Deck 11: Management and Leadership

Question 1

Which behaviors by the nurse manager model intrinsic motivation for nursing staff? Select all that apply.

A) Treating staff with respect, thoughtfulness and support
B) Taking time to go to yoga class at least 4 nights per week
C) Having a few nurses on the unit who are the "go to" staff for projects
D) Presenting a talk to the local chapter of a professional organization
E) Working 60 hours a week or as much as necessary to get the work done

Answer 1

Treating staff with respect, thoughtfulness and support
Taking time to go to yoga class at least 4 nights per week
Presenting a talk to the local chapter of a professional organization

Question 2

Which scenario is most likely to decrease safety on a psychiatric-mental health unit?

A) A patient with frequent hypoglycemia episodes
B) A patient with depressive symptoms and a history of hypertension
C) Mostly long-term admissions with increased length of stay
D) Mostly RN staff with a few unlicensed assistive personnel (UAPs)

Answer 2

A patient with frequent hypoglycemia episodes

Question 3

The psychiatric-mental health nurse manager has just initiated several changes on the unit. Which change is most likely to help prevent burnout and be most beneficial to the well-being of the nurses on the unit?

A) Negotiating with upper management to add two new RN positions.
B) Redecorating the nurses' station and lounge with therapeutic colors.
C) Electing a committee to oversee the day-to-day operations of the unit.
D) Moving the nurse manager's office to another floor to make more room for storage.

Answer 3

Negotiating with upper management to add two new RN positions.

Question 4

A charge nurse organizes a 2-day class for staff about learning to be a preceptor. Which best describes how this action facilitates a safe and healing environment?

A) Uses formal power to effect change.
B) Promotes leadership skills in each nurse.
C) Ensures employees have access to CE credit.
D) Improves general morale of the staff on the unit.

Question 5

The novice nurse understands that the nurse with the greatest ability to directly impact the therapeutic nurse-patient relationship is in which position?

A) Charge nurse
B) Nurse manager
C) Frontline nurse
D) Director of nursing

Question 6

A psychiatric-mental health nurse states, "I love my job so much-I can't imagine doing anything else, even if I made more money or had better hours!" This statement is an example of which of the following?

A) Impact
B) Empowerment
C) Self-determination
D) Intrinsic motivation

Question 7

The nurse manager is planning strategies to empower nurses. Which is most likely to be beneficial to a frontline nurse at the point of service? Select all that apply.

A) A library where nurses can read quietly during breaks and lunch
B) A strong, well-organized orientation program for new hires
C) A weekly staff meeting with CE opportunities offered frequently
D) An active, well-attended bicycling club which meets every week
E) A manager who encourages staff to join professional organizations

Question 8

The nurses and other staff have increased vigilance over the patients in the unit because of several high acuity admissions. Which statement does the nurse manager assess to be true?

A) "The staff should place the patients who are violent in seclusion to keep others safe."
B) "The staff is likely overestimating the perceived danger from these patients."
C) "Greater vigilance may prevent the staff from interacting with patients proactively."
D) "This heightened awareness is the way the staff should always function, ideally."

Question 9

The charge nurse notes unusually high acuity on the mental health unit. A patient cannot be safely contained without being placed in physical restraints. What does the nurse recognize as priority concerns in the unit at this time? Select all that apply.

A) Decrease in trust level among patients and staff
B) Staffing ratio or mix changes for the following shift
C) Increased length of stay for this patient's admission
D) Decreased reimbursement for this patient's admission
E) Increased risk of physical or psychological injury to patients and staff

Question 10

Which action by the nurse manager best reflects the element of support in the empowered workplace?

A) Involving the staff in evaluating patient outcomes
B) Providing the staff with frequent and timely feedback on their performance
C) Advocating for appropriate staffing ratios based on patient acuity and mix of staff
D) Informing the staff that the hospital will be undergoing some administrative changes soon

Question 11

Which nursing behavior is an example of an innovative practice?

A) Facilitating a group therapy session for small groups of patients
B) Displaying unit information on bulletin boards in the nursing lounge
C) Planting a community garden with patients and having a cooking class
D) Having patients line up at the medication cart at 9:00 a.m. for their morning meds

Question 12

Which variable would the charge nurse recognize as having the greatest impact on the ability to provide safe quality nursing care on the mental health unit?

A) The orientation process lasts more than 6 weeks.
B) Novice nurses are mentored by more experienced nurses.
C) Many hours are spent developing therapeutic relationships with the patients.
D) Most of the nurses' time is spent on medication administration and paperwork.

Question 13

The nurse manager wants to create an empowered workplace for his staff. Which activities would be most helpful in accomplishing this?

A) Keeping bad news about an upcoming layoff from staff members to avoid upsetting them
B) Avoiding giving negative feedback to employees so that they do not become discouraged
C) Providing a loosely structured orientation process so that nurses can develop innovative behaviors
D) Teaching a class on the neurobiological reactions that lead to burnout and reinforcing healthy coping skills.

Question 14

The nurse manager steps in to assist with a critical incident when the psychiatric-mental health unit is short-staffed. This leadership behavior is an example of what type of activity?

A) Role modeling
B) Innovative practice
C) Frontline leadership
D) Psychological empowerment

Question 15

The new psychiatric-mental health nurse expresses confidence in her ability to perform to expectations. These feelings reflect which domain of psychological empowerment?

A) Impact
B) Meaning
C) Competence
D) Self-determination Impact

Question 16

A nurse manager believes that one of the nurses on the mental health unit has developed burnout and depersonalization. Which actions by the nurse support this evaluation? Select all that apply.

A) Calling in sick almost every other week.
B) Forming a committee to focus on improving staff satisfaction.
C) Starting a yoga class for the patients on the evening shift.
D) Taking her breaks at different times than her co-workers.
E) Working on many of the occasions when unit acuity was high.

Question 17

Which situation on a psychiatric-mental health unit is most likely to cause repeated stress arousal leading to burnout in nursing staff?

A) Administering medications to schizophrenic patients daily
B) Responding to hospital psychiatric emergencies once per month
C) Working without enough nursing staff every day for 6 weeks during staff vacations
D) Performing cardiopulmonary resuscitation (CPR) on a patient on rare occasions

Question 18

Which domain of psychological empowerment is best supported when a mental health facility supports nurses in determining their own work schedules?

A) Meaning
B) Competence
C) Self-determination
D) Impact

Question 19

Which behavior by a psychiatric-mental health nurse manager is most likely to promote a safe and healing environment on the unit? Select all that apply.

A) Making sure the budget is balanced every month
B) Maintaining a restraint-free/seclusion-free environment
C) Having a birthday party each month so staff can socialize
D) Moderating in nurse/physician disagreements when they arise
E) Using national benchmarks to advocate for optimal staffing ratios

Question 20

Immediately following an attempted assault by a patient, the nurse experiences muscle tension, dry mouth, anger, and depleted energy. Which would best describe this response?

A) Exhaustion
B) Stress arousal
C) Critical incident
D) Depersonalization

Question 21

The nurse manager is planning to apply structural empowerment theory by providing access to professional development programs. The manager understands that this intervention is likely to support which domain of psychological empowerment?

A) Impact
B) Meaning
C) Competence
D) Self-determination

Question 22

The nursing staff quality improvement committee recommends a new practice change be implemented based on outcome analysis. Which response by their manager would be most effective in fostering the empowerment of the nurses?

A) "We'll take this to all the hospital committees and see if they approve it."
B) "This is a great idea-let's share your success with the other units."
C) "You have done a nice job. I'll revise this and then we can write a policy on it."
D) "I don't think the physicians will want to continue you this, but it was a good effort."

Question 23

Which elements of both structural empowerment and psychological empowerment are supported when the nurse manager involves staff in both quality improvement (QI) projects and evaluation outcomes of practice changes?

A) Information and impact
B) Information and meaning
C) Opportunities and impact
D) Support and self-determination

Question 24

Which nursing behaviors best indicate that an empowered staff has shifted the paradigm of care in their unit?

A) Routine use of new neoprene restraints when this is necessary for control.
B) Making rounds every 2 hours on patients not in restraints or seclusion.
C) Routinely involving the patient and family in the plan of care and treatment choices.
D) Staying in the nurses' station with locked glass windows while administering medications.