11 minute read
Chapter 10: Power and Conflict
Huber: Leadership & Nursing Care Management, 6th Edition
Multiple Choice
1. A nurse on a medical-surgical floor has been asked to join a research committee. She agrees to this request because of her great admiration for the vice president of nursing. This is an example of _____ dimension of power.
a. dependence b. relational c. subversive d. tactical
ANS: B
Relational dimension of power is a property of a social relationship. Many classic definitions indicate that power has to do with relationships between two or more actors in which the behavior of one is affected by the other.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
2. A staff nurse frequently is providing positive comments to get the manager in a good mood before asking about additional vacation time. This influence tactic is known as: a. consultation. b. ingratiation. c. inspiration appeals. d. rational persuasion.
ANS: B
Ingratiation occurs when the agent uses praise, flattery, friendly behavior, or helpful behavior to get the target in a good mood or to think favorably of him or her before asking for something.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. Management offers a day of pampering at a spa if nurses agree to work 3 out of 4 weekends over the summer. This type of power is known as: a. coercive. b. expert. c. legitimate. d. reward.
ANS: D
French and Raven’s five sources of power (1959) include reward, coercive, expert, referent, and legitimate. When reward power is used, most people comply because of the positive benefits of doing so.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
4. The nursing supervisor informs the staff that if they refuse to stay on the nursing unit and work an additional 8-hour shift, they will be reported to the state for patient abandonment. This type of power is known as: a. coercive. b. expert. c. legitimate. d. reward.
ANS: A
French and Raven’s five sources of power (1959) include reward, coercive, expert, referent, and legitimate. When coercive power is used, an individual reacts to the fear of the negative consequences that might occur for failure to comply.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. Subunit power is derived from: a. being independent within the organization. b. providing resources on which the organization most depends. c. supplying multiple cross-trainable functions within the organization. d. voicing unique opinions and values within the organization.
ANS: B
Subunit power is derived from providing resources on which the organization most depends. Subunit power also is derived from dependence, coping with uncertainty, being irreplaceable, having the ability to affect the decision process, and having shared consensus within the organizational subunit.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Competitive b. Disruptive c. Organizational d. Task
6. A nursing manager is leading a recruitment and retention committee. She manages in a laissez-faire style. Her co-leader is a staff nurse who is very detail oriented. The nurse manager usually leads the meetings. During the meeting, the staff nurse frequently needs to interject information that has not been presented. She also creates the agenda and communicates information with other team members. This scenario depicts which type of conflict?
ANS: D
Task conflict is an awareness of differences in viewpoints and opinions pertaining to a group task.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
7. A hospital nurse manager is involved in conflict management between two staff members. The process of collaborating occurs when: a. one person seeks to satisfy his/her own interests. b. both sides strive to meet the interests of both parties. c. a person chooses to withdraw from conflict. d. one party seeks to appease the other.
ANS: B
Collaborating ensues when the parties to conflict each desire to fully satisfy the concerns of all parties. The intention is to solve the problem by clarifying differences rather than by accommodating.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
8. Nurses derive much of their power from being: a. authority figures in emergent situations. b. central to the delivery of health care services. c. organized through public associations. d. the care coordinator of the health care team.
ANS: B
Professional nurses have a high degree of centrality within health care organizations. They are critical to the operation of most health care organizations, and without nurses, many health care facilities would not be able to offer services. Nursing maintains power by being central to the actual delivery of health care services, which is the core business function.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. coercive b. expert c. legitimate d. referent
9. A well-known talk show host presents information to a congressional committee to garner support for cancer research. This type of power refers to _____ power.
ANS: D
Referent power is based on admiration for a person who has desirable resources or personal traits.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Assertiveness b. Ingratiation c. Rationality d. Upward appeal
10. _____ is an influence tactic where another person is given praise or sympathy in an effort to make the other person feel important.
ANS: B
Ingratiation means trying to make the other person feel important giving praise or sympathizing. Ingratiation is attempting to advance oneself by trying to make another person feel important.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. vertical b. organizational c. horizontal d. exertional
11. Subunit or _____ power refers to relationships across departments.
ANS: C
Subunit or horizontal power pertains to relationships across departments.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. intragroup b. intergroup c. interpersonal d. intrapersonal
12. A disagreement or differences between the members of two or more groups over authority, territory, and resources is called _____ conflict.
ANS: B
Intergroup conflict refers to disagreements or differences between the members of two or more groups or their representatives over authority, territory, and resources.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Problem solving b. Authority c. Knowledge d. Coercive power
13. _____ is a personal quality that is admired in the person with referent power.
ANS: A
Referent power comes from the affinity other people have for someone. They admire the personal qualities, the problem-solving ability, the style, or the dedication the person brings to the work.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
14. A common source of conflict in nursing occurs when the nurse wants to perform patient teaching or counseling, but there are competing priorities and the nurse has inadequate time to spend with the patient. This type of conflict is related to: a. interpersonal conflict. b. intergroup conflict. c. intrapersonal conflict. d. intragroup conflict.
ANS: C
Intrapersonal conflict means discord, tension, or stress inside or internal to an individual that results from unmet needs, expectations, or goals. It often is manifested as a conflict over two competing roles. A nursing example occurs when the nurse determines that a patient needs teaching or counseling, but the organization’s assignment system is set up in a way that does not provide an adequate amount of time. When other priorities compete, an internal or intrapersonal conflict of roles exists.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
Multiple Response
1. Nurses must use which of these to facilitate change in health care organizations? (Select all that apply.)
a. Actualization b. Authorization c. Influence d. Ratification e. Power
ANS: C, E
As the largest health care profession, nursing must use power and influence as a legitimate tool to facilitate change in health care organizations and the health care system.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Increased compensation and benefits b. Decreased burnout c. Decreased job strain d. Increased job satisfaction and work effectiveness e. Increased trust in the workplace
2. What are the consequences or outcomes of nurse empowerment? (Select all that apply.)
ANS: B, C, D
Rao (2012) summarized the consequences or outcomes of nurse empowerment as (1) the potential for improved nurse and patient outcomes, (2) decreased burnout, (3) decreased job strain, (4) increased trust in the workplace, and (5) increased job satisfaction and work effectiveness.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Remove barriers to practice and care. b. Maintain current leadership roles. c. Promote diversity. d. Transform education. e. Improve data.
3. The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine have assessed progress made on recommendations for the future of nursing. What are the recommendations for nurses? (Select all that apply.)
ANS: A, D, E
In 2014 the Robert Wood Johnson Foundation asked the Institute of Medicine (IOM, now called the National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division) to convene a committee to assess progress made on implementing the recommendations of The Future of Nursing (IOM, 2010) and identify areas that should be emphasized over the next 5 years. This report outlines specific areas to accelerate implementation of the IOM recommendations for nurses: (1) removing barriers to practice and care, (2) transforming education, (3) collaborating and leading, (4) promoting diversity, and (5) improving data.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Social aspect b. Relational aspect c. Dependence aspect d. Independent aspect e. Sanctioning aspect
4. Which of the following are the formal dimensions of power? (Select all that apply.)
ANS: B, C, E
The three formal dimensions of power are the relational, dependence, and sanctioning aspects of power. The relational aspect of power suggests that power is a property of a social relationship. The dependency aspect of power suggests that power resides implicitly in the other’s dependency. The sanctioning aspect of power is the active component of the power relationship, referring to the direct manipulations of the other’s outcomes.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. A state in which a nurse has assumed control over his or her own practice b. A social relationship between two or more people c. A workplace that promotes opportunities for growth d. A nurse’s sense of meaning as expressed in values and work role e. Interdependence of personnel
5. Empowerment for nurses may consist of three components. Which three of the following components may help nurses become empowered to use their power for better patient care? (Select all that apply.)
ANS: A, C, D
Nurse empowerment was defined as a state in which an individual nurse has assumed control over his or her practice, enabling him or her to successfully fulfill professional nursing responsibilities within an organization. Organizational antecedents to nurse empowerment include the “opportunities for mobility and growth and access to resources, support, and information provided within the nurse’s work environment.” The organizational and individual antecedents lead to psychological empowerment, including a nurse’s sense of meaning as expressed in values and work role.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Influence b. Integrity c. Authority d. Dominance e. Control
6. What are the two major content dimensions of power? (Select all that apply.)
ANS: A, C
Authority and influence are two major content dimensions of power. Influence, dominance, and control may occur in separate dimensions.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Connection power is based on the perception that the influencer has access to powerful people or groups. b. Legitimate power is based on fear. c. Expert power results from expertise, special skill, or knowledge. d. Information power refers to skill in making rational appeals. e. Referent power is based on admiration for a person.
7. Which of the following statements accurately describe the varying mechanisms of power? (Select all that apply.)
ANS: A, C, E
Connection power is based on another’s perception that the influencer has access to powerful people or groups. Expert power results from expertise, special skill, or knowledge. Referent power is based on admiration for a person.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Power is derived from independence. b. Power is derived from providing resources. c. Power is derived from certainty. d. Power is derived from being irreplaceable. e. Power is derived from the ability to affect the decision process.
8. Which of the following statements describe structural determinants of power within an organization? (Select all that apply.)
ANS: B, D, E
The following are structural determinants of power within organizations: Power is derived from dependence; power is derived from providing resources; power is derived from coping with uncertainty; power is derived from being irreplaceable; power is derived from the ability to affect the decision process; and power is derived if there is a shared consensus within the organizational subunit.
DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Loss of team morale b. Disrupted communication c. Disability or stress claims d. Decreased management productivity related to time spent resolving conflict e. Loss of motivation for achieving team goals
9. Organizational change is associated with both direct and indirect costs for which leaders must be prepared. Which of the following are examples of indirect costs associated with conflict? (Select all that apply.)
ANS: A, B, E
Dysfunctional outcomes of conflict include development of discontent, reduced group effectiveness, disrupted communication, reduced group cohesiveness, and infighting among group members, which then overrides the focus on group goals.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Absenteeism b. Team cohesiveness c. Disrupted communication d. Stimulation of creativity and innovation e. Improved quality of decisions
10. The main effects of conflict are individual effects, interpersonal relationships, and organizational effects. What are some of the positive effects of conflict within an organization? (Select all that apply.)
ANS: B, D, E
Positive outcomes of conflict include stronger relationships and team cohesiveness, stimulation of creativity and innovation, and improved quality of decisions.
DIF: Cognitive Level: Apply (Application)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Conciliation b. Distributive bargaining c. Arbitration d. Mediation e. Collective bargaining
11. Negotiation is a form of conflict resolution. Which of the following terms are associated with negotiation? (Select all that apply.)
ANS: A, B, D
Conflict resolution involves eliminating all forms of conflict. Negotiation, mediation, and arbitration are often referred to in discussions of conflict resolution. These terms are also included under the umbrella of alternative dispute resolution (ADR). According to Knickle and colleagues (2012), the resolution continuum includes negotiation, mediation, arbitration, and litigation as a spectrum of third-party dispute resolution. A conciliator is like a third friend who might attempt to intercede in an argument between two other friends. Conciliators attempt to diffuse the negative emotions that are often involved in the conflict, and they strive to establish more effective communications between the parties.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care a. Behavioral predispositions of individuals b. Bureaucratic hierarchy c. Social pressure in the environment d. Rules and procedures e. Position power
12. Which of the following are factors that influence the way conflict is handled within an organization? (Select all that apply.)
ANS: A, C, D
A structural model of conflict exists that examines four factors that seem to influence the way conflict is handled in organizations: behavioral predispositions of individuals, social pressure in the environment, the organization’s incentive structure, and rules and procedures.
DIF: Cognitive Level: Remember (Knowledge)
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
