NCLEX Power, Politics, and Influence Flashcards
A nurse manager is experiencing poor staff morale on her unit. While participating in a baccalaureate course, the nurse manager had learned that one of the reasons nurses lack power today is related to the past. In the early decades of the profession, nurses lacked power because:
a. nurses freely chose to defer to physicians and administrators with more education.
b. women lacked legal, social, and political power because of legal and cultural barriers.
c. the first nursing licensure laws prohibited nurses from making most decisions.
d. nurses astutely recognized the risks of grabbing too much power too soon.
ANS: B
Nursing mirrored the lack of legal, social, and political power that was prevalent in the early decades of the profession.
Nurses who engage in infighting, seek physician support against nursing colleagues, and avoid political advocacy through membership in nursing organizations:
a. refuse to believe that they are acting like members of groups that suffer socioeconomic oppression.
b. do not understand how their failure to exercise power can limit the power of the whole profession.
c. purposefully choose to exercise their power in the workplace through indirect means.
d. suffer from learned helplessness as a result of abuse by powerful nurse executives
ANS: B
Becoming an active, productive, collegial member of groups and teams within the workplace and in professional associations and community groups ensures that the nursing voice is heard on healthcare issues and problems and is an appropriate exercise of power.
A nurse belongs to several professional organizations, serving on a state-level committee of one group and on two task forces at work. The nurse is committed to a range of health issues and knows the state senator from the nurse’s district, as well as the name of the representative in Washington, DC. This nurse exemplifies which level of political activism in nursing?
a. Gladiator
b. Buy-in
c. Self-interest
d. Political astutenes
ANS: D
Political involvement is a professional responsibility and nurses’ perspectives of the critical issues for improving the healthcare system can shape the policy agenda of the nation’s political leadership. This nurse exemplifies several of the skills associated with political astuteness.
A manager relies on his director (immediate supervisor) for advice about enrolling in graduate school to prepare for a career as a nurse executive. The director may exercise what kinds of power in the relationship with the manager in this advisorysituation?
a. Expert, coercive, and referent
b. Reward, connection, and information
c. Referent, expert, and information
d. Reward, referent, and information
ANS: C
Because the director is in a leadership role, he comes with knowledge or expertise that is required to assume a leadership role, and he has information that he is willing to share, which gives him the power of information. The employee sees him as credible and seeks his advice, which gives him referent power.
A nurse manager must implement a 2% budget cut on the nursing unit. What approach would the manager use to most effectively empower the staff of the unit?
a. Discuss the guidelines for the budget cuts with the staff, making the decisions with those who participate.
b. Inform the staff of the budget cuts in a series of small group meetings and accept their ideas in writing only.
c. Provide the staff with handouts about the budget cuts and let them make recommendations in writing.
d. Hold a series of mandatory meetings on the budget cuts, asking staff for ideas on the cuts.
ANS: A
Empowerment is the process of exercising one’s own power to facilitate the participation of others in decision making and taking action so they are free to exercise power. It means releasing authority and enabling others to have accountability, for participation and decisions.
During orientation of new nurse managers, the chief nursing officer stresses strategies that help nurse managers to achieve a powerful image. What behaviors best contribute to a powerful image for the nurse manager?
a. Greeting patients, families, and colleagues with a handshake and a smile; listening carefully when problems arise
b. For men, no facial hair, always wearing a suit and tie; for women, always wearing a suit and high-heeled shoes
c. Maintaining a soft voice during times of conflict; making unbroken eye contact during interactions
d. Smiling all the time; always wearing a suit, carrying a briefcase, and, if a woman, wearing no jewelry
ANS: A
A powerful and positive approach is communicated through confident behaviors such as greeting others, smiling, and showing respect for the opinions of others through listening. Grooming and dress need to be clean, neat, and appropriate to the situation. Speech needs to
be firm and confident.
Two nurses approach their manager about a conflict regarding the next month’s schedule. The nurses are talking loudly and at the same time. The manager most effectively uses communication skills to resolve the conflict by:
a. taking both nurses aside, separately and then together, and charging them with resolving the problem without her direct intervention.
b. listening to each nurse speak to the other without interruption and asking clarifying questions to help them resolve the issue themselves.
c. separating the nurses, instructing each to decide how the problem can be resolved, and meeting with them the next day.
d. calling an emergency scheduling committee meeting and asking volunteers to resolve the conflict between the two nurses.
ANS: B
Negotiation involves the presentation of an opening position with each party, then moving on until they achieve a mutually agreeable result or until one or both move away from a failed negotiation. Negotiation occurs when one party has something that the other party values, such as a desired schedule.
A nurse manager recognizes the need to expand her professional network as she begins a job search for a middle-management position. What action is least likely to expand her job-searching network?
a. Reviewing her address book or card file for names and phone numbers of former colleagues who are now in middle-management positions
b. Making an appointment to meet with a former instructor from her graduate program in nursing administration
c. Making a long overdue return call to a former colleague who is now a chief nurse executive
d. Attending a state-level conferences for nurse managers and executives and volunteering to help with professional organizations’ informal luncheons and receptions
ANS: C
Networking is the result of identifying, valuing, and maintaining relationships with a system of individuals who are sources of information, advice, and support. Many nurses have relatively limited networks within the organizations where they are employed. Active
participation in nursing organizations is the most effective method of establishing a professional network outside one’s place of employment.
A staff nurse asks the nurse manager for a few days off for personal reasons. The nurse manager turns in the request to the human resources office with a note indicating that the staff nurse has demonstrated excellent working skills and is a valued employee. The nurse manager has used the influence of her position to help this staff member. Influence is the process of:
a. using power.
b. empowering others.
c. understanding power.
d. moving past apathy
ANS: A
Influence involves the use of power to effect certain outcomes—in this situation, to arrange days off for a valued employee.
A nurse is participating in a baccalaureate course. For the class, she has to attend the legislative session regarding the new role of medication assistants. Why is it important for nurses to be involved in shaping public policy?
a. Involvement will enable nurses to take over the healthcare system at some point in the future.
b. Other healthcare professions are less concerned about the essential needs of clients.
c. Such activities are important career builders for nurses who seek top-level executive positions.
d. They are closest to the front line of health care and see how it affects clients and families
ANS: D
Nurses can no longer be passive observers of the political world. Political involvement is a professional responsibility. Nurses’ perspectives of the critical issues for improving the healthcare system can shape the policy agenda of the nation’s political leadership.
Sondra, a new graduate, recently began a position as a registered nurse in a rural hospital, where she is the youngest and newest staff member. Although she has limited experience, she has a strong knowledge base, is confident, and was considered to have strong entry-level skills on graduation. Sondra meets with her former instructor and confides that she is very frustrated that others do not seem to accept her leadership. What might you suggest that would help
Sondra to understand what is happening in terms of power and influence?
a. As a new graduate, it is unlikely that she has acquired the experience and knowledge of other staff, including aides and practical nurses.
b. Rural settings tend to be closed systems and therefore are, not welcoming of those who are not from their community.
c. Morale on her unit can be improved by engaging in shared decision making.
d. Identify the informal leaders on her unit and how they affect care decisions.
ANS: DDeveloping organizational savvy includes identifying the real decision makers and those persons who have a high level of influence with the decision makers. Recognize the informal leaders within any organization may have more power than the formal leader because of more knowledge of the organization, more informational power, or more expertise.
What has the literature on oppression in nursing demonstrated?
a. Verified the presence of behaviors associated with oppression within nursing.
b. Suggested that oppression leads to bullying but has little or no effect on patient outcomes.
c. Failed to establish that oppression is present in nursing groups.
d. Indicated that nurses use oppression negatively.
ANS: A
Oppressed group behavior is apparent when a population is dominated by another group and begins to take on the characteristics of the dominant group (Roberts, 1983), often bullying and abusing their peers. In the twenty-first century, bullying and incivility have become epidemic in both nursing education and clinical settings.
Politics is identified in what areas?
a. Confined to legislatures
b. Seen in dysfunctional workplaces
c. Found in all social organizations
d. A representation of self-interest
ANS: C
Politics involves social interaction among organizations and as such, politics permeates in all organizations, workplaces, legislatures, professions, and even families.
Your colleague Mary, a recent graduate, announces that she intends to leave nursing in 3 to 4 months to pursue a position in marketing. While at your agency, she plans to give patients excellent care and to learn as much as she can, because “Who knows? Nursing is a great job with a great pay and I may return someday.” Mary’s statements most accurately exemplify which orientation to the concept of nursing? Nursing as a(n):
a. profession.
b. occupation.
c. flexible discipline.
d. career with off and on ramps
ANS: B
Concern with nursing as potentially one in a series of possibly well-paid jobs reflects a view of nursing as an occupation
Lucy, head nurse on the surgical unit, works with her staff to find ways in which they can work together with other disciplines to provide more effective care for patients on the unit. Lucy likely knows her power is:
a. limited, thereby necessitating involvement of others in implementing ideas.
b. restricted, which necessitates finding alternative means to achieve strong patient outcomes.
c. directed primarily toward those who are subordinate to her.
d. of unlimited capacity when shared with others.
ANS: D
Those like Lucy, who share power, tend to be the strong collaborators and see power as an unlimited quantity when shared. Empowered nurses make professional practice possible, creating a culture that satisfies all nurses
