Resources for Leading and Managing in Nursing, 7th Edition: Midterm leadership Exam.

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Resources for Leading and Managing in Nursing, 7th Edition Chapter 1 leadership 1. 1.ID: 37 A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is asked to as... sess 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 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. 2. 2.ID: 35 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. 3. 3.ID: 56 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 the 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 for clarity issues. C. Ask each party to examine their own motives and issues in the conflict. D. Continue to listen as the parties repeat their thoughts and feelings about the conflict. 4. 4.ID: 45 At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. What is the appropriate next step? A. Arrange another meeting in a week’s time so as to allow a cooling-off period. B. Elevate the next negation session to the next manager, one level above. C. Insist that participants continue to talk until a resolution has been reached. D. Back the unit manager’s actions and end the dispute. 5. 5.ID: 60 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 ambulate patients. The RNs on the staff 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 this change B. Leaving the RNs alone for a time so they can think about the change before it is implemented C. Dropping the idea and trying for the change in a year or so when some of the present RNs have retired D. Hiring the assistants and allowing the RNs to see what good additions they are 6. 6.ID: 78 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 are not 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 night LPNs and NAs. B. Allow the LPNs and NAs greater decision-making power within the scope of their positions in the institution. C. Hire additional staff so that there are more staff available for enhanced care, and individual workloads are lessened. D. Ask the director of nursing to increase job security for night staff by having them sign contracts that guarantee work. 7. 7.ID: 72 The nurse manager wants to increase motivation by providing motivating factors for the nurse on the unit. What action would be appropriate to motivate the staff? A. Collaborate with the human resource/personnel department to develop on-site daycare services. B. Provide a hierarchical organizational structure. C. Implement a model of shared governance. D. Promote the development of a flexible benefits package. 8. 8.ID: 39 A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The family member leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner? A. Reflect to gain insight into how the situation could be handled differently in the future. B. Try to catch up with the angry family member to resolve the concern. C. Discuss the concern with the patient after the family member has left. D. Notify nursing administration of the situation. 9. 9.ID: 33 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 the units, 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 competency program. 10. 10.ID: 64 The nurse manager has been asked to implement an evidence-based approach to teach ostomy patients self-management skills postoperatively. The program is to be implemented across the entire 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 familiar to staff. C. You decide to implement the approach at a later date because of feedback from the RNs that the new approach takes too much time. D. An RN who is already familiar with the new approach of volunteers to take the lead in mentoring and teaching others how to implement it. 11. 11.ID: 52 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 in regard to the statement? A. The statement is . 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 other positions. D. The general perception is that nurse leaders and managers are not satisfied in their jobs. 12. 12.ID: 70 The charge nurse walks into Mr. Smith’s room and finds him yelling at the LPN. He is obviously very upset. The charge nurse determines that he has not slept for three nights because of unrelieved pain levels. The LPN is very upset and calls Mr. Smith an “ugly, old man.” The charge nurse acknowledges the LPN’s feelings and concerns and then suggests that Mr. Smith’s behavior was aggressive but was related to lack of sleep and to pain. The charge nurse asks, “Can you, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling his pain?” This situation is an example of what? A. Lack of empathy and understanding for Miss Jones B. Concern with placating Mr. Smith C. Leadership behavior D. Management behavior 13. 13.ID: 80 After assessing an older adult patient in long-term care who has been slowly deteriorating for weeks, the nurse manager calls the family and asks them to come in, as the patient is dying. What is the most likely basis for the nurse manager’s request? A. An established clinical pathway B. Confirmatory scientific evidence C. Unit protocol D. Experience 14. 14.ID: 76 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 to find 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 15. 15.ID: 68 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 distant family 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 Chapter 3 1. The manager in the coronary care unit believes an important ethical consideration in performance evaluations is to include the employee’s good qualities and give positive direction for professional growth. What ethical principle does this represent? A. Justice B. Fidelity C. Beneficence D. Nonmaleficence 2. 2.ID: 92 A staff nurse in the area that you manage has excelled in the delivery of patient education. You are considering implementing a new job description that would broaden her opportunity to teach patients and orient new staff members to the value of patient education. What ethical principle is being reinforced? A. Justice B. Fidelity C. Paternalism D. Respect for others 3. 3.ID: 46 A patient refuses a simple procedure that you believe is in the patient’s best interest. What two ethical principles are in conflict in this situation? A. Fidelity and justice B. Veracity and fidelity C. Autonomy and beneficence D. Paternalism and respect for others 4. 4.ID: 73 An individual in a wheelchair is applying for the position of receptionist in an outpatient clinic. What does the nurse manager understand based on The Americans with Disabilities Act of 1990 requirements for employers? A. Make reasonable accommodations for persons who are disabled. B. Allow modified job expectations for persons recovering from alcoholism. C. Hire disabled individuals before hiring other qualified, nondisabled persons. D. Treat, for purposes of employment, homosexuals and bisexuals as disabled. 5. 5.ID: 61 A staff nurse, who was fired for reporting patient abuse to the appropriate state agency, files a whistleblower lawsuit against the former employer. What reason would the court provide to uphold a valid whistleblower suit claiming retaliation by the nurse? A. Previously reported the complaint, in writing, to hospital administration. B. Threatened to give full details of the patient abuse to local media sources. C. Was discharged after three unsuccessful attempts at progressive discipline had failed. D. Had organized, before filing the complaint, a work stoppage action by fellow employees. 6. 6.ID: 44 In keeping with standards of The Joint Commission (TJC), the nurse manager organizes an orientation for new staff members. As part of the orientation, the nurse manager reviews the employee handbook. What is the basis that binds employers to statements in the employee handbook? A. Under the doctrine of apparent agency B. Under the doctrine of respondent agency C. Based on the employee’s or the employer’s expectations D. Based on the theory that the handbook creates an explicit contract 7. 7.ID: 55 To reduce the incidence of falls in a skilled nursing unit, the nurse manager contacts the risk manager. Risk management is a process that attempts to identify potential hazards and: A. compensate for previous injuries. B. eliminate these risks before anyone else is harmed. C. supersede the need for staff members to file incident reports. D. discipline staff members who have been involved in previous incident reports. 8. 8.ID: 57 One means of ensuring that the nurses floated to other patient care areas in healthcare organizations are qualified to work in the areas they are floated is: A. employing additional staff to assist with orientation processes. B. crosseducating staff members to other areas of the institution. C. transferring patients to units where the staffing pattern is optimal. D. orienting staff members to all patient care areas as part of their general orientation to the institution. 9. 9.ID: 65 A colleague asks you to give her your password access so that she can view her partner’s healthcare record without using her login. This request violates the patient’s right to: A. privacy. B. confidentiality. C. undue authorization of treatment. D. protection against slander. 10. 10.ID: 42 On your nursing unit, you employ LPNs, RNs, and advanced practice nurses. You will need to be familiar with at least: A. two nursing practice acts. B. two nursing practice acts in most states. C. one nursing practice act. D. one nursing practice act and a medical act. 11. 11.ID: 86 A nurse on your inpatient psychiatric unit is found to have made sexually explicit remarks toward a patient with a previous history of sexual abuse. The patient sues, claiming malpractice. What conditions do not apply in this situation and do not support malpractice? A. Injury B. Causation C. Breach of duty D. Breach of duty of care owed 12. 12.ID: 82 As a charge nurse, you counsel your RN staff member that they have has their duty of care by notifying a child’s physician regarding concerns about deterioration in the child’s status at 0330 hours. The physician does not come in to assess the child and does not provide additional orders. The child dies at 0630 hours. As the charge nurse, you could be held liable for what? A. Professional negligence B. Assault C. Avoidance D. Murder 13. 13.ID: 79 The parents of a toddler who dies after being brought to the ER launch a lawsuit, claiming that the failure of nurses to pursue concerns related to their son’s deteriorating condition contributed to his death. How is senior nurse executive is named in the suit? A. As a global respondent B. Under the doctrine of respondeat superior C. As a frivolous action D. Under the element of causation 14. 14.ID: 84 During a staff shortage, you hire an RN from a temporary agency. The RN administers a wrong IV medication that results in cardiac arrest and a difficult recovery for the patient. Liability in this situation: A. is limited to the temporary agency. B. is restricted to the RN. C. could include the RN, the agency, and your institution. D. may depend on the patient’s belief regarding the employment relationship. 15. 15.ID: 88 You volunteer at a free community clinic. A 13-year-old girl presents with chlamydia. The team leader at the clinic advises that: A. the state-defined age of legal consent is 18; therefore, no treatment can be delivered. B. the teen is underage and should be referred to the family general practitioner. C. care can be provided as long as consent is voluntary and information about treatment and options is provided. D. treatment is provided as long as telephone consent is obtained from a parent or legal guardian. Chapter 04 According to Leininger, “cultural imposition” is a major concern in nursing because nurses have a tendency to impose their values, beliefs, and practices on patients of other cultures. The discussion topic most likely to be without cultural imposition would be: A. abortion. B. wound management. C. blood transfusion. D. advance directives. 2. 2.ID: 01 Cultural diversity is the term used to describe a vast range of cultural differences. Events have symbolic meanings for the nurse manager and the staff. The event that would be most likely to provide symbolic meaning to a nurse manager and staff is a: A. task force formed to commemorate a New Year’s celebration in the Western tradition. B. project to provide Christmas gifts to the children in a daycare program. C. celebration of National Nurses Week with the focus on cultural care. D. task force to develop a poster for the unit depicting religions of the world. 3. 3.ID: 05 One of the staff nurses on your unit makes the comment, “All this time I thought Mary was black. She says she is Jamaican.” The best response would be to say: A. “Who cares what she is?” B. “What did you think when you learned she was Jamaican?” C. “Why did you assume she was black?” D. “We have never had a Jamaican on this unit.” 4. 4.ID: 29 As a nurse manager, you notice that Maria, a Hispanic nurse aide, is visibly upset. When you ask her if something is wrong, she becomes tearful and says, “Why is it that when John and I work together in giving patients care, he jokes about my being “a little fat Mexican”? The nurse manager’s best response is, “Do you think he: A. is sensitive to your culture?” B. wants to learn more about you?” C. has been hurt and wants to hurt others?” D. is stereotyping you without thinking?” 5. 5.ID: 27 The nurse manager of a unit is asked by a family member of a dying Native American patient if it is possible to have the patient’s eight-member family recite the rosary by the bedside. The manager responds affirmatively. The nurse manager is most likely exhibiting behavior related to: A. acculturation. B. ethnocentricity. C. cultural diversity. D. cultural sensitivity. 6. 6.ID: 23 A 66-year-old native Chinese patient, hospitalized for a myocardial infarction, asks the nurse manager about seeing his “acupuncture doctor” for treatment of his migraine headache. The best response to this patient would be: A. “How long have you been using acupuncture treatment?” B. “Do you think acupuncture relieves your pain satisfactorily?” C. “What have you told your heart specialist about your migraines and treatment?” D. “Have you tried nonprescription pain medication or been given a prescription drug for your headaches?” 7. 7.ID: 37 Maintaining a culturally diverse staff and working with a culturally diverse patient population is an important function of a nurse manager who works in the hospital of a large medical center. On your palliative care unit, you have recently received complaints from families about ineffective pain management for their family members and you determine this occurs primarily when certain nurses are working. What approach might you take to resolve the concerns of the families, patients, and potentially, the staff? A. Reinforce to staff that practice guidelines support as-needed analgesia for the terminally ill. B. Ask staff input on the development of stricter guidelines to ensure that all terminally patients are given sufficient analgesia. C. Encourage conversation with patients and among staff that facilitates learning about cultural beliefs and priorities in dying. D. Advise families that the administration of analgesia is based on the expert clinical judgment of nurses who are familiar with care of patients in palliative care. 8. 8.ID: 21 Because an increasing number of Hispanic patients are being admitted, a nurse manager designs a staff- development program to help her staff understand the Hispanic culture. A nurse should understand that culture is determined by which of the following? A. Behavior B. Love for people C. Shared vision D. Genetic predisposition 9. 9.ID: 44 The nurse manager for a unit’s culturally diverse staff creates a staff-development program so the professional nursing staff members can enhance their understanding of cultures on the basis of published literature. The literature reveals that the following characteristic is inherent in a culture. It: A. develops over time. B. maintains a strong work ethic. C. changes easily. D. develops quickly. 10. 10.ID: 03 In designing programs through your institution to address the health needs of Hispanics in your community, you most likely would develop programs related to: A. diabetes. B. cardiovascular disease. C. cancer. D. asthma. 11. 11.ID: 17 Within the deaf culture, there is considerable disagreement about the use of SEE (Signed Exact English) and ASL (American Sign Language). This is indicative of: A. dominant versus nondominant behaviors. B. the need to recognize diversity within groups. C. the impact of cross-culturalism. D. how language separates subgroups. 12. 12.ID: 07 When interviewing a candidate for a nursing position who has an Aboriginal background, you recognize that the candidate’s lack of eye contact reflects the candidate’s: A. lack of confidence. B. professional behavior. C. cultural sensitivity. D. ethnicity. 13. 13.ID: 99 When interviewing a candidate for a nursing position who has an Aboriginal background, you recognize that the candidate’s lack of eye contact reflects the candidate’s cultural sensitivity. You are exhibiting: A. acculturation. B. cultural sensitivity. C. ethnocentrism. D. transculturalism. 14. 14.ID: 19 Mary joins 5W nursing unit. Mary is a new graduate who is anxious to fit in. She soon learns that some of her “book learning” is being criticized by her colleagues, so she adapts her practice to what others on the unit are doing. She is demonstrating: A. cultural awareness. B. cultural sensitivity. C. acculturation. D. cultural marginality. 15. 15.ID: 95 At Health Center XYZ, staff members on the rehabilitation unit have a head nurse who is intolerant of error and publicly chides anyone who makes a mistake. Over time, the rules on the unit dictate that mistakes are hidden and that areas of concern related to the functioning of the unit are discussed in tub rooms and are never openly discussed during periodic meetings. New staff members are quickly made to realize that silence is expected. The situation described is an example of: A. ethnicity. B. work environment. C. work culture. D. marginalization. Chapter 7 1. 1. As a nurse manager, you observe a staff nurse who over the past few weeks has become withdrawn and has had several absences due to minor ailments. Your best action would be to: A. ask the nurse if she is okay during report. B. refer the nurse to the employee assistance program. C. ask the nurse to meet with you for a few minutes before she leaves for the day. D. write a note to the nurse advising her that her work attendance must improve. 2. 2.ID: 19 The nurse manager of a unit has lost many staff members, and the unit is now staffed with a large number of agency and traveling nurses. She knows that the agency and traveling nurses are all contracted to stay on the unit for the next 3 months. One way to improve morale and decrease stress in the unit would be to: A. plan a social event and include the agency and traveling nurse staff members. B. plan unit-based social events for your remaining permanent staff members. C. request hospital-based “floating” nurses to substitute for the temporary staff. D. implement team nursing. 3. 3.ID: 15 As a nurse manager, the one activity you should not overlook is: A. posting the yearly rotation schedule. B. reviewing vacation requests. C. scheduling staffing for holidays 6 months in advance. D. anticipating staff sick days. 4. 4.ID: 23 A nurse manager has decided that she must institute some personal time-management steps to survive work and home life. Her first step should be to: A. determine what takes up so much of her time and energy. B. organize her personal and work spaces. C. purchase a handheld personal digital assistant to help remind her of important meetings. D. determine her personal and professional goals. 5. 5.ID: 90 A hospice nurse has been feeling very stressed at work because of both the physical strain and the emotional drain of working with clients with AIDS. She tries to walk 1 to 2 miles three times a week and to talk regularly with her husband about her work-related feelings. One reasonable stress-management strategy would be to: A. start taking yoga lessons. B. make an appointment to meet with a psychiatrist. C. start jogging 5 to 6 miles every day. D. plan to go out for a drink with fellow nurses after work every day. 6. 6.ID: 09 The nurse manager is implementing a shared governance model to help with communication and decision making. Although staff members like the concept, change is difficult. Staff nurses feel: A. more empowered. B. more communicative. C. less stressed. D. more powerless and devalued. 7. 7.ID: 97 The chief nursing officer listens to nurse managers verbalize their feelings of internal stress. One common source of internal stress seems to be: A. the death of a loved one. B. perfectionism. C. getting married. D. losing a job. 8. 8.ID: 34 The staff development educator presents a series of programs on stress management to the nurse managers. Research has indicated that an individual’s ability to deal with stress is moderated by psychological hardiness. Psychological hardiness is a composite of: A. commitment, control, and challenge. B. commitment, powerlessness, and passivity. C. commitment, control, and passivity. D. decreased isolation, challenge, and passivity. 9. 9.ID: 95 The chief nursing officer understands that a nurse manager can exhibit stress that is related to trying to keep up with the number of electronic messages that arrive, as well as trying to remain accessible to staff. What is a strategy that would assist the manager to manage the information overload effectively? A. Ignore messages unless they are labeled as important. B. Determine who is most likely to send useful or important information or requests. C. Check e-mail messages once a day. D. Encourage face-to-face meetings rather than e-mail. 10. 10.ID: 25 In helping nurse managers to manage their time, the chief nursing officer suggests that they: A. maintain a perfectionistic attitude. B. set up a complaint list. C. have good negotiation skills. D. have good information literacy skills. 11. 11.ID: 03 Which of the following statements would best define stress? Stress is: A. the comfortable gap between how we like our life to be and how it actually is. B. everyday life, both the highs and the lows. C. a consequence or response to an event or stimulus that can be positive or negative. D. identical to distress. 12. 12.ID: 13 In a job interview for a nursing position, Marley can be assured that which of the following will occur? A. Both eustress and distress B. Only eustress C. Only distress D. Neither eustress nor distress 13. 13.ID: 36 Which one of the following statements has been proven to be true? A. Recent research has found that women do not have a unique physiologic response to stress. B. Both men and women interpret the same stressor in the same manner without regard to past experiences. C. [Show More]

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