FINAL EXAM Leadership Ch. 5, 6, 7, 14, 17, 18, 19, 21, 23, 25, 26, 27, 31

Which is the manager's best example of coaching used to encourage and improve an employee's daily work performance?

"Would you consider taking on the role of preceptor?"

The nurse-manager is preparing for the unit ward clerk's annual evaluation and sends out a short questionnaire requesting feedback on the ward clerk's job effectiveness in her job. The nurse-manager sent the request to one doctor who uses the unit frequently, to a staff nurse on each shift, to the housekeeping department head, and to the head of the volunteer program. In addition, the nurse-manager interviews three clients to determine how courteous the ward clerk is when answering call lights from the unit desk. What is this an example of?

A 360-degree evaluation

The nurse-manager is negotiating for the funds necessary to purchase several new isolettes for the facility's newborn nursery. The Chief Financial Officer (CFO) states, "I've always been curious about that piece of equipment; how does it actually work?" What negotiation action has the CFO engaged in? Collaborating Smoothing A diversionary tactic Appropriate fact finding

A diversionary tactic

An employee believes that the performance appraisal was unfairly influenced by a drug error that the employee committed several weeks ago. The employee states, "The manager focused almost exclusively on this one mistake, and that event characterized my entire appraisal." This employee may have experienced what phenomenon?

A horns effect

Which employee is most likely experiencing the Matthew effect in his or her performance appraisal?

A nurse whose performance appraisal has included the same points for several consecutive years

Which of the following would be considered sentinel events that should be reported to The Joint Commission. Select all that apply.

A. A client experiences nephrotoxicity and requires dialysis because of a medication error. B. A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. E. A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells.

A health-care organization has experienced a rise in medical errors and has committed to implementing Leapfrog initiatives. What aspects of health care should the organization address? Select all that apply

A. Ensuring that hospital referrals are evidence-based B. Utilizing the Leapfrog Safe Practices scores C. Expanding the use of computerized physician-provider order entry D. Ensuring that adequately trained intensive care physicians are easily accessible

When monitoring medication inventories for possible diversion or theft by nurses who abuse chemicals, what medication classifications should the manager monitor most closely? Select all that apply.

A. Opioid analgesics B. Benzodiazepines F. Central nervous system stimulants

The performance appraisal system in a health-care organization has been replaced by performance management. Under this new system, the nurse-manager should perform what actions? Select all that apply.

A. Work with employees to set performance goals B. Provide coaching to employees on an ongoing basis D. Provide leadership training to employees

A nurse-manager is planning a performance appraisal of an employee who has a number of performance deficiencies. What is the best approach to the performance appraisal of this employee?

Acknowledge the employee's strengths, focus on the key deficiencies, and create a long-term coaching plan.

How should the nurse-manager implement McGregor's hot stove rules when setting standards for employee behavior on the unit?

All employees should be made aware of the rules and associated punishments beforehand.

What is the result of arriving at a consensus? All involved parties agree to support the way a conflict has been resolved A conflict is resolved by meeting the goals of all involved parties It resolves a conflict by an initial unanimous decision Conflict is resolved through the mediation process

All involved parties agree to support the way a conflict has been resolved

The nurse-manager has received a memo from the director of human resources stating that the organization will be adopting a performance management system. The manager should recognize what implication of this announcement?

Annual performance reviews will likely be discontinued.

Which is a management function associated with dealing with a problem employee?

Applies a progressive discipline model when employees fail to meet standards

Several RNs on the unit want to address the possibility of initiating flextime on the unit. What is the manager's initial response? Assuring the RNs that their suggestion will be taking under consideration Asking the RNs to circulate a partition to be signed by employees who support the change Arranging for the RNs to air their views at the next staff meeting Sharing with the RNs that they need to address the issue with upper management

Arranging for the RNs to air their views at the next staff meeting

What piece of data should the nurse-manager include in an outcome audit?

At discharge, a client was able to ambulate 40 feet unassisted.

A health-care organization has experienced a rise in medical errors and has committed to implementing Leapfrog initiatives. What aspects of health care should the organization address? Select all that apply.

B. Utilizing the Leapfrog Safe Practices scores C. Ensuring that hospital referrals are evidence-based D. Expanding the use of computerized physician-provider order entry E. Ensuring that adequately trained intensive care physicians are easily accessible

What should the manager do in completing an annual performance appraisal?

Base the appraisal on a standard to which all are held accountable

Which action is an accepted tactic when engaged in a negotiation? Being willing to win at any cost Communicating only when asked direct questions Compromising only as a last resort Beginning with a high but realistic expectation

Beginning with a high but realistic expectation

What factor contributes most to a performance appraisal being viewed as valid and relevant by the employees?

Belief that it is based on the performance of job description-related tasks

The nurse-manager is completing a competence assessment of an unlicensed care provider (UAP) on the unit. What components should the manager evaluate? Select all that apply.

C. The UAP's skill level E. The UAP's knowledge level for giving care

Which personal characteristics will best help meet the psychological needs of conflict negotiation? Perseverance and assertiveness Calmness and self-assuredness Compassion and reflectiveness Organization and preparedness

Calmness and self-assuredness

After a compromise has been made, what is the manager's initial action? Clearly restating the compromise's specific outcomes to all involved Thanking all involved for their cooperation on reaching the compromise Evaluating the compromise's outcomes for fairness to all involved parties Assuring all involved that the compromise will not cause a change in goals

Clearly restating the compromise's specific outcomes to all involved

A nurse-manager and several colleagues are reviewing the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These results will allow the team to make what assessment?

Clients' perspectives on the care they received

What are the least common sources of organizational conflict? Communication problems Organizational structure Individual behavior within the organization Self-scheduling

Communication problems

What task will best allow a health-care organization to benchmark its performance?

Comparing the organization's performance with that of best performing institutions

Which practice has the U.S. Food and Drug Administration suggested in order to decrease the risk of medication errors?

Computerized order entry with a drug bar code system

When creating a clinical practice guideline for the management of aggressive behavior on a mental health unit, the nursing committee should perform what action first?

Conducting a search of the literature for research results

One of the experienced nurses on a unit frequently approaches the manager to provide feedback on a recently hired nurse's performance. When preparing the new nurse's performance appraisal, how should the manager integrate the experienced nurse's feedback?

Consider the nurse's feedback but supplement it extensively with data from several other sources

After the first few months on the job, the nurse-manager has recognized that an experienced practical nurse at the clinic is a marginal employee. What strategy by the manager is most likely to be effective?

Create a personalized improvement plan with the nurse and work with the nurse to promote improvement

The nurse is admitting a new client and is reviewing the results of the medication reconciliation. What data will be included in the client's medication reconciliation? Select all that apply

D. The medications that the client was taking prior to admission E. The list of medications the client has been prescribed by the admitting physician

A novice nurse-manager is a member of a team that will oversee quality control in a health-care organization. What action should the nurse and the other members off the team perform first?

Determine the specific criteria and standards by which quality will be measured

What is the function of an ombudsperson? Providing expert testimony in conflict cases Mediating disputes between an organization and its employees Educating individuals involved in a grievance situation of their rights Monitoring the implementation of the terms of a conflict's compromise

Educating individuals involved in a grievance situation of their rights

An inexperienced nurse-manager has been excessively favorable to employees in their performance appraisals in an effort to garner their approval and acceptance. This strategy is likely to lead to what unintended consequence?

Employees will be unable to gauge their improvements in subsequent years.

An employee has come to the manager with a long list of complaints about a coworker, all of which are attributable to personality factors rather than unsafe practice. What is the manager's best initial action?

Encourage the employee to seek directly with the coworker

What is the best course of action to stimulate broad participation of employees in quality control efforts?

Engage closely with the frontline staff who provide client care

A charge nurse assists a group of personnel to resolve their conflict, with the outcome being that the two opposing goals were discarded and new goals were adopted. What is this an example of? Smoothing of conflict by the leader Facilitating collaboration among personnel A majority rule approach A good lesson in compromising

Facilitating collaboration among personnel

A registered nurse reports to the nurse-manager that the team's nursing assistant regularly fails to complete assigned tasks. The nurse-manager responds that it is the nurse's responsibility to talk with the nursing assistant about this problem. The manager is engaged in what aspect of conflict? Conflict avoidance Conflict smoothing Encouraging competitive conflict Facilitating conflict resolution

Facilitating conflict resolution

A focus group has been organized so that employees can give feedback on their manager's work performance. What characteristic of the focus group will best ensure a productive and positive process?

Have an impartial employee relations officer facilitate the discussion

What is the most important criterion for success for health-care providers collaborate on patient care? Having mutual respect for one another's knowledge and expertise Having the skills to negotiate successfully Liking each other enough to want to collaborate Being willing to cooperate with each other

Having mutual respect for one another's knowledge and expertise

The leadership of a large health-care organization is considering the adoption of Behaviorally Anchored Rating Scales (BARS) for the performance appraisal system. This change in practice may require what task by the nurse-manager?

Helping develop a separate rating form for each job classification

Which factor should the nurse-manager prioritize when writing an employee's performance evaluation?

History of completing required tasks

During a quality improvement initiative, the leadership of a health-care organization have worked with senior managers to implement the principles of Lean Manufacturing. This initiative will focus on what factor?

Identifying and preventing waste

The nurse-manager has had difficulty improving the performance of a registered nurse who is a marginal employee on the hospital medical unit. The manager no longer wishes to work with the employee and has arranged a transfer to the postsurgical unit of the hospital. What type of transfer has the manager arranged?

Inappropriate

Which action is associated with the nursing leadership role in quality improvement

Inspiring staff to establish and maintain high standards regarding patient care

What action should the nurse-manager and other leaders in the health-care organization perform in order to ensure that a quality control program will be effective?

Integrate quality control through all levels of the organizational hierarchy

What term is used when two or more people have conflict about values or goals? Intergroup conflict Common control Intrapersonal conflict Interpersonal conflict

Interpersonal conflict

Which statement reflects the contemporary thinking about conflict? It can lead to new ideas It leads to decreased motivation It should be avoided whenever possible It is neither qualitative nor quantitative

It can lead to new ideas

Which statement best defines conflict? It involves an internal struggle resulting from value-related discord Its basis is the violation of personal rights or values It centers on either internal or external discord between individuals It is the outcome of a visible struggle between individuals

It centers on either internal or external discord between individuals

Which statement is accurate when describing performance deficiency coaching?

It is less spontaneous and requires more planning than ongoing coaching.

Which statement is true concerning perceived conflict? It develops during the first stage of the conflict process It is sometimes referred to as antecedent conflict It occurs if the conflict is intellectualized It occurs when the conflict is emotionalized

It occurs if the conflict is intellectualized

Which is a true statement regarding TQM?

It recognizes that the customer is the focal element on which production and service depend

What did the interactionist theorists of the 1970s believe about organizational conflict? It should be dealt with immediately It should be encouraged It was an indication of poor management It should be avoided

It should be encouraged

Considering dispute resolution, which statement is true regarding what occurs during mediation? It uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict It asks questions to clarify the issues It makes a final decision for the parties in conflict It involves presentation of evidence including that of expert witnesses

It uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict

A nurse-manager has referred staff members to a clinical practice guideline (CPG) that addresses the prevention of pressure ulcers. What is a characteristic of this CPG?

It will describe interventions for nurses to follow in an effort to provide evidence-based care.

Which statement correctly describes using self-appraisal as a performance appraisal tool?

It works best when used in conjunction with other appraisal tools rather than in isolation.

The nurse-manager is taking action to avoid the recency effect when conducting employees' performance appraisals. What is the manager's best action?

Keep ongoing notes on each employee's performance

What is the name given to the first stage in the conflict process? Latent Perceived Felt Manifest

Latent

What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)?

Managed care organizations are not required to collect HEDIS data.

Which is a true statement about negotiation tactics? Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic Most managers successfully resist the illness/wellness tactic because of their nursing preparation Negotiation tactics can be manipulative; thus, managers should know how to identify and counter destructive tactics The tactic of paternalism allows both parties in the negotiation to reach a consensus of opinion

Negotiation tactics can be manipulative; thus, managers should know how to identify and counter destructive tactics

Following much debate, a health-care organization has adopted a system of peer review for the first time. How can the success of this system be best promoted?

Orient employees thoroughly to the purpose and process of the new system

As part of the quality control process, managers have set standards for performance and assessed whether these standards are being met. It has been determined that several standards are not being met. What is the prioritize response to this finding?

Perform interventions that will correct the deficiencies

A nurse-manager is focusing on management controlling functions that are associated with quality control. What task best addresses this goal?

Periodically evaluating the unit mission and philosophy

The nurse-manager works at a unionized health-care facility and is preparing for a disciplinary conference for an employee with a history of unexcused absences. What activity should the manager prioritize in this conference?

Presenting objective evidence that demonstrates the employee's deficient performance

High-achieving nursing students were found to have studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for one week before the examination. What type of audit provided data about the students' preparation?

Process

What goal should the nurse-manager prioritize when preparing performance appraisals?

Promotion of employee growth

A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically impaired. What is the manager's most appropriate action?

Promptly confront the nurse to discuss this suspicion

A nursing aide has been given a formal written warning regarding arguing repeatedly with the team leader about the given assignment. Today, the nursing aide has taken four lengthy personal phone calls during work time. This is the first offense of this nature. How will the manager deal with this disciplinary situation?

Provide a verbal warning that includes the rules related to personal telephone calls

A hospital is using the guidelines of the Leapfrog Group to inform safety improvements in the organization. What action will best incorporate these guidelines?

Purchasing a computerized physician-provider order entry system

The nurse-manager facilitates a conflict that involves the delineation of staff job descriptions. What is this an example of? Responsibility charting Smoothing conflict Alternate dispute resolution Mediation counseling

Responsibility charting

A nurse-manager is participating in a hospital's quality control efforts and is collating data sources. What data source should the manager identify as a qualitative source?

Results of interviews with discharged clients

What action should the nurse-manager perform when preparing for and conducting a disciplinary conference?

Schedule the conference in advance at a time agreeable to both the employee and the manager

Which principle should guide the manager's use of self-appraisals for employees?

Self-appraisals usually require reflection and introspection on the part of the employee.

What role has The Joint Commission assumed in ensuring quality at the organizational level?

Standardizing clinical outcome data collection

A nurse-manager is overseeing an organization that uses the nursing minimum data set (NMDS). What will the use of the NMDS achieve?

Standardizing the collection of nursing data for use by multiple users

What occurs when there is very little conflict in an organization? Stasis Increased productivity Decreased effectiveness Employee immobilization

Stasis

A nurse-manager is engaged in a negotiation with staff representatives when the discussion becomes controlled by a particularly aggressive member. Which action will the nurse-manager take to assure that the process is successful? Asks that the aggressive individual recognize the rights of all the other members States, "I need to have time to think over all that we have discussed." Halts any discussion until new representatives can be appointed Shares with the members that aggressiveness negatively impacts the negotiations

States, "I need to have time to think over all that we have discussed."

A hospital system is trying to address some of the deficits in care that were described in To Err Is Human. When addressing the errors that this report identified, the hospital's leaders should focus on what factor?.

Systemic flaws in health-care delivery

A nurse-manager is preparing to perform a 360-degree evaluation of a nurse on the unit. What is the manager's best action when preparing to do this type of evaluation?

Take action to protect the nurse's right to confidentiality

An employee is found to have grossly mistreated a client, which the employee has never done before. What consequence should be administered to the employee?

Termination

What is a critical goal in negotiation? That gains for each party are different but equal That the hidden agendas of all parties be exposed That each party willingly reveals their negotiated limits That both parties perceive that they have won something they value

That both parties perceive that they have won something they value

A nurse-manager is opposing the expansion of the prospective payment system (PPS). What argument against the PPS should the manager cite

The PPS has been linked to a decline in the quality of care.

A nurse-manager is opposing the expansion of the prospective payment system (PPS). What argument against the PPS should the manager cite?

The PPS has been linked to a decline in the quality of care.

An inexperienced nurse-manager has provided vague and ambiguous feedback to an employee during a performance appraisal. What is the most likely outcome of this practice?

The employee is uncertain of the value of the feedback.

The nurse-manager is contributing to the plan for the workplace reentry of an employee with a history of chemical abuse. What should be included in the reentry plan?

The employee should agree to random urine screening.

The nurse-manager recognizes that performance appraisals can be intense and wants to make sure that the process will have a positive outcome for employees. What action best promotes this goal?

The employees provide input into developing the performance standards.

What is the principle that guides constructive discipline?

The focus of constructive discipline is employee growth.

The manager is working with a staff member who has twice arrived late for assigned shifts over the past few weeks. What is the fundamental rationale for conducting a disciplinary conference for this employee?

The problem will get worse if it is ignored.

What is "Consensus" in negotiation referring to? One party wins at the expense of another The willingness by all parties to accept agreed-on conditions The most rapid conflict resolution strategies An unanimous decision has been reached

The willingness by all parties to accept agreed-on conditions

When is the competing approach to resolving conflict used? When fair play is important to all involved parties When one party wins at the expense of the others When managers need to control a volatile situation When an appropriate political strategy is necessary

When one party wins at the expense of the others

A nurse became frustrated with a client and deliberately damaged the medication cart in a subsequent outburst. How should the manager discipline this employee?

Written admonishment

What action should the manager take to arrive at a more fair and accurate assessment during performance appraisals?

Written anecdotal notes regarding the employee's performance should be maintained throughout the evaluation period.

The nurse-manager will be using management by objectives (MBO) to appraise employees' performance. When using MBO, the manager should

coach and support the employee in an effort to help the employee meet goals and outcomes.

In order to adhere with the recommendations of The Joint Commission around employee performance appraisals, the manager should:

ensure the appraisal is based on employee job descriptions.

In order to improve the likelihood that errors in the health-care system will be reported, nurse-managers should

foster a climate where analysis of errors is not solely focused on blame.

In order to improve the likelihood that errors in the health-care system will be reported, nurse-managers should:

foster a climate where analysis of errors is not solely focused on blame.

The nurse-manager is initiating the process of progressive discipline in response to an employee's tardiness. The manager should:

privately administer a verbal reprimand to the employee.

As part of a quality improvement initiative, administrators are conducting outcomes analysis and have included nursing-sensitive outcome measures. These outcome measures will:

separate out the unique contributions that nurses make to client outcomes.

A nurse-manager is using management by objectives (MBO) as a performance appraisal tool. When using this form of performance appraisal, the manager should:

support employees to help them reach mutually identified goals.

A client was treated in the hospital for a stroke and was the client's family members assert that the client was discharged too early and did not receive sufficient rehabilitation. The client's early discharge may have been attributable to:

the effect of diagnosis-related groups.