Chapter 01 Leading, Managing, and Following

Chapter 01  Leading, Managing, and Following

Complete Chapter Questions And Answers
 

Sample Questions

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 in making this change?
a.
Leverage the hierarchical management position to get unit staff involved in assessment and 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, every voice counts, and therefore all levels of staff would be involved in decision making.

REF: Page 13
TOP: AONE competency: Communication and Relationship-Building

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 very much 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 this nurse may be calling in frequently in the future.
d.
Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife’s treatments.

ANS: D
Placing the nurse on unpaid leave may threaten physiologic needs and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect patient care and threaten the needs of staff to feel competent. Arranging the schedule around the wife’s needs meets the needs of the staff and of patients while satisfying the nurse’s need for affiliation.

REF: Page 10
TOP: AONE competency: Communication and Relationship-Building

3. A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation session, the staff nurse repeatedly calls the unit manager’s actions unfair, and the unit manager continues to reiterate the reasons for her actions. What would be the best course of action at this time?
a.
Send the two disputants away to reach their own resolution.
b.
Involve another staff nurse in the discussion so as to clarify issues.
c.
Ask each party to examine her own motives and issues in the conflict.
d.
Continue to listen as the parties repeat their thoughts and feelings about the conflict.

ANS: C
Ury, Brett, and Goldberg outline steps to restoring unity, the first of which is to address the interests and involvement of participants in the conflict by examining the real issues of all parties.

REF: Page 17
TOP: AONE competency: Communication and Relationship-Building

4. At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. It would now be best to:
a.
Arrange another meeting in a week’s time so as to allow a cooling-off period.
b.
Turn the dispute over to the director of nursing.
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
According to the principles outlined by Ury, Brett, and Goldberg, a “cooling-off” period is recommended if resolution fails.

REF: Page 17 TOP: AONE competency: Leadership

5. The manager of a surgical area has a vision for the future that requires the addition of RN assistants or unlicensed persons to feed, bathe, and walk patients. The RNs on the staff have always practiced in a primary nursing-delivery system and are very resistant to this idea. The best initial strategy in this situation would include:
a.
Exploring the values of the RN group in relationship to this change.
b.
Leaving the RNs alone for a time so they can think about the change before they are approached again.
c.
Dropping the idea and trying for the change in another year or so.
d.
Hiring the assistants and allowing the RNs to see what good additions they are.

ANS: A
Leadership involves engaged decision making around a vision that is based on evidence and tacit knowledge. Influencing others requires emotional intelligence in domains such as empathy and handling relationships.

REF: Pages 6, 7 TOP: AONE competency: Knowledge of Healthcare Environment