CHAPTER 45. Leadership & Management My Nursing Test Banks, Exams of Advanced Education

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CHAPTER 45. Leadership &

Management My Nursing Test

Banks

Theories that focus on what the leader does are called:

1. Trait theories.
2. Behavioral theories.
3. Situational theories.
4. Transformational theories. - 2) Behavioral theories. Behavioral theories are concerned with what a leader does, whereas trait theories are concerned with what a leader is. Situational theories recognize that each situation is different and that leaders must consider a number of factors when deciding how to take action. Transformational theories focus on the ability of the leader to communicate her vision in such a way that it inspires commitment among workers. At a recent nurse staff meeting, the chief nursing officer (CNO) announced that all nursing staff would work 12-hour shifts on a daynight rotation schedule that would alternate every 6 weeks. The CNO announced that she made this decision as a means to solve discord between the day- and night-shift nurses. She explained that this plan will allow the staff to experience the work on each shift and to appreciate the various job responsibilities on each shift. What type of leadership is the CNO displaying?
5. Management
6. Laissez-faire
7. Democratic
8. Authoritarian - 4) Authoritarian The authoritarian leader makes decisions for the group as a whole, gives orders, and bears most of the responsibility for the outcomes. A laissez-faire leader postpones making decisions or may never make a decision at all. Thus, laissez-faire leadership is really a lack of leadership. A democratic leader shares the planning, decision making, and responsibility for outcomes with other members of the group. This type of leader tends to provide guidance rather than control. There is no leadership style called management.

A graduate nurse completed her nursing education 3 weeks ago and has just begun work at the local hospital. She is orienting to her new position with an experienced nurse, one who has been an RN for 15 years and an employee at the hospital for 7 years. She will provide guidance and practical teaching to the new graduate as she assumes a new position in the nursing unit. What role is the experienced RN assuming?

1. Mentor
2. Manager
3. Preceptor
4. Leader - 3) Preceptor A preceptor is someone with more experience who provides practical teaching and guidance for a student or new employee. In contrast, a mentor is someone more experienced who provides career development information and serves as a role model. A manager is an employee of an organization who has the power, authority, and responsibility for planning, organizing, coordinating, and directing the work of others. A leader is someone who has the ability to influence others and commit them to action. What is the first stage of the complex process of change?
5. Recognizing resistance
6. Unfreezing
7. Forming a comfort zone
8. Actively resisting - 2) Unfreezing The first stage in the change process is unfreezing. In this stage, the person leaves the stable comfort zone that has existed and begins to make changes. Recognizing resistance and actively resisting are activities associated with change, but they are not the first stage of the process. Within the past month, there has been a change in the nursing documentation requirements at the hospital. The nurses have been trained in the new requirements and are documenting as requested, with the exception of one nurse. This nurse has been unable to attend any of the documentation in- service meetings and has been too busy to attend a private training session with the nurse manager. Meanwhile, she continues to use the old documentation process. What do the nurses actions illustrate?
9. Unfreezing
10. Active resistance
11. Passive resistance

4. Comfort zone - 3) Passive resistance Passive resistance behaviors include avoidance; canceling appointments to discuss implementing change; being too busy to make the change; agreeing to the change but doing nothing to change; and simply ignoring the entire process as much as possible. In the above situation, the nurse is not actively refusing to comply with the new documentation requirements; however, her actions are a passive approach to resisting change. When a person knows what to expect and how to deal with whatever problems arise in the course of a day, that person is operating within her comfort zone. The first stage in the change process is when the person begins moving out of the comfort zone, unfreezing. This nurse is resisting, not unfreezing. The surgical unit is experiencing difficulty recruiting new RNs, although the hospital has an excellent reputation in the community and has no difficulty recruiting nurses for other units. A task force has been formed, consisting of one nurse from each shift on the unit, the unit manager, and the hospital nurse recruiter. The group has gathered data and identified the problem. What is the next step in this process?
5. Generate possible solutions.
6. Evaluate whether the problem has been resolved.
7. Implement the solution changes.
8. Evaluate suggested solutions. - 1) Generate possible solutions. The next step in the process is to generate possible solutions. Once several possibilities have been identified, each of the suggested solutions should be evaluated. From among that list, the best solution is chosen and then implemented. Finally, the task force critiques the process by evaluating whether the problem has been resolved. A nurse with 2 years experience frequently appears stressed and has difficulty completing his work. He is clocking out 30 to 45 minutes late every day, even when his assignment load is light. The charge nurse describes his problem as running from one duty to the next and having no organization or daily routine. Which situation most likely describes this nurse?
9. Has time management problems
10. Has a heavy patient load
11. Works at a hospital that is understaffed
12. Is in a management position - 1) Has time management problems

This nurse most likely has trouble managing his time. Time management entails setting your own goals and organizing your work. Although there will be difficult days, the nurse who consistently finishes late and has no organization to his daily schedule has a problem managing time. Time management includes efficiently meeting clients care needs during a nursing shift and organizing ones workload. An expert nurse feels confident in her role as a clinician on the unit. The nurse enjoys her work and feels in charge of her career. Which leadership state is she experiencing?

1. Power-based authority
2. Effective management skills
3. Empowerment in her role
4. Followership skills - 3) Empowerment in her role Empowerment is a psychological state, a feeling of competence, control, and entitlement that a person experiences. Empowerment refers to feelings, whereas power refers to action. The person who feels empowered has feelings of self-determination, meaning, competence, and impact. This nurse may have power on the unit because of her expertise, but there is no evidence that she is an authority figure. Empowerment is not always associated with management. Managers have authority by virtue of their position but do not always thrive in that role. There is not enough information in the scenario to judge the nurses followership skills. The physical therapy department and the nursing department at a local rehabilitation hospital are in conflict over which department is responsible for transporting patients to and from therapy appointments. The members of the therapy department state they do not have sufficient time to come to the nursing unit to pick up the patients and that patients often are not ready to be transported. Nursing staff members state that they do not have the time to transport the patients from the unit and this leaves a shortage of nursing personnel on the floor. Managers from both departments have attempted to resolve the conflict with input from nursing and therapy staff members. All attempts at conflict resolution have failed. What is the next step the managers should take?
5. Inform the nurses that they must take the patients to and from therapy.
6. Inform the therapists that they must take the patients to and from therapy.
7. A - 4) Begin informal negotiation between the two departments. One of a managers responsibilities is to function as an informal negotiator when a resolution to conflict cannot be reached.

The manager is conducting an informal negotiation between two staff members who have had ongoing difficulty working together peacefully. Most recently there was an argument about who would be scheduled for first lunch each day. At this stage of the informal negotiation, the manager is focusing on managing the emotions and setting the ground rules. Which stage does this demonstrate?

1. Setting the stage
2. Conducting the negotiation
3. Making offers and counteroffers
4. Agreeing on resolution of the conflict - 2) Conducting the negotiation The manager has begun conducting informal negotiation. This includes managing the emotions, setting ground rules, and clarifying the problem. The first step of conflict resolution is introspective and is similar to data gathering. The negotiator thinks, What am I trying to achieve? What problems am I likely to encounter? The next step, setting the stage, may involve confronting the two parties with their behavior toward one another and making direct statements designed to open communication and challenge them to seek resolution of the situation. After conducting the negotiation, the parties move to making offers and counteroffers, and then to agreeing on the resolution of the conflict. A nurse observes a nursing assistant (NAP) fail to wash her hands before and after placing a patient on a bedpan. When giving negative feedback to the NAP, the nurse should:
5. Be certain to offer constructive criticism about the task and do so in private.
6. Ask the unit manager to be present to document responses of both parties.
7. Call a meeting of all NAPs and stress hand washing to the entire group.
8. Keep a record of the NAPs actions and save them for her annual formal review. - 1) Be certain to offer constructive criticism about the task and do so in private. It is important to provide negative feedback in private. It is not necessary for the nurse manager to be present because staff nurses are responsible for delegating to and supervision of NAPs. The nurse should not call a meeting. It would be a waste of time for those who are already washing their hands properly, and it dilutes the effect of the feedback to the NAP who is not washing her hands. She might think, Oh, everybody does it; no big deal. It is important to allow some time every day for timely feedback. This allows the worker to know what she is doing right and wrong, and allows her to make corrective actions. The nurse should not allow this NAP to continue with her hand washing errors until her annual formal review because this can pose a threat to patient safety and increase the risk of transmitting infectious microbes.

Which of the following are characteristics of an effective nurse manager? Choose all that apply.

1. Clinical expertise
2. Business sense
3. Masters degree
4. Leadership skills - 1) Clinical expertise
5. Business sense
6. Leadership skills An effective nurse manager possesses a combination of qualities: leadership skills, clinical expertise, and business sense. It is the combination of all these that prepares a person for the complex task of managing a group or team of healthcare providers. The extent of education that a person has does not determine her effectiveness as a manager. Which of the following activities is/are involved when delegating tasks to other members of the nursing team? Choose all that apply.
7. Supervising patient care that is given
8. Determining the skill mix of unit personnel
9. Assessing the needs of the clients involved
10. Deciding which tasks to assign to a team member - 1) Supervising patient care that is given
11. Determining the skill mix of unit personnel
12. Assessing the needs of the clients involved
13. Deciding which tasks to assign to a team member Delegation of patient care tasks to other healthcare workers is one of the most important responsibilities of the registered nurse. When delegating tasks, the nurse must take into consideration the skills and competency of the team members as well as the condition and needs of the clients receiving care. The nurse is also responsible for supervising patient care to ensure that it is competently delivered. An experienced nurse serves as a mentor to a new graduate. Which of the following are responsibilities of the person being mentored? Choose all that apply.

1. Demonstrates an ability to move toward independence
2. Has the ability to encourage excellence in others
3. Seeks feedback and uses it to modify behaviors
4. Demonstrates flexibility and an ability to change - 1) Demonstrates an ability to move toward independence
5. Seeks feedback and uses it to modify behaviors
6. Demonstrates flexibility and an ability to change The ability to encourage excellence in others is a responsibility of the mentor. Responsibilities of the person being mentored are the following: demonstrates an ability to move toward independence; seeks feedback and uses it to modify behaviors; and demonstrates flexibility and an ability to change.

1. Compared with management, ____________________ is the ability to influence other people with or without an official appointment to a position in the organization. - leadership A(n) ____________________ is someone with more experience who provides career development behaviors. - mentor A(n) ____________________ is an employee of an organization who has the power, authority, and responsibility for planning, organizing, coordinating, and directing the work of others. - manager The new graduate RN needs to have a preceptor assigned to him as he begins working in the pediatric clinic. The BEST person for this assignment would be A.The charge RN who is a natural leader and knows all of the policies. B.The staff RN who has 3 years of experience and enjoys orienting new employees. C.The LPN with 15 years of experience who knows all of the doctors' preferences. D.The staff RN with 10 years of experience who refuses to work with students. - B. The staff RN who has 3 years of experience and enjoys orienting new employees.

The preceptor role often includes orienting a new employee to the routine of the work area as well as to the policies and procedures. The preceptor must have ample time, adequate experience, and a positive attitude to complete the new employee's training. Lisa is an RN who transferred to the pediatrics unit 2 months ago. She noted the low morale and conflict among the nurses based on the manager's authoritarian leadership style. What are Lisa's best actions? Select all that apply. A.Talk with the manager in private about the unit's needs. B.Discuss various leadership styles with the nurses. C.Ask the nursing supervisor to talk with the manager about her leadership style. D.Do nothing and continue to observe for improvements. E.Organize a staff meeting so the nurses can voice their concerns to the manager. - A.Talk with the manager in private about the unit's needs. B.Discuss various leadership styles with the nurses. •Caring: Lisa's desire to improve the situation demonstrates a concern for the overall work environment, nurses, and clients. She recognizes the manager as a unique individual and, as a strong follower, avoids what may appear as sabotage and demeaning by organizing a staff meeting so nurses can air their concern. Communications with the manager should be done in private and not through a third person (nursing supervisor). •Doing: Lisa is applying her practical knowledge of leadership, management, change, and conflict theories to educate the nurses on various leadership styles. This information can provide the nurses with an understanding of the leader and methods to better communicate their concerns at the appropriate time. A nursing unit is now doing a walking change-of-shift report. The unit manager puts out a survey asking for employee feedback about the new process. This would be termed: § A.Overcoming resistance B.Unfreezing C.Implementing change D.Integrating change - D.Integrating change

Integrating change occurs after the change has been made and involves evaluating acceptance, comfort levels, and residual resistance of those affected.