Chapter 13- Working with Others in a Leadership Role My Nursing Test Banks

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Chapter: Chapter 13: Working with Others in a Leadership Role

Multiple Choice

1. The nature of healthcare requires the development of healthcare teams and collaboration among its members. Which of the following statements represents an element of this teamwork?

A) Each group member of a team is the leader of the team.

B) The organization sets the goals for its teams.

C) Communication patterns in teams flow both up and down.

D) Team members are not legally responsible for decisions and outcomes.

Ans: C

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 1

Page and Header: 461, Teams and Healthcare

Feedback: Teams may be led by facilitators or coaches, have members who share responsibility for decisions, setting goals, and achieving outcomes, use communication patterns that flow both up and down, and have members who share responsibility for decisions and outcomes. Not every member of the group is in a leadership role and goals may be set independently. A team may be legally responsible for the decisions its members make.

2. A client receives the care of a physician, a nurse, an occupational therapist, and a counselor working together as a team. What is the term for this type of healthcare?

A) Cross-discipline healthcare

B) Comprehensive healthcare

C) Holistic healthcare

D) Interdisciplinary healthcare

Ans: D

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Easy

Integrated Process: Communication and Documentation

Objective: 2

Page and Header: 468, Team Building

Feedback: Interdisciplinary healthcare involves collaboration and extensive communication between members of different health disciplines. This model is not termed cross-discipline, comprehensive, or holistic healthcare.

3. A nurse will soon become a member of a newly-established care team. Which of the following is a goal of team building?

A) Acknowledging individual achievements

B) Providing client care based on the direction of the team leader

C) Creating a type of synergy when addressing client care

D) Allowing care to be determined by nurses who are not too close to the situation

Ans: C

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 3

Page and Header: 468, Team Building

Feedback: The goal of team building is to create a type of synergy, in which the effect of everyone working together toward the shared goal results in a greater total effect than could be achieved by the sum of the efforts of everyone working individually. Individual achievements should be acknowledged, but this is not the goal of team building. The process of building the team does not immediately result in changes to client care

4. A registered nurse is responsible for organizing the care at a facility that has several UAPs. Which of the following tasks can an RN delegate to a UAP?

A) Performing an ongoing assessment

B) Answering call lights

C) Administering medications

D) Counseling clients

Ans: B

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 5

Page and Header: 477, Knowing When Not to Delegate

Feedback: Any activity that requires knowledge and judgment that is unique to the function of an RN cannot be delegated to others. Such activities include ongoing assessment, medication administration, and counseling clients. Answering call lights is within the scope of a UAP and can thus be delegated.

5. A nurse recognizes the importance of safely and efficiently delegating tasks in order to achieve a high standard of care. Which of the following is one of the NCSBNs five rights of delegation?

A) Right education

B) Right assessment

C) Right circumstances

D) Right motivation

Ans: C

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Easy

Integrated Process: Communication and Documentation

Objective: 6

Page and Header: 479, Display 13.4

Feedback: The five rights of delegation include the right task, circumstances, person, direction/communication, and supervision/evaluation.

6. A nurse is aware of the pivotal role that motivation plays in the formation of effective teams and the provision of excellent nursing care. Which of the following actions is most likely to motivate a team member?

A) Ensure that the consequences of substandard performance are well-known.

B) Publicize those individuals who have made exceptional contributions and point out those who have failed to perform adequately.

C) Openly acknowledge team members who have made a particularly valuable contribution.

D) Be clear that only the highest levels of performance are acceptable to the team.

Ans: C

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 4

Page and Header: 474, Display 13.2

Feedback: There are numerous ways to foster motivation in others, including the use of genuine praise and acknowledging high performance. Negative methods, or punishments, have been shown to be less effective. These would include emphases on consequences, shame, and threats.

7. A registered nurse is responsible for overseeing the care that is provided in a long-term care facility. The skills mix at the facility includes the registered nurse, a practical nurse, and several unlicensed assistive personnel (UAP). Which of the following statements is true of the delegation that the RN performs?

A) The RN is accountable for the care that the other members of the team provide.

B) The RN may only delegate tasks that are outside of her own scope of practice.

C) The RN can delegate tasks that are outside the PNs or UAPs scope of practice if she first provides adequate teaching.

D) Once a task is delegated, the person who performs the tasks is solely responsible for the outcomes.

Ans: A

Client Needs: A-1

Cognitive Level: Application

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 5

Page and Header: 477, Critical Aspects of Effective Delegation

Feedback: It is critical to remember that although you have asked someone else to carry out a nursing task, you are still accountable for the care that is given. A person cannot be delegated a tasks that is outside his or her scope of practice, regardless of whether teaching is provided. A person cannot delegate a task that is outside of his or her own scope of practice.

8. Healthcare is a field that continues to undergo constant and profound change, both planned and unplanned. Which of these situations is an example of reactive change?

A) Hospital administrators have announced a desire to implement the principles of evidence-based practice.

B) A hospitals accreditation review revealed systemic problems and the hospital has been directed to resolve these.

C) The introduction of automated medication dispensing machines at a hospital is scheduled for later this year.

D) A transition will soon begin whereby the practical (vocational) nurses will begin to practice within their full scope.

Ans: B

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 7

Page and Header: 484, Planned and Unplanned Change

Feedback: Planned change has a definite design and structure established to facilitate the process, including time lines, identification of stake holders, goals, plans for implementation, and processes for evaluation. Thoughtful planning often results in more effective and efficient change processes and is essential for projects that are complex or large in scope and that require greater time, resources, or skills. Change also may be unplanned and occur as a reaction to another issue, such as a failed accreditation. This is referred to as reactive change. Reactive change occurs when some problem or event arises that requires a different way of doing things.

9. Kurt Lewins force-field theory of change is one of the most widely accepted and remains in current use today. The central concepts of this theory of change include

A) the forces that govern intrinsic and extrinsic motivation.

B) the relationship between driving forces and restraining forces.

C) the forces of resilience and inertia in an organization.

D) the relationship between the will for change and the ability to effect change.

Ans: B

Client Needs: A-1

Cognitive Level: Comprehension

Difficulty: Difficult

Integrated Process: Communication and Documentation

Objective: 8

Page and Header: 485, Lewins Theory of Change

Feedback: According to Lewin, change requires an imbalance between the forces that call for changethe driving forces, which push the system toward change and the restraining forces that pull the system away from change. Lewin does not explicitly address the issues of motivation, inertia, resilience, and will for change.

10. A nurse has identified glaring inefficiencies in the way that care is organized on a medical unit. Which of the following tasks will this nurse perform if he or she is to act as a change agent?

A) Informing others about the need for change

B) Ensuring that others comply with any change that is implemented

C) Establishing punishments and rewards to foster compliance with change

D) Evaluating the long-term outcomes associated with change

Ans: A

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 9

Page and Header: 485, The Unfreezing Stage

Feedback: A change agent is the person who seeks to create change and is responsible for facilitating the change process with others. Having gathered data, identified the problem, and decided that change is needed, the change agent sets about making others aware of the need for change. A change agent is not necessarily involved with evaluating a change or ensuring compliance.

11. A nurse leader has been commissioned to implement a new electronic documentation system in a hospital, replacing the existing paper-based system that has been in place for decades. What is the first step that this nurse should take toward facilitating this change?

A) Enlist the support of the physicians and advanced practice nurses in the hospital.

B) Publicize the deficits of the existing documentation system.

C) Understand how and why individuals are often resistant to change.

D) Begin the process of evaluation before the change is implemented.

Ans: C

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 10

Page and Header: 488, Understanding Resistance to Change

Feedback: A first step in facilitating change is gaining a thorough understanding of resistance to change. This should precede the evaluation process, even though this should indeed begin early in the change process. An understanding of the change process is necessary before the nurse begins eliciting support from care providers or publicizing the deficits of the current system.

12. Jessica is a recent nursing graduate who was able to secure a position on the postsurgical unit where she completed the final preceptorship of her baccalaureate degree. Jessica has just received word that there will be sweeping changes in the organization of care on the unit, a development that she finds intimidating since she has only recently become adept at working in the existing system. How should Jessica best respond to this news?

A) Elicit support from nurses who support maintaining the existing system

B) Learn as much as she can about the proposed system

C) Research alternatives to the change that has been proposed

D) Express her concerns about the proposed change to the nurse manager

Ans: C

Client Needs: A-1

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 11

Page and Header: 492, Learn About the Change

Feedback: As a novice nurse, you should take all available opportunities to learn about any anticipated changes. This is more beneficial that actively or passively opposing a change and should precede a presentation of concerns to the manager.

13. Healthcare institutions are frequently the site of conflict. Which of the following situations exemplifies interpersonal conflict?

A) A nurse is undecided whether to pursue a management position or to continue providing bedside care.

B) A recent graduate and a more experienced nurse disagree on the thoroughness of the recent graduates assessments.

C) A cohort of experienced nurses have concerns about the way that younger nurses dress and present themselves.

D) The nurses on a unit are having difficulty getting physicians to return pages.

Ans: B

Client Needs: A-1

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 12

Page and Header: 496, Intrapersonal, Interpersonal, and Intergroup Conflict

Feedback: Interpersonal conflict occurs between or among individuals. This is where differences in values, ideas, perceptions, and goals play an important role. Intrapersonal conflict occurs within ones self in circumstances in which a choice must be made between two alternatives. Intergroup conflict exists between defined groups of individuals, such as recent nursing graduates, experienced nurses or physicians.

14. Alex is a nurse who has been taken aside by a colleague and the colleague has described another nurse as a backstabber and battleaxe. The colleague has gone on to give Alex details of ongoing conflict between the colleague and this nurse. Which conflict management technique should Alex apply in this situation?

A) Withdrawing from conflict

B) Accommodating the conflict

C) Negotiating

D) Collaborating

Ans: A

Client Needs: C

Cognitive Level: Application

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 13

Page and Header: 499, Withdrawing from or Avoiding Conflict

Feedback: The strategy of avoiding or withdrawing from the conflict is employed when you choose not to address the issue at hand. There are many times when this approach is appropriate. This includes situations in which the conflict clearly is not your problem or when there is little or nothing that you can do about it. This is the case when a conflict is limited to two other individuals and does not involve patient safety. Accommodating, negotiating, and collaborating are likely not appropriate responses by the nurse to this interpersonal conflict.

15. The approach that a nurse chooses in the management of a conflict is entirely dependent on many of the factors and variables involved in the specific conflict. In which of the following situations would the nurse be most likely justified in forcing the issue or competing?

A) A nurse is embarrassed that a colleague discovered the nurses medication error and completed an incident report.

B) A nurse observed a colleague remove an opioid analgesic from the locked medication cupboard and put it in her pocket.

C) A nurse disagrees with a colleague about the need for increased staffing levels.

D) A nurse has received constructive criticism from his manager during his latest performance appraisal.

Ans: B

Client Needs: A-2

Cognitive Level: Analysis

Difficulty: Moderate

Integrated Process: Communication and Documentation

Objective: 13

Page and Header: 499, Forcing the Issue or Competing

Feedback: Forcing the issue might be the best approach if the nurse observes a violation of ethical or legal standards, such as suspected substance abuse. Interpersonal disagreements about feedback or staffing levels are more likely to benefit from a more collaborative or constructive conflict management technique.

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