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You have recently been appointed as a unit manager. After 3 months, you notice that staff are not seeking your advice as frequently as they did during your first weeks as manager. This observation may suggest that:
- A. Staff no longer perceive you as an expert
- B. Staff have increasing confidence in their own decision making
- C. There has been erosion in your relationships with staff
- D. Staff are experiencing dissatisfaction with your leadership
Correct Answer: B
Rationale: Staff seeking less advice after three months likely signals growing confidence in their own decisions, a natural shift as they adjust to your leadership and rely on their skills. It's not necessarily expertise loss, eroded ties, or dissatisfaction context matters, but reduced dependence often marks autonomy, a positive outcome in a stable unit. New managers see this as staff adapt, suggesting your initial support built their competence, aligning with effective leadership fostering independence over time.
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In Hospital STV, senior administration is strongly oriented toward fiscal and social conservatism. The nursing department is deeply concerned with the provision of quality to the community, which includes a high number of poor and unemployed. To accomplish the goals of the nursing department, resources need to be allocated that administration is not able to allocate. Nursing and administration:
- A. Are engaged in shared governance
- B. Are involved in an irreconcilable conflict of interests
- C. Represent separate subcultures in the institution
- D. Represent union and nonunion conflict
Correct Answer: C
Rationale: Hospital STV's administration and nursing department reflect distinct subcultures administration's fiscal conservatism versus nursing's quality focus for a needy community. Subcultures within organizations have unique values and goals, here creating tension over resource allocation. This isn't shared governance (collaborative decision-making), irreconcilable conflict (not proven unresolvable), or union disputes (no union mentioned). These separate ideologies can coexist, potentially constructively, but currently highlight differing priorities, fitting the subculture concept where groups within an institution operate with distinct, sometimes clashing, perspectives.
Which of the following is expert power
- A. Leader can exercise power as a result of their position in the organisation
- B. Leader has power because of their expert knowledge
- C. Leader has power because subordinates trust him/her
- D. Leader can punish staff who do not comply with instructions
Correct Answer: B
Rationale: Expert power stems from knowledge not position, trust, or punishment. Nurse leaders like clinical specialists wield this, contrasting with formal authority. In healthcare, it builds credibility, aligning leadership with skill.
As a nurse manager, you introduce a program that enables staff nurses to recognize peers for teamwork and exceptional patient care with care awards.' Your rationale for this program is that peer recognition:
- A. Increases staff accountability
- B. Reduces organizational conflict
- C. Increases job satisfaction
- D. Reduces the need for managerial oversight
Correct Answer: C
Rationale: Peer care awards' for teamwork and care boost job satisfaction nurses feel valued by colleagues, lifting morale, as studies link recognition to engagement. It's not primarily about accountability, conflict, or less oversight, though it may ease tensions. In your unit, this fosters positivity amid stress, reinforcing good practice via peer praise, a low-cost, high-impact way to enhance fulfillment and retention, aligning with morale-building goals.
A nurse is reviewing the laboratory results of a client who is scheduled for surgery. Which of the following results should the nurse report to the provider?
- A. Potassium 3.8 mEq/L
- B. Hemoglobin 7.8 g/dL
- C. Sodium 140 mEq/L
- D. Creatinine 0.9 mg/dL
Correct Answer: B
Rationale: Preoperative lab review identifies risks impacting surgery anemia, electrolytes, or organ function. Hemoglobin 7.8 g/dL below the normal 12-15 g/dL for females or 13-17 g/dL for males indicates anemia, reducing oxygen-carrying capacity, a concern for anesthesia and healing, warranting provider notification for possible transfusion or delay. Potassium 3.8 mEq/L (normal 3.5-5.0), sodium 140 mEq/L (135-145), and creatinine 0.9 mg/dL (0.6-1.2) are within range, posing no immediate threat. Low hemoglobin directly affects surgical safety, triggering urgent communication to adjust the plan, ensuring optimal oxygenation and recovery, a critical nursing responsibility in preoperative care coordination.
A nurse manager is implementing a team nursing approach on his unit, hiring licensed practical nurses (LPNs) and assistive personnel (AP) as additional staff. Which of the following actions should the nurse manager take to facilitate acceptance of this change?
- A. Introduce the new approach and facilitate the development of a task force to plan implementation
- B. Announce the change and expect immediate compliance
- C. Train only the new staff on the approach
- D. Leave the staff to adapt on their own
Correct Answer: A
Rationale: Implementing a team nursing approach requires staff buy-in to ensure smooth adoption and effective collaboration. Introducing the new approach and creating a task force to plan its implementation actively involves the existing staff, giving them a sense of ownership and control over the change process. This strategy fosters acceptance by addressing concerns, encouraging input, and building a collaborative environment, which is critical in healthcare settings where teamwork directly impacts patient outcomes. Simply announcing the change without engagement risks resistance, as staff may feel blindsided or undervalued. Training only new staff excludes current employees, potentially creating resentment or confusion, while leaving staff to adapt independently neglects the need for structured guidance. Involving staff in planning leverages their expertise, reduces anxiety about the unknown, and aligns with leadership principles that prioritize communication and inclusion, ultimately enhancing the transition to a team-based model.