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A charge nurse on the step-down unit will likely use which leadership style during resuscitation efforts for a cardiac arrest?
- A. Democratic
- B. Laissez-faire
- C. Servant
- D. Autocratic
Correct Answer: D
Rationale: Autocratic leadership assumes control over the decisions and activities of the group, such as taking charge of emergencies, dictating schedules and work responsibilities, and scheduling mandatory in-service training. Polling other nurses is an example of democratic leadership, which is characterized by a sense of equality among the leader and other participants, with decisions and activities being shared. In laissez-faire leadership, the leader relinquishes power to the group and encourages independent activity by group members. Examples of laissez-faire leadership style are allowing the nurses to divide up the tasks and encouraging them to work independently.
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A nurse manager is planning to update a health care provider's office from paper to electronic health records (EHR) by using the eight-step process for planned change. Place the following actions in the order in which they should be initiated:
- A. The nurse devises a plan to switch to EHR.
- B. The nurse records the time spent on written records versus EHR.
- C. The nurse attains approval from management for new computers.
- D. The nurse analyzes all options for converting to EHR.
- E. The nurse installs new computers and provides an in-service for the staff.
- F. The nurse explores possible barriers to changing to EHR.
- G. The nurse follows up with the staff to check compliance with the new system.
Correct Answer: B,F,D,C,A,E,G
Rationale: Planned change involves the following steps: (1) recognize symptoms that indicate a change is needed and collect data, (2) identify a problem to be solved through change, (3) determine and analyze alternative solutions, (4) select a course of action from possible solutions, (5) plan for making the change, (6) implement the change, (7) evaluate the change, and (8) stabilize the change.
A nurse erroneously administered two tablets of acetaminophen totaling 650 mg to their patient. When reporting this to the nurse manager, the nurse states, 'there are two tablets in a package labeled '325 mg, acetaminophen.' The prescription reads 'administer 325 mg of acetaminophen;' therefore, I administered what was in the package.' Based on a philosophy of just culture, what should happen next?
- A. The nurse should be found at fault for not clarifying the order.
- B. The package labeling should be reviewed with the pharmacy.
- C. The nurse should be disciplined.
- D. No follow-up is needed as the medication is over the counter.
Correct Answer: B
Rationale: A just culture is committed to accountability and safety. Nurses are encouraged to disclose clinical errors and potential error situations without the fear of punitive actions, allowing others to learn from this experience. Health care workers within the organization discuss concerns and challenges related to patient care, turning them into opportunities for improvement. Reviewing the package labeling with the pharmacy addresses the root cause of the error, which is unclear labeling, rather than solely blaming the nurse.
After observing conflicts between nurses about scheduling, a nurse manager compliments the nurses for achieving the monthly goal of no patient falls. What strategy for conflict resolution did the manager display?
- A. Collaborating
- B. Competing
- C. Compromising
- D. Smoothing
Correct Answer: D
Rationale: The manager who avoids conflict by complimenting the parties and avoids disagreements is using smoothing to reduce the emotion of the conflict. The original conflict is rarely resolved with this technique. Collaborating is a joint effort to resolve the conflict with a win-win solution. All parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. Competing results is a win for one party at the expense of the other group. Compromising occurs when both parties relinquish something of equal value.
Nursing students enrolled in a leadership and management course attend clinical on a surgical unit. As they are planning their day, they note one student has a complex patient with multiple medications and the need for frequent turning, pressure injury wound care, and tube feedings. Which action by the group best reflects effective teamwork and coordination?
- A. Asking patients to prioritize what they want to accomplish each day
- B. Including a 'nice to do' for every 'need to do' task on the list
- C. Front loading' their schedules with 'must do' priorities
- D. Scheduling times to assist the student with the complex patient
Correct Answer: D
Rationale: The students use teamwork and collaboration to appropriately coordinate patient care; this is the best response. By asking the patient to prioritize what they want to accomplish each day, the nurse is demonstrating an effective time management technique. To manage time, the nurse should establish goals and priorities for each day, differentiating 'need to do' from 'nice to do' tasks; the nurse should include the patient in this process. The nurse should also establish a time line, allocating priorities to hours in the workday in to keep track of falling behind and correct the problem before the day is lost.
A chief nursing officer with a transformational leadership style is developing a plan for success to obtain Magnet status. What are the most appropriate strategies for the leader to use? Select all that apply.
- A. Sharing their vision of excellence in patient care and high-level education
- B. Encouraging nurses to incorporate evidence-based practice through hospital committees and to join nursing organizations
- C. Promoting compliance by reminding subordinates that they have a good salary and working conditions
- D. Ensuring employees are kept abreast of new developments in their department and the larger organization
- E. Writing the Magnet application and supporting documentation with limited input from the nursing staff
- F. Encouraging nurse managers and nurses to self-schedule as long as proper coverage is maintained
Correct Answer: A,B
Rationale: Transformational leaders inspire, motivate, create intellectually stimulating practice environments, and challenge themselves and others to grow personally and professionally. They demonstrate caring and vulnerability, communicating honestly and openly. They are risk takers and pay attention to process as well as outcomes. Instituting a reward program and reminding workers that they have a good salary and working conditions are examples of transactional leadership, which is based on a task-and-reward orientation. Ensuring that employees keep abreast of new developments in nursing care is a characteristic of quantum leadership. The group and leader work together to accomplish mutually set goals and outcomes with the democratic leadership style, and the laissez-faire style encourages independent activity by group members, such as setting their own schedules and work activities.