Taylor Chapter-22 review questions Nurse, leader, Manager, Care coordinator
Explicit Explanation: Maggie's official assigned role gives her 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 her/his personality and charisma. Situational and democratic are types of leadership rather than power.
Maggie Brown, RN, is the designated charge nurse on the telemetry unit. She organizes and facilitates the unit meetings, in addition to making assignments and performing staff evaluations. Maggie's power to lead is defined by which of the following terms? A. Situational B. Democratic C. Implied D. Explicit
resources Explanation: The organizing function of the nurse manager involves acquiring, managing, and mobilizing resources to meet both clinical and financial objectives.
A nurse working in a physician's office uses the managerial function known as "organizing." What is involved in this function? A. problems B. workforce C. evaluation D. resources
explicit power Explanation: Leadership is the ability to direct or motivate others to achieve set goals. An elected class leader has explicit power.
A senior student nurse has been elected class president. What type of power will the student have in this position? A. absolute power B. explicit power C. implied power D. assumed power
Nurse midwife Explanation: Rural impoverished areas are in need of advanced practice nurses. Related to her interests, a nurse midwife has advanced education and certification in the care of women during uncomplicated pregnancy and delivery.
A student has asked her nursing instructor about advanced practice roles. The student aspires to work independently in obstetrics and gynecology and work in a rural impoverished setting. Of the following advanced practice roles, which would be most suitable for the student?
C. Communicate with all groups Explanation: Communication, a prerequisite to problem solving, is one of the fundamental skills of management.
A typical day for the nurse manager includes the time she spends with other nurses, client, physicians, and ancillary staff. The most important skill she must have is the ability to A. Plan for the future B. Provide direct client care C. Communicate with all groups D. Maintain the unit's budget
Assess whether the desired results have occurred Explanation: The nurse manager must evaluate the results of his or her efforts to determine whether the desired results have occurred.
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. Ask the staff members for other solutions D. Assess whether the desired results have occurred
Offer two days paid vacation. Explanation: 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.
A nurse manager has asked staff to create a plan to improve patient outcomes. In the past, the staff have not met deadlines. How can the nurse manager use transactional leadership style to ensure the deadline is met? A. Offer two days paid vacation. B. Ask politely. C. Demand efficiency. D. Give extensions as needed.
Explicit power Explanation: Explicit power is determined by virtue of the nurse's position. A charge nurse is responsible for making decisions and carrying out tasks not performed by staff nurses. Implied power involves a person without a leadership position being in a position of authority with peers. Reward power involves rewarding staff with something that they deem important. Coercive power involves using threats as punishments to force staff to do something they do not want to do.
The nurse manager has recently promoted a staff nurse to the charge nurse position. Which type of power does the charge nurse now have? A. Explicit power B. Implied power C. Reward power D. Coercive power
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.
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?
Correct response: D. Conflict resolution Explanation: To produce high-quality care, the manager must constantly be developing the staff to meet new challenges. Along with their managers, nurses engage in conflict resolution. Problem solving consists of using generic or ad hoc methods in an orderly manner to find solutions to problems. Delegation is the assignment of any responsibility or authority to another person to carry out specific activities. Client protection is where the nurse keeps client data private.
A nurse manager and the charge nurse have two employees who disagree with the accomplishment of client care. The manager determines a mutually agreed-upon time to discuss this situation with all the members involved. This activity is called what? A. Problem solving B. Client protection C. Delegation D. Conflict resolution
"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.
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? A. "Check the infusion rate." B. "Dispose of the disconnected IV set." C. "Discontinue the IV solution." D. "Inspect the site for thrombophlebitis."
Implied Explanation: Implied power arises when a person who has no official assigned role assumes a leadership role by virtue of the force of his or her personality and charisma. The designated charge nurse's official assigned role gives her explicit power by virtue of that assignment. Situational and democratic are types of leadership rather than power.
The designated charge nurse on the telemetry unit organizes and facilitates the unit meetings; however, during most of the meetings, another registered nurse runs the show and influences staff decisions just by her charisma and personality. Her power to lead is defined by which of the following terms? A. Implied B. Democratic C. Situational D. Explicit
Correct response: "I've heard those machines don't even cut down on med errors like they say they do." Explanation: 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.
The nurses who provide care on a medical unit are skeptical about the planned change from a traditional narcotic cupboard to a computerized medical supply and management system. Which of the following statements demonstrates mistrust about the benefits of this proposed change?
Correct response: A. Directive leadership Explanation: Directive leadership describes a leader who makes all the decisions and tells followers what to do.
A nurse informs the client that he has no choice and must take his bath in the morning. What type of leadership does this exemplify? A. Directive leadership B. Institutional governance C. Shared governance D. Participative leadership
Leader Explanation: Leadership is the ability to influence others to strive for a vision or goal or to change.
A nurse manager is educating his staff in 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(an) A. Educator B. Clinic specialist C. Guide D. Leader
see question #80 and #84 The nurses decide to share the preceptor. The preceptor will precept one nurse at the beginning of the orientation and precept the other nurse at the end of the orientation. Explanation: Compromise involves both parties willing to relinquish something of equal value. The nurses decision to share the preceptor, one at the beginning of the orientation and the other one at the end of the orientation, demonstrates compromise. Each nurse ignoring the other's request illustrates avoidance. Allowing the preceptor to decide which nurse she will precept encourages competition. Competition involves a win-lose approach to conflict. The nurses' making an arrangement illustrates accommodation. Accommodation involves one party deciding to let the other party win in exchange for something else of value.
Two new graduate nurses are requesting the same preceptor for unit orientation. Both new graduates have been very vocal about being unhappy if they do not receive their choice of preceptors. Which illustrates the nurses using a compromise approach to conflict resolution? A. The nurses will allow the preceptor to decide which nurse she will precept. B. The nurses decide to share the preceptor. The preceptor will precept one nurse at the beginning of the orientation and precept the other nurse at the end of the orientation. C. The nurses ignore the other nurse's request for the preceptor. D. The nurses make an arrangement for the preceptor. One nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend.
The charge nurse is providing support for the staff nurse in new responsibilities. Explanation: 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 with their current role or an expanded one. Preceptorship typically is a paid position, and is 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 their daily assignments.
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 being paid to supervise the staff nurse. B. The staff nurse is learning about all the hospital policies from the charge nurse. C. The charge nurse is providing support for the staff nurse in new responsibilities. D. The staff nurse is orienting to the unit as a newly hired graduate nurse.
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.
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. Laissez-faire leadership C. Autocratic leadership D. Transactional leadership
Organizing role Explanation: The role of management is to plan, organize, direct, and control available human, material, and financial resources to deliver quality care to clients and families. Organizing would include acquiring, managing, and mobilizing resources to meet both clinical and financial objectives. Planning would include identifying problems and developing goals, objectives, and related strategies to meet the demands identified. Directing would include leading others in achieving goals within the constraints of the setting. Controlling would include implementing mechanisms for ongoing evaluation in the setting.
A nurse arranges all the resources available to teach a teenage girl how to manage her asthma. Which role is this nurse performing? A. planning B. controlling C. directing D. organizing
Organizing role Explanation: The role of management is to plan, organize, direct, and control available human, material, and financial resources to deliver quality care to clients and families. Organizing would include acquiring, managing, and mobilizing resources to meet both clinical and financial objectives. Planning would include identifying problems and developing goals, objectives, and related strategies to meet the demands identified. Directing would include leading others in achieving goals within the constraints of the setting. Controlling would include implementing mechanisms for ongoing evaluation in the setting.
A nurse arranges all the resources available to teach a teenage girl how to manage her asthma. Which role is this nurse performing? A. Controlling role B. Organizing role C. Planning role D. Directing role
Evaluating success with accomplishment of goals in client care Explanation: 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 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 can improve his or her skill with time management by doing which of the following? A. Setting priorities without involving clients or their families B. Starting each day as a new day without considering the previous day C. Allowing the flow of the day to control how time is managed D. Evaluating success with accomplishment of goals in client care
obtaining vital signs every 4 hours Explanation: 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.
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)? A. administering nebulizer treatments as needed B. obtaining vital signs every 4 hours C. assessing for shortness of breath instructing the client about the need to alternate D. activity with rest
obtaining vital signs every 4 hours Explanation: 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.
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)? A. administering nebulizer treatments as needed B.instructing the client about the need to alternate activity with rest C. assessing for shortness of breath D. obtaining vital signs every 4 hours
Authoritarian Explanation: With authoritarian, or autocratic, leadership, the activities of the group are primarily directive, with activities determined by the leader and dictated to the followers, with no input from the followers on decisions. Coercive management forces actions upon staff. 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.
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? A. Authoritarian B. Coercive C. Democratic D. Laissez-faire
Leader Explanation: Leadership focuses on people and inspires them to perform or to change.
A nurse is successful in promoting change on his nursing division. This nurse would be considered a A. Guide B. Manager C. Leader D. Specialist
Explore the pros and cons of potential scheduling models. Explanation: Before a nurse leader can begin planning the process of change, a selection of a new system by fully exploring different models should be completed. Once a selection is made, the process for the change can begin by describing how change will be implemented with the timetable that is developed and enlisting support from the staff who will champion the cause.
A nurse leader is planning to change the scheduling process in order to improve staffing on the unit. Which of the following would be the next step in implementing a change? A. Explore the pros and cons of potential scheduling models. B. Describe to the staff how the change will be implemented. C. Select a group of nurses to help champion the change process. D. Develop a timetable for making the change to a new system.
"I understand why I need to eat a low-sodium diet." Explanation: 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 their health status. If there is not a problem recognized, as with continuing 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 their daily menu is in the refreezing stage, where change has been effectively made.
A nurse leader is working with a client with hypertension who needs to learn about a low-sodium diet. The nurse recognizes the client is in the unfreezing stage of Lewin's Change theory with which client statement? A. "I have selected my daily menu with low-sodium foods." B. "I understand why I need to eat a low-sodium diet." C. "I don't see a problem with what I normally eat." D. "I am developing a daily meal plan for a low-sodium diet."
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 nurse manager best demonstrates effective leadership characteristic by which action? A. Sharing a vision for the unit and enlisting support B. Indicating an interest in becoming a role model C. Being very structured and rigid with the unit flow D.Knowing all information about the unit processes
Correct response: Autocratic 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.
A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check patients' blood glucose levels. The nurse manager informs the group this was a new policy on the unit, and discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating? A. Autocratic B. Laissez-faire C. Democratic D. Transformational
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, involves having an adequate amount 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 is implementing the function of directing in his or her role on the unit. Which action by the nurse manager demonstrates this role? A. Utilizing a weekly system for keeping workforce budget balanced B. Helping manage unit flow with client care if there is a staff call-out C. Identifying a goal for the nurse-client ratio on the clinical unit D. Hiring an adequate amount of nurses to staff the unit on all shifts
Collaborating Explanation: 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 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 value.
A nurse manager is trying to resolve a conflict between the day and night shifts. She 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 of the following types of conflict resolution? A. Collaborating B. Compromising C. Competing D. Avoiding
Decisions are made by those who are most knowledgeable about the issue. Explanation: 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 client, staffing, supplies, and/or budgets.
A nurse manager of a hospital unit is working within a decentralized management structure. Which nursing action best exemplifies this type of system? A. Nurse managers are not accountable for client, staffing, supplies, or budgets. B. Decisions are made by those who are most knowledgeable about the issue. C. Nurses are not intimately involved in decisions involving client care. D. Senior managers make all the decisions.
Laissez-faire Explanation: 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 leadership or shared leadership, is a type of leadership style in which members of the group take a more participative role in the decision-making process. Autocratic leadership, also known as authoritarian leadership, is a leadership style characterized by individual control over all decisions and little input from group members. Decentralized decision-making is any process where the decision-making authority is distributed throughout a larger group.
A registered nurse (RN) serves as the chair of the Nursing Practice Committee for the hospital. The meetings 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 chairman's leadership style could be termed what? A. Laissez-faire B. Democratic C. Autocratic D. Decentralization
Democratic Explanation: 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. 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 staff nurse works on a medical unit where staff retention is very high. There is a 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 of the following leadership styles? A. Transformational B. Democratic C. Autocratic D. Laissez-Faire
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. 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.
A staff nurse works on a surgical unit where the nurse leader allows the staff to make all decisions and direct themselves. The staff nurses fill out the work schedule and sometimes there are days where the unit is short staffed. The staff nurse feels the unit needs better leadership. The nurse leader is practicing which of the following leadership styles? A. Democratic B. Transformational C. Laissez-Faire C. 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.
Karen Wolf, RN, is the charge nurse on the orthopedic unit. She 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 Karen contributes. Karen's style of leadership can be described as which of the following? A. Laissez-faire B. Democratic C. Transformational D. Autocratic
Autocratic Explanation: 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.
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? A. Democratic B. Autocratic C. Nondirectional D. Laissez-faire
Administer a dose of digoxin (lanoxin) that is two hours behind schedule. Explanation: The first step in time management is to determine which tasks are priority tasks. Digoxin (lanoxin) is a critical client medication and therefore takes priority when considering the other options. Dressing changes, discharge orders, and completing facility forms can be delayed until critical tasks are complete.
The new graduate 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. Of the following outstanding tasks, which nursing intervention should the nurse complete first? A. Obtain discharge orders for a client who is ready to be transferred to a long-term nursing facility. B. Perform a dressing change to an abdominal abscess that is three hours behind schedule. C. Administer a dose of digoxin (lanoxin) that is two hours behind schedule. D. Complete a medication reconciliation form on a client who has recently been admitted to the hospital.
Initiating intravenous therapy Explanation: When delegating the RN must determine the skill level, education of the UAP, client's condition, complexity of the client, and potential for harm. Initiating intravenous therapy is reserved for the nurse due to the potential for harm and scope of the UAP. The UAP can assist the nurse by obtaining equipment, securing the client, and soothing the client.
The nurse and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate to delegate to the UAP? A. Securing the client on a papoose board B. Soothing the client during the procedure C. Gathering equipment needed for intravenous therapy D. Initiating intravenous therapy
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.
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. Laissez-faire C. Autocratic D. Democratic
Autocratic Explanation: Autocratic leadership style involves assuming control over the decisions and activities of the group. Democratic leadership style involves sharing the decision making process and activities with others who have an interest. 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.
The nurse has recently been promoted to nurse manager on an oncology unit and has decided to be the sole decision maker regarding issues that concern the unit. Which type of leadership style is the nurse embodying? A. Quantum B. Laissez-faire C. Autocratic D. Democratic
The client acknowledges the need to lose weight. Explanation: Unfreezing recognizes the need for change. The client's acknowledgment of the need to lose weight is the only example provided 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 she will begin to count caloric intake beginning with the next meal. The client also states intentions to begin an exercise program with friends. Which statement illustrates Lewin's stage of unfreezing? A. The client also states intentions to begin an exercise program with friends. B. The nurse provides education on how to count calories in food and the importance of daily exercise. C. The client acknowledges the need to lose weight. D. The client states she will begin to count caloric intake with the next meal.
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. Explanation: 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.
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. 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. B. 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. C. Nurses work in groups to care for clients. Physicians collaborate with nurses. Quality client care is provided. D. 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.
Better patient outcomes Explanation: Magnet® hospitals have better patient outcomes than facilities without the recognition. Magnet® hospitals have higher nurse retention and job satisfaction scores, but this does not have a direct effect on client care. Magnet® hospitals have shorter lengths of stays.
The nurse is working at a facility that is applying for Magnet® Recognition. The nurse recognizes that research supports Magnet® hospitals as having which direct effect on client care? A. Higher nurse retention B. Longer lengths of stays C.Improved job satisfaction scores D. Better patient outcomes
Delegate bathing and vital signs tasks. Explanation: 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.
The nurse is working to enhance time management skills and has to administer pain medications to several patients, obtain vital signs, and assist clients with bathing. What should the nurse do next? A. Obtain vital signs. B. Delegate bathing and vital signs tasks. C. Bathe clients. D. Administer pain medications.
Laissez-faire Explanation: 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 calls a staff into a unit meeting to discuss patient 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. Quantum D. Democratic
Provide incentives, such as time off. Explanation: To help the nurses adapt to change, it would be beneficial for the nurse manager to: (1) explain the proposed change to all affected people in simple, concise language; (2) list the advantages of the proposed change, both for the individual and for members of the group; (3) relate the proposed change to the person's (or group's) existing beliefs and values; (4) help overcome resistance by providing opportunities for open communication and feedback; (5) indicate clearly how the change will be evaluated; (6) introduce change gradually and involve everyone affected by the change in the design and implementation of the process; (7) provide incentives for commitment to change, such as money, status, time off, or a better working environment. Threatening to end employment, demands for loyalty, and refusal to listen to discussion are sure ways to turn staff against the planned change.
The nurse manager for a surgical unit is planning a significant change in how the unit functions. They plan to include some things that will help the staff overcome any resistance to the change. Which of the following might help overcome resistance to the nurse manager's planned change? A. Demand loyalty and commitment. B. Refuse to hear any discussion. C. Threaten to end staff's employment. D. Provide incentives, such as time off.
Collaborating Explanation: With "collaborating" there is a joint effort to resolve the conflict with a win-win solution. All parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. With "avoiding" there is awareness of the conflict situation, but the parties involved decide to either ignore the conflict or avoid/postpone its resolution. "Competing" is an approach that results in a win for one party at the expense of the other. "Smoothing" is an effort to complement the other party and focus on agreement rather than disagreement, thus reducing the emotion in the conflict. The original conflict is rarely resolved with this technique.
The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which of the following conflict resolution styles does the nurse manager display? A. Smoothing B. Collaborating C. Competing D. Avoiding
Collaborative mindset Explanation: The collaborative mindset involves listening more than talking, and allowing people to take initiative and control their own work. The reflective mindset allows managers to mentally digest experiences and reflect on them in a different way. The analytical mindset encourages introspection so that one can recognize biases and see things in a unique new way. The action mindset mobilizes energy to change while being sensitive about the capabilities of the team and the direction that is needed.
The nurse manager in a critical care unit actively listens to the staff and engages the staff to offer decisions regarding problem solving and implementing these decisions. What type of managerial mindset does this manager exhibit? A. Collaborative mindset B. Analytical mindset C. Action mindset D. Reflective mindset
Relate the proposed change to the group's existing beliefs and values. Explanation: Approaches to overcoming resistance to change include relating the proposed change to the group's existing beliefs and values; explaining the rationale for change in clear, concise language and allowing for opportunities of open discussion; and listing the advantages of this change both for individuals and the group. Discouraging dialogue, using email to address concerns, and ignoring staff concerns are ineffective managerial communication skills.
The nurse manager is aware that nurses in the operating room are concerned about a proposed change in their working hours. Which of the following is the nurse manager's best approach in addressing this problem and the nurses? A. Explain the rationale for this change in an e-mail to each of the nurses. B. Relate the proposed change to the group's existing beliefs and values. C. Discuss the disadvantages for the hospital if the change is not made. D. Discourage the nurses from discussing the problem because the change is going to occur.
Enlist volunteers to help develop a community outreach project that will educate teenagers on methods to prevent pregnancy. Explanation: 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 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? A. Create a new policy that will limit the number of teenage mothers the clinic can treat. B. Enlist volunteers to help develop a community outreach project that will educate teenagers on methods to prevent pregnancy. C. Conduct community-based research into the number of teenagers who have become parents over the last five years. D. Talk to each teenager who comes in to the clinic about ways to not get pregnant again.
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. Explanation: 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.
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. 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. C. Emphasize the importance of arriving to work on time during a monthly unit meeting. D. Allow the nursing staff to develop a plan to decrease tardiness within the unit.
Democratic Explanation: 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 nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and physicians is exhibiting what style of leadership? A. Transactional B. Laissez-faire C. Democratic D. Autocratic
The new mother attempts to breastfeed the baby again using the techniques recently acquired and is successful. Explanation: Refreezing involves making the change operational. The mother feeding her baby using new techniques is an example of refreezing.
The nurse recognizes that a new mother is having difficulty breastfeeding her baby. The nurse provides assistance by demonstrating various positions to hold the baby while feeding. The nurse also educates the mother on ways to ensure proper latching. The new mother attempts to breastfeed the baby again using the new techniques and is successful. Which statement illustrates Lewin's stage of refreezing? A. The new mother attempts to breastfeed the baby again using the techniques recently acquired and is successful. B. The nurse provides assistance by demonstrating various positions to hold the baby while feeding. C. The nurse also educates the mother on ways to ensure proper latching. D. The nurse recognizes that a new mother is having difficulty breastfeeding her baby.
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 Manger 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 graduates to transition into the RN role through mentorship or preceptorship. Working extra shifts will not help leadership skills. Abruptly starting transformational change on a unit and engage staff can disrupt harmony on the unit. Writing delegation competencies does not improve leadership skills.
The proficient nurse wants to become a more effective leader. Which step will be appropriate for the nurse to take? A. Review the Nurse Manager Leadership Collaborative model and write delegation competencies. B. Promote a healthy work environment and become a nurse mentor. C. Start a transformational change on the nursing unit and engage staff in the movement. D. Become a preceptor and work extra shifts on the nursing unit.
The charge nurse Explanation: The RN should follow the proper channels for communication and consult the next direct supervisor. The next direct supervisor would be the charge nurse and then the nurse manager. The client and the LPN should not be consulted.
The registered nurse (RN) has received orders to perform an unsafe practice on a client. The RN voices concern with the physician who gave the order, but the physician refuses to change the order. Whom should the nurse consult next regarding the order? A. The charge nurse B. The client C. The nurse manager D. The licensed practice nurse (LPN)
Assessing oxygen (O2) saturation Explanation: When delegating the RN must determine the skill level, education of the UAP, client's condition, complexity of the client, and potential for harm. Assessing O2 saturation is within the scope of an UAP. Monitoring ICP, measuring intravenous therapy intake, and calculating fluid volume resuscitation should be performed by a licensed professional.
The registered nurse (RN) is preparing to delegate tasks to an unlicensed assisted personnel (UAP). Which tasks would be appropriate for the RN to delegate to the UAP? A. Calculating fluid volume resuscitation B. Measuring intravenous therapy intake C. Assessing oxygen (O2) saturation D. Monitoring intracranial pressure (ICP)
The nurse practice act or facility's policy and procedures Explanation: 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 physician practice and may not contain information on the task that is to be delegated.
The registered nurse (RN) wants to delegate a task to an 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
The stability of the patient'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, stability of the patient's condition, complexity of the activity to be delegated, potential for harm, predictability of the outcome, and overall context of other patient 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? A. The stability of the patient's condition, potential for harm, and complexity of the activity B. The context of the other patient needs, the desired outcome, and autonomy of the patient C. Predictability of the UAP, the amount of time required for the task, and RN's skill level D. The complexity of the activity, age of the UAP, and predictability of the outcome
Implied Explanation: The staff nurse, as a role model for the rest of the staff and, therefore, influential with making change, would have implied power. Explicit or legitimate power is that power that is directly given, such as with the unit manager role; coercive power is a negative type of power that results from using threats or negative punishment to force someone to do what they do not want to do.
The unit manager on a medical unit is trying to encourage the nursing staff to use a new protocol for documentation. To help with this, the nurse manager recruits one of the staff nurses who serves as a role model for many of the staff. Which type of power does the staff nurse exhibit? A. Legitimate B. Explicit C. Implied D. Coercive
SEE QUESTION 13 Collaborating Explanation: Collaborating involves working with all parties to resolve the assignment issue. Compromising involves discussing with the new graduate nurses independently to develop a mutually agreeable solution. Accommodating involves the nurse manager independently placing one new graduate nurse with the preceptor and disregarding the other new nurse graduate's upset feelings. Avoiding involves the nurse manager ignoring the problem altogether.
Two new graduate nurses are requesting the same preceptor for unit orientation. Both new graduates have been very vocal about being unhappy if they do not receive their choice of preceptor. The nurse manager sets up a meeting with the new graduate nurses in order to come to a resolution regarding the preceptor. Which conflict resolution style is the nurse manager using? A. Collaborating B. Compromising C. Avoiding D. Accommodating
see question #80 and #13 One nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend. Explanation: Accommodation involves one party deciding to let the other party win in exchange for something else of value. The nurses making an arrangement illustrates accommodation. In compromise both parties are willing to relinquish something of equal value. The nurses' decision to share the preceptor, one at the beginning of the orientation and the other one at the end of the orientation, demonstrates compromise. Each nurse ignoring the other's request illustrates avoidance. Allowing the preceptor to decide which nurse she will precept encourages competition. Competition involves a win-lose approach to conflict.
Two new graduate nurses are requesting the same preceptor for unit orientation. Both new graduates have been very vocal about being unhappy if they do not receive their choice of preceptors. Which illustrates the nurses using an accommodating approach to conflict resolution? A. The nurses will allow the preceptor to decide which nurse she will precept. B. The nurses discuss the situation with the preceptor to come to an agreement mutually beneficial for both parties. C. One nurse will obtain the preceptor for orientation in exchange for that nurse working each weekend. D. The nurses ignore the other nurse's request for the preceptor.
Accomodating Explanation: 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 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. Accomodating C. Competing D. Collaborating
Laissez-faire leadership Explanation: Laissez-faire leadership would work best in this situation. To allow the nurse's the creative environment they will need to complete the project, it would be better to allow them autonomy to do so. Autocratic, democratic, and authoritarian leadership styles may stifle the creativity the nurses require to complete the project.
Two nurses have requested that the nurse manager allow them to plan in-service education with creative, new education techniques. Which leadership style would be best for the nurse manager to use to get the new project completed? A. Laissez-faire leadership B. Democratic leadership C. Authoritarian leadership D. Autocratic leadership
Committed Explanation: 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.
When a staff member has successfully completed the activities delegated by the nurse manager, the result is usually that the staff member is more A. Time efficient B. Committed C. Responsive D. Cost effective
A leader who is dynamic, inspiring, and promotes change by the power of her convictions Explanation: Transformational leaders can create revolutionary change. They are often described as charismatic, and they are unique in their ability to inspire and motivate others. A careful examination of contextual factors is associated with situational leadership. Delegation to group members and an emphasis on equality are typical of laissez-faire and democratic leadership.
Which of the following nurse leaders most clearly exemplifies transformational leadership? A. A leader who prioritizes the delegation of leadership to the individual members of the group B. A leader who is careful to thoughtfully assess the issues and priorities surrounding a problem prior to acting C. A leader who prioritizes the fact that every member of the team is considered valuable and equal D. A leader who is dynamic, inspiring, and promotes change by the power of her convictions
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 lack of quality client outcomes would not be characteristics of a Magnet hospital.
Which of these statements reflects the expected functioning at a hospital that has achieved Magnet status? A. Nursing administration is in control of all decision- making. B. Most client outcomes have improved but are not at target range. C. There is a decreased rate of retention among the nursing staff. D. Staff nurses are developing innovative solutions to problems.
To effectively manage the nursing unit, the nurse manager should also be a leader. Explanation: 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.
Which of these statements regarding a nurse manager role is accurate? A. The nurse manager will decide on the financial targets for the nursing unit. B. A healthy work environment is not within the scope of the nurse manager's role. C. To effectively manage the nursing unit, the nurse manager should also be a leader. D. The nurse manager's main role in the nursing unit is to manage the unit budget.
To effectively manage the nursing unit, the nurse manager should also be a leader. Explanation: 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.
Which of these statements regarding a nurse manager role is accurate? A. The nurse manager will decide on the financial targets for the nursing unit. B. To effectively manage the nursing unit, the nurse manager should also be a leader. C. A healthy work environment is not within the scope of the nurse manager's role. D. The nurse manager's main role in the nursing unit is to manage the unit budget.
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.
Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses? A. Autocratic B. Transformational C. Democratic D. Laissez-faire
Refreezing Explanation: Refreezing is the long-term solidification of the new pattern of behavior.
A female client has been having yearly Pap smears and yearly mammograms for more than 10 years. According to Lewin, this is an example of what type of change? A. Refreezing B. Choosing C. Unfreezing D. Prizing
Obtaining an admission weight for the client utilizing the client's bed scale Explanation: The nurse should delegate obtaining the initial weight to the UAP, as this is within the capability of the UAP. The task of obtaining a history, including home medications, is a responsibility of the nurse with documentation in the medical record. The nurse should also interpret the initial rhythm of the client. Although UAPs may be able to interpret the rhythm based on special training, there is no indication of this being true for the UAP in the scenario and the nurse should still verify the initial rhythm interpretation is correct.
A nurse on a telemetry unit is admitting a client and has an unlicensed assistive person (UAP) helping with the admission process. Which task can the nurse delegate to the UAP? A. Listing the client's home medications on a medication reconciliation form B. Obtaining an admission weight for the client utilizing the client's bed scale C. Gathering information about the client's medical history and any allergies D. Determining what heart rhythm the client is in based on telemetry reading
Hold a unit meeting to discuss how the changes will benefit staff. Explanation: 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 nursing facility has recently implemented new policies regarding nurse-to-patient ratios. The nursing staff seems very resistant to the change. How can the nurse manager help the staff accept the change? A. Use the laissez-faire leadership style to address staff concerns. B. Institute the changes immediately and collectively to decrease anticipation anxiety. C. Hold a unit meeting to discuss how the changes will benefit staff. D. Challenge staff's beliefs and values regarding providing quality patient care.
A. Problem solving Explanation: 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.
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. Problem solving B. Continuing processes C. Directive initiatives D. Controlling client outcomes
A regular employee who is a natural leader Explanation: There are some people who are "natural leaders" because of their demonstrated ability to influence others. These are the "key power players" whose support is essential to effecting change. The other choices do not describe persons who necessarily have power.
April and Sara are nurse managers for different units in the hospital. They are planning for a major change to occur on both units. Sara tells April she has identified a key power player on her unit. Which of the following describes what Sara means by this term? A. A regular employee who is a natural leader B. Someone in whom Sara can confide C. An employee who will resist the change D. Someone who spreads untrue rumors
Unfreezing Explanation: Unfreezing is the recognition of the need for change and the dissolution of previously held patterns of behavior. Unfreeze, 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, they must be melted (Unfreeze), poured into a mold (Change) and frozen again in the new shape (Refreeze). Prizing is not a component of the model.
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 is an example of what type of change? A. Prizing B. Refreezing C. Movement D. Unfreezing
Leadership is the process of guiding, educating, motivating, and directing others. Explanation: 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.
How might one define leadership? A. Leadership is the process by which the leader shares power with others. B. Leadership is the process of planning, organizing, directing, and controlling activities. C. Leadership is the process of guiding, educating, motivating, and directing others. D. Leadership is the process of interviewing, hiring, and firing personnel.
The interdisciplinary health care team collectively developing plans of care for clients Explanation: Democratic leader 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 case manager works in a facility that supports a participative leadership style. Which of the following should the nurse recognize as an example of democratic leadership style? A. The dietitian completing a nutritional assessment for a registered nurse (RN) B. The interdisciplinary health care team collectively developing plans of care for clients C. The unlicensed assistive personnel (UAP) taking vital signs for several nurses D. The nurse implementing the physician's written orders for client care
Assess the need for assistance with ambulation. Explanation: The diverse physiologic and psychological capabilities of people and encounters with various safety hazards across the lifespan put various age groups at risk for different safety concerns and associated potential injuries. The older clients are at higher risk for hurting themselves while meeting their needs.
The client tells the nurse that he needs to use the restroom. Which safety intervention must be done by the nurse first? A. Ask the unlicensed assistive personnel (UAP) to help the client to the restroom. B. Ask a family member to help the client to the restroom. C. Assess the need for assistance with ambulation. D. Offer the bedpan to keep the client safe.
Democratic Explanation: 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 nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and physicians is exhibiting what style of leadership? A. Democratic B. Autocratic C. Laissez-faire D. Transactional
Resource management Explanation: In modern health care organizations, managers usually are responsible for accomplishing the work of the unit within the constraints of available resources. This process is called resource management. Allocation is the assignment of available resources to various uses. Management is the process of dealing with or controlling things or people. Financial management is the process of dealing with or controlling money.
A nurse manager must provide care to the units clients and employees under the constraints of the resources. This involves maintaining the financial constraints of the division. What term best describes this scenario? A. Allocation B. Resource management C. Financial management D. Management
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.
Conflict has emerged on a nursing unit due to the perception by new graduates 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? A. Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible. B. Reassure the new graduates that the more experienced nurses are acting in the interests of both staff and clients. C. Arrange for the newer nurses to organize the client assignment for a trial period. D. Gather evidence over the next several weeks in order to determine if the practice is indeed happening.
A. Explain the benefits of the change and elicit honest feedback. Explanation: Strategies for overcoming resistance to change include maximizing explanations in terms of those affected, and encouraging feedback. Emphasizing benefits 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.
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.
Jane Doe, MSN, RN; nurse manager; 7 years of nursing experience; supportive; engaged in community service activities Explanation: Jane Doe is the only nurse qualified to become a CNL. The American Association of Colleges of Nursing (AACN) requires that the registered nurse must have received a minimum of a master's degree.
The chief nursing officer (CNO) wants to encourage nurses in the hospital to become clinical nurse leaders (CNL) and is reviewing a roster of nurses working on the medical-surgical unit. Which nurse should the CNO recognize as being qualified to take the CNL examination?
Advising the new graduate to consult her before making decisions regarding client care Explanation: 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 new nurse in the decision making process. Requiring the new nurse to report to her before making decisions can hinder the new graduate's confidence level.
The new graduate nurse is evaluating the effectiveness of her assigned nurse mentor. Which characteristic should the new graduate recognize as being inappropriate for the nurse mentor to role model? A. Introducing the new graduate to members of the interdisciplinary team B. Encouraging the new graduate to enroll in continuing education courses C. Advising the new graduate to consult her before making decisions regarding client care D. Providing daily feedback to the new graduate
create plans and budgets Explanation: Information about trends is necessary to project human and financial resource needs and to create plans and budgets. Nurse managers must be able to develop budgets that provide sufficient resources to accomplish unit goals. Nurses are responsible for direct patient care, discharge planning, and evaluating nursing care plans.
The primary responsibility of the nurse manager is to ... A. create plans and budgets B. provide direct client care C. evaluate nursing care plans D. direct discharge planning
