Final Test

Which statement is accurate when describing performance deficiency coaching? A) It is less spontaneous and requires more planning than ongoing coaching. B) It is a one-time way of solving problems. C) It requires the manager to assume the role of enforcer rather than supporter or enabler. D) It occurs as a component of an employee's annual performance appraisal.

A

What type of interview is a predictor of job performance and overall effectiveness? A) Unstructured 2. B) Semistructured 3. C) Structured 4. D) Informal

A) Unstructured 2. B) Semistructured 3. C) Structured 4. D) Informal Ans: C Feedback: As a predictor of job performance and overall effectiveness, the structured interview is much more reliable than the unstructured, semistructured, or informal interviews.

A manager is implementing a patient classification system (PCS). Which external and internal variables should the manager address when implementing the PCS? Select all that apply. A) The presence of nursing students on the unit B) The hiring of two graduates as staff C) The increase of scheduled medical students D) Language barriers presented by nursing staff E) The hospital's accreditation status

A,B,C,D

What should managers do to maintain adequate staff in their organization? A) Proactively plan to hire two RNs for each unit each year B) Use knowledge of turnover rates on their units for planning and hiring C) Look at staff-to- patient ratios at other health-care organizations in the area D) Hire consultants to study national turnover rates to determine recruitment needs

Ans: B Feedback: Staffing needs are unique to each institution and should be determined by looking at patient census, patient health-care needs, the type of patient care management used, and budget. None of the remaining options are accurate statements concerning adequate staffing.

Which statement accurately reflects self-scheduling? 1. A) Self-scheduling requires greater worker accountability 2. B) The manager has little responsibility in self-scheduling 3. C) Self-scheduling has few or no shortcomings 4. D) Self-scheduling works in most organizations

Ans: A Feedback: Self-scheduling requires greater worker participation in decision making and shared responsibility for adequate staffing. None of the remaining options is accurate.

It is 2 PM. You are calculating the nursing care hours for the 3 to 11 PM shift and must decide whether you need to call in additional help. You have three RNs, three nursing assistants, and one ward clerk scheduled. You have 22 patients with the following acuity and nursing care hours allotted for the evening shift: Category I, 4 patients @ 2.0 hours Category II, 2 patients @ 2.3 hours Category III, 10 patients @ 2.8 hours Category IV, 6 patients @ 3.4 hours What are the needed hours of nursing care? 1. A) 61 hours 2. B) 52.6 hours 3. C) 68.4 hours 4. D) 48.4 hours

Ans: A Feedback: Four category I patients require 8 hours of care; two category II patients require 4.6 hours of care; 10 category III patients require 28 hours; six category IV patients require 20.4 hours; total nursing care hours equal 61.

What is the advantage of staff turnovers? A.) Fresh Ideas B) Younger staff C) Cost containment D) Increased groupthink

Ans: A Feedback: Some turnover is normal and, in fact, desirable. Turnover infuses the organization with fresh ideas. It also reduces the probability of groupthink, in which everyone shares similar thought processes, values, and goals. However, excessive or unnecessary turnover reduces the ability of the organization to produce its end product and is expensive.

What does a competence assessment evaluate? 1. Knowledge and education to perform the task 2. Skills to perform the task 3. Experience to perform the task 4. How well the individual completes the task 1. A) 1, 2, 3 2. B) 1, 2, 4 3. C) 1, 3, 4 4. D) 2, 3, 4

Ans: A Feedback: A competence assessment evaluates whether an individual has the knowledge, education, skills, or experience to perform the task, whereas a performance evaluation examines how well that individual actually completes that task.

Which statement accurately identifies a concern associated with decentralized staffing? 1. A) It carries risks that employees may be treated unequally or inconsistently 2. B) It uses one individual or a computer to do the staffing 3. C) The manager's role is that of making minor adjustments or providing input 4. D) It provides good control for the organization

Ans: A Feedback: A manager being perceived as granting special treatment to some employees is a risk of decentralized staffing. None of the other options identifies an associated concern.

What is the primary goal of a performance appraisal? A) Promotion of employee growth 2. B) Compliance with stated regulations 3. C) Identification of ineffective staff 4. D) Providing a basis for staff wage increases

Ans: A Feedback: A performance appraisal wastes time if it is merely an excuse to satisfy regulations and the goal is not employee growth. None of the remaining options express the goal of a performance appraisal.

What is the advantage of decentralized scheduling? A) Unit manager understands the needs of the unit and staff intimately B) Employees will be treated equally and consistently C) Manager role is limited to making minor adjustments and providing input D) It allows the most efficient use of resources

Ans: A Feedback: Advantages of decentralized staffing are that the unit manager understands the needs of the unit and staff intimately, which leads to the increased likelihood that sound staffing decisions will be made. In addition, the staff feels more in control of their work environment because they are able to take personal scheduling requests directly to their immediate supervisor. Decentralized scheduling and staffing also lead to increased autonomy and flexibility, thus decreasing nurse attrition.

Which area of questioning is considered an illegal interview inquiry? 1. A) Questions about the applicant's marital status 2. B) The languages the applicant speaks or writes 3. C) Inquiries about educational experiences 4. D) Place of residence

Ans: A Feedback: Asking applicants about their marital status or whether they have children is unlawful. None of the other options are considered illegal areas of questioning.

Although some subjectivity is inescapable in performance appraisals, what action can the manager take to arrive at a more fair and accurate assessment? 1. A) Written anecdotal notes regarding the employee's performance should be maintained throughout the evaluation period 2. B) Evaluation criteria that reflect on the employee as a person rather than just on work performance should be used 3. C) Data gathered by the manager in preparation for the performance appraisal should be limited to not more than two sources, so no conflicting information is received 4. D) The manager should rate all employees using central tendency whenever possible

Ans: A Feedback: Because a manager will tend to remember an employee's performance better in the weeks or months directly preceding the appraisal, a manager should take notes on an employee's performance throughout the year. The other options are less affective in proving a balanced appraisal.

From an economic perspective, what is driving the current nursing shortage? A) Supply side of the supply/demand equation B) Demand side of the supply/demand equation C) Both the supply and demand sides of the supply/demand equation D) Short-term rise in demand in nursing services

Ans: A Feedback: From an economic perspective, the current nursing shortage is being driven more by the supply side of the supply/demand equation than the demand side. None of the other options identify that connection.

What contributed to beginning of an acute shortage in many health-care settings in the late 1990s? 1. Hospital downsizing 2. National businesses downsizing 3. Shortsightedness regarding recruitment 4. Shortsightedness regarding retention 1. A) 1, 2, 3 2. B) 1, 2, 4 3. C) 1, 3, 4 4. D) 2, 3, 4

Ans: A Feedback: Hospital downsizing and shortsightedness regarding recruitment and retention contributed to the beginning of an acute shortage of RNs in many health-care settings by the late 1990s. Retention was not considered a factor.

Which statement about rules is correct? 1. A) If a rule or regulation is worth having, it should be enforced 2. B) Most rule breaking is a result of the actions of a few employees 3. C) Organizations should have as many rules and regulations as possible so employees are clear about what they are to do 4. D) Managers should increase monitoring efforts if a particular rule is constantly broken by many staff members

Ans: A Feedback: If a rule or regulation is worth having, it should be enforced. When rule breaking is allowed to go unpunished, other people tend to replicate the behavior of the rule breaker. An organization can have too many rules making enforcement very difficult. Evaluation of a rule that is being constantly broken is more effective than simple increased monitoring.

Which statement about the proper placement of employees within the organization is correction? 1. A) It occurs when an attempt is made to place employees in units where they have the greatest chance of success 2. B) It is overrated as a retention strategy because most employees readily adapt to whatever unit on which they are placed 3. C) It refers to placing employees on units that have the greatest need for new staff 4. D) It occurs when employees are able to modify their own personal values and beliefs to coincide with that of the unit on which they are placed

Ans: A Feedback: If employees are placed where they have the greatest chance of success, employee morale and retention will be positively affected. None of the other options are accurate statements.

Which is an appropriate strategy for planning, conducting, and controlling the interview? 1. A) When an applicant clearly does not have the proper qualifications for a position, the interviewer should be tactful, but advise the applicant as soon as possible that there is a lack of appropriate qualifications for the job 2. B) Personal questions should be asked early during the interview process so a rapport can be established between the interviewer and the applicant 3. C) The interviewer should develop questions that can be answered with a yes or no answer 4. D) The interviewer should assess an applicant's perceptive skills by sending nonverbal cues to the applicant during his or her responses

Ans: A Feedback: In situations in which the interviewee is not qualified for the position, the interviewer must inform the interviewee of this early and tactfully. After the interview is completed, the interviewer should take notes for the file of the exact reason for rejection in case of later discrimination charges. None of the other options identify an appropriate strategy.

Which statement describes the induction phase of employee indoctrination? 1. A) It occurs after hiring but before performing the role 2. B) It includes the activities performed by the personnel department 3. C) It relates to the information included in the employee's handbook 4. D) It is the responsibility of the staff development department

Ans: A Feedback: Induction, the first phase of indoctrination, includes all activities that educate the new employee about the organization and personnel policies and procedures before actually assuming nursing responsibilities. None of the other options identify that phase accurately.

What type of interview questions are difficult to respond to without some advance thought? 1. Personal philosophy of nursing 2. Professional organizations membership 3. Individual strengths and weaknesses 4. Career goals 1. A) 1, 3, 4 2. B) 1, 2, 3 3. C) 1, 2, 4 4. D) 2, 3, 4

Ans: A Feedback: It is difficult to spontaneously answer interview questions about your personal philosophy of nursing, your individual strengths and weaknesses, and your career goals if you have not given them advance thought.

How does a leader effectively use a performance appraisal? 1. A) To motive staff 2. B) To identify staff educational needs 3. C) To follow up on identified deficiencies 4. D) To provide feedback on work performance

Ans: A Feedback: Leaders use the appraisal process to motivate employees and promote growth. The remaining options are manager responsibilities.

Which statement is true regarding chemical addiction among nursing professionals? 1. A) Most chemically impaired nurses obtain drugs by stealing them from work 2. B) Morphine is the most commonly abused drug by nurses 3. C) Most nurses obtain their drugs on the street and avoid taking drugs from work 4. D) Most chemically impaired nurses cannot be diverted from drug use

Ans: A Feedback: Most chemically impaired nurses abuse drugs they were taking for legitimate health reasons, or they steal drugs from work. The remaining options are not statements supported by research.

What is a leadership role associated with staffing and scheduling? A) Role models the use of evidence in making appropriate staffing and scheduling B) Uses organizational goals and patient classification tools to minimize understaffing 3. C) Periodically examines the unit standard of productivity to determine if changes are needed 4. D) Evaluates scheduling and staffing procedures and policies on a regular basis

Ans: A Feedback: Role modeling is a leadership responsibility. The other options are recognized management responsibilities associated with staffing and scheduling.

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? 1. A) Provide a verbal warning that includes the rules related to personal telephone calls 2. B) Determining whether there is a legitimate personal problem that justifies the telephone calls 3. C) Presenting the nursing aide with a formal written reprimand 4. D) Suspending the nursing aide for a week

Ans: A Feedback: The best choice of action in this case would be to provide an explanation for the rule and proceed to give a verbal admonishment. Since this is a new infraction, the progressive discipline starts with a verbal warning again and none of the other options.

Which factor is considered the greatest obstacle to solving the projected nursing shortage? 1. A) Lack of nursing faculty 2. B) Expense of nursing education 3. C) Lack of interest in nursing as a career 4. D) Poor social respect of the nursing profession

Ans: A Feedback: The nursing faculty shortage will likely be the greatest obstacle to solving the projected nursing shortage. None of the other options have the impact on the nursing shortage that the lack of nursing faculty has on the projected nursing shortage.

When was the veteran generation born? 1. A) 1925 to 1942 2. B) 1943 to early 1960s 3. C) Early 1960s to 1980 4. D) Late 1970s to 1986

Ans: A Feedback: The veteran generation is typically recognized as those nurses born between 1925 and 1942.

An increasingly common staffing and scheduling alternative is the use of supplemental nursing staff such as agency nurses or travel nurses. Which statement is correct about agency nurses or travel nurses? 1. A) Work for premium pay 2. B) Employed directly by the health-care agency 3. C) Result in increased continuity of nursing care 4. D) They receive the standard facility benefits

Ans: A Feedback: These nurses are usually directly employed by an external nursing broker and work for premium pay (often two to three times that of a regularly employed staff nurse), without benefits. While such staff provide scheduling relief, especially in response to unanticipated increases in census or patient acuity, their continuous use is expensive and can result in poor continuity of nursing care.

Which statement is accurate when describing performance deficiency coaching? 1. A) It is less spontaneous and requires more planning than ongoing coaching 2. B) It is a one-time way of solving problems 3. C) It requires the manager to assume the role of enforcer rather than supporter or enabler 4. D) It occurs as a component of an employee's annual performance appraisal

Ans: A Feedback: This form of coaching is less spontaneous and requires more managerial planning than ongoing coaching. In performance deficiency coaching, the manager actively brings areas of unacceptable behavior or performance to the attention of the employee and works with him or her to establish a plan to correct deficiencies.

Which method rates a person against a set standard, which may be the job description, desired behaviors, or personal traits? 1. A) Trait Rating Scale 2. B) Checklist 3. C) Essay 4. D) MBOs

Ans: A Feedback: Trait Rating Scale is a method of rating a person against a set standard, which may be the job description, desired behaviors, or personal traits. The Trait Rating Scale has been one of the most widely used of the many available appraisal methods. None of the other options rates a person against a set standard.

In checking the background of a potential candidate for hire, which is the least frequently checked source? 1. A) Academic credentials 2. B) References of former employers 3. C) References of recent teachers 4. D) Verification of work history

Ans: A Feedback: Academic credentials are the least frequently checked background information. All of the other options are frequently checked.

What is the most common initial response of an employee to a manager's confrontation regarding suspected chemical impairment? 1. A) Emphatic denial and defensiveness 2. B) Reluctant acceptance 3. C) Gratefulness for finally being discovered 4. D) Silence

Ans: A Feedback: Employee denial and defensiveness are common behaviors in those who are confronted with their impairment. Often, these individuals are in self-denial.

When do nursing shortages historically occur? 1. A) When the economy is beginning an upswing 2. B) When the economy is receding 3. C) When nursing salaries decline 4. D) When patient acuity increases

Ans: A, B Feedback: Historically, nursing shortages occur when the economy is on the upswing and decline when the economy recedes. Historically, salaries were not a factor in existing nursing shortages. Currently, as the nursing pool ages, there is a nursing shortage projected.

Health disparities in the patient care population are most likely to occur when the health-care workforce lacks diversity in which area? Select all that apply. 1. A) Age 2. B) Gender 3. C) Ethnicity 4. D) Education

Ans: A, B, C Feedback: The workforce should also reflect the gender, culture, ethnicity, age, and language diversity of the communities that the organization serves. The lack of ethnic, gender, and generational diversity in the workforce has been linked to health disparities in the populations served. The importance of this goal cannot be overstated. The remaining options do not have the impact that the correct options have on this situation.

Which factor affects the accurate prediction of staffing needs? Select all that apply. 1. A) When staff resignations historically occur 2. B) How long new hires usually stay employed 3. C) Education of current nursing staff members 4. D) Third-party insurer reimbursement levels

Ans: A, B, C, D Feedback: Accurately predicting staffing needs is a crucial management skill because it enables the manager to avoid staffing crises. Managers should know the usual length of employment of newly hired staff and peak staff resignation periods. In addition, managers must consider the education and knowledge level of needed staff and have a fairly sophisticated understanding of third-party insurer reimbursement since this has a significant impact on staffing in contemporary health-care organizations.

Which external and internal forces must a manager adjust for when implementing the PCSs associated with unit staffing? Select all that apply. 1. A) Presence of nursing students on the unit 2. B) The hiring of two graduates as staff 3. C) The increase of scheduled medical students 4. D) Language barriers presented by nursing staff

Ans: A, B, C, D Feedback: Regarding PCS, the middle-level manager must be alert to internal or external forces affecting unit needs that may not be reflected in the organization's patient care classification system. Examples of such forces could be a sudden increase in nursing or medical students using the unit, a lower skill level of new graduates, or cultural and language difficulties of recently hired foreign nurses. The organization's classification system may prove to be inaccurate, or the hours allotted for each category or classification of patient may be inaccurate (too high or too low). An anxious patient is not a force that should affect the staffing process.

Which statement is true regarding the float pool nurse? Select all that apply. 1. A) They are classified as per-diem staff 2. B) The nurse trades increased personal flexibility for less pay 3. C) Float pool nurses do not receive usual staff benefits 4. D) They are crossed trained on multiple units

Ans: A, D Feedback: Some hospitals have created their own internal supplemental staff by hiring per-diem employees and creating float pools. Per-diem staff generally have the flexibility to choose if and when they want to work. In exchange for this flexibility, they receive a higher rate of pay but usually no benefits. Float pools are generally composed of employees who agree to cross-train on multiple units so that they can work additional hours during periods of high census or worker shortages. Float pools are adequate for filling intermittent staffing holes but, like agency or registry staff, they are not an answer to the ongoing need to alter staffing according to census since they result in a lack of staff continuity.

Which statement accurately describes a disciplinary conference? 1. A) It is generally a highly charged emotional event, so the manager should try to soften criticisms to reduce the employee's defensiveness 2. B) It should be scheduled in advance at a time agreeable to both the employee and the manager 3. C) When it is held in front of peers it can be used as a teaching tool 4. D) It requires the manager to adopt nurturing and counseling roles

Ans: B Feedback: All formal disciplinary conferences should be scheduled in advance at a time agreeable to both the employee and the manager. Both will want time to reflect on the situation that has occurred. Allowing time for reflection should reduce the situation's emotionalism and promote employee self-discipline, because employees often identify their own plan for keeping the behavior from recurring. None of the other options accurately describe this process.

What is the term used to identify the effect that results when some negative aspect of an employee's performance unduly influence all other aspects of performance? 1. A) A halo effect 2. B) A horns effect 3. C) Central tendency 4. D) A job dimension scale

Ans: B Feedback: Data should be gathered from many different sources and must reflect the entire time period of the appraisal to avoid the horns effect, which is when some negative aspect of an employee's performance unduly influences all other aspects of his or her performance. None of the other options accurately identifies this outcome.

What should the manager do in completing an annual performance appraisal? A) Consider good intentions as well as actual performance B) Base the appraisal on a standard to which all are held accountable C) Always make an effort to include subjective data D) Closely observe the employee for the 2 weeks preceding the appraisal conference

Ans: B Feedback: For an objective appraisal, the manager must have a fair performance appraisal tool that is used for all employees in the same classification.

In preparation for an appraisal conference, how many days of advanced notice will the manager give the employee? 1. A) 1 2. B) 2 to 3 3. C) 4 to 5 4. D) 6 to 7

Ans: B Feedback: Give the employee 2- to 3-day advance notice of the scheduled appraisal conference so that he or she can be prepared mentally and emotionally for the interview.

What factor contributes most to a performance appraisal being viewed as relevant by the employees? 1. A) Its influence on whether a raise will be awarded 2. B) Belief that it is based on the performance of job descriptionñrelated tasks 3. C) The perception that the manager truly likes and approves of them personally 4. D) The formality with which the appraisal is conducted and presented

Ans: B Feedback: If employees believe that the appraisal is based on their job description rather than on whether the manager approves of them, they are more likely to view the appraisal as relevant. The remaining options are not viewed as being factors in the view that the appraisal is relevant.

What does indoctrination include for an employee? 1. Induction 2. Orientation 3. Socialization 4. Continuing Education A) 1, 3, 4 2. B) 1, 2, 3 3. C) 1, 2, 4 4. D) 2, 3, 4

Ans: B Feedback: Indoctrination consists of induction, orientation, and socialization of employees.

What is the relationship between the national and local economy and an organization's ability to maintain an adequate workforce? 1. A) When the economy is on an upswing, many unemployed nurses return to work and recruitment becomes easier 2. B) When a recession occurs it causes many part-time nurses to return to full-time employment and others to delay their retirement 3. C) Although the economy tends to affect the size of the blue-collar workforce, professions such as nursing remain fairly stable regardless of economic changes 4. D) When there is an economic downturn, many nurses reduce their work hours from full time to part time

Ans: B Feedback: Nursing shortages occur when the economy is on the upswing and decline when the economy recedes, because many unemployed nurses return to the workforce and part- time employees return to full-time employment. None of the other options identify that relationship.

What has research shown regarding interviewing reliability? A) Interviewer reliability is high if the interview is unstructured B) Interviewer reliability improves if the interview is structured uniformly C) Reliability increases when there is a team approach to the interview D) Positive information is weighed more heavily than negative information

Ans: B Feedback: Reliability means that something is measured consistently time after time. Therefore, if more than one interviewer uses the same format to interview a candidate, the reliability of the interviews improves. None of the other options identify the research findings.

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 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 patients to determine how courteous the ward clerk is when answering call lights from the unit desk. What is this an example of? 1. A) Peer review 2. B) A 360-degree evaluation 3. C) An overreaching performance review 4. D) An anecdotal performance review

Ans: B Feedback: Seeking feedback from patients, staff, and other departments who interact with an employee to determine his or her effectiveness in his or her job is called a 360-degree evaluation. None of the other options are associated with the scenario described.

Which statement is true regarding the Behaviorally Anchored Rating Scale (BARS)? 1. A) Has long been used as a performance appraisal tool in the health-care industry 2. B) Requires that a separate rating form be developed for each job classification 3. C) Is often referred to as a free-form review 4. D) Is a rapidly scored and administered performance appraisal tool

Ans: B Feedback: The BARS key areas of responsibility are delineated and ranked by importance. This system reduces subjectivity, but has the drawback of being time-consuming.

What does the Joint Commission advocate about employee performance appraisals? A) They be conducted at least every 6 months 2. B) They be based on employee job descriptions 3. C) They be documented by anecdotal notes 4. D) They be reflective of employees' personal goals

Ans: B Feedback: The Joint Commission advocates that employee performance appraisals be based on employee job descriptions. None of the other options are identified for this purpose.

Since 2008 what is the legal minimum staffing radios for a medicalñsurgical nursing unit? 1. A) 1:4 2. B) 1:5 3. C) 1:6 4. D) 1:7

Ans: B Feedback: The expected legal ratio is 1:5.

What is the priority goal for a manager with regard to staffing and scheduling? A) Schedule staff so there is no overtime 2. B) Ensure that there is adequate staff to meet the needs of each patient 3. C) Develop trust in staff by seeing that staffing is carried out in a fair manner 4. D) Ensure that staff members usually have days off and special requests granted

Ans: B Feedback: The manager is tasked with seeing that patient care needs are met first and foremost. While the other options are relevant, they are not the priority goal of the manager.

The manager may be greatly or minimally involved with recruiting, interviewing, and selecting personnel. What factors are important to consider in this process? 1. Size of the institution 2. Existence of a separate personnel department 3. Presence of a nurse recruiter within the organization 4. Use of decentralized nursing management system only 1. A) 1, 3, 4 2. B) 1, 2, 3 3. C) 1, 2, 4 4. D) 2, 3, 4

Ans: B Feedback: The manager may be greatly or minimally involved with recruiting, interviewing, and selecting personnel depending on (a) the size of the institution, (b) the existence of a separate personnel department, (c) the presence of a nurse recruiter within the organization, and (d) the use of centralized or decentralized nursing management.

There are advantages and disadvantages to each type of scheduling. What is true about extending the workday with 10- or 12-hour shifts? 1. Requires overtime pay 2. Increases nurse satisfaction 3. Decreases cost 4. Increases judgment errors 1. A) 1, 2, 3 2. B) 1, 2, 4 3. C) 1, 3, 4 4. D) 2, 3, 4

Ans: B Feedback: There are advantages and disadvantages to each type of scheduling. Twelve-hour shifts have become commonplace in acute care hospitals even though there continues to be debate about whether extending the length of shifts results in increased judgment errors related to fatigue. Because extending the workday with 10- or 12-hour shifts may require overtime pay, the resultant nurse satisfaction must be weighed against the increased costs.

Which is the most accurate statement regarding staffing and scheduling policies? 1. A) It is more important to communicate policies verbally than in writing 2. B) It is necessary that policies are written in a manner that allows some flexibility 3. C) Policies should focus on the process 4. D) Managers should have autocratic control over scheduling and staffing policies

Ans: B Feedback: To retain employees, the staffing policies must allow some flexibility, which could include job sharing, flextime, a part-time staffing pool for weekends, or allowing employees to exchange hours of work among themselves.

What term identifies a system that allows employees to select among variations in work start-time schedules to meet their personal needs? 1. A) Self-scheduling 2. B) Flextime 3. C) Decentralized staffing 4. D) Cyclical staffing

Ans: B Feedback: When a hospital uses flextime, employees arrive at the unit and leave at many different times. The other options are not associated with the system described.

Which statement correctly describes using self-appraisal as a performance appraisal tool? 1. A) It should always be totally unstructured so employees can write about whatever they want to 2. B) It is effective because most employees are self-aware and rate themselves accurately and appropriately 3. C) It works best when used in conjunction with other appraisal tools 4. D) It relieves the manager of the responsibility for preparing the performance appraisal

Ans: C Feedback: Because employees cannot be objective concerning their own performance, a self- appraisal is most effective when used in conjunction with other appraisal tools. The remaining options are incorrect statements regarding self-appraisal tools.

Which statement about the role of unit managers in recruitment and selection is accurate? 1. A) The more centralized nursing management is and the more complex the personnel department, the greater the involvement of the unit manager 2. B) Unit managers should always leave such decisions to a centralized personnel department so consistency can be maintained 3. C) Regardless of the extent of their involvement, all managers must be aware of recruitment and selection constraints within their organization 4. D) Unit managers should assume total responsibility for recruitment and selection of personnel on their units

Ans: C Feedback: Although some institutions have personnel departments and nurse recruiters to carry out most of the hiring responsibilities, the nurse-manager must understand how recruitment and selection are accomplished within the organization. None of the remaining options are accurate statements concerning recruiting.

Which statement accurately reflects self-appraisals? 1. A) Self-appraisals are more objective than the other types of appraisals 2. B) Self-appraisals provide an opportunity to give positive feedback to employees 3. C) Self-appraisals usually require some introspection on the part of the employee 4. D) Self-appraisals should be read before the supervisor does an appraisal

Ans: C Feedback: Although they require some work on the employees' part, self-appraisals can provide introspection and personal growth. The remaining options are not accurate statements.

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? 1. A) Tell the employee that he or she is not performing well and ask the employee where improvement is needed 2. B) Prepare a list of the employee's deficiencies and give him or her time to look it over before asking for a response 3. C) Recognize the employee's strengths, focus on one or two key deficiencies, and create a long-term coaching plan 4. D) Tell the employee that he or she is liked as a person but is not meeting the requirements for the job and will need to brush up on skills during the next year

Ans: C Feedback: An employee who is overwhelmed with negative feedback during the performance appraisal cannot grow as a result of the appraisal. The manager should recognize the employee's strengths, focus on one or two key deficiencies, and create a long-term coaching plan.

What would be the most appropriate level of employee discipline for a first infraction of gross mistreatment of a patient? 1. A) Suspension with pay 2. B) Suspension without pay 3. C) Termination 4. D) Written admonishment

Ans: C Feedback: For a first infraction of gross mistreatment of a patient, the most appropriate level of employee discipline would probably be termination. The organization's first responsibility is in the protection of patients.

Which is the best example of coaching used to encourage and improve daily work performance? 1. A) ìLet's discuss how to improve your charting notes.î 2. B) ìDid you enjoy working as team leader this weekend?î 3. C) ìWould you consider taking on the role of preceptor?î 4. D) ìYour interpersonal skills have shown great improvement.î

Ans: C Feedback: For coaching to be effective, it must be specific, not self-serving, directed toward behavior that can be changed, well timed, and understood by the employee. This is the only option that fulfills those criteria.

Which statement concerning the recognition of chemical impairment in an employee is correct? 1. A) It is relatively easy to identify employees who are chemically impaired 2. B) It is easier to recognize if the employee is impaired by alcohol than by drugs 3. C) Impairment should result in an immediate intervention by the manager 4. D) Impairment must be supported by data gathering before intervention occurs

Ans: C Feedback: For safety reasons and to protect clients, employees should be confronted as soon as possible after chemical impairment is recognized. None of the remaining options are true statements regarding the recognition of a chemically impaired employee.

What increases the likelihood that the performance appraisal will have a positive outcome? 1. A) The manager refrains from making any comments about the worker's performance 2. B) The employee is encouraged to identify three areas of satisfactory performance 3. C) The employee provides input into developing the performance standards 4. D) The manager identifies not more than three areas of deficient performance

Ans: C Feedback: If the employee has some input into developing the standards or goals on which his or her performance is judged, there is more of a chance that the appraisal will have a positive outcome. The remaining options fail to contribute to an effective performance appraisal.

Which is an outcome of decentralized staffing? 1. A) Increased fairness to employees through consistent, objective, and impartial application 2. B) Cost-effectiveness through better use of resources 3. C) Greater manager autonomy to control the staffing on the units, resulting in an increase in self-esteem and teamwork 4. D) Increased availability of data for monitoring the effect of staffing size and composition, quality of care, and costs

Ans: C Feedback: In an institution that has no human resources department and no nurse recruiters, the unit manager does the hiring and has greater autonomy in personnel matters. The other options are not associated with decentralized staffing.

In performance management, appraisals are eliminated. What does the manager do in place of the appraisal? 1. Periodical coaching 2. Mutual goal setting 3. Leadership training of subordinates 4. Employee accountability for own actions 1. A) 1, 2 2. B) 1, 4 3. C) 2, 3 4. D) 3, 4

Ans: C Feedback: In performance management, appraisals are eliminated. Instead, the manager places his or her efforts into ongoing coaching, mutual goal setting, and the leadership training of subordinates.

What is the outcome when a manager provides vague and ambiguous feedback to an employee during a performance appraisal? 1. A) The employee receives the information in a positive manner 2. B) The manager is able to avoid the appearance of being too negative 3. C) The employee is uncertain of the value of the feedback 4. D) The manager is viewed as being an ineffective communicator

Ans: C Feedback: Indirectness and ambiguity are more likely to inhibit communication than enhance it, and the employee is left unsure about the significance of the message. The employee is not likely to feel positive about the process. When the feedback is present appropriately, the manager will not be viewed as too negative but rather honest and helpful.

Why have health-care organizations been slow to adopt peer review? 1. A) It tends to be an inaccurate performance appraisal tool 2. B) Colleagues generally have little data they can contribute regarding a peer's work performance 3. C) It requires staff be oriented to the process effectively 4. D) It works better for professionals such as physicians than for nurses

Ans: C Feedback: Peer review is effective only when adequate time is spent orienting staff to the process and the necessary support is provided to complete the process. The remaining options are not generally considered barriers to the use of peer reviews.

What must be completed before a position is offered? A) Physical examination 2. B) Preemployment testing 3. C) Reference check 4. D) Personal interview

Ans: C Feedback: Positions should never be offered until information on the application has been verified and references have been checked.

Which statement is true regarding legislated minimum staffing ratios? 1. A) They are mandated by federal law 2. B) They are required by 28 states 3. C) They are proposed to improve patient care 4. D) They are necessary to reduce costs

Ans: C Feedback: Several states have proposed or passed mandatory staffing ratios for the purpose of improving patient care, although there is no guarantee improved care will result from such legislation. None of the other options are associated with minimum staffing ratios.

What A) Accept the resume as an honest and objective source of data regarding the should selectors do when processing the employment application? applicant 2. B) Require a physical examination before making a hiring decision 3. C) Always follow up on references and verify employment history 4. D) Use unsolicited personal information about an applicant as a valid reason for job disqualification

Ans: C Feedback: Some managers prefer to verify credentials and references before the interview; others do it after the interview. Either way, doing a comprehensive check of credentials and references is of absolute importance. None of the other options identify the selector's processing role.

Which term is used to identify the effect that occurs when the appraisal is based on recent performance over less recent performance during the evaluation period? 1. A) Halo 2. B) Horns 3. C) Recency 4. D) Mathew

Ans: C Feedback: Taking regular notes on employee performance is a way to avoid the recency effect, which favors appraisal of recent performance over less recent performance during the evaluation period. None of the other options accurately identifies this effect.

Which statement concerning self-discipline is true? 1. A) It is one of the least effective forms of discipline 2. B) It decreases as an awareness of the rules and regulations that govern behavior increases 3. C) It increases when employees identify with the goals of the organization 4. D) It is internalized, and thus the leader can do little to create an environment that promotes self-discipline in employees

Ans: C Feedback: The highest level and most effective form of discipline is self-discipline. When employees feel secure, validated, and affirmed in their essential worth, identity, and integrity, self-discipline is enhanced.

What outcome is associated with a good PCS? A) It eliminates most staffing problems 2. B) It decreases the amount of overtime 3. C) It provides an understanding of staffing problems 4. D) It eliminates the need for adjustment or review

Ans: C Feedback: The main strength of the PCS is that it provides data with which to make staffing decisions. It will not solve all staffing problems, and it will not replace a manager's judgment.

What action will the manager take when implementing the second step in the progressive disciplinary process? 1. A) Suspend the employee from work for a specified period of time 2. B) Explain in detail the nature of the inappropriate behavior 3. C) Complete a formal written reprimand 4. D) Verbally instruct the employee not to repeat the infraction

Ans: C Feedback: The second step in the progressive disciplinary process is for the manager to complete a formal written reprimand signed by the employee and the manager. The second step in the progressive disciplinary process does not involve any of the other options.

What should an employee expect when a manager terminates his/her employment for continuous rule breaking? 1. A) The employee will be escorted from the building by security staff 2. B) The employee will be allowed to work out a 2-week termination period 3. C) The manager will describe what, if any, references will be supplied to future employers 4. D) The manager will arrange for a meeting between the employee and senior administration

Ans: C Feedback: When a manager terminates an employee for continuous rule breaking, the manager should tell the employee what, if any, references will be supplied to future employers. The remaining options are not generally associated with such a termination.

What generational work group values the more flexible part-time and 12-hour shift options? 1. A) Veteran generation 2. B) Baby boomer 3. C) Generation X 4. D) Generation Y

Ans: C Feedback: ìGeneration Xersî (born between 1961 and 1981), a much smaller cohort than the baby boomers who preceded them, or the Generation Yers who follow them, may lack the interest in lifetime employment at one place that prior generations have valued, instead valuing greater work hour flexibility and opportunities for time off.

What is the most fiscally responsible method for determining staffing needs for a hospital unit? 1. A) Maximum patient load capacity of the unit 2. B) Numbers of patients present for an upcoming shift 3. C) An agreed-upon staffing formula currently in use 4. D) Total beds on the unit

Ans: C Feedback: A staffing formula is the best way to determine staffing needs, provided it is based on an accurate patient classification system (PCS). The remaining options are not as fiscally responsible since they involve uncontrollable factors.

What factor contributed significantly to the beginning of the acute RN shortage that originated in the late 1990s? 1. A) Closing of nursing programs 2. B) Lack of interest in nursing 3. C) Hospital downsizing 4. D) Poor nursing salaries

Ans: C Feedback: Hospital downsizing and shortsightedness regarding recruitment and retention contributed to the beginning of an acute shortage of RNs in many health-care settings by the late 1990s. None of the other options were significant contributors to the nursing shortage that began in the late 1990s.

What is an advantage of centralized staffing? Select all that apply A) It is flexible B) It is staff focused C) It is cost-effective D) It is consistent and impartial

Ans: C, D Feedback: Centralized staffing is generally fairer to all employees because policies tend to be employed more consistently and impartially. In addition, centralized staffing frees the middle-level manager to complete other management functions. Centralized staffing also allows for the most efficient (cost-effective) use of resources because the more units that can be considered together, the easier it is to deal with variations in patient census and staffing needs. Centralized staffing, however, does not provide as much flexibility for the worker, nor can it account as well for a worker's desires or special needs. In addition, managers may be less responsive to personnel budget control if they have limited responsibility in scheduling and staffing matters.

Which factor is the focus of an individual's performance evaluation? 1. A) Related knowledge 2. B) Individual skills 3. C) Appropriate experience 4. D) History of task completion

Ans: D Feedback: A competence assessment evaluates whether an individual has the knowledge, education, skills, or experience to perform the task, whereas a performance evaluation examines how well that individual actually completes that task.

What occurs when RN hours decrease in a unit's calculation of nursing care hours per patient day (NCH)/(PPD)? 1. A) Adverse patient outcomes generally increase 2. B) Decreased errors 3. C) Decreased patient falls 4. D) Decreased patient satisfaction

Ans: D Feedback: A review of current literature suggests that as RN hours decrease in NCH/PPD, adverse patient outcomes generally increase, including increased errors and patient falls as well as decreased patient satisfaction.

Which statement is correct concerning prenegotiated budget management? 1. A) It is incompatible with ethical accountability 2. B) It is only the responsibility of the centralized staffing office 3. C) It is inappropriate with new practice models 4. D) It is a critical responsibility of managers

Ans: D Feedback: Accountability for a prenegotiated budget is a management function. The other options are incorrect regarding this function.

What does the filing of a grievance by an employee do? A) It serves as evidence that a manager's actions have been unfair or arbitrary B) It means that the conflict will have to be resolved in arbitration C) It negates the need for the manager to attempt to solve the conflict through communication, negotiation, compromise, or collaboration D) It requires a great deal of time and energy from both the employee and the manager

Ans: D Feedback: Although grievance procedures extract a great deal of time and energy from both employees and managers, they serve several valuable purposes. However, most grievances or conflicts between employees and management can be resolved informally through communication, negotiation, compromise, and collaboration before grievance procedures need to be undertaken. The remaining options are not the result of a grievance filing.

What positive impact do new practice models have on the staffing mix? A) Automatically cancel the PCS B) Will result in fiscal savings C) Require no changes in scheduling policies D) Impact patient care assignment methods

Ans: D Feedback: As new practice models are introduced, there must be a simultaneous examination of the existing staff mix and patient care assessments to ensure that appropriate changes are made to the staffing and scheduling policies. They are not associated with the impact suggested by the other options.

What is the primary difference between constructive and destructive discipline? A) The manager is friendlier to the employee in constructive discipline than in destructive discipline, so that the employee likes the manager as a person B) Constructive discipline includes verbal and written reprimands, whereas destructive discipline includes suspension without pay and termination C) The person who has received constructive discipline always appreciates and believes the feedback given, whereas it is resented and disbelieved in destructive discipline D) Constructive discipline helps the person to grow and to behave in a manner that allows him or her to be self-directive in meeting organizational goals. Destructive discipline focuses more on punishment

Ans: D Feedback: Constructive discipline uses discipline as a means of helping the employee grow. It is not used as a punitive measure. Destructive discipline focuses more on punishment. The remaining options are not necessarily true statements

Which statement about PCSs is accurate? 1. A) Classification systems are able to solve staffing problems 2. B) Nursing care hours assigned to a classification system should remain constant 3. C) A good classification system is without fault 4. D) Internal and external forces may affect classification systems

Ans: D Feedback: Examples of internal and external forces that may affect a PCS are a sudden increase in nursing or medical students using the unit, a lower skill level of new graduates, or cultural or language difficulties of recently hired foreign nurses. None of the remaining options is totally accurate because of uncontrollable factors.

Which question asked during an interview is acceptable? 1. A) Are you married? 2. B) Have you ever been arrested? 3. C) What is your religious preference? 4. D) What professional organizations do you belong to?

Ans: D Feedback: It is lawful for an interviewer to ask about professional organizations, but the interviewer cannot ask the interviewee to produce a list of all memberships. None of the other options identify an acceptable question.

What type of evaluation has been proved to increase productivity and commitment in employees? 1. A) Rating scale 2. B) Checklist 3. C) Essay 4. D) MBO

Ans: D Feedback: MBO has been proved to increase productivity and commitment in employees. Research does not support that claim related to the other options.

How do managers view their responsibility to discipline staff? 1. A) It is a necessary means for controlling an unmotivated and self-centered workforce 2. B) It is a ìBig stickî that management can use to eliminate behavior that conflicts with organizational goals 3. C) It is a means to assist in the development of self-discipline in an employee 4. D) It is necessary to the organization if established rules are to be enforced

Ans: D Feedback: Managers use discipline to enforce established rules, policies, and procedures. The other options are very limited views regarding discipline.

What must staff and scheduling policies not violate? 1. Local laws 2. Labor laws 3. State or national laws 4. Union contracts 1. A) 1, 2, 3 2. B) 1, 2, 4 3. C) 1, 3, 4 4. D) 2, 3, 4

Ans: D Feedback: Staffing and scheduling policies must not violate labor laws, state or national laws, or union contracts.

What does the employee's signature on the performance appraisal form denote? A) The employee agrees with everything written on the form B) The employee objects to what is written on the form C) The employee agrees that a merit raise is due D) The employee has read the appraisal information

Ans: D Feedback: The employee's signature on the performance appraisal form denotes that the employee has received and read the appraisal information. The signature does not mean that the employee agrees with or disagrees with the appraisal.

What is the process involved in progressive discipline? A) A written warning precedes verbal warnings 2. B) Formal warnings are followed up with informal warnings 3. C) Written warnings are advocated only in the most serious of offenses 4. D) The initial step is the delivery of a verbal warning by the manager

Ans: D Feedback: The first step of the progressive disciplinary process is an informal reprimand or verbal warning. This reprimand is followed by a formal reprimand or written warning when the behavior has not been changed.

What should the interviewer do to increase the reliability and validity of an interview? 1. A) Conduct single, rather than multiple, interviews 2. B) Trust his or her first impressions of an applicant 3. C) Avoid taking notes during the interview 4. D) Develop a structured interview format

Ans: D Feedback: The same structured interview should be used for all employees applying for the same job classification. None of the other options identify an appropriate technique.

What is the manager's role when dealing with employees who break the rules? A) To terminate their employment 2. B) To be a good listener 3. C) To act as counselor 4. D) To ensure organizational goals are met

Ans: D Feedback: To act as coach and supporter, counselor, or good listener could be enabling to the employee who breaks the rules. The manager should be humanistic, however, and not scold or blame. Not all situations would result in employment termination.

Which statement most accurately describes how discipline in a unionized organization may vary from one that is nonunionized? 1. A) Nonunionized organizations require a demonstration of just cause, whereas unionized organizations do not 2. B) Discipline in nonunionized organizations tends to entail more procedural, legalistic safeguards than unionized organizations 3. C) Only unionized organizations have grievance procedures 4. D) Unionized employees must generally be disciplined according to specific steps and penalties within an established time frame

Ans: D Feedback: Unionized employees must generally be disciplined according to specific, pre- established steps and penalties within an established time frame. The remaining options do not accurately describe unionized organizational discipline procedures.

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) Halo effect B) Horns effect C) Central tendency D) A job dimension scale

B

Interviews at a large health-care organization are conducted by various individuals and groups, due to the high number of positions and applicants. What action will best ensure interrater reliability when different individuals are conducting interviews? A) Use a semi-structured format and have interviewers practice with one another B) Create a structured interview format and adhere to it closely C) Have at least two, but not more than four, interviewers conduct each interview D) Use yes-no questions whenever possible, rather than open-ended questions

B

What goal should the nurse-manager prioritize when organizing staffing and scheduling? A) Schedule staff so there is a minimum of overtime B) Ensure that there is adequate staff to meet the needs of each client C) Develop trust in staff by seeing that staffing is carried out in a fair manner D) Ensure that staff members achieve a healthy work-life balance

B

What should the manager do in completing an annual performance appraisal? A) Consider the employee's good intentions as well as actual performance B) Base the appraisal on a standard to which all are held accountable C) Prioritize subjective data over objective data whenever possible D) Closely observe the employee for several days preceding the appraisal conference

B

Which statement about the role of unit managers in recruitment and selection is accurate? A) The more centralized nursing management is and the more complex the personnel department, the greater the involvement of the unit manager. B) Unit managers should always leave such decisions to a centralized personnel department so consistency can be maintained. C) Regardless of the extent of their involvement, all managers must be aware of recruitment and selection constraints within their organization. D) Unit managers should assume total responsibility for recruitment and selection of personnel on their units.

C

Which statement identifies an important consideration when using management by objectives (MBO) as a performance appraisal tool?

C) The manager's role is supportive, assisting employees to reach goals by counseling and coaching

A novice nurse-manager admits to feeling nervous about the possibility of disciplining employees. How should the manager be encouraged by superiors to view discipline? A) As a necessary means for controlling an unmotivated and self-centered workforce B) As a "big stick" that management can use to eliminate behavior that conflicts with organizational goals C) As a means of narrowing the power-authority gap D) As a necessary part of fostering excellence in the organization

D