Prep U's - Chapter 10 - Leadership, Managing, and Delegating (TF)
A nurse manager is educating the staff on new forms of charting. Within the education session, the manager sets a goal for complete use of the charting. Through goal setting, the manager is acting as: A. a leader. B. an educator. C. a guide. D. a clinical specialist.
Answer: A Rationale: Leadership is the ability to influence others to strive for a vision or goal or to change. Thus, goal setting is the act of a leader. Although educators may set educational goals, the primary focus of an educator is teaching. A guide provides advice but does not set goals. A clinical specialist develops expert skills and knowledge in one specific area of practice.
Which nursing model results in the greatest continuity of care? A. Primary nursing B. Total client care C. Modular nursing D. Team nursing
Answer: A Rationale: Primary nursing results in increased continuity of care because the same nurse is assigned to provide care for a given client over an extended period of time. The other approaches listed involve multiple nurses providing care to the client at the same time.
A nurse is caring for a client with pneumonia. Which task is most appropriate for the nurse to delegate to experienced unlicensed assistive personnel (UAP)? A. Assessing for shortness of breath. B. Administering nebulizer treatments as needed. C. Instructing the client about the need to alternate activity with rest. D. Obtaining vital signs every 4 hours.
Answer: D Rationale: Having the UAP obtain vital signs every 4 hours is most appropriate, as it is within the UAP's scope of practice to perform this task. Assessment, teaching, and administration of medication are not in the current scope of practice for UAPs.
After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to: A. plan to monitor the supply cabinets. B. make an appointment with the chief nursing officer. C. assess whether the desired results have occurred. D. ask the staff members for other solutions.
Answer: C Rationale: The nurse manager must evaluate the results of the efforts to determine whether the desired results have occurred. The nurse manager should solicit input from staff members about potential solutions before, not after, implementing a solution. Monitoring the supply cabinets would be more appropriate if the problem were suspected drug diversion by staff but would be unnecessary for evaluating for improvement in delays for obtaining supplies. Making an appointment with the chief nursing officer is not necessary and would not help the nurse manager evaluate the change in procedure related to obtaining supplies.
A registered nurse is delegating activities to unlicensed assistive personnel (UAP) on a hospital unit. Which activity(ies) could this nurse normally delegate? Select all that apply. A. transferring a client to another floor. B. determining a nursing concern for care planning for a client with breast cancer. C. taking routine vital signs. D. administering medications to a client. E. giving a bed bath to a client. F. planning education for a client with a colostomy.
Answer: A, C, E Rationale: The nurse should be familiar with guidelines for delegating nursing care. The nurse could delegate the following tasks to UAP: giving a bed bath to a client, taking routine vital signs, and transferring a client to another floor. The nurse could not delegate the administering of medications, planning client education for a client with a colostomy, or the determining a nursing concern for care planning.
The registered nurse (RN) wants to delegate measuring a client's urinary output to unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task? A. Predictability of the UAP, the amount of time required for the task, and RN's skill level. B. The context of the other client needs, the desired outcome, and autonomy of the client. C. The stability of the client's condition, potential for harm, and complexity of the activity D. The complexity of the activity, age of the UAP, and predictability of the outcome
Answer: C Rationale: RNs should consider the following when delegating tasks to UAPs: qualifications and capabilities of the UAP (not the age of the UAP or the RN's skill level), stability of the client's condition (not the autonomy of the client), complexity of the activity to be delegated (not the time required to complete the activity), potential for harm, predictability of the outcome (not the predictability of the UAP or the desired outcome), and overall context of other client needs.
Two nurses are having a disagreement over who will take the next admission to the unit. The nurse manager asks one of the nurses to take the admission and explains that this will be considered a personal favor. Which style of conflict resolution did the nurse manager display? A. Avoiding B. Collaborating C. Competing D. Accommodating
Answer: D Rationale: The nurse manager is displaying a conflict resolution style of accommodating by asking one of the nurses to accept the assignment of the admission. If the nurse manager had ignored the situation, this would have been the avoiding style of conflict resolution. With a competing style, the nurse manager would have told the nurse to accept the admission, rather than asking the nurse. If collaborating is the conflict resolution style used, the nurse manager would have discussed the situation with both nurses in order to achieve a solution to this conflict.
The nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and health care providers is exhibiting what style of leadership? A. Laissez-faire B. Quantum C. Autocratic D. Democratic
Answer: D Rationale: The nurse manager who involves staff members in decision-making by asking for suggestions is exhibiting a democratic style of leadership. Autocratic leadership style would be exhibited by a leader who gave staff little opportunity to give feedback or suggestions. Transactional leadership also involves little input by staff into decision-making and is instead focused on providing rewards when tasks are completed. A leader with a laissez-faire style would give all control to staff members to determine how to improve collaboration.
The new nurse is evaluating the effectiveness of the assigned nurse mentor. Which characteristic should the new nurse recognize as being inappropriate for the nurse mentor to role model? A. Advising the new nurse to consult the nurse mentor before making decisions regarding client care. B. Providing daily feedback to the new nurse. C. Encouraging the new nurse to enroll in continuing education courses. D. Introducing the new nurse to members of the interdisciplinary team.
Answer: A Rationale: Effective mentors should provide feedback to the mentee, encourage opportunities for continued growth, and provide resources that will be supportive in the new role of nurse, including members of the interdisciplinary team. Effective mentors should promote confidence in the new nurse in the decision making process. Requiring the new nurse to report to the nurse mentor before making decisions can hinder the new nurse's confidence level.
How should a nurse leader best address nurses' resistance to a change in the shift-scheduling protocol on their hospital unit? A. Explain the benefits of the change and elicit honest feedback. B. Put the matter to a vote and respect the wishes of the majority. C. Explain the cost savings that the change will bring for the hospital. D. Allow those who remain unconvinced to temporarily opt out of the proposed change.
Answer: A Rationale: Strategies for overcoming resistance to change include explaining the benefits of the change to those who are affected and encouraging feedback. Emphasizing the benefits of the change to the institution is not likely to overcome resistance. Allowing skeptics to opt out or putting the matter to a vote are likely impractical and unrealistic and may lead to further conflict and resistance.
In the hospital setting, a nurse is responsible for overseeing the quality and financial outcomes of client care while working collegially with health care providers. What type of professional nursing practice is this considered? A. Case management B. Primary nursing C. Nurse mentorship D. Functional nursing
Answer: A Rationale: The case management model is when one nurse is responsible for overseeing the quality and financial outcomes of client care; the nurse works collegially with health care providers and other caregivers as well as with payers to manage clients along an agreed-on clinical pathway. Functional nursing is when nurses and other staff are assigned to specific tasks for a group of clients. This model is based on the assembly-line concept. Specializing tasks increases efficiency but results in impersonal care. Primary nursing is when a nurse is accountable for planning, evaluating, and directing the care of a client 24 hours a day throughout the client's stay. Nurse mentorship can be key in helping a less experienced nurse assume added responsibilities and position changes but does not relate to issues with clients.
A charge nurse on a medical-surgical unit is asked by the nurse manager to serve as a mentor to another staff nurse who is less experienced. Which of these would best describe this role? A. The charge nurse is providing support for the staff nurse in new responsibilities. B. The staff nurse is orienting to the unit as a newly hired nurse. C. The staff nurse is learning about all the hospital policies from the charge nurse. D. The charge nurse is being paid to supervise the staff nurse.
Answer: A Rationale: A mentor is not a paid position, but, instead, is a person who provides support and encouragement to a less experienced nurse who is learning new responsibilities for a current role or an expanded one. Preceptorship typically is a paid position, and is provided for a new or experienced nurse who is training for a new position on a unit. The preceptor would teach the new nurse about hospital policies and procedures, as well as supervise the nurse in daily assignments.
The charge nurse on a unit receives a report that a licensed practical nurse (LPN) is taking clients' opioids and hiding them in the nurses' lounge. The charge nurse disregards the report and continues to work on a scheduled task. Which conflict resolution style is the charge nurse using? A. Avoiding B. Accommodating C. Compromising D. Collaborating
Answer: A Rationale: The charge nurse approaching the LPN would potentially cause conflict. To prevent the potential conflict, the charge nurse has chosen to avoid the situation. Collaborating, compromising, and accommodating would involve the charge nurse talking to the LPN to resolve the problem. Collaborating is a joint effort to resolve the conflict with a win-win solution in which all parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. Compromising is an approach in which both parties relinquish something of equal value. Accommodating involves one party making a conscious decision to let the other group win and may collect an "IOU" for use in the future.
The nurse manager notices a trend in nurses routinely arriving to work late. How can the nurse use the transactional leadership style to get nurses to arrive to work on time? A. Monitor time clock reports on a monthly basis and enter all nurses who have not been tardy into a raffle for a paid day vacation. B. Emphasize the importance of arriving to work on time during a monthly unit meeting. C. Generate a report of nurses who routinely arrive to work late and set an example by firing the nurse who has been tardy the most. D. Allow the nursing staff to develop a plan to decrease tardiness within the unit.
Answer: A Rationale: Transactional leadership style involves creating a reward system to get the desired outcome. Entering the nurses who have not been tardy is the only option that provides a reward. Allowing the nursing staff to assist in correcting the problem is an example of democratic leadership style. Emphasizing the importance of arriving to work on time is an example of autocratic leadership. Firing is an example of coercive power.
A nurse manager has asked the staff to create a plan to improve client outcomes. In the past, the staff have not met deadlines. How can the nurse manager use transactional leadership style to ensure that the deadline is met? A. Demand efficiency. B. Give extensions as needed. C. Ask politely. D. Offer 2 days of paid vacation.
Answer: D Rationale: The transactional leadership style involves a task and reward system. Paid vacation is a reward for meeting the deadline. Asking politely, demanding efficiency, and giving extensions are not rewarding behaviors.
The charge nurse on the orthopedic unit believes in giving the staff as much power as possible. The nurses are allowed, among other things, to create their own work schedules, provide dates and times for unit meetings, and create the agendas, to which the charge nurse contributes. The charge nurse's style of leadership can be described as which? A. Laissez-faire B. Democratic C. Autocratic D. Transformational
Answer: A Rationale: With laissez-faire leadership, the leader relinquishes power to the group. Autocratic leadership involves the leader assuming complete control. Democratic leadership displays a sense of equality among the leader and other participants. Transformational leaders create intellectually stimulating practice environments and challenge themselves and others to grow personally and professionally and to learn.
An inner-city hospital is seeing a declining client census. The nurse managers begin to strategically plan to determine ways to increase their client population. In the implementation of these strategies, they also evaluate their success and failure and renew their plan. This activity is: A. controlling client outcomes. B. directive initiatives. C. continuing processes. D. problem solving.
Answer: D Rationale: Management involves getting a job done or accomplishing a goal. The process they use is similar to the problem-solving process, which is based on the scientific or research method. The nurses are not making directive initiatives. Although this work is a continuing process, this description is too vague. Nurses cannot control client outcomes; they can only hope to improve them by making changes that may or may not work.
A staff nurse who has been working as a clinical manager is demonstrating strong leadership qualities on the unit. Which behaviors and competencies by the nurse would be recognized by senior management as indicators of strong leadership during evaluation? Select all that apply. A. The nurse has recognized an error in practice and performance and is managing a task force to change policy. B. When delegating tasks to unlicensed assistive personnel, the nurse supervises, guides care, and evaluates outcomes. C. The nurse volunteers for extra shifts in order to receive overtime benefits. D. The nurse has achieved certification in the field of professional practice and belongs to that professional practice. E. The nurse manages to avoid conflict on the unit by using the conflict management technique of smoothing.
Answer: A, B, D Rationale: One of the competencies according to the American Nurses Association that demonstrates leadership in the professional practice setting and profession is that the nurse retains accountability for delegated nursing care. Another competency that demonstrates leadership is that the nurse contributes to the evolution of the profession through participation in professional organizations. The nurse also demonstrates leadership by influencing policy to promote health. Working to promote financial gain is not a demonstrated quality of leadership. Avoidance of conflict rather than promoting an environment that supports and maintains respect, trust, and dignity does not demonstrate a level of leadership competency.
Which attributes should be characteristic of a nurse mentor? Select all that apply. A. Demonstrates leadership abilities. B. Is an experienced, licensed professional. C. Deconstructs health care networks. D. Embraces disruptive conflict. E. Is supportive. F. Is driven by financial reward. G. Is resourceful.
Answer: A, B, E, F Rationale: Mentors should demonstrate characteristics that will help the less experienced person grow in the profession. Mentors should be supportive, resourceful, experienced, respectable, and trustworthy leaders. Mentors do not receive financial compensation for their effort as preceptors typically do. Mentors should not embrace conflict that is disruptive to tasks. Mentors should build and use health care networks, not deconstruct them.
Which attributes should be characteristic of a nurse mentor? Select all that apply. A. Is supportive. B. Embraces disruptive conflict. C. Is an experienced, licensed professional. D. Demonstrates leadership abilities. E. Deconstructs health care networks. F. Is resourceful. G. Is driven by financial reward.
Answer: A, C, D, F Rationale: Mentors should demonstrate characteristics that will help the less experienced person grow in the profession. Mentors should be supportive, resourceful, experienced, respectable, and trustworthy leaders. Mentors do not receive financial compensation for their effort as preceptors typically do. Mentors should not embrace conflict that is disruptive to tasks. Mentors should build and use health care networks, not deconstruct them.
A client is received into the emergency department after getting shot in the chest. The client is hemorrhaging profusely and is in hypovolemic shock. The nurse calls a code blue. What type of leadership style will be most effective during the management of the code? A. Democratic leadership B. Autocratic leadership C. Laissez-faire leadership D. Transactional leadership
Answer: B Rationale: Autocratic leadership will be most effective in this scenario. Autocratic leadership involves the leader assuming control over the decision and activities of the group. During code blue, a leader is needed to direct the actions needed and make quick decisions to positively affect the client. Laissez-faire leadership would ultimately lead to the demise of the client. Democratic leadership could possibly delay the client receiving life-sustaining measures and would be less effective than autocratic leadership. Transactional leadership would involve a reward system which would be unethical in this situation.
Which statement by a registered nurse (RN) represents appropriate delegation to the unlicensed assistive personnel (UAP)? A. "Inspect the site for thrombophlebitis." B. "Dispose of the disconnected IV set." C. "Discontinue the IV solution." D. "Check the infusion rate."
Answer: B Rationale: Disposing of a disconnected IV set is a task that is within the scope of practice of the unlicensed assistive personnel (UAP). Discontinuing an IV solution, inspecting an IV site for thrombophlebitis, and checking the IV infusion rate are not within the scope of practice of the UAP and should be performed by the RN.
The registered nurse (RN) wants to delegate a task to unlicensed assistive personnel (UAP) but is unsure if the task can be delegated. What is the best resource for the RN to use in determining if the task is appropriate? A. A nurse mentor or a nurse preceptor B. The medical practice act website C. The nurse practice act or facility's policy and procedures D. A more experienced nurse working on the same unit.
Answer: C Rationale: The RN should consult the nurse practice act or the facility's policy and procedures. The nurse mentor or preceptor and the more experienced nurse are good resources, but may mistakenly give inaccurate information. The medical practice act is designed to govern health care provider practice and may not contain information on the task that is to be delegated.
The registered nurse (RN) and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate for the RN to delegate to the UAP? A. Securing the client on a papoose board. B. Soothing the client during the procedure C. Initiating intravenous therapy. D. Gathering equipment needed for intravenous therapy.
Answer: C Rationale: When delegating, the RN must determine the skill level and education of the UAP, the client's condition and the complexity of that condition, and the potential for harm. Initiating intravenous therapy is reserved for the RN due to the potential for harm and the scope of the UAP. The UAP can assist the nurse by obtaining equipment, securing the client, and soothing the client.
The nurse has recently been promoted to nurse manager on a pediatric unit and has decided to accept input from staff regarding changes they would like to see on the unit. Which type of leadership style is the nurse embodying? A. Quantum B. Democratic C. Autocratic D. Laissez-faire
Answer: B Rationale: Democratic leadership style involves sharing the decision-making process and activities with others who have an interest. Autocratic leadership style involves assuming control over the decisions and activities of the group. Laissez-faire leadership style involves the leader relinquishing power or control to the group. Quantum leadership style involves seeing an organization and members as interconnected and collaborative. This style involves change as continually unfolding, and frequently incorporates technology.
Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses? A. Autocratic B. Laissez-faire C. Quantum D. Democratic
Answer: B Rationale: In laissez-faire leadership, also called nondirective leadership, the leader relinquishes power to the group, such that an outsider could not identify the leader in the group. Autocratic leadership, also called directive leadership or authoritarian leadership, involves the leader assuming control over the decisions and activities of the group. Transformational is often described as charismatic; transformational leaders are unique in their ability to inspire and motivate others. Democratic leadership, also called participative leadership, is characterized by a sense of equality among the leader and other participants.
Two nurse managers working on different units in a hospital are planning for a major change to occur on both units. One nurse manager reports to the other having identified a key power player on the unit. Which description most applies to a key power player in this context? A. Someone in whom the nurse manager can confide. B. A regular employee who is a natural leader C. Someone who spreads untrue rumors. D. An employee who will resist the change.
Answer: B Rationale: People who are "natural leaders" because of their demonstrated ability to influence others are "key power players," whose support is essential to effecting change. The other choices do not describe persons who necessarily have power.
On a medical unit, the nurses complain that they have no voice in the decisions that are made in the operation of the unit. The nurses state they are always told by the nurse manager to perform tasks instead of being asked. Which of this best describes the leadership style of the nurse manager? A. Laissez-faire B. Nondirectional C. Autocratic D. Democratic
Answer: C Rationale: This nurse manager, by not soliciting staff feedback and telling the staff what to do rather than ask, would be demonstrating autocratic leadership. Democratic leadership involves equal sharing of power between the leader and the staff; everyone is working together toward a mutual vision and goals. Laissez-faire leadership, which is also known as nondirectional leadership, gives power to the group rather than the leader.
A nurse can improve one's skill with time management by taking which action? A. Allowing the flow of the day to control how time is managed. B. Starting each day as a new day without considering the previous day. C. Evaluating success with accomplishment of goals in client care. D. Setting priorities without involving clients or their families.
Answer: C Rationale: Time management is a skill that can be improved for nurses by taking time during the day to evaluate whether goals have been accomplished and then setting new priorities based on this. Goals and priorities should be established at the beginning of each day, and clients and their families should be involved in this. At the end of the day, a nurse should look back and determine what has and has not been accomplished; this helps to set a time line for the next day. If a timeline is not set each day, then the nurse will allow the flow of the day to control the day, rather than having a plan for what needs to be accomplished.
A registered nurse serves as the chair of the Nursing Practice Committee for the hospital. The meetings of this committee do not have a planned agenda; members of the committee who are interested in a particular topic feel free to suggest it and then to lead the subsequent discussion. This chair's leadership style could be most accurately termed what? A. Decentralization B. Autocratic C. Democratic D. Laissez-faire
Answer: D Rationale: Little or no direction is provided in laissez-faire management: coworkers develop their own goals, make their own decisions, and take responsibility for their own management. Democratic leadership, also known as participative or shared leadership, involves members of the group taking a more participative role in the decision-making process. Autocratic leadership, also known as authoritarian leadership, is characterized by the leader's individual control over all decisions and little input from group members. Decentralized decision-making is any process in which the decision-making authority is distributed throughout a larger group.
The nurse manager calls a staff into a unit meeting to discuss client satisfaction. During the meeting, several staff members assume control. The nurse manager does not intervene to regain control of the group. Which type of leadership style is the nurse embodying? A. Autocratic B. Laissez-faire C. Democratic D. Quantum
Answer: B Rationale: Laissez-faire leadership style involves the leader relinquishing power or control to the group. Democratic leadership style involves sharing the decision-making process and activities with others who have an interest. Autocratic leadership style involves assuming control over the decisions and activities of the group. Quantum leadership style involves seeing an organization and members as interconnected and collaborative. This style involves change as continually unfolding, and frequently incorporates technology.
A nurse manager reviews an employee's contribution to the nursing division annually. This process is: A. reward and development survey. B. performance appraisal. C. employee's job satisfaction survey. D. interpreting quality indicators.
Answer: B Rationale: Performance appraisal is typically conducted annually. Each organization determines a reward structure to define and to acknowledge success. Interpreting quality indicators pertains to evaluation of general client care, not of an individual nurse. An employee's job satisfaction survey is a tool that allows the employee to give feedback on the employee's satisfaction with work, not a review of the employee's contribution conducted by the nurse manager.
The proficient nurse wants to become a more effective leader. Which step would be most appropriate for the nurse to take to achieve this goal? A. Become a preceptor and work extra shifts on the nursing unit. B. Promote a healthy work environment and become a nurse mentor. C. Review the Nurse Manager Leadership Collaborative model and write delegation competencies. D. Start a transformational change on the nursing unit and engage staff in the movement.
Answer: B Rationale: Research indicates that a nurse can become a more effective leader by striving to become an authentic leader, developing leadership skills including reviewing modules such as the Nurse Manager Leadership model and incorporating knowledge into personal practice, promoting a healthy work environment, engaging staff to commit their best effort at work, and assisting new nurses to transition into the RN role through mentorship or preceptorship. Working extra shifts would not help leadership skills. Abruptly starting transformational change on a unit and engaging staff could disrupt harmony on the unit. Writing delegation competencies would not improve leadership skills.
A staff nurse works on a medical unit where staff retention is very high. There is a sense of equality between the leader and the staff nurses. The unit decisions and activities are shared between the leader and the group. The designated nurse leader practices which leadership style? A. Autocratic B. Democratic C. Transformational D. Laissez-faire
Answer: B Rationale: The democratic leadership style is characterized by a sense of equality among the leader and other participants and shared decision making. The autocratic leader assumes complete control over the decisions and activities of the group. Transformational leaders create intellectually stimulating practice environments, and challenge themselves and others to grow personally, to grow professionally, and to learn. In laissez-faire leadership, also called nondirective leadership, the leader relinquishes power to the group, such that an outsider could not identify the leader in the group.
The nurse is caring for an older adult client who states the need to use the restroom. Which safety intervention must the nurse perform first? A. Arrange furniture so that the client has something to hold on to. B. Assess the need for assistance with ambulation. C. Put the client's bedside rails up. D. Apply socks to the client's feet.
Answer: B Rationale: The diverse physiologic and psychologic capabilities of people and encounters with various safety hazards across the lifespan put various age groups at risk for different safety concerns and potential injuries. Older adult clients are at a higher risk for falling. Thus, the nurse should assess the client's ability to ambulate independently before allowing the client to go to the restroom and to provide assistance, if needed. The nurse would lower, not raise, the bedside rails before having the client exit the bed. The nurse would put nonskid footwear like slippers, not socks, on the client to help prevent falls. Furniture should be arranged so that the client has a clear and easy path to the restroom.
Two nurses are having a disagreement over who will take the next admission to the unit. The nurse manager asks one of the nurses to take the admission and explains that this will be considered a personal favor. Which style of conflict resolution did the nurse manager display? A. Collaborating B. Accommodating C. Avoiding D. Competing
Answer: B Rationale: The nurse manager is displaying a conflict resolution style of accommodating by asking one of the nurses to accept the assignment of the admission. If the nurse manager had ignored the situation, this would have been the avoiding style of conflict resolution. With a competing style, the nurse manager would have told the nurse to accept the admission, rather than asking the nurse. If collaborating is the conflict resolution style used, the nurse manager would have discussed the situation with both nurses in order to achieve a solution to this conflict.
Two new nurses are requesting the same preceptor for unit orientation and say they will be unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using an accommodating approach to conflict resolution? A. The nurses ignore each other's request for the preceptor. B. The nurses discuss the situation with the preceptor to come to an agreement mutually beneficial for both parties. C. The nurses agree for one nurse to obtain the preceptor for orientation in exchange for that nurse working each weekend. D. The nurses allow the preceptor to decide which nurse to precept.
Answer: C Rationale: Accommodation involves one party deciding to let the other party win in exchange for something else of value, such as one nurse agreeing to let the other have the preceptor in exchange for the first nurse not having to work weekends. Each nurse ignoring the other's request illustrates avoidance. Allowing the preceptor to decide which nurse to precept encourages competition. Competition involves a win-lose approach to conflict. Collaborating is a joint effort to resolve the conflict with a win-win solution in which all parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal.
The nurse is delegating care to unlicensed assistive personnel (UAP). Which intervention would be most important for the nurse to perform independently? A. Measure the client's blood pressure. B. Obtain a postprandial blood sugar reading. C. Assess the client with difficulty breathing. D. Assist the client with turning in bed.
Answer: C Rationale: Any assessment is the responsibility of the registered nurse. A UAP is able to measure vital signs, assist with turning, and measure blood pressure or blood sugar.
A nurse leader on a unit allows the staff to make all decisions and direct themselves, including filling out the work schedule. The nurse leader is practicing which leadership style? A. Democratic B. Transformational C. Laissez-faire D. Autocratic
Answer: C Rationale: In laissez-faire leadership, also called nondirective leadership, the leader relinquishes power to the group, such that an outsider could not identify the leader in the group. The democratic leadership style is characterized by a sense of equality among the leader and other participants. The autocratic leader assumes complete control over the decisions and activities of the group. Transformational leaders create intellectually stimulating practice environments and challenge themselves and others to grow personally, to grow professionally, and to learn.
Two staff nurses on a unit disagree with one another over certain key aspects of providing client care. The nurse manager of the unit arranges a meeting with the charge nurse and the two staff nurses at a mutually agreed-upon time to discuss this situation. This activity is most accurately described as what? A. Delegation B. Client protection C. Conflict resolution D. Problem solving
Answer: C Rationale: Nurse managers frequently encounter conflict between employees and between themselves and employees. Unresolved conflict can lower morale and threaten quality care. Conflict resolution, also known as conflict management, is a process to work through conflicts in a way that minimizes negative effects and promotes positive consequences. In this scenario, the nurse manager is practicing conflict resolution by bringing the parties involved in the conflict together to discuss possible solutions. Problem solving consists of using generic or ad hoc methods in an orderly manner to find solutions to problems. In a way, conflict resolution is a type of problem solving, in which the problem to be solved is the relational conflict between two or more people. Delegation is the assignment of any responsibility or authority to another person to carry out specific activities. Client protection refers to preventing harm to the client, such as when the nurse keeps client data private.
The nurse recognizes that a new mother is having difficulty breastfeeding. The nurse demonstrates various positions in which to hold the infant while feeding. The nurse also educates the mother on ways to ensure proper latching. The new mother attempts to breastfeed the infant again using the new techniques and is successful. Which statement in this scenario illustrates Lewin's stage of refreezing? A. The nurse also educates the mother on ways to ensure proper latching. B. The nurse demonstrates various positions in which to hold the infant while feeding. C. The new mother attempts to breastfeed the infant again using the new techniques and is successful. D. The nurse recognizes that a new mother is having difficulty breastfeeding.
Answer: C Rationale: Refreezing involves making a change operational, or a part of one's everyday life. The mother feeding the infant using new techniques is an example of refreezing. The nurse recognizing that a new mother is having difficulty breastfeeding is an example of unfreezing, in which the need for a change is recognized. The nurse educating the mother on ways to ensure proper latching and demonstrating various positions in which to hold the infant while feeding are examples of moving, in which change is initiated after a careful process of planning.
Following a myocardial infarction (heart attack), a client begins to recognize the need to increase exercise, eat a low-fat diet, and implement relaxation techniques. According to Lewin, this client is in which stage of the change process? A. Moving B. Refreezing C. Unfreezing D. Prizing
Answer: C Rationale: Unfreezing is stage in the change process in which the person recognizes the need for change and the dissolution of previously held patterns of behavior. Unfreeze, move (or change), refreeze, also known as the Kurt Lewin Change Model, is a method for managing change within a client or organization. For a client to change, the client must be melted (unfreeze), poured into a mold (move), and frozen again in the new shape (refreeze). Prizing is not a component of the model.
The registered nurse (RN) and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate for the RN to delegate to the UAP? A. Securing the client on a papoose board. B. Soothing the client during the procedure. C. Initiating intravenous therapy. D. Gathering equipment needed for intravenous therapy.
Answer: C Rationale: When delegating, the RN must determine the skill level and education of the UAP, the client's condition and the complexity of that condition, and the potential for harm. Initiating intravenous therapy is reserved for the RN due to the potential for harm and the scope of the UAP. The UAP can assist the nurse by obtaining equipment, securing the client, and soothing the client.
A staff nurse is talking with a clinical nurse leader and asks, "What exactly do you do?" Which statement by the clinical nurse leader would be appropriate? A. "I'm an advanced practice nurse with a specific specialty area." B. "My position is one of management." C. "I'm an administrator involved with client care." D. "I collaborate with health care teams to promote client care."
Answer: D Rationale: A clinical nurse leader is a master's-prepared nurse who has earned the certified CNL credential and works collaboratively with the health care team to facilitate, coordinate, and oversee care provided to clients. This role is not considered an administrative or management role, but rather one of leadership in all health care settings. Clinical nurse specialists are advanced practice nurses with specialist education in a defined area of practice.
A nurse manager is trying to resolve a conflict between the day and night shifts. The nurse manager wants to convince the involved persons to set aside their differences, determine a priority common goal having to do with improved client care, and accept mutual responsibility for achieving this goal. The nurse manager is using which type of conflict resolution? A. Avoiding B. Compromising C. Competing D. Collaborating
Answer: D Rationale: Collaborating has all parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. This requires mutual respect, honest communication, and shared decision making. Avoidance, as a method of conflict resolution, involves looking the other way and doing nothing to resolve the conflict. Competing has one side winning at the expense of the other. Compromising means that each side gives up something of equal value.
Two new nurses are requesting the same preceptor for unit orientation. Both new nurses have been very vocal about being unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using a compromise approach to conflict resolution? A. The nurses agree that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend. B. The nurses ignore each other's request for the preceptor. C. The nurses agree to allow the preceptor to decide which nurse to precept. D. The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end.
Answer: D Rationale: Compromise involves both parties willingly relinquishing something of equal value. The nurses' decision to share the preceptor, with one having the preceptor at the beginning of the orientation and the other at the end, demonstrates compromise. The nurses ignoring each other's request illustrates avoidance. Allowing the preceptor to decide which nurse to precept encourages competition. Competition involves a win-lose approach to conflict. The nurses agreeing that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend illustrates accommodation. Accommodation involves one party deciding to let the other party win in exchange for something else of value.
A nurse manager best demonstrates effective leadership characteristic by which action? A. Being very structured and rigid with the unit flow. B. Indicating an interest in becoming a role model. C. Knowing all information about the unit processes. D. Sharing a vision for the unit and enlisting support.
Answer: D Rationale: The nurse leader on a nursing unit should have a vision for the unit and be able to share this with the staff in order to enlist support and cooperation among the staff. The nurse leader should already be a role model, rather than just demonstrating interest. This would be related more to someone who was developing leadership qualities. The nurse leader should be flexible, not rigid, and does not have to know all information about the unit; rather, the nurse leader needs to know what resources are available among the staff and other leadership in helping reach expected goals and outcomes.
