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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.
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A nursing student is actively working toward strengthening their leadership skills. What action will best assist the student to meet this goal?
- A. Being self-reliant in solving problems
- B. Being self-directed and asking for assistance when needed
- C. Using written communication instead of face-to-face communication
- D. Reporting nurses who do not follow policies to the nurse manager
Correct Answer: B
Rationale: Leader behavior includes being self-directed and knowing your limitations; demonstrating a commitment to excellence; having a clear vision and strategic focus that allow movement forward toward a creative solution; showing commitment to and passion for your work; and displaying problem-solving skills, trustworthiness and integrity, respectfulness, accessibility, empathy and caring, desire to be of service, and responsibility to enhance the personal growth of all staff.
A nurse manager who is working to institute the SBAR communication process for all health care providers is meeting resistance to the change. How does the manager best approach the resistance?
- A. Containing the anxiety in a small group and moving forward with the initiative
- B. Explaining the change and listing the advantages to the person and the organization
- C. Reprimanding those who oppose the new initiative and praising those who willingly accept the change
- D. Quickly introducing the change and involving staff in implementation of the change
Correct Answer: B
Rationale: Change is ubiquitous, as is resistance to change. The manager should explain the proposed change to all affected, list the advantages of the proposed change for all parties, introduce the change gradually, and involve everyone affected by the change in the design and implementation of the process. The manager should not use the reward/punishment style to overcome resistance to change.
An RN on a telemetry unit is falling behind while performing assessments and administering medications. Which task can the nurse safely delegate to the AP?
- A. Assessing a patient who has just arrived on the unit
- B. Teaching a patient with newly diagnosed diabetes about foot care
- C. Documenting a patient's I & O in the electronic health record
- D. Helping a postoperative patient out of bed for the first time
Correct Answer: C
Rationale: Documenting a patient's I & O on a flow chart does not require professional judgment and can be delegated to AP. Professional nurses are responsible for the initial patient assessment, discharge planning, health education, care planning, triage, interpretation of patient data, care of invasive lines, administering parenteral medications. What they can delegate are assistance with basic care activities (bathing, grooming, ambulation, feeding) and things like taking vital signs, measuring intake and output, weighing, simple dressing changes, transfers, and postmortem care.
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 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.