(Test Bank) Yoder-Wise’s Leading and Managing in Canadian Nursing

Yoder-Wise, 7

Nursing

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7th Edition

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Test Bank for Yoder-Wise’s Leading and Managing in Canadian Nursing, The downloadable file consists of 199 pages, and the total size of the file is 3.7 MB. Purchase now only for highly discounted price.

Author(s): Yoder-Wise

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TEST BANK FOR YODER -WISE’S LEADING AND MAN AGING IN CANADIAN NURSING 7th EDITION BY YODER -WISE N U R S I N G T B . C O M Chapter 01: Leading, Managing, and Following Yoder -Wise: Leading and Managing in Nursing, 7th Edition MULTIPLE CHOICE 1. A nurse manager of a 20 -bed medical unit finds that 80% of the patients are older adults. She is asked to assess and adapt the unit to better meet the unique needs of the older adult patient. Using complexity principles, what would be the best approach to take for implementation of this change? a. Leverage the hierarchical management position to get unit staff involved in assessment and planning. b. Engage involved staff at all levels in the decision -making process. c. Focus the assessment on the unit and omit the hospital and community environment. d. Hire a geriatric specialist to oversee and control the project. ANS: B Complexity theory suggests that systems interact and adapt and that decision making occurs throu ghout the systems, as opposed to being held in a hierarchy. In complexity theory, every voice counts, and therefore, all levels of staff would be involved in decision making. TOP: AONE competency: Communication and Relationship -Building 2. A unit manag er of a 25 -bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing tre atment for breast cancer. According to Maslow’s need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients? a. Line up agency nurses who can be called in to work on short notice. b. Place the nurse on unpaid leave for the remainder of his wife’s treatment. c. Sympathize with the nurse’s dilemma and let the charge nurse know that this nurse may be calling in frequ ently in the future. d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife’s treatments. ANS: D Placing the nurse on unpaid leave may threaten the nurse’s capacity to meet physiologic needs and demotivate the nurse. Unsatisfactory coverage of shifts on short notice could affect patient care and threaten the needs of staff to feel competent. Arranging the schedule around the wife’s needs meets the needs of the staff and of patients while satisfying the nurse’s need for affiliation. TOP: AONE competency: Communication and Relationship -Building 3. A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation session, the staff nurse repeatedly calls the unit manager’s actions unfair, and the unit manager continues to reiterate the reasons for the actions. What would be the best course of action at this time? a. Send the two disputants away to reach their own resolution. b. Involve another staff nurse in the discussion for clarity issues. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M c. Ask each party to examine their own motives and issues in the conflict. d. Continue to listen as the parties repeat their thoughts and feelings about the conflict. ANS: C For resolution of conflict, one should address the interests and involvement of p articipants in the conflict by examining the real issues of all parties. TOP: AONE competency: Communication and Relationship -Building 4. At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. What is the appropriate next step? a. Arrange another meeting in a week’ s time so as to allow a cooling -off period. b. Elevate the next negation session to the next manager, one level above. c. Insist that participants continue to talk until a resolution has been reached. d. Back the unit manager’s actions and end the dispu te. ANS: B Part of leadership is understanding conflict resolution and ability to negotiate and manage for resolution of issues and concerns. This situation has failed a se cond negotiation session, elevation to a manager with additional training to facilitate conflict resolution is important at this point. TOP: AONE competency: Communication and Relationship -Building 5. The manager of a surgical area has a vision for the future that requires the addition of RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff have always practiced in a primary nursing -delivery system and are very resistant to this idea. What would be the best ini tial strategy for implementation of this change? a. Exploring the values and feelings of the RN group in relationship to this change b. Leaving the RNs alone for a time so they can think about the change before it is implemented c. Dropping the idea and trying for the change in a year or so when some of the present RNs have retired d. Hiring the assistants and allowing the RNs to see what good additions they are ANS: A Influencing others requires emotional intelligence in domains such as empathy, handling relationships, deepening self -awareness in self and others, motivating others, and managing emotions. Motivating others recognizes that values are powerful forces that influence acceptance of change. Leaving the RNs alone for a p eriod of time before implementation does not provide opportunity to explore different perspectives and values. Avoiding discussion until the team changes may not promote adoption of the change until there is opportunity to explore perspectives and values r elated to the change. Hiring of the assistants demonstrates lack of empathy for the perspectives of the RN staff. TOP: AONE competency: Knowledge of the Health Care Environment NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M 6. As the RN charge nurse on the night shift in a small long -term care facility, you’ve found that there is little turnover among your LPN and nursing assistant (NA) staff members, but they are not very motivated to go beyond their job descriptions in their w ork. Which of the following strategies might motivate the staff and lead to greater job satisfaction? a. Ask the director of nursing to offer higher wages and bonuses for extra work for the night LPNs and NAs. b. Allow the LPNs and NAs greater decision -making power within the scope of their positions in the institution. c. Hire additional staff so that there are more staff available for enhanced care, and individual workloads are lessened. d. Ask the director of nursing to increase job security for night staff by having them sign contracts that guarantee work. ANS: B Hygiene factors such as salary, working conditions, and security are consistent with Herzberg’ s two -factor theory of motivation; meeting these needs avoids job dissatisfaction. Motivator factors such as recognition and satisfaction with work promote a satisfying and enriched work environment. Transformational leaders use motivator factors liberally to inspire work performance and increase job satisfaction. TOP: AONE competency: Communication and Relationship -Building 7. The nurse manager wants to increase motivation by providing motivating factors for the nurse on the unit. What action would be appropriate to motivate the staff? a. Collaborate with the human resource/personnel department to develop on -site daycare services. b. Provide a hierarchical organizational structure. c. Implement a model of shared governance. d. Promote the development of a flexible benefits package. ANS: C Complexity theory suggests that systems interact and adapt and that decision making occurs throughout systems, as opposed to being held in a hiera rchy. In complexity theory, every voice counts, and therefore all levels of staff would be involved in decision making. This principle is the foundation of shared governance. TOP: AONE competency: Communication and Relationship -Building 8. A charge nurse on a busy 40 -bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visit ors. The family member leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner? a. Reflect to gain insight into how the sit uation could be handled differently in the future. b. Try to catch up with the angry family member to resolve the concern. c. Discuss the concern with the patient after the family member has left. d. Notify nursing administration of the situation. ANS: A NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M Goleman suggests that emotional intelligence involves insight and being able to step outside of the situation to envision the context of what is happening as well as being able to manage emotions such as frustration effectively. TOP: AONE competency: Leadership 9. The chief nursing officer has asked the staff development coordinato r to facilitate the development of a clinical competency program for the facility. While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competen cy program. What behavior by the staff development coordinator is most appropriate in this situation? a. Disregard staff concerns and continue with development of the program. b. Inform the nurses that this program is a requirement for JCAHO accreditation . c. Schedule a meeting with the chief nurse executive to apprise her of the situation. d. Facilitate a meeting so nurses can articulate their values and concerns about a competency program. ANS: D The manager role involves guiding others through a set of derived practices that are evidence -based and known to satisfy preestablished outcomes such as participation in a competency program. This involves engagement of staff through sharing of concerns an d ideas. A close analysis of the IOM report and the summary of the PPACA suggests that no health reform can unfold without active nursing engagement. Each document emphasizes that nurses must lead, manage, and behave as active collaborators with other memb ers of the health team and with those being served. TOP: AONE competency: Communication and Relationship -Building 10. The nurse manager has been asked to implement an evidence -based approach to teach ostomy patients self -management skills postoperatively. The program is to be implemented across the entire facility. What illustrates effective leadership in this situation? a. The training modules are left in the staff room for times when staff are available. b. The current approach is continued because it is also evidence -based and is more familiar to staff. c. You decide to implement the approach at a later date because o f feedback from the RNs that the new approach takes too much time. d. An RN who is already familiar with the new approach of volunteers to take the lead in mentoring and teaching others how to implement it. ANS: D Followership occurs when there is acquiescence to a peer who is leading in a setting where a team has gathered to ensure the best clinical decision making, and actions are taken to achieve clinical or organizational outcomes. Followership promotes good cli nical decisions and use of clinical resources. TOP: AONE competency: Communication and Relationship -Building 11. You overhear a new graduate RN telling a nurse colleague that leadership and management belong to the unit manager, not to her. As a nursin g colleague, what do you know to be true in regard to the statement? a. The statement is correct. Leadership is not the role of the staff nurse. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M b. The new graduate would benefit from further understanding of her role as a professional, whose influence ma y affect the decision making of patients, colleagues, and other professionals. c. The new graduate has been influenced by nurse leaders and managers who leave for other positions. d. The general perception is that nurse leaders and managers are not satisfied in their jobs. ANS: B Care coordination that involves the intersection of individual, family, and community -based needs requires that nurses have self -confidence, knowledge of o rganizations and health systems, and an inner desire to lead and manage. There is often a view that leadership is isolated to those holding managerial positions, and that a direct care nurse is subject to following by adhering to the direction of others. S uch views fail to acknowledge that to be a nurse requires each licensed individual to lead, manage, and follow when practicing at the point -of-care and beyond. TOP: AONE competency: Leadership 12. The charge nurse walks into Mr. Smith’s room and finds him yelling at the LPN. He is obviously very upset. The charge nurse determines that he has not slept for three nights because of unrelieved pain levels. The LPN is very upset and calls Mr. Smith an “u gly, old man.” The charge nurse acknowledges the LPN’s feelings and concerns and then suggests that Mr. Smith’s behavior was aggressive but was related to lack of sleep and to pain. The charge nurse asks, “Can you, together with Mr. Smith, determine trigge rs for the pain and effective approaches to controlling his pain?” This situation is an example of what? a. Lack of empathy and understanding for Miss Jones b. Concern with placating Mr. Smith c. Leadership behavior d. Management behavior ANS: C The situation between Mr. Smith and Miss Jones is a complex situation involving unrelieved patient symptoms and aggressiveness toward a staff member. Providing engaged, collaborative guidance and decision making in a complex situation where there is no standardized solution reflects leadership. TOP: AONE competency: Leadership 13. After assessing an older adult patient in long -term care who has been slowly deteriorating for weeks, the nurse manager calls the family and asks them to come in, as the patien t is dying. What is the most likely basis for the nurse manager’s request? a. An established clinical pathway b. Confirmatory scientific evidence c. Unit protocol d. Experience ANS: D The nurse manager is employing knowledge and experience in determining that the patient is dying, because the course of dying is not standardized and cannot be determined by clinical pathways. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M TOP: AONE competency: Knowledge of the Health Care Environment 14. Chart audits have revealed significant omissions of data that could have legal and financial guideline ramifications. The unit manager meets with the staff to di scuss audit findings and to find approaches that will address the gaps in charting and achieve desired goals. What is the manager demonstrating? a. Leadership b. Management c. Decision making d. Vision ANS: B The process of guiding others to meet established goals, outcomes, and procedures is management. This can require collaborative decision making to determine how best to reach predetermined goals and follow established practices. TOP: AONE competency: Know ledge of the Health Care Environment 15. A family is keeping vigil at a critically ill patient’s bedside. Distant family members call the unit continuously asking for updates and expressing concern. The nurse speaks with the distant family members and s tates she is referring them to the hospital social worker, whose role is to work with family in this situation. What role is the nurse assuming through this action? a. Manager b. Leader c. Follower d. Laissez -faire ANS: A As a manager, you are concerned with managing and coordinating resources to achieve outcomes in accordance with established clinical processes. Referral to a social worker alleviates demand on staff time and is consistent with hospital procedures. TOP: AONE competency: Communication and Relationship -Building 16. A family is keeping vigil at a critically ill patient’s bedside. The nurse appro aches the unit manager with concern over the family dynamics for the patient concerned there are patient -family conflicts based on patient’s wishes. The nurse suggests that the patient’s provider may need to discuss the treatment plan with the family. The unit manager states he will arrange a discussion with the patient’s provider and ask the nurse to support the provider’s decisions. What is the role of the nurse in this situation? a. Leadership b. Management c. Follower d. Evidence -based ANS: C In the followership role, you bring to the manager your concerns about concerns for patients and the outcomes and accept the direction given by the manager in response to your concerns. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M TOP: AONE competency: Knowledge of the Health Care Environment 17. The manager calls the staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becomin g distanced from the family. After inviting the concerns of staff, the manager explains that the organization values patient -centered care and that evidence supports that acting as an advocate and a listener is helpful to families. The manager asks the sta ff for ideas and strategies that are effectively patient -centered in dealing with families in similar situations. What is the role of the nurse manager in this situation? a. Leadership b. Management c. Follower d. Visionary ANS: A As a leader, the manager is providing and communicating vision and direction based on evidence and experience. The manager is engaging others in decision making that moves them toward the vision with a reasonable level of risk taking. TOP: AONE competency : Leadership 18. The manager of a unit is finding it difficult to work with a new graduate nurse. The new nurse has many ideas; however, his manner of presenting them irritates the manager. After reflection and discussion with others, the manager recognizes that she feels threatened by his behavior. She comes to understand that the new nurse is trying to establish his own role on the unit; is not trying to challenge her; and needs guidance, coaching, and affirmation. What is the nurse manager demonstrating in this situation? a. A positive self -concept b. Deepening self -awareness c. Leadership d. Acquiescence ANS: B Stepping outside oneself to envision the situation while assuming ownership is a component of emotional intelligence. This is an example of self -awareness to identify the resolve to self-conflict in this situation. TOP: AONE competency: Professionalism 19. As the head of a nursing program, you consistently invite the ideas of you r team about innovations in teaching, community partnerships, and curriculum design and invite participation in decisions. Many of these ideas have been implemented successfully, and your staff members are keen to try on other ideas. What is the leadership you are employing? a. Situational b. Trait -based c. Contingency -based d. Transformational ANS: D NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M Transformational leadership involves attending to the needs and motives of followers, which results in creativity, improvement, and employee development. TOP: AONE competency: Professionalism 20. As a leader on a rehab unit, the manager encourages all staff members to see themselves as having a role in decision making and quality care. The manager sees their role as involving particular responsibilities in decision making but not as a hierarchal ro le. What is this view of the role consistent with in this situation? a. Trait theories b. Complexity theory c. Situated theory d. Emotional intelligence ANS: B Complexity theory involves envisioning each member of the team involved in decision making, management, and leadership, with the leader not seen in a hierarchal relationship to other team members. TOP: AONE competency: Leadership 21. A staff nurse has been recent ly promoted to unit manager. During the time on the unit, the nurse formed a strong social network among staff, has promoted the development of relationships between staff and workers in other areas of the organization, and has formed relationships that ge nerate ideas from patient organizations and the local nursing education program. According to complexity theory, what principle is being engaged? a. Empowerment b. Systematic thinking c. Development of networks d. Bottom -up interactions ANS: C According to complexity theory, social networks evolve around areas of common interest and are able to respond to problems in creative and novel ways. TOP: AONE competency: Knowledge of the Health Care Environment 22. According to the complexity theory, what would be the focus of measurement? a. Cost per hospital day b. Bed utilization c. Infection rates d. Staff morale and budgets ANS: D According to complexity theory and the principle “Think systematically,” one cannot ignore objective data or nonmeasurable data, as both inform decisions. TOP: AONE competency: Business Skills 23. During a staff meeting held to discuss developing a mi ssion statement for the unit, the idea of placing patient needs first is discussed. What is considered when the suggestion by the manager is for the unit mission to be derived from the organization mission? NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M a. Empowering b. A leadership tag c. A symbol d. A management task ANS: B According to complexity theory, leadership tags, which are similar to values, reflect the patient -centered philosophies and values -driven characteristics that define an organization and give it personality. TOP: AONE competency: Knowledge of the Health Care Environment 24. A dispute arises between an RN and an LPN over a patient issue. The tension cont inues between the two and begins to affect other staff members, who are drawn into the conflict. Over time, the team becomes polarized toward either the RN or the LPN. How might this situation be prevented? a. Expediency in responding to the initial disput e, once it became apparent that it could not be resolved by the two parties themselves b. Asking other staff members what the real issues were in the dispute between the RN and the LPN c. Reassigning one of the parties to another unit when it became appa rent that the two individuals could not resolve the dispute themselves d. Calling a staff meeting at the onset of the dispute to allow the team and the RN and LPN to discuss the initial dispute ANS: A The initial step in conflict resolution should have involved an expedient response to the issues and putting a focus on the issues involved in the dispute between the LPN and RN through negotiation involving the two parties, before the dispute involved oth ers. TOP: AONE competency: Communication and Relationship -Building 25. The unit is shifting from primary nursing to a team model in an effort to contain costs. Staff members are upset about the change and ask for a meeting to discuss the new model. Aft er hearing their concerns related to reduction in professional autonomy, what is the initial response by the manager to address the concerns? a. Acknowledge the loss. b. Explain the reasons for change, emphasizing the need to reduce costs. c. Repeat the information several times, giving detailed budget overviews. d. Adjourn the meeting and provide explanation through e -mail. ANS: A Visioning involves engaging with others to assess the current reality, specify t he end point, and then strategize to reduce differences. This requires trusting relationships that acknowledge the differences in values and ideas. When done well, the nurse manager and the nurses within a unit experience creative tension that inspires wor king in concert to achieve desired goals. TOP: AONE competency: Communication and Relationship -Building MULTIPLE RESPONSE NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M 1. A new graduate nurse wonders about the directions that her preceptor has given her regarding management of incontinent, confused patients. The new nurse brings the preceptor evidence -based information she located regarding incontinence interventions for co nfused patients and asks to talk about the guidance that given after the preceptor reviews the information in the article. What is the new nurse demonstrating in this situation? ( Select all that apply. ) a. Assertiveness b. Followership c. Management d. Insubordination ANS: A, B This is an example of followership in which a staff nurse is demonstrating asser tive behavior and presenting evidence that may influence the decision making of her nurse leader and manager. TOP: AONE competency: Knowledge of the Health Care Environment NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank N U R S I N G T B . C O M Chapter 02: Clinical Safety: The Core of Leading, Managing, and Following Yoder -Wise: Leading and Managing in Nursing, 7th Edition MULTIPLE CHOICE 1. In an effort to control c osts and maximize revenues, the Rehabilitation Unit at Cross Hospital reduced the number of its managers and increased the number of units for which each manager was responsible. Within a year, the number of adverse events on the units had doubled. How do the increase in adverse events relate to decreased managers? a. The overload of staff nurse duties b. Resistance to change by staff c. A change in reporting system for everyone d. Fewer clinical leaders facilitate best practice ANS: D Eliminating barriers to the implementation of best practices is the role of managers and leaders. When there are insufficient resources for leadership to encourage a culture in which evidence -based practice is embraced, frontline nurses recognize this as a stumbling block for delivering quality care. TOP: AONE competency: Knowledge of the Health Care Environment 2. The Rehabilitation Unit at Pleasant Valley Hospital has a high number of falls. Wh at interventions might assist to reduce the number of falls on the unit? a. Determining who is responsible for the falls b. Strengthening unit policies to avoid inappropriate admissions c. Encouraging involvement of nurses in education related to falls and safety d. Ensuring that patients are appropriately restrained if they are at risk for falls ANS: C The IOM (2010) emphasizes the need for nurses to engage in lifelong learning and to use evidence and best practices to inform practice and ensure safety. TOP: AONE competency: Professionalism 3. How would the nurse executive begin to increase safety i n patient care areas of the Valley Hospital? a. Asking the community what the safety issues are b. Consulting with a management expert about staffing schedules c. Ensuring that the se nior nursing officer attends the board meetings d. Instituting improved practices to reduce needlestick injuries ANS: C The IOM report (2004) highlighted the importance of the attendance of the senior nurse executive at board meetings to be a key spoke sperson on safety and quality issues. TOP: AONE competency: Knowledge of the Health Care Environment NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M 4. During review of back injuries, it is determined that a large number of injuries are occurring in spite of mechanical lifts being used. Furthermore, it is determined that some lifts are outdated. In addressing this concern, the unit manager: a. meets individually with nurses who are observed to be using the lifts incorrectly to review the correct procedure. b. after consultation with the staff about the review, orders new lifts to replace older ones that are malfunctioning. c. blames the system for inadequate funding for resources. d. reviews the system of reporting incidents to ensure that appropriate reporting is occurring. ANS: A The involvement of staff nurses in safety on the unit is imperative in improvement of quality and the provision of patient care. This is a relationship engagement by the manager to engage the nurses and building these relationships improves quality. TOP: AONE competency: Communication and Relationship -Building 5. What did the IOM Health Professions Education report highlight as a concern for patient safety? a. A normal risk in professional practice b. A result of disciplinary silos c. A reflection of frontline staff d. Related to systems errors ANS: B The IOM Health Professions Education report (2004) highlighted the education of health disciplines in silos as a major concern in patient safety and endorsed five recommendations. One to be increased and improved communication between the health disciplines. TOP: AONE competency: Knowledge of the Health Care Environment 6. A nurse manager is implementing strategies to support the steps in the AHRQ document “Five Steps to Safer Health Care.” What does the manager include in the implementation? a. Patients are actively encouraged to make decisions related to care. b. Rules an d decisions are made through centralized processes. c. You monitor the performance of each staff member closely. d. Preference is given to increasing staff numbers rather than staff credentials. ANS: A The Agency for Healthcare Research and Quality (AHRQ) outlines “Five Steps to Safer Health Care,” which suggests that safe, patient -centered care is facilitated by assisting patients to become active partners in their own care. TOP: AONE competency: Knowl edge of the Health Care Environment 7. After consulting with practice environments about quality and safety concerns in health care, a dean in a health care program implements what to improve quality and safety in health care? a. A nursing program that emphasizes the development of a strong disciplinary identity. b. Programming that stresses discipline -based research. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M c. Partnerships with health care to develop software for the reporting of adverse events. d. An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams. ANS: D Health Professions Education identified that education related to health disciplines in silos leads to compromised communication and inability to function as an integrated whole for patient -centered care. TOP: AONE competency: Knowledge of the Health Care Environment 8. What would be the primary emphasis in designing and implementing a quality, safe healthcare environment? a. Evidence -based practice b. Informatics c. Staffing d. The patient ANS: D Focusing on the patient moves care from concern about who controls care to a focus on what care is provided to and with patients, which was an aim identified in the IOM report Crossing the Quality Chasm . TOP: AONE competency: Knowledge of the Health Care Environment 9. The nurse is educating older adult patients on staying safe in the healthcare system. What information does the nurse include in the teaching? a. The need to understand and record all medications being taken. b. Bringing their own linens and other personal items to the hospital. c. Washing hands frequently while in a healthcare environment and using a hand sanitizer. d. Following closely the directions and orders of healthcare providers. ANS: A The Five Steps to Safer Health Care for patients include keeping a list of medications that patients are taking. TOP: AONE competency: Knowledge of the Health Care Environment 10. As a nurse manager on the West Surgery Unit, you are interested in increasing patient safety and reducing morbidity and mortality on your unit. What recommendations would be consistent with the IOM The Future of Nursing report? a. Careful screening of nursing staff for substance use and abuse b. Increased RN staffing on the unit c. Salary and benefits that reflect nursing accountabilities d. Increase in the percentage of baccalaureate -prepared nurses to 80% ANS: D The Future of Nursing advocates for having 80% of the nursing population at a baccalaureate -prepared level. This recommendation reflects research that suggests that improved mortality and morbidity rates occur with a better educated work force. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M TOP: AONE competency: Knowledge of the Health Care Environment 11. On the West Surgery unit, you want to institute a new system for checking armbands that evidence suggests may increase safety in medication administration. The system involves technology. What str ategy may assist with rapid adoption of the technology and system? a. Employ a centralized decision -making approach. b. Use simulators for initial practice to build confidence. c. Bring in a nurse consultant who is familiar with the technology. d. Use early adopters among the staff as leaders and role models in implementation. ANS: D The Institute for Healthcare Improvement (IHI) is dedicated to rapid improvement in patient care through a variety of mechanisms such as rapid cycle change. Rapid cycle change diffuses innovation and changes quickly through early adopters who share information and energy over time and act as role models for others. TOP: AONE competency: Knowledge of the Health Care Environment 12. To achieve Nurse -Sensitive Care Standards developed by the NQF, you advocate for which of the following in your health facility? a. Evidence -based practice to reduce the prevalence of pressure sores b. Implementation of informatics at the bedside c. Staff -manager conferences to review reporting of adverse medical events d. Patient councils to review food, recreation, and nurse -patie nt relations ANS: A The National Quality Forum (NQF) outlines nursing -centered intervention measures related to prevalence of pressure sores, ventilator -associated pneumonias, volunteer turnover, nursing care hours per day, and skill mix of staff. TOP: AONE competency: Knowledge of the Health Care Environment 13. You notice that Sally, a student on y our unit, is giving information to an anxious young teen who seems very uncertain about preparation for an upper GI series. After Sally leaves the room, you ask her how she thought her conversation with the patient. What is the appropriate response for you to give Sally? a. Encourage her to ask the patient if he has questions or concerns about the procedure. b. Advise her to consider providing the patient with more information. c. Suggest that she leave some brochures on the procedure with the patient. d. Suggest that she also provide teaching to the adolescent’s parents. ANS: A The Five Steps to Safer Health Care for Patients includes the step of asking questions if there are d oubts or concerns. The nurse can encourage patients to take a larger role in care by taking these steps and by providing patients with coaching in the steps. TOP: AONE competency: Communication and Relationship -Building NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M 14. The NQF provides a model for advancement of healthcare quality that could be used in healthcare organizations. What does the use of this model by the Centers for Medicare and Medicaid Services specificity link with adverse patient events for healthcare fac ilities? a. Staffing b. Funding c. Composition of executive councils d. Composition of consumer -based councils ANS: B The Centers for Medicare and Medicaid Services (CMS) have adopted a policy based on the NQF’s “Never Events.” The CMS will no longer pay for patient conditions or events that result from poor practice while patients are under the care of a health professio nal. TOP: AONE competency: Knowledge of the Health Care Environment 15. Pleasant Valley Hospital has amended its safety practices and policies. What has the hospital elected to emphasize accordance with changes by The Joint Commission (TJC)? a. Safety goals specific to Pleasant Valley b. Decision -making processes c. Sufficient staffing for safe care d. Increased numbers of baccalaureate -prepared RNs ANS: A When TJC, a not -for-profit organization that accredits healthcare organizations, changed its focus from processes to outcomes, it emphasized patient safety and issues setting -specific annual patient safety goals. TOP: AONE competency: Knowledge of the Hea lth Care Environment 16. What would managers and staff review annually in order to ensure compliance with The Joint Commission (TJC) to improve patient safety? a. Appropriateness of charting terms and abbreviations b. Nursing hours per patient c. Acuity of patient admissions d. Wait times for care ANS: A The Joint Commission issues setting -specific patient goals annually, as well as a list of “do-not-use” terms, abbreviations, and symbols and sentinel events. TOP: AONE competency: Knowledge of the Health Care Environment 17. How would a nurse manager a nd the staff prepare for redesignation as a Magnet® Hospital? a. Commit staff resources over a 6 -month period to updating procedure manuals. b. Educate staff through meetings and training sessions regarding appropriate answers to questions. c. Prepare a manual that outlines orientation procedures and ensure that all safety issues are addressed. d. Ensure that there are empirical data to support review of patient outcomes, actions taken, and results of actions. ANS: D NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M Through the Magnet® mode l, organizations must demonstrate how they provide excellence in five areas. Between designation and redesignation as a Magnet® organization, greater emphasis is placed on empirical quality results. TOP: AONE competency: Knowledge of the Health Care Envir onment 18. Sarah is a second -year nursing student. The clinical instructor overhears Sarah telling a patient that she “always” checks patients’ bracelets before giving medi cation and she is not sure how the nurses on the unit “get away with” not making more errors than they do. The clinical instructor pulls Sarah aside and explores with her how her communication might affect the patient and what it reflects about her beliefs related to the team. What competency does this action outline? a. QSEN b. IHI c. DNV/NIAHO d. AHRQ ANS: A The Quality and Safety Education for Nurses (QSEN) project provides resources re lated to competencies that prelicensure and graduate students need to develop to serve as safe practitioners. These competencies include leading and managing, teamwork and collaboration. TOP: AONE competency: Knowledge of the Health Care Environment 19. What does the SBAR approach to patient safety encourage? a. Consistency in assessment and practices b. Continuing education c. Multidisciplinary approaches d. Patient feedback ANS: A The use of SBAR (Situation, Background, Assessment, and Recommendation) checklists are designed to decrease omission of important information and practices. TOP: AONE competency: Knowledge of the Health Care Environment 20. As a manager in a new nursing home, where might you consult for guidance and evidence to support the development of safe patient practices? a. Hospitals b. Business c. Industry d. Outpatient clinics ANS: A Practices that were once mostly studied in hospital settings are now scrutinized for implementation in other settings, such as outpatient clinics, rural settings, and nursing homes. TOP: AONE competency: Knowledge of the Health Care Environment 21. Wha t facilitate the development of decision -making skills related to safe patient care for a nurse manager? a. Regular reflection on decisions NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M b. A culture of perfectionism c. Recognition of who should be held responsible for individual errors d. A culture of trust between the staff and you ANS: A Reflection on how well decisions were enacted enables knowledge of the complexity of situations and ramifications of the decision s made. Reflection enables elimination of strategies and methods that are inappropriate in meeting needs and aids in narrowing choices of best actions to take. TOP: AONE competency: Leadership 22. Mary, an 85 -year-old patient with cognitive impairment and gross instability, wanders continuously. Lately, she has fallen twice, and the family demands that she be restrained. As the unit manager, you have initiated a least restraint practice. What is an appropriate action in this situation? a. Setting up a nursing team meeting to review practices b. Calling the family to inform them of the practice c. Initiating a multidisciplinary and family meeting to focus on Mary’s needs d. Restraining Mary to sati sfy the family’s wishes ANS: C Crossing the Quality Chasm emphasizes the importance of rendering care with the client (client -centered) rather than to the client. In this situation, the patient includes family in transparent discussions about quality needs and takes a team approach that involves healthcare professionals, the family, Mary’s needs, and evidence associated with safe practice. TOP: AONE co mpetency: Knowledge of the Health Care Environment 23. A client requires an appendectomy. The surgeon explains the procedure and asks the client to sign the consent. The patient speaks very little English and looks worried. What is the appropriate actio n by the nurse? a. Suggest that an interpreter explain the procedure to the client and answer any questions. b. Ask the client if he has any questions. c. Draw a picture to show the incision. d. Not intervene. ANS: A The Five Steps to Safer Patient Care identifies that encouraging patients to ask questions when there are doubts and concerns and ensuring understanding before surgery is performed are ways in which nurses can support patients in having greater influence i n their own care. In this situation, asking an interpreter to help enables access to information for the patient and active assessment of his understanding. TOP: AONE competency: Knowledge of the Health Care Environment 24. As the manager on an acute care medical unit, you note that the incidence of medication errors has increased since the implementation of staffing changes. What is an important stratagem to reduce errors? a. Revisit reporting standards for medication errors in your organization. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M b. Ensure that medication errors are consistently reported. c. Provide staff with additional education related to safe practice in medication administration. d. Involve RN staff in determining reasons for errors and practice solut ions to increase the safety of medication administration. ANS: D Keeping Patients Safe: Transforming the Work Environment of Nurses (2004) identified many past practices that had a negative impact on nurses, and thus on patients, and recommended the inclusion of nurses in direct care in decision making involving their practice. Future of Nursing: Leading Change, Advancing Health (2010 ) also emphasizes the role of nurses as leaders in changes that improve health. TOP: AONE competency: Professionalism MULTIPLE RESPONSE 1. What patients would be considered “at risk” consumers during a healthcare visit? ( Select all that apply. ) a. Clyde requires an anticoagulant. He tells the nurse about his medications. He does not include an herbal supplement. b. George is very shy and withdrawn. He asks the nurse to leave him alone. c. Sarah is a new parent who finds that nurses on the children’s unit are very helpful. She is eager to accept all suggestions, including those that she does not yet understand. d. Claude is booked for bowel surgery. His doctor explains about the colostomy. Later, Claude tells his wife that he really doesn’t know what the doctor meant by colostomy. ANS: A, C, D Safer health care involves the patient as an active consumer who keeps and brings a list of all medications, including natural remedies and questions if there are doubts, concerns, or lack of understanding. TOP: AONE competency: Knowledge of the Health Care Environment NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:17 GMT -05:00 https://www.coursehero.com/file/54769006/02pdf/This study resource was shared via CourseHero.com Powered by TCPDF (www.tcpdf.org) N U R S I N G T B . C O M Chapter 03: Legal and Ethical Issues Yoder -Wise: Leading and Managing in Nursing, 7th Edition MULTIPLE CHOICE 1. The manager in the coronary care unit believes an important ethical consideration in performance evaluations is to include the employee’s good qualities and give positive direction for professional growth. What ethical principle does this represent? a. Justice b. Fidelity c. Beneficence d. Nonmaleficence ANS: D Nonmaleficence refers to “doing no harm.” For a nurse manager following this pri nciple, performance evaluation should emphasize an employee’s good qualities and give positive direction for growth. Destroying the employee’s self -esteem and self -worth would be considered doing harm under this principle. TOP: AONE competency: Profession alism 2. A staff nurse in the area that you manage has excelled in the delivery of patient education. You are considering implementing a new job description that would broaden her opportunity to teach patients and orient new staff members to the value of patient education. What ethical principle is being reinforced? a. Justice b. Fidelity c. Paternalism d. Respect for others ANS: C The principle of paternalism allows one person to make partial decisions for ano ther and is most frequently deemed to be a negative or undesirable principle. Paternalism, however, may be used to assist persons to make decisions when they do not have sufficient data or expertise. Paternalism becomes undesirable when the entire decision is taken away from the employee. TOP: AONE competency: Professionalism 3. A patient refuses a simple procedure that you believe is in the patient’s best interest. What two ethical principles are in conflict in this situation? a. Fidelity and justice b. Veracity and fidelity c. Autonomy and beneficence d. Paternalism and respect for others ANS: C Autonomy refers to the freedom to make a choice (e.g., refuse a procedure), and beneficence to doing good (performing a procedure that will benefit the patient). TOP: AONE competency: Professionalism NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:34 GMT -05:00 https://www.coursehero.com/file/54768997/03pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M 4. An individual in a wheelchair is applying for the position of receptionist in an outpatient clinic. What does the nurse manager understand based on The Americans with Disabilities Act of 1990 requirements for employers? a. Make reasonable accommodations for persons who are disabled. b. Allow modified job expectations for persons recovering from alcoholism. c. Hire disabled individuals before hiring other qualified, non -disabled persons. d. Treat, for purposes of employmen t, homosexuals and bisexuals as disabled. ANS: A The purposes of the ADA are to eliminate discrimination against persons with dis abilities and to provide consistent, enforceable standards to address discrimination in the workplace. TOP: AONE competency: Business Skills 5. A staff nurse, who was fired for reporting patient abuse to the appropriate state agency, files a whistlebl ower lawsuit against the former employer. What reason would the court provide to uphold a valid whistleblower suit claiming retaliation by the nurse? a. Previously reported the complaint, in writing, to hospital administration. b. Threatened to give full details of the patient abuse to local media sources. c. Was discharged after three unsuccessful attempts at progressive discipline had failed. d. Had organized, before filing the complaint, a work stoppage action by fellow employees. ANS: A An employer is unable to fire an employee who, in good faith, reports what is believed to be a violation of a law, rule, or state or federal law. TOP: AONE c ompetency: Knowledge of the Health Care Environment 6. In keeping with standards of The Joint Commission (TJC), the nurse manager organ izes an orientation for new staff members. As part of the orientation, the nurse manager reviews the employee handbook. What is the basis that binds employers to statements in the employee handbook? a. Under the doctrine of apparent agency b. Under the do ctrine of respondent agency c. Based on the employee’s or the employer’s expectations d. Based on the theory that the handbook creates an explicit contract ANS: C The handbook is an implied contract and frames the employment contract. This contract binds the employer to meeting the handbook statements. TOP: AONE competency: Knowledge of the Health Care Environment 7. To reduce the incidence of falls in a skilled nursing unit, the nurse manager contacts the risk manager. Risk management is a process that attempts to identify potential hazards and: a. compensate for previous injuries. b. eliminate these risks before anyone else is harmed. c. supersede the need for staff members to file incident reports. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:34 GMT -05:00 https://www.coursehero.com/file/54768997/03pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M d. discipline staff members who have been involved in previous incident reports. ANS: B Risk management involves taking proactive steps to identify and eliminate risks and liability. TOP: AONE competency: Knowledge of the Health Care Environment 8. One means of ensuring that the nurses floated to other patient care areas in hea lthcare organizations are qualified to work in the areas they are floated is: a. employing additional staff to assist with orientation processes. b. cross -educating staff members to other areas of the institution. c. transferring patients to units where the staffing pattern is optimal. d. orienting staff members to all patient care areas as part of their general orientation to the institution. ANS: B Nurses should be floated to units as similar as possible to their own to decrease the potential for liability. Negotiating cross -training, a proactive approach to temporary staffing problems, reduces the potential for liability. TOP: AONE competency: Know ledge of the Health Care Environment 9. A colleague asks you to give her your password access so that she can view her partner’s healthcare record without using her login. This request violates the patient’s right to: a. privacy. b. confidentiality. c. undue authorization of treatment. d. protection against slander. ANS: A Privacy refers to the right to protection against unreasonable and unwarranted interference with the patient’s solitude. Privacy standards limit how personal health information may be used or shared and mandate safeguards for the protection of health information. Institutions can reduce potential liability in this area by allowing access to patient data, either written or oral, only to those with a “need to know.” Persons with a need to know include physicians and nurses caring for the patient, technicians, unit clerks, therapists, social service workers, and patient advocates. Others wishing to access patient data must first ask the patient for permission to review a record. TOP : AONE competency: Knowledge of the Health Care Environment 10. On your nursing unit, you employ LPNs, RNs, and advanced practice nurses. You will need to be familiar with at least : a. two nursing practice acts. b. two nursing practice acts in most states. c. one nursing practice act. d. one nursing practice act and a medical act. ANS: C In all states, you will need to be familiar with at least one nursing practice act. In some states, there may be two nursing practice acts if RNs and LPNs/LVNs come under different licensing boards. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:34 GMT -05:00 https://www.coursehero.com/file/54768997/03pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M TOP: AONE competency: Knowledge of the Health Care Envir onment 11. A nurse on your inpatient psychiatric unit is found to have made sexually explicit remarks toward a patient with a previous history of sexual abuse. The patient sues, claiming malpractice. What conditions do not apply in this situation and do not support malpractice? a. Injury b. Causation c. Breach of duty d. Breach of duty of care owed ANS: A By virtue of employment, the nurse owes a duty of care to the patient; this care has been breached by a nurse, who would be expected to know that this behavior violates usual standards of care. The resultant injury, the fifth malpractice element, must be p hysical, not merely psychological or transient. In other words, some physical harm must be incurred by the patient before malpractice will be found against the healthcare provider, which is not evident in this situation where the action did not involve phy sical harm. TOP: AONE competency: Knowledge of the Health Care Environment 12. As a charge nurse, you counsel your RN staff member that they have has their duty of care by notifying a child’ s physician regarding concerns about deterioration in the child’s status at 0330 hours. The physician does not come in to assess the child and does not provide additional orders. The child dies at 0630 hours. As the charge nurse, you could be held liable for what? a. Professional negligence b. Assault c. Avoidance d. Murder ANS: A Professional negligence can be asserted when there is failure to do what a reaso nable and prudent nurse would do in the same situation. In this situation, the charge nurse might have advocated further for the patient in light of the evident seriousness of the child’s condition. TOP: AONE competency: Knowledge of the Health Care Envir onment 13. The parents of a toddler who dies after being brought to the ER launch a lawsuit, claiming that the failure of nurses to pursue concerns related to their son’s deteriorating condition contributed to his death. How is senior nurse executive na med in the suit? a. As a global respondent b. Under the doctrine of respondeat superior c. As a frivolous action d. Under the element of causation ANS: B Known as vicarious liability, the do ctrine of respondeat superior makes employers accountable for the negligence of their employees, using the rationale that the employee could not have been in a position to have caused the wrongdoing unless hired by the employer. NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:34 GMT -05:00 https://www.coursehero.com/file/54768997/03pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M TOP: AONE competency: Know ledge of the Health Care Environment 14. During a staff shortage, you hire an RN from a temporary agency. The RN administ ers a wrong IV medication that results in cardiac arrest and a difficult recovery for the patient. Liability in this situation: a. is limited to the temporary agency. b. is restricted to the RN. c. could include the RN, the agency, and your institution. d. may depend on the patient’s belief regarding the employment relationship. ANS: D Apparent agency may apply here because your liability and that of your instituti on could be established if it can be shown that the patient believes that the RN was an employee of yours and of your institution. TOP: AONE competency: Knowledge of the Health Care Environment 15. You volunteer at a free community clinic. A 13 -year-old girl presents with chlamydia. The team leader at the clinic advises that: a. the state -defined age of legal consent is 18; therefore, no treatment can be delivered. b. the teen is underage and should be referred to the family general practitioner. c. care can be provided as long as consent is voluntary and information about treatment and options is provided. d. treatment is provided as long as telephone consent is obtained from a parent or legal guardian. ANS: C All states have a legal age for cons ent; generally, this age is 18. However, emancipated minors, minors seeking treatment for substance abuse, and minors seeking treatment for communicable diseases can provide their own consent. TOP: AONE competency: Knowledge of the Health Care Environment 16. Three gravely ill patients are candidates for the only available bed in the ICU. As the supervisor, you assign the bed to the patient with the best chance of rec overy. This decision reflects which of the following ethical principles? a. Beneficence b. Autonomy c. Veracity d. Nonmaleficence ANS: A Beneficence refers to doing what’ s good for the patient; in this situation, doing what’s good means providing care to the patient with the best likelihood of recovery. TOP: AONE competency: Professionalism 17. Which ethical principle is primarily involved in informed consent? a. Vera city b. Autonomy NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:34 GMT -05:00 https://www.coursehero.com/file/54768997/03pdf/This study resource was shared via CourseHero.comN U R S I N G T B . C O M c. Beneficence d. Nonmaleficence ANS: B Autonomy refers to the right to choose freely, which is inherent in informed consent. TOP: AONE competency: Knowledge of the Health Care Environment 18. The principle that requires nurses to uphold a professional code of ethics, to p ractice within the code of ethics, and to remain competent is which of the following? a. Veracity b. Autonomy c. Fidelity d. Honesty ANS: C Fidelity refers to promise keeping or upholding one’s promise to practice as a r easonable and prudent nurse would do and in an ethically competent manner. TOP: AONE competency: Professionalism 19. Mr. M. complains to you that one of your staff asked him details about his sexual relationships and financial affairs. He says that th ese questions were probing and unnecessary to his care, but he felt that if he refused to answer, the nurse would be angry with him and would not provide him with good care. Mr. M.’s statements reflect concern with: a. privacy. b. confidentiality. c. veracity. d. informed consent. ANS: A Privacy protection includes protection against unwarranted intrusion into the patient’s affairs. TOP: AONE competency: Knowledge of the Health Care Environment 20. To satisfy duty of care to a patient, a nurse manager is legally responsible for all of the following except : a. notifying staff of changes to policies related to medication administration. b. scheduling and staffing to ensure safe care. c. delegating in accordance with practice acts. d. supervising the practice of the physician. ANS: D Legally, the nurse manager is accountable to nursing practice standards, standards for nurse administrators, and hospital policies and procedures. TOP: AONE competency: Knowledge of the Health Care Environment NURSINGTB.COM Leading and Managing in Nursing 7th Edition Yoder-Wise Test Bank This study source was downloaded by 100000822899794 from CourseHero.com on 04-18-2021 07:36:34 GMT -05:00 https://www.coursehero.com/file/54768997/03pdf/This study resource was shared via CourseHero.com