PrepU Chapter 10 Leadership, managing and Delegating
When a staff member has successfully completed the activities delegated by the nurse manager, the result is usually that the staff member is more: responsive. committed. time efficient. cost effective.
committed. Because successful completion of delegated activities helps staff members to grow and to become more committed to the organization, delegation is an important development method. The staff member is not necessarily more cost effective, time efficient, or responsive.
Magnet® status recognizes an institution for creating an environment that supports three approaches toward nursing services: self-governance at the unit level, acknowledgment of professional autonomy, and_____ a decision-making process.
decentralized phi tap trung
A nurse who transfers responsibility for the performance of an activity to another nurse, while retaining accountability for the outcome, is using the process of _____nursing care.
delegating
Two nurses who are trying to resolve a conflict use the conflict resolution strategy known as compromise when both nurses agree to relinquish something of value.
t
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? Apply socks to the client's feet. Put the client's bedside rails up. Assess the need for assistance with ambulation. Arrange furniture so that the client has something to hold on to.
Assess the need for assistance with ambulation. 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.
The nurse manager is concerned about the large number of teenage mothers being seen in the obstetrics clinic. How can the nurse manager use the transformational leadership style to address the concern? Conduct community-based research into the number of teenagers who have become parents over the last five years. Create a new policy that will limit the number of teenage mothers the clinic can treat. Enlist volunteers to help develop a community outreach project that will educate teenagers on methods to prevent pregnancy. Talk to each teenager who comes in to the clinic about ways to not get pregnant again. Enlist: chieu mo/tuyen
Enlist volunteers to help develop a community outreach project that will educate teenagers on methods to prevent pregnancy. Transformational leaders create revolutionary change and inspire others to become involved with their cause or concern. Enlisting others to make a change in the community is an example of transformational leadership. Creating new policies to distract attention from the problem and talking individually to each teenager does not inspire others to become involved in the change. Conducting research may be a step taken when developing the community outreach project; however, conducting research does not involve others getting inspired to be a part of the change.
The registered nurse (RN) and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate for the RN to delegate to the UAP? Initiating intravenous therapy Soothing the client during the procedure Securing the client on a papoose board Gathering equipment needed for intravenous therapy
Initiating intravenous therapy 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 proficient nurse wants to become a more effective leader. Which step would be most appropriate for the nurse to take to achieve this goal? Promote a healthy work environment and become a nurse mentor. Become a preceptor and work extra shifts on the nursing unit. Review the Nurse Manager Leadership Collaborative model and write delegation competencies. Start a transformational change on the nursing unit and engage staff in the movement.
Promote a healthy work environment and become a nurse mentor. Explanation: 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.
Which of these statements regarding a nurse manager role is accurate? To effectively manage the nursing unit, the nurse manager should also be a leader. The nurse manager's main role in the nursing unit is to manage the unit budget. A healthy work environment is not within the scope of the nurse manager's role. The nurse manager will decide on the financial targets for the nursing unit.
To effectively manage the nursing unit, the nurse manager should also be a leader. In order to be an effective nurse manager, the nurse manager must also be a leader. This is important with management of a healthy work environment, which is a responsibility of the nurse manager. This is done by helping ensure that interpersonal conflicts are resolved. The nurse manager is also accountable for client census, staffing, supplies, and budget, but is not responsible for setting financial targets for the budget; this is usually managed at the executive level.
The nurse is working to enhance time management skills and has to administer pain medications to several clients, obtain vital signs, and assist clients with bathing. What should the nurse do next? Obtain vital signs. Administer pain medications. Bathe clients. Delegate bathing and vital signs tasks.
Delegate bathing and vital signs tasks. Steps to enhancing time management include: establish goals, evaluate ability to meet goals and identify tasks that can be delegated, establish a timeline, evaluate success of the plan, and use the evaluation to make future plans. Goals were established in the stem of the question and therefore, the next step would be to delegate task.
Explicit power refers to power vested in the position (e.g., unit manager), whereas ____ power refers to the power to influence as a leader.
implied
Democratic leadership is characterized by a sense of equality among the leader and other participants.
t
A nursing facility has recently implemented new policies regarding nurse-to-client ratios. The nursing staff seems very resistant to the change. How can the nurse manager help the staff accept the change? Use the laissez-faire leadership style to address staff concerns. Institute the changes immediately and collectively to decrease anticipation anxiety. Challenge staff's beliefs and values regarding providing quality client care. Hold a unit meeting to discuss how the changes will benefit staff.
Hold a unit meeting to discuss how the changes will benefit staff. Holding meetings allows open communication and opportunities for feedback. Listing the benefits of change to the individual and group also helps with buy-in. Laissez-faire leadership styles tend to increase conflicts and anxiety during times of change. Challenging staff beliefs will increase anxiety and create unpleasant work environments. Change should be instituted gradually, if possible.
A nurse can delegate the initial or ongoing assessment of the patient to an unlicensed assistant as long as the primary nurse reviews the documentation within 24 hours.
F
How might one define leadership? Leadership is the process of guiding, educating, motivating, and directing others. Leadership is the process of planning, organizing, directing, and controlling activities. Leadership is the process of interviewing, hiring, and firing personnel. Leadership is the process by which the leader shares power with others.
Leadership is the process of guiding, educating, motivating, and directing others. Leadership may be viewed as - the process of guiding, - educating, -motivating, and -directing the activities of others toward attaining goals. Management includes planning, organizing, directing and controlling activities. Empowerment is the process by which the leader shares power with others. It is the manager who interviews, hires, and fires.
The primary responsibility of the nurse manager is to: provide direct client care. direct discharge planning. create unit plans and budgets. evaluate nursing care plans.
create unit plans and budgets. The primary responsibility of a nurse manager is to create plans and budgets for the unit as a whole. Staff nurses are responsible for direct client care, discharge planning, and evaluating nursing care plans.
In a nursing unit, the RN delegates nursing tasks to the nursing assistant. Keeping in mind the delegation guidelines, which statement denotes the right communication for the nursing assistant? "Dispose of the disconnected IV set." "Inspect the site for thrombophlebitis." "Check the infusion rate." "Discontinue the IV solution."
"Dispose of the disconnected IV set." Explanation: The statement, "Dispose of the disconnected IV set" is in accordance with the delegation guidelines of right communication. The nurse should provide all the necessary information to carry out the assigned task. The other statements do not follow the delegation guideline of right communication. The tasks mentioned in the other instructions are not a nursing assistant's role.
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? "My position is one of management." "I collaborate with health care teams to promote client care." "I'm an advanced practice nurse with a specific specialty area." "I'm an administrator involved with client care."
"I collaborate with health care teams to promote client care." Explanation: 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.
The new nurse is having difficulty managing the time required to care for a group of complex clients and is several hours behind in completing nursing interventions. Which intervention should the nurse complete first? Obtain discharge orders for a client who is ready to be transferred to a long-term nursing facility. Administer a dose of digoxin that is two hours behind schedule. Perform a dressing change to an abdominal abscess that is three hours behind schedule. Complete a medication reconciliation form on a client who has recently been admitted to the hospital.
Administer a dose of digoxin that is two hours behind schedule. The first step in time management is to determine which tasks are priority. Digoxin is a critical client medication and therefore takes priority over the other options. Dressing changes, discharge orders, and completing facility forms can be delayed until critical tasks are complete.
The nurse is working at a facility that is applying for Magnet® Recognition. The nurse knows that compared with other hospitals, Magnet® hospitals have which direct effect on client care? Longer client stays Better client outcomes Improved job satisfaction scores Higher nurse retention
Better client outcomes Explanation: Magnet® hospitals have better client outcomes than facilities without the recognition. Magnet® hospitals have higher nurse retention and job satisfaction scores, but these do not have a direct effect on client care. Magnet® hospitals have shorter, not longer, client stays.
The designated charge nurse on the telemetry unit organizes and facilitates the unit meetings, makes assignments, and performs staff evaluations. This nurse's power to lead is of which type? Situational Explicit Democratic Implied
Explicit This nurse's official assigned role gives this nurse explicit power by virtue of that assignment. Implied power arises when a person who has no official assigned role assumes a leadership role by virtue of the force of the person's personality and charisma. Situational and democratic are types of leadership rather than power.
The nurse is delegating care to an unlicensed assistive personnel (UAP). Which intervention would be most important for the nurse to perform independently? Measure the client's blood pressure Obtain a postprandial blood sugar reading Assess the client with difficulty breathing Assist the client with turning in bed
Assess the client with difficulty breathing Explanation: 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.
On a medical unit, the nurses complain that they have no voice in the decisions that are made in the operation of the unit. The nurses state they are always told by the nurse manager to perform tasks instead of being asked. Which of these best describes the leadership style of the nurse manager? Autocratic Democratic Laissez-faire Nondirectional
Autocratic 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 manager is trying to resolve a conflict between the day and night shifts. The nurse manager wants to convince the involved persons to set aside their differences, determine a priority common goal having to do with improved client care, and accept mutual responsibility for achieving this goal. The nurse manager is using which type of conflict resolution? Collaborating Compromising Avoiding Competing
Collaborating 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.
A nurse manager of a hospital unit is working within a decentralized management structure. Which nursing action best exemplifies this type of system? Nurse managers are not accountable for clients, staffing, supplies, or budgets. Decisions are made by those who are most knowledgeable about the issue. Nurses are not intimately involved in decisions involving client care. Senior managers make all the decisions.
Decisions are made by those who are most knowledgeable about the issue. The best example of a nurse manager of a hospital unit working within a decentralized management structure would be that decisions are made by those who are most knowledgeable about the issue. Nurses would be greatly involved in decisions involving client care. Senior managers would not make all the decisions within a decentralized management structure. Nurse managers could be accountable for clients, staffing, supplies, and/or budgets.
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? Autocratic Quantum Democratic Laissez-faire
Democratic Explanation: 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.
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? Autocratic Laissez-faire Democratic Transformational
Democratic Explanation: 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.
A registered nurse is delegating activities to unlicensed assistive personnel (UAP) on a hospital unit. Which activities could this nurse normally delegate? Select all that apply. The determination of a nursing diagnosis for a client with breast cancer Planning education for a client with a colostomy Giving a bed bath to a client Transferring a client to another floor Administering medications to clients Taking routine vital signs
Giving a bed bath to a client Transferring a client to another floor Taking routine vital signs 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 determination of a nursing diagnosis. Ref
The nurses who provide care on a medical unit are skeptical about the planned change from a traditional opioid cupboard to a computerized medical supply and management system. Which statement best demonstrates mistrust about the benefits of this proposed change? "There's no way that I'm going to be able to learn to deal with a computer." "Those machines cost a fortune and there are way better ways to spend that money." "I think that they want us to use these machines just so they can track our work activity closer." "I've heard those machines don't even cut down on medication errors like they say they do."
I've heard those machines don't even cut down on medication errors like they say they do." Resistance to change takes many forms, including doubts about the benefits of a change. Expressing doubt that a new process will reduce medication errors expresses such a doubt. Fears about the necessary learning, cost, and effects on workload are also common points of resistance, but these do not focus on the purported benefits.
A nurse leader on a unit allows the staff to make all decisions and direct themselves, including filling out the work schedule. The nurse leader is practicing which leadership style? Laissez-faire Autocratic Transformational Democratic
Laissez-faire 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.
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? Democratic Autocratic Laissez-faire Quantum embody /im bo' di/ hien than
Laissez-faire 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.
The nurse manager notices a trend in nurses routinely arriving to work late. How can the nurse use the transactional leadership style to get nurses to arrive to work on time? Monitor time clock reports on a monthly basis and enter all nurses who have not been tardy into a raffle for a paid day vacation. 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. Emphasize the importance of arriving to work on time during a monthly unit meeting. Allow the nursing staff to develop a plan to decrease tardiness within the unit.
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. 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. tardy/thá di/ sluggish cham chap, tre raffle/ra' phồ/ sổ số
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? Give extensions as needed. Offer 2 days of paid vacation. Ask politely. Demand efficiency.
Offer 2 days of paid vacation. 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.
Which nursing model results in the greatest continuity of care?
Primary nursing : 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 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 clinical specialist. an educator. a guide. a leader.
a leader. 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.
Transactional leadership theory views an organization and its members as interconnected and collaborative.
F
The new nurse is having difficulty managing the time required to care for a group of complex clients and is several hours behind in completing nursing interventions. Which intervention should the nurse complete first? Administer a dose of digoxin that is two hours behind schedule. Obtain discharge orders for a client who is ready to be transferred to a long-term nursing facility. Perform a dressing change to an abdominal abscess that is three hours behind schedule. Complete a medication reconciliation form on a client who has recently been admitted to the hospital.
Administer a dose of digoxin that is two hours behind schedule. Explanation: The first step in time management is to determine which tasks are priority. Digoxin is a critical client medication and therefore takes priority over the other options. Dressing changes, discharge orders, and completing facility forms can be delayed until critical tasks are complete. Reference:
According to Lewin's change theory, the process of initiating change after a careful process of planning is known as "unfreezing."
F
Which attributes should be characteristic of a nurse mentor? Select all that apply. Is resourceful Is driven by financial reward Deconstructs health care networks Is supportive Embraces disruptive conflict Demonstrates leadership abilities Is an experienced, licensed professional
Is supportive Is resourceful Demonstrates leadership abilities Is an experienced, licensed professional 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.
After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to: ask the staff members for other solutions. plan to monitor the supply cabinets. assess whether the desired results have occurred. make an appointment with the chief nursing officer.
assess whether the desired results have occurred. 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.
The nurse is conducting an in-serve on change theories. Which example should the nurse include in the presentation illustrating Lewin's three stages of change? A need for a safer intravenous therapy pump is identified. New intravenous therapy pumps are purchased and training for staff nurses is provided. Intravenous therapy pumps are placed on the nursing unit for client care. Staff voice concerns among themselves about the requirement of mandatory overtime. A unit meeting is called to discuss the issues with management. The mandatory overtime requirement is reinforced by management. Multifunctional machines monitor clients' vital signs. Data from the machines is used to create trends in clients' health. The trends are compared to national norms and used to determine if measures can be taken to improve client care. Nurses work in groups to care for clients. Physicians collaborate with nurses. Quality client care is provided.
A need for a safer intravenous therapy pump is identified. New intravenous therapy pumps are purchased and training for staff nurses is provided. Intravenous therapy pumps are placed on the nursing unit for client care. Lewin's three stages of change are: unfreezing - recognizing need for change; moving - initiating change after planning; and refreezing - making change operational. Identifying a need for new intravenous therapy pumps, training staff to use the pumps, and then placing the pumps for client care is the only option that illustrates Lewin's stages.
A nurse is in charge of a large group of employees on a busy surgical floor. Today's care must be completed early due to a special event involving most of the employees. Which management style would work best in this situation? Coercive Authoritarian Laissez-faire Democratic
Authoritarian With authoritarian, or autocratic, leadership, the leader determines, dictates, and directs the activities of the group, with no input from the followers on decisions. It is particularly effective when decisions for a large group need to be made quickly and efficiently, as in this scenario. Coercion--involving forcing actions upon the staff--is not a recognized leadership style and, in any case, would not be an advisable approach as it would likely trigger resistance in the group and be counterproductive. Democratic leadership is appropriate when the task, or decision at hand, is not one that requires urgent action, when subordinates can be expected to make meaningful contributions, and when their input can be taken into account. Laissez-faire management provides little or no direction; coworkers develop their own goals, make their own decisions, and take responsibility for their own management.
The charge nurse on the orthopedic unit believes in giving the staff as much power as possible. The nurses are allowed, among other things, to create their own work schedules, provide dates and times for unit meetings, and create the agendas, to which the charge nurse contributes. The charge nurse's style of leadership can be described as which? Laissez-faire Democratic Transformational Autocratic
Laissez-faire Explanation: 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.
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? Autocratic Decentralization Democratic Laissez-faire
Laissez-faire 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. Reference:
Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses?
Laissez-faire Explanation: 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.
A leader who relinquishes power to the group in such a way that an outsider could not identify the leader is said to be practicing_____ leadership.
laissez-faire
A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check clients' blood glucose levels. The nurse manager informs the group that this is a new policy on the unit and that discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating? Democratic Laissez-faire Transformational Autocratic
Autocratic Explanation: Autocratic leadership involves the leader assuming complete control of the decisions and activities of the group. An extremely autocratic leader might make all decisions for the workers or followers without considering their ideas or feelings. Democratic leadership is characterized by a sense of equality among the leader and the other participants. In laissez-faire leadership, the leader relinquishes power to the group. Transformational leadership can create a revolutionary change and may be directed by a charismatic leader who has a unique ability to inspire and motivate others.
Which action by the nurse manager demonstrates the function of directing? Helping manage unit flow with client care if there is a staff call-out Hiring an adequate number of nurses to staff the unit on all shifts Identifying a goal for the nurse-client ratio on the clinical unit Using a weekly system for keeping the workforce budget balanced
Helping manage unit flow with client care if there is a staff call-out Explanation: The four managerial functions are planning, organizing, directing, and controlling. Directing is leading others to achieve the goals of the unit; in this case, helping on the unit with client care, if there is inadequate staffing. Planning involves identifying a problem, which, in this case, is a lack of staff for the clinical unit; this function also involves having goals and strategies to achieve an adequate nurse-client ratio. The controlling phase includes implementing mechanisms for ongoing evaluation; the nurse manager will do this when checking the budget weekly to be sure the resources are adequate. The organizing phase would involve hiring the staff.
A nurse manager best demonstrates effective leadership characteristic by which action? Knowing all information about the unit processes Being very structured and rigid with the unit flow Sharing a vision for the unit and enlisting support Indicating an interest in becoming a role model
Sharing a vision for the unit and enlisting support Explanation: 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.
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? Transactional leadership Democratic leadership Autocratic leadership Laissez-faire leadership hypovolemic shock: sot giam the chat
Autocratic leadership Explanation: 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 attributes should be characteristic of a nurse mentor? Select all that apply. Demonstrates leadership abilities Embraces disruptive conflict Is resourceful Deconstructs health care networks Is supportive Is an experienced, licensed professional Is driven by financial reward
Is supportive Is resourceful Demonstrates leadership abilities Is an experienced, licensed professional 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.
Two new nurses are requesting the same preceptor for unit orientation. Both new nurses have been very vocal about being unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using a compromise approach to conflict resolution? The nurses agree to allow the preceptor to decide which nurse to precept. The nurses ignore each other's request for the preceptor. The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end. The nurses agree that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend.
The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end. 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.
The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task? The complexity of the activity, age of the UAP, and predictability of the outcome The stability of the client's condition, potential for harm, and complexity of the activity Predictability of the UAP, the amount of time required for the task, and RN's skill level The context of the other client needs, the desired outcome, and autonomy of the client
The stability of the client's condition, potential for harm, and complexity of the activity 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.
The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task? The stability of the client's condition, potential for harm, and complexity of the activity The context of the other client needs, the desired outcome, and autonomy of the client The complexity of the activity, age of the UAP, and predictability of the outcome Predictability of the UAP, the amount of time required for the task, and RN's skill level
he stability of the client's condition, potential for harm, and complexity of the activity Explanation: 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.
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? Encouraging the new nurse to enroll in continuing education courses Introducing the new nurse to members of the interdisciplinary team Providing daily feedback to the new nurse Advising the new nurse to consult the nurse mentor before making decisions regarding client care
Advising the new nurse to consult the nurse mentor before making decisions regarding client care 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.
Conflict has emerged on a nursing unit because new graduates have found that some of the more experienced nurses are manipulating the client assignment to ensure a lighter workload during night shifts. How should the manager of the unit best address this conflict? Reassure the new graduates that the more experienced nurses are acting in the interests of both staff and clients. Arrange for the newer nurses to organize the client assignment for a trial period. Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible. Gather evidence over the next several weeks in order to determine if the practice is indeed happening.
Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible. Open, explicit, and participatory conflict resolution that is based on collaboration is an effective strategy for the management of conflict. Gathering evidence does not directly address the conflict that currently exists and reassurance may be unwarranted and false. A llowing the new graduates to create the client assignment may perpetuate selfish practices and does not resolve animosity between the two camps. explicit: ro rang / eks pli' sit
Conflict has emerged on a nursing unit because new graduates have found that some of the more experienced nurses are manipulating the client assignment to ensure a lighter workload during night shifts. How should the manager of the unit best address this conflict? Arrange for the newer nurses to organize the client assignment for a trial period. Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible. Reassure the new graduates that the more experienced nurses are acting in the interests of both staff and clients. Gather evidence over the next several weeks in order to determine if the practice is indeed happening.
Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible. Explanation: Open, explicit, and participatory conflict resolution that is based on collaboration is an effective strategy for the management of conflict. Gathering evidence does not directly address the conflict that currently exists and reassurance may be unwarranted and false. Allowing the new graduates to create the client assignment may perpetuate selfish practices and does not resolve animosity between the two camps.
The nurse is working at a facility that is applying for Magnet® Recognition. The nurse knows that compared with other hospitals, Magnet® hospitals have which direct effect on client care? Improved job satisfaction scores Longer client stays Better client outcomes Higher nurse retention
Better client outcomes Magnet® hospitals have better client outcomes than facilities without the recognition. Magnet® hospitals have higher nurse retention and job satisfaction scores, but these do not have a direct effect on client care. Magnet® hospitals have shorter, not longer, client stays.
A nurse can improve one's skill with time management by taking which action? Allowing the flow of the day to control how time is managed Starting each day as a new day without considering the previous day Evaluating success with accomplishment of goals in client care Setting priorities without involving clients or their families
Evaluating success with accomplishment of goals in client care 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 nurse is caring for a client with pneumonia. Which task is most appropriate for the nurse to delegate to an experienced unlicensed assistive personnel (UAP)? Administering nebulizer treatments as needed Instructing the client about the need to alternate activity with rest Obtaining vital signs every 4 hours Assessing for shortness of breath
Obtaining vital signs every 4 hours 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
Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status? Most client outcomes have improved but are not at target range. Staff nurses are developing innovative solutions to problems. Nursing administration is in control of all decision-making. There is a decreased rate of retention among the nursing staff.
Staff nurses are developing innovative solutions to problems. Explanation: A hospital that has achieved Magnet status has recognition of quality client care that is provided by nursing staff who are professional and well-qualified. The staff nurses participate in self-governance and, therefore, work toward innovative solutions to problems. Having an increased turnover among staff nurses and a lack of quality client outcomes would not be characteristics of a Magnet hospital.
The case manager works in a facility that supports a participative leadership style. Which action should the nurse recognize as an example of democratic leadership style? The interdisciplinary health care team collectively developing plans of care for clients The nurse implementing the physician's written orders for client care The dietitian completing a nutritional assessment for a registered nurse (RN) The unlicensed assistive personnel (UAP) taking vital signs for several nurses
The interdisciplinary health care team collectively developing plans of care for clients Democratic or participative leadership style is characterized by a sense of equality among the leader and other participants. The interdisciplinary health care team collectively developing plans of care for clients Explanation: Democratic or participative leadership style is characterized by a sense of equality among the leader and other participants. The interdisciplinary health care team collectively developing plans of care for clients is the only option that shows shared responsibility to achieve the same client outcome. The other answers are simply individual healthcare team members carrying out their assigned tasks. collectively developing plans of care for clients is the only option that shows shared responsibility to achieve the same client outcome. The other answers are simply individual healthcare team members carrying out their assigned tasks.
Directive or authoritarian leadership, also known as______ leadership, involves the leader assuming control over the decisions and activities of a group.
autocratic
When communicating with an employee, the nurse manager must: reserve time to be attentive. communicate congruently. giao tiep dong thoi be aware of surroundings. be agreeable.
communicate congruently. Explanation: Congruent communication is that in which the sender's tone, inflection of voice, facial expression, or other nonverbal behaviors are consistent with the verbal message; this approach enhances communication. The nurse manager does not always need to be agreeable, reserve time to be attentive, or be aware of surroundings when communicating with an employee.
A nurse leader is working with a client with hypertension who needs to learn about a low-sodium diet. The nurse recognizes that the client is in the unfreezing stage of Lewin's Change theory with which client statement? "I don't see a problem with what I normally eat." "I am developing a daily meal plan for a low-sodium diet." "I understand why I need to eat a low-sodium diet." "I have selected my daily menu with low-sodium foods."
"I understand why I need to eat a low-sodium diet." Lewin's Change theory involves three phases, which include unfreezing, moving, and freezing. With the unfreezing stage, the person recognizes the need for change. The client who understands why a low-sodium diet is needed with hypertension recognizes that this is a necessary change for the client's health status. If the client does not recognize a problem that needs to be changed, as in the client who wants to continue with a normal diet, the person is not ready for change. The person who is planning a meal is in the moving phase, which is the initiation of change after planning. The person who has already made the change with the daily menu is in the refreezing stage, where change has been effectively made.
The nurse is advising a client about health problems related to being overweight. The client acknowledges the need to lose weight. The nurse provides education on how to count calories in food and the importance of daily exercise. The client states an intention to begin counting calories with the next meal. The client also states an intention to begin an exercise program with friends. Which statement associated with this scenario illustrates Lewin's stage of unfreezing? The nurse is advising a client about health problems related to being overweight. The client acknowledges the need to lose weight. The nurse provides education on how to count calories in food and the importance of daily exercise. The client states an intention to begin counting calories with the next meal. The client also states an intention to begin an exercise program with friends. Which statement associated with this scenario illustrates Lewin's stage of unfreezing? The nurse provides education on how to count calories in food and the importance of daily exercise. The client acknowledges the need to lose weight. The client also states an intention to begin an exercise program with friends. The client states an intention to begin counting calories with the next meal.
The client acknowledges the need to lose weight. In unfreezing, one recognizes the need for change. The client's acknowledgment of the need to lose weight is the only example provided of unfreezing. The nurse providing education on how to count calories in food and the importance of daily exercise is an example of moving, in which change is initiated after a careful process of planning. The client's intentions to begin an exercise program with friends and to begin counting calories with the next meal are examples of refreezing, which involves making a change operational, or a part of one's everyday life.
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? Transformational Democratic Autocratic Laissez-faire
aissez-faire Explanation: 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 new nurses are requesting the same preceptor for unit orientation. Both new nurses have been very vocal about being unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using a compromise approach to conflict resolution? The nurses agree to allow the preceptor to decide which nurse to precept. The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end. The nurses ignore each other's request for the preceptor. The nurses agree that one nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend.
he nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end. Explanation: 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.
