Leading and Managing in Nursing – 7th Edition (2023–2024) by Patricia S. Yoder-Wise & Susa, Exams of Nursing

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Test Bank For Leading and Managing in

Nursing 7th Edition By Patricia S. Yoder- Wise;

Susan Sportsman (2023 - 2024)

All Chapters 1-30 Questions And Answers |A+ Graded

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Chapter 01 MULTIPLE CHOICE 1.A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults.She is asked to assess and adapt the unit to better meet the unique needs of the older adult patient. Using complexity principles, what would be the best approach to take for implementation of this change? a. Leverage the hierarchical management position to get unit staff involved in assessmentand planning. b. Engage involved staff at all levels in the decision-making process. c. Focus the assessment on the unit and omit the hospital and community environment. d. Hire a geriatric specialist to oversee and control the project. ANS: B Complexity theory suggests that systems interact and adapt and that decision making occurs throughout the systems, as opposed to being held in a hierarchy. In complexity theory, everyvoice counts, and therefore, all levels of staff would be involved in decision making. 2.A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he verymuch wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow’s need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients? a. Line up agency nurses who can be called in to work on short notice. b. Place the nurse on unpaid leave for the remainder of his wife’s treatment. c. Sympathize with the nurse’s dilemma and let the charge nurse know that thisnurse may be calling in frequently in the future.

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c. Insist that participants continue to talk until a resolution has been reached. d. Back the unit manager’s actions and end the dispute. ANS: B Part of leadership is understanding conflict resolution and ability to negotiate and manage forresolution of issues and concerns. This situation has failed a second negotiation session, elevation to a manager with additional training to facilitate conflict resolution is important at this point. 5.The manager of a surgical area has a vision for the future that requires the additionof RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff Stuvia.com - The Marketplace to Buy and Sell your Study Material have always practiced in a primary nursing-delivery system and are very resistant to this idea. What would be the best initial strategy for implementation of this change? a. Exploring the values and feelings of the RN group in relationship to thischange b. Leaving the RNs alone for a time so they can think about the change before it isimplemented c. Dropping the idea and trying for the change in a year or so when some of thepresent RNs have retired d. Hiring the assistants and allowing the RNs to see what good additions they are ANS: A Influencing others requires emotional intelligence in domains such as empathy, handling relationships, deepening self-awareness in self and others, motivating others, and managing emotions. Motivating others recognizes that values are powerful forces that influence acceptance

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of change. Leaving the RNs alone for a period of time before implementation does not provide opportunity to explore different perspectives and values. Avoiding discussion until the team changes may not promote adoption of the change until there is opportunity to explore perspectives and values related to the change. Hiring of the assistantsdemonstrates lack of empathy for the perspectives of the RN staff. TOP: AONE competency: Knowledge of the Health Care Environment 6.As the RN charge nurse on the night shift in a small long-term care facility, you’ve found that there is little turnover among your LPN and nursing assistant (NA) staff members, but they arenot very motivated to go beyond their job descriptions in their work. Which of the following strategies might motivate the staff and lead to greater job satisfaction? a. Ask the director of nursing to offer higher wages and bonuses for extra work for the nightLPNs and NAs. b. Allow the LPNs and NAs greater decision-making power within the scope of theirpositions in the institution. c. Hire additional staff so that there are more staff available for enhanced care, andindividual workloads are lessened. d. Ask the director of nursing to increase job security for night staff by having them signcontracts that guarantee work. ANS: B Hygiene factors such as salary, working conditions, and security are consistent with Herzberg’s two-factor theory of motivation; meeting these needs avoids job dissatisfaction. Motivator factors such as recognition and satisfaction with work promote a satisfying and enriched work environment. Transformational leaders use motivator factors liberally to inspirework performance and increase job satisfaction. 7.The nurse manager wants to increase motivation by providing motivating factors for the nurseon the unit. What action would be appropriate to motivate the staff? a. Collaborate with the human resource/personnel department to develop on-site daycareservices.

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9.The chief nursing officer has asked the staff development coordinator to facilitate the development of a clinical competency program for the facility. While making rounds on theunits, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. What behavior by the staff development coordinator is most appropriate in this situation? a. Disregard staff concerns and continue with development of the program. b. Inform the nurses that this program is a requirement for JCAHO accreditation. c. Schedule a meeting with the chief nurse executive to apprise her of the situation. d. Facilitate a meeting so nurses can articulate their values and concerns about a competencyprogram. ANS: D The manager role involves guiding others through a set of derived practices that are evidence- based and known to satisfy preestablished outcomes such as participation in a competency program. This involves engagement of staff through sharing of concerns and ideas. A close analysis of the IOM report and the summary of the PPACA suggests that no health reform canunfold without active nursing engagement. Each document emphasizes that nurses must lead, manage, and behave as active collaborators with other members of the health team and with those being served. 10.The nurse manager has been asked to implement an evidence-based approach to teach ostomypatients self-management skills postoperatively. The program is to be implemented across theentire facility. What illustrates effective leadership in this situation? a. The training modules are left in the staff room for times when staff are available. b. The current approach is continued because it is also evidence- based and is more familiarto staff. c. You decide to implement the approach at a later date because of feedback from the RNsthat the new approach takes too much time. d. An RN who is already familiar with the new approach of volunteers to take the lead inmentoring and teaching others how to implement it.

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ANS: D

Followership occurs when there is acquiescence to a peer who is leading in a setting where a team has gathered to ensure the best clinical decision making, and actions are taken to achieveclinical or organizational outcomes. Followership promotes good clinical decisions and use of clinical resources. 11.You overhear a new graduate RN telling a nurse colleague that leadership and management belong to the unit manager, not to her. As a nursing colleague, what do you know to be true inregard to the statement? a. The statement is correct. Leadership is not the role of the staff nurse. b. The new graduate would benefit from further understanding of her role as a professional,whose influence may affect the decision making of patients, colleagues, and other professionals. c. The new graduate has been influenced by nurse leaders and managers who leave for otherpositions. d. The general perception is that nurse leaders and managers are not satisfied in their jobs. ANS: B Care coordination that involves the intersection of individual, family, and community- basedneeds requires that nurses have self-confidence, knowledge of organizations and health systems, and an inner desire to lead and manage. There is often a view that leadership is isolated to those holding managerial positions, and that a direct care nurse is subject to following by adhering to the direction of others. Such views fail to acknowledge that to be anurse requires each licensed individual to lead, manage, and follow when practicing at the point-of-care and beyond. TOP: AONE competency: Leadership

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14.Chart audits have revealed significant omissions of data that could have legal and financial guideline ramifications. The unit manager meets with the staff to discuss audit findings and tofind approaches that will address the gaps in charting and achieve desired goals. What is the manager demonstrating? a. Leadership b. Management c. Decision making d. Vision ANS: B The process of guiding others to meet established goals, outcomes, and procedures is management. This can require collaborative decision making to determine how best to reachpredetermined goals and follow established practices. TOP: AONE competency: Knowledge of the Health Care Environment 15.A family is keeping vigil at a critically ill patient’s bedside. Distant family members call the unit continuously asking for updates and expressing concern. The nurse speaks with the distantfamily members and states she is referring them to the hospital social worker, whose role is to work with family in this situation. What role is the nurse assuming through this action? a. Manager b. Leader c. Follower d. Laissez-faire ANS: A As a manager, you are concerned with managing and coordinating resources to achieveoutcomes in accordance with established clinical processes. Referral to a social worker alleviates demand on staff time and is consistent with hospital procedures.

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16.A family is keeping vigil at a critically ill patient’s bedside. The nurse approaches the unit manager with concern over the family dynamics for the patient concerned there are patient- family conflicts based on patient’s wishes. The nurse suggests that the patient’s provider may need to discuss the treatment plan with the family. The unit manager states he will arrange a discussion with the patient’s provider and ask the nurse to support the provider’s decisions. What is the role of the nurse in this situation? a. Leadership b. Management c. Follower d. Evidence-based ANS: C In the followership role, you bring to the manager your concerns about concerns for patients and the outcomes and accept the direction given by the manager in response to your concerns. TOP: AONE competency: Knowledge of the Health Care Environment 17.The manager calls the staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, the manager explains that the organization values patient- centered care and that evidence supports that acting as an advocate and a listener is helpful to families. The manager asks the staff for ideas and strategies that are effectively patient-centeredin dealing with families in similar situations. What is the role of the nurse manager in this situation? a. Leadership b. Management c. Follower d. Visionary ANS: A As a leader, the manager is providing and communicating vision and direction based on evidence and experience. The manager is engaging others in decision making that moves themtoward the vision with a reasonable level of risk taking.

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ANS: D

Transformational leadership involves attending to the needs and motives of followers, whichresults in creativity, improvement, and employee development. TOP: AONE competency: Professionalism 20.As a leader on a rehab unit, the manager encourages all staff members to see themselves as having a role in decision making and quality care. The manager sees their role as involving particular responsibilities in decision making but not as a hierarchal role. What is this view ofthe role consistent with in this situation? a. Trait theories b. Complexity theory c. Situated theory d. Emotional intelligence ANS: B Complexity theory involves envisioning each member of the team involved in decision making, management, and leadership, with the leader not seen in a hierarchal relationship toother team members. TOP: AONE competency: Leadership 21.A staff nurse has been recently promoted to unit manager. During the time on the unit, the nurseformed a strong social network among staff, has promoted the development of relationships between staff and workers in other areas of the organization, and has formed relationships that generate ideas from patient organizations and the local nursing education program. According to complexity theory, what principle is being engaged? a. Empowerment b. Systematic thinking

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c. Development of networks d. Bottom-up interactions ANS: C According to complexity theory, social networks evolve around areas of common interest andare able to respond to problems in creative and novel ways. TOP: AONE competency: Knowledge of the Health Care Environment

22. According to the complexity theory, what would be the focus of measurement? a. Cost perhospital day b. Bed utilization c. Infection rates d. Staff morale and budgets ANS: D According to complexity theory and the principle “Think systematically,” one cannot ignoreobjective data or nonmeasurable data, as both inform decisions. TOP: AONE competency: Business Skills
23. During a staff meeting held to discuss developing a mission statement for the unit, the idea of placing patient needs first is discussed. What is considered when the suggestion by the manageris for the unit mission to be derived from the organization mission? a. Empowering b. A leadership tag c. A symbol d. A management task ANS: B

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c. Repeat the information several times, giving detailed budget overviews. d. Adjourn the meeting and provide explanation through e-mail. ANS: A Visioning involves engaging with others to assess the current reality, specify the end point, and then strategize to reduce differences. This requires trusting relationships that acknowledgethe differences in values and ideas. When done well, the nurse manager and the nurses within a unit experience creative tension that inspires working in concert to achieve desired goals. 26.A new graduate nurse wonders about the directions that her preceptor has given her regarding management of incontinent, confused patients. The new nurse brings the preceptorevidence- based information she located regarding incontinence interventions for confused patients and asks to talk about the guidance that given after the preceptor reviews the information in the article. What is the new nurse demonstrating in this situation? (Select all that apply.) a. Assertiveness b. Followership c. Management d. Insubordination ANS: A, B This is an example of followership in which a staff nurse is demonstrating assertive behaviorand presenting evidence that may influence the decision making of her nurse leader and manager. TOP: AONE competency: Knowledge of the Health Care Environment Chapter 02: Clinical Safety: The Core of Leading, Managing, and Following Yoder-Wise: Leading and Managing in Nursing, 7th Edition

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MULTIPLE CHOICE

1. In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross Hospital reduced the number of its managers and increased the number of units for which each manager was responsible. Within a year, the number of adverse events on the units had doubled. How dothe increase in adverse events relate to decreased managers? a. The overload of staff nurse duties b. Resistance to change by staff c. A change in reporting system for everyone d. Fewer clinical leaders facilitate best practice ANS: D Eliminating barriers to the implementation of best practices is the role of managers and leaders. When there are insufficient resources for leadership to encourage a culture in which evidence- based practice is embraced, frontline nurses recognize this as a stumbling block for delivering quality care. TOP: AONE competency: Knowledge of the Health Care Environment
2. The Rehabilitation Unit at Pleasant Valley Hospital has a high number of falls. What interventions might assist to reduce the number of falls on the unit? a. Determining who isresponsible for the falls b. Strengthening unit policies to avoid inappropriate admissions c. Encouraging involvement of nurses in educationrelated to falls and safety d. Ensuring that patients are appropriately restrained if they are at risk for falls ANS: C The IOM (2010) emphasizes the need for nurses to engage in lifelong learning and to useevidence and best practices to inform practice and ensure safety. TOP: AONE competency: Professionalism

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c. A reflection of frontline staff d. Related to systems errors ANS: B The IOM Health Professions Education report (2004) highlighted the education of health disciplines in silos as a major concern in patient safety and endorsed five recommendations. One to be increased and improved communication between the health disciplines. TOP: AONE competency: Knowledge of the Health Care Environment

6. A nurse manager is implementing strategies to support the steps in the AHRQ document “FiveSteps to Safer Health Care.” What does the manager include in the implementation? a. Patientsare actively encouraged to make decisions related to care. b. Rules and decisions are made through centralized processes. c. You monitor the performance of each staff member closely. d. Preference is given to increasing staff numbers rather than staff credentials. ANS: A The Agency for Healthcare Research and Quality (AHRQ) outlines “Five Steps to Safer Health Care,” which suggests that safe, patient- centered care is facilitated by assisting patientsto become active partners in their own care. TOP: AONE competency: Knowledge of the Health Care Environment
7. After consulting with practice environments about quality and safety concerns in health care, adean in a health care program implements what to improve quality and safety in health care? a. A nursing program that emphasizes the development of a strong disciplinary identity. b. Programming that stresses discipline-based research. c. Partnerships with health care to develop software for the reporting of adverse events.

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d. An interdisciplinary program for nurses, pharmacists, and medical practitioners thatemphasizes collaborative learning teams. ANS: D Health Professions Education identified that education related to health disciplines in silosleads to compromised communication and inability to function as an integrated whole for patient- centered care. TOP: AONE competency: Knowledge of the Health Care Environment

8. What would be the primary emphasis in designing and implementing a quality, safe healthcareenvironment? a. Evidence-based practice b. Informatics c. Staffing d. The patient ANS: D Focusing on the patient moves care from concern about who controls care to a focus on what care is provided to and with patients, which was an aim identified in the IOM report Crossingthe Quality Chasm. TOP: AONE competency: Knowledge of the Health Care Environment
9. The nurse is educating older adult patients on staying safe in the healthcare system. What information does the nurse include in the teaching? a. The need to understand and record all medications beingtaken. b. Bringing their own linens and other personal items to the hospital.