is very possible for a manager to set goals but then fail to manage his or her time. A person's ability to handle emergencies does not necessarily indicate his or her ability to manage time on a day-to-day basis. An administrative assistant can be a valuable asset but does not facilitate the manager's own time management skills.

A recent nursing graduate has not performed a dressing change on a central catheter for several mont

Procedures delineate a series of specific steps of a required action. such as performing a specific type of dressing change. Policies are plans reduced to statements or instructions that direct organizations in their decision making. not specific nursing actions. Procedures are not synonymous with documentation of "practice rules."

A client has been diagnosed with a degenerative neurologic disease and has expressed interest in phy

Providing the client and family with the tools necessary to make an informed decision is the best demonstration of client advocacy. Documentation is important in this situation, but this action does not necessarily demonstrate advocacy. The moral implications of physician-assisted suicide must be identified by the family rather than provided by the nurse these are subjective and this will be part of the family's decision-making process. The nurse should avoid presuming that the client is fearful and anxious. This may not necessarily be the motivation behind the client's request.

A nurse manager-leader is experiencing many challenges overseeing the care in a health-care organiza

Quantum leadership posits that today's workplace is a highly fluid, flexible, and mobile environment, and this calls for an entirely innovative form of leadership. Quantum leadership encompasses varied aspects of this uncertainty, such as conflict and emotion, but these not the central focuses of this theory.

Which action represents a management function in planned change?

Recognizing the need for planned change and identifying the options and resources available to implement change are management functions. Inspiration. role modeling. and exercising vision are more closely aligned with leadership functions.

An experienced nurse-manager has been described as being a right-brain thinker. This manager's dec

Right-brained thinkers have traditionally been characterized as being creative and intuitive. Linear analysis is more closely aligned with left-brained thinking. Transparency and efficiency are desirable qualities that are not particularly aligned with either of these two paradigms.

The care team is working with a client who has mental illness and who has been deemed a threat to self and others. It may be justified to take away the clients right to

Self Determination

How should the nurse-manager most effectively deal with the ever-changing nature of the nursing work

Setting new priorities or adjusting priorities to reflect ever-changing work situations is an ongoing reality for the unit manager. Although the other options are appropriate. they are not directed to the management role in dealing with the ever-changing nature of the environment of nursing.

A nurse-manager is prioritizing tasks. Which tasks should the manager put into the do now category

Short-term staffing needs are a priority because this has direct implications for client safety. Following up an incident report. meeting with a committee. and providing performance reviews are actions that are necessary but less time-dependent and with less direct implications for safety.

A nurse-manager has been attending several conferences and workshops in order to network with collea

Social skills are a component of emotional intelligence, and involve proficiency in handling relationships and building networks in an effort to find common ground. Servant leadership is characterized by selfless acts, which are not in evidence in this scenario. Similarly, there is no obvious evidence of the manager building on his or her strengths. Self-regulation is a component of emotional intelligence, but it involves controlling or redirecting disruptive impulses or moods; there is no indication that the manager is doing this.

Accreditors are scheduled to visit a hospital site, and staff members have been made aware of what t

The Hawthorne effect indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. Avoiding scrutiny does not demonstrate this effect, which involves improving one's performance, knowing that it is being observed. Blame shifting does not reflect this deliberate improvement in performance, or does adopting a leadership role on a temporary basis, which may or may not be seen as beneficial.

The nurse-manager is applying an evidence-based approach to a clinical question around client mobili

The PICO (patient or population, intervention, comparison, and outcome) format is used in evidence-based practice to guide the search for the current best evidence to address a problem. Client and family preferences and cost are included in evidence-based practice but are not explicit components of the PICO format. Intuition is a component of decision making but is not specifically included in the PICO format.

The nurse is admitting a client to the health-care facility who is in the late stages of pancreatic

The PSDA requires acute care facilities to document on the medical record whether a patient has an AD and to provide written information to patients who do not. This legislation does not directly address such matters as ensuring the client's understanding of treatment options, including the family in care planning and determining the client's expectations even though each of the actions is necessary for providing quality care.

The nurse has accepted a job in a workplace where organizational power has a pronounced effect. This

The ability of the powerful to influence individual decision making in an organization often requires adopting a private personality and an organizational personality. The nurse will often have to accept decisions that solely reflect the values of more powerful individuals. This may lead to a feeling of powerlessness but not necessarily mistrust and lack of communication. Delegation of decision making is likely to be rare, not common, because it is concentrated with those in power.

The nurse-manager is overseeing the care of a client who is taking a passive role in his care. How s

The advocate informs others of their rights and makes certain they have sufficient information to make decisions. This contextualizes any further teaching or dialogue such as role modeling or educating him about the benefits of being more assertive. As well, not every client has the desire or skills necessary to be assertive and an active participant in care. It is important to assess clients' social support networks, but this is not directly related to advocacy.

A nurse-manager is participating in the budgeting process. What task should the manager perform firs

The first step in the budgetary process involves assessment. That is . the manager must assess what needs to be covered in the budget. Creating a plan and maximizing cost-effectiveness occur after the assessment. Identifying the organization's larger strengths and weaknesses is not an explicit part of the budgetary assessment.

A nurse has recently begun a leadershipmanagement role and is most likely to face challenges in:

The fiscal realities of nursing and health care are known to make great demands on managers and leaders, regardless of their setting. For this reason, this challenge is more likely than intraprofessional tensions, which are more likely to be isolated. Marketing is not normally the responsibility of the nurse manager-leader. Scope of practice affects what nurse can and cannot do, but it is not the manager's responsibility to educate them about this; most professionals have a grasp of this before beginning a job.

What changed the structure of Medicare payments from a retrospectively adjusted cost reimbursement s

The impetus of diagnosis-related groupings changed the structure of Medicare payments from a retrospectively adjusted cost reimbursement system to a prospective . risk-based one. None of the other options were involved in the change.

The nurses on a medical unit are using several different techniques for performing wound care and th

The implementation of EBP usually follows a linear approach that begins with formulating a specific question that can be used to guide a literature search. This should be done before starting a literature review or consulting experts in the field.

The nurse who provides oversight to a large health-care organization can best demonstrate leadership

The leader should be open and receptive to change and views change as a challenge and an opportunity for growth. A focus on responsibilities may create a backlash and increase resistance. Collaboration is necessary. but this is not synonymous with asking permission for change. Resistance should be expected. but stating this fact does not demonstrate leadership.

The nurse is working with a client who has a terminal diagnosis and who is facing difficult decision

The main advocacy role for nurses involves giving clients all they need to make informed decisions. Teaching the client how to make a decision is likely to be perceived as paternalistic. Referrals may be helpful for the client, but this does not advocate for the client's need to make a decision. Introducing a client to another client in similar circumstances can be ethically challenging and may or may not be perceived as helpful.

The manager of a busy emergency department is primarily concerned with the practical, day-to-day operations...

The traditional manager, concerned with the day-to-day operations, is termed a transactional leader. Transformational leadership prioritizes longer term vision and empowerment. Bureaucratic leadership emphasizes rules and regulations, whereas interactional leadership focuses on the link between personality and situations.

Which statement concerning a budget is true?

budget that is predicted too far in advance has greater probability for error. For this reason . it is not desirable to create a budget too far in advance.

A recent switch to a new laundry provider at a long-term care facility has been described as cost-e

cost-effective does not necessarily imply the cheapest . but it requires that the expenditure be worth the cost. The other options are not characteristic of the term cost-effective.

The nurse-manager at a long-term care facility is participating in fiscal planning for the first tim

fiscal planning is a learned skill and must include nursing management input. It should be proactive . not reactive . and it is part of the planning process of management.

A nurse is ostracizing a staff member who dresses unprofessionally and is encouraging other nurses

normative-reeducative strategies use group norms and peer pressure to socialize and influence people so that change will occur and do not require the change agent to have a legitimate power base. This exercise of power is not the principle guiding any of the other options.

A change in the skills mix has been proposed at a care facility. What action by the nurse-manager wo

rational-empirical change strategies assume that resistance to change comes from a lack of knowledge and that humans are rational beings who will change when given factual information documenting the need for change. Actions to create awareness and enthusiasm are more consistent with normative-reeducative strategies. A punitive approach would be more consistent with a power-coercive strategy.

The nurse-manager has begun the movement stage of a proposed change. What is the manager's most appr

responsibility during the movement stage is to develop a plan. Responsibilities of the change agent in the unfreezing stage include gathering data. accurately diagnosing the problem. and deciding if change is needed.