management test 3
ED waiting room, a patient sitting, head in his hands, who has been waiting for 5 hours for relief. When you approach him to ask him how he is doing he says, "I can't believe that I have to wait this long for help! Do you know what it is like to be in pain for 10 hours?" Your response would be:
"It is frustrating to wait when you are in pain and when you are expecting to receive relief right away."
In designing a new healthcare facility, it is particularly important to pay close attention to safety elements related to violence and aggression in which of the following settings?
1. emergency 2. psychiatry 3. gerontology
Nurses entering into the workforce today are faced with which of the following relationships that could create organizational conflict? (select all that apply)
1. nurse-physician relationship 2. nurse-nurse relationship 3. nurse patient relationship 4. nurse-chief nursing officer relationship 5. nurse-auxiliary personnel relationships
as a unit manager, you chair the unit meetings. For each meeting, you consider and establish the purpose of the meeting. Second, you prepare an agenda. Arrange the following steps in an order that would make the meetings productive and successful. 1. distribute an agenda 2. control the flow of interactions 3. select team members 4. start on time 5. keep the meeting focused and directed toward accomplishing the set objectives
3, 1, 4, 5, 2
The nurse manager frequently interacts with staff and other hospice facility employees. Communication was purposeful because the manager assessed current issues, such as specific satisfactions and dissatisfactions with the newly implemented computerized documentation system. informally, the manager gathered available staff members to address similar learning needs. Many times, staff members were found coaching other staff about improving use of the new system. According to Senge (1990), the activities demonstrated in this example are: a. dialogue, team learning b. resilience, personal mastery c. shared vision, systems thinking d. mental models, teachable moments
A
as a new manager, you are shocked to learn that your unit is still using heparin in heparin locks. You are aware of evidence related to this practice and you want to change this practice as quickly as possible on your unit. you are in which stage of Lewin's stages of change? a. unfreezing b. experiencing the change c. integrating the change d. refreezing
A
complex change situations require that the change leader promote ongoing visioning among staff members. One strategy is to: a. consciously evaluate invisible mental models b. allow for individual outcomes c. encourage cooperative activities d. operate between order and disorder
A
in deciding whether to say no to a request that involves a time commitment, the professional nurse must consider: a. the cost/benefit ration b. the time commitment of coworkers c. ways to buffer saying no d. personal preference
A
the nurse manager of a rehab unit wants to purchase a new anti-embolic stocking. To make a high-quality decision, the nurse manager would: a. involve the rehab staff in the decision b. involve the sales representative c. make the decision alone d. involve administration in the decision
A
the risk manager wants to evaluate the reasons for an increased number of falls on the rehab unit. The risk manager devises a fishbone diagram. A fishbone diagram is a useful tool to: a. identify the root causes of problems b. list possible solutions to problems c. help leaders select the best options d. evaluate the outcomes of decisions made
A
to engage your staff in awareness of their current practice and how it is affirmed or not by evidence, you plan a short series of learning presentations on evidence and sue of heparin and saline to maintain IV patency. you meet with the educator to plan out the goals for each session with the overall purpose of increasing knowledge and awareness of staff and readiness to consider questions related to the IV practice. This learning approach is an example of which change management approach? a. linear b. nonlinear. c. facilitative d. integrative
A
After keeping a log of activities designed to improve time management, the nurse divides the distractions into internal and external sources. The nurse would classify which distraction as internal? a. responding to recurring crises at work or in one's personal life b. unsuccessful attempts to communicate with the unit manager c. talking with potential faculty candidates d. being given unclear job responsibilities
A internal distraction is one that can be controlled only by the person affected; it is important for each of us to recognize and understand the distracters that inhibit our ability to complete tasks and to meet our objectives and goals
When choosing to delegate, the nurse should delegate the task to the most qualified person or to the person he or she wishes to: a. develop b. promote c. punish d. reward
A develop
Which of the following are examples of application of the leadership rounding tool? (select all that apply) a. "what is working well for you during bedside reporting?" b. "what has not worked for you today?" c. " is there someone on your team who deserves special recognition for their efforts in the implementation?" d. "Did you have a good vacation?"
A,B,C,D
in a busy rehabilitation unit, the team manager decided that the best way to reward the staff was to give them a monetary bonus rather than time off. The staff was very concerned about the decision and went to the administration with a number of complaints. Critical thinking is a process that entails a number of steps. What steps did the manager omit? she should have (select all that apply): a. identified the assumptions that were underpinning the issues b. considered the context of the present problem or situation c. gathered data before making her decision and evaluated all possible outcomes d. attained a majority consensus of all staff
ABC
Mrs. Hill, age 68, was hospitalized after a stroke. Recommended that oral feeding be stopped because of her dysplasia. Mr. Hill fed his wife some noodles. According to Thomas' Four Stages of Conflict, in which stage could the nurse have been more effective?
Action
Which of the following exemplifies the predominant conflict management style of nurse managers?
Ann, RN, asks her head nurse if she can go on the permanent evening shift. The head nurse, Rajib, agrees, as long as Ann agrees to be involved in assisting to mentor evening staff in the use of the new clinical information system
Based on Elizabeth's insights and suggestions, you involve pharmacy, only to discover that the change in practice involves practice committees, a medical practice committee, and concerns from administration about potential costs and safety of the proposed change to the IV protocols. The change process at this point is: a. linear b. nonlinear c. sabotaged d. neutral
B
When using the ABC system of managing time, those items coded A include: a. calling the pharmacy to see whether a drug insert is available for a patient b. checking to see why a ventilator is alarming c. organizing the medication cart d. writing memos to remind everyone to contribute to the boss's birthday gift
B
an example of one strategy used to improve participation in the change process by staff fitting the behavioral description of innovators and early adopters is to: a. repeat the benefits of the change b. share change experiences early in the process c. initiate frequent interactions among staff d. provide select information to the staff
B
an inexperienced nurse has heard of other novice nurses who take shortcuts in providing patient care. This nurse feels that this is unacceptable and that all tasks must be performed faultlessly, which leads to her inability to complete all assigned tasks. This nurse would benefit from the seminar "Obstacles to Time Management: How to Deal With: a. creativity." b. perfectionism." c. Failure." d. Downtime."
B
during a fire drill, several psychiatric patients become agitated. The nurse manager quickly assigns a staff member to each patient. The autocratic decision style is most appropriate for: a. routine problems b. crisis situations c. managers who prefer a "telling" style d. followers who cannot agree on a solution
B
staff nurses who gain information on current IV therapy practices are engaging in which phase of Rogers' decision-making process? a. persuasion b. knowledge c. confirmation d. decision
B
when goals/outcomes are somewhat unclear in early preparation for a complex change, the manager and the change management team develop several acceptable goals/outcomes. this change in management approach is termed: a. unfreezing b. nonlinear c. cybernetic d. linear
B
Becky, RN, works as a staff nurse in mental health; Sharon works as a data entry clerk in admissions; Sarah is an ER physician; and Donna is a housekeeper in geriatrics. Which of these four is most at risk for violence and aggression?
Becky
Edith has been vocal about her negative concerns related to a new charting system and frequently expresses the view that keeping the "old system" would have been just fine. In facilitating change, your best approach to Edith would be to: a. put her in the pilot planning group for the change b. determine if she has considered retirement c. scheduler her work assignment so that it coincides with those 3 staff members who are confident with technology and the change d. avoid discussion of the change and trust that with sufficient training and information, she will change
C
Elizabeth is an example of an a. early adopter b. late adopter c. laggard d. register
C
The oncology clinic manager and the educational coordinator asked nursing staff to complete a brief written survey to assess their attitudes and knowledge related to having used the new infusion equipment for 6 weeks. The stage of change in this situation is: a. developing awareness b. experiencing the change c. integrating the change d. perceiving awareness
C
To solve a problem, the nurse manager understands that the most important problem-solving step is: a. the implementation phase b. identification of numerous solutions c. accurate identification of the problem d. evaluation of the effectiveness of problem resolution
C
a novice nurse is unsure of his ability to insert a nasogastric tube for one of the assigned patients who is vomiting coffee ground emesis. The novice nurse waits, hoping that someone with more experience will volunteer to do the job, or hw just waits until the end of the shift. This nurse is practicing: a. energy management b. priority setting c. procrastination d. introspection
C
as the unit manager on the unit that is leading changes to heparin locks, you find that elizabeth is very valuable in terms of her observations about other units and her knowledge of organizational processes, and now in discussing the new procedure with others. Elizabeth might be considered an: a. engager b. innovator c. informal change agent d. informant
C
high-quality decisions are most likely to be made in nursing situations when: a. team leaders made the crucial decisions b. individuals are advised of the problems c. group size is neither too small nor too large d. members are passively involved
C
the home health agency hired an expert in financial management to evaluate and propose a plan for reversing growing expenses and decreasing revenues. The expert is well respected, both personally and professionally, by members living in this small community. to be effective, staff will need to perceive this change agent as: a. trusted, quiet b. flexible, informal c. credible, legitimate d. communicative, personable
C
to conduct a productive meeting, the nurse should: a. provide each person all the time needed to discuss desired topics b. cover all emotional topics first c. create an agenda with specific times allotted for each agenda item d. wait for latecomers and ask for their excuse for being late
C
which of the following would be the most effective response to elizabeth? a. "i understand how you feel, but you are going to have to change." b. "It is unfortunate that you feel this way. Others seem quite excited about the new information." c. " It is difficult sometimes to change what we know very well. Sometimes it can be frightening." d. "perhaps i can arrange some more information sessions for you, so you can see just how important this change is to patient safety."
C
When deciding whether and when a task should be completed, a nurse must: a. complete all tasks as they are thought of to prevent having to take time to consider which is most important b. procrastinate and hope that someone will volunteer to do it. c. ask, "What will happen if I don't complete the task now?" d. view large projects holistically and not as many small pieces
C stopping to evaluate what is going on is important because you may have to readjust your plan and reprioritize in order to reach your goal
A nurse is having difficulty keeping up with the six assigned patients and serving on the ethics committee. In order to take charge of both personal and work life, the nurse focuses on improving physical energy by: (select all that apply) a. telling herself, "I provide safe quality care and will provide this level of care to all my patients." b. taking a deep breath and remaining calm to develop patience c. keeping a bottle of water available to consume a minimum of 24 ounces each shife d. going into the nurses break room every 1.5 hrs to eat a healthy snack and prioritize remaining care e. enrolling in the hospital's fitness program, Nurses Need Nutrition
C, D, E
A patient who has a history of drugs and weapons comes up to you in the hallway and asks you a question. When you respond, he moves closer in to you and puts both hands up on either side of your neck. No one else is in the hallway. Your best response at this point is to:
Calmly ask the patient to remove his hands
In which of the following situations would you, as the head nurse, be concerned about potential safety issues?
Carla, RN, has just ended an abusive relationship with Jake, RN, and he will not leave her alone. You are meeting with Jake today because colleagues on nights have reported that Jake seems to have been intoxicated last night and the previous night.
nurses come from different backgrounds and graduated from different universities. Set of new orders from the manager. Each nurse displays different emotions in response. Nurse A says new orders include too many changes; Nurse B disagrees and verbally indicates why. Thomas' stages of conflict?
Conceptualization
a nurse educator is giving a workshop on conflict. During the sessions, he makes various statements regarding conflict. All of the statements are true except:
Conflict can decrease creativity, thus acting as a deterrent for the development of new ideas.
A nursing instructor is teaching a class on conflict and conflict resolution. She relates to the class that conflict in an organization is important, and that an optimal level of conflict will generate:
Creativity, a problem-solving atmosphere, a strong team spirit, and motivation for its workers.
A student nurse assigned to work with the charge nurse is given the opportunity to help revise the nursing assessment form. She receives several compliments from management and her nursing instructor for her creative suggestions. The student nurse enjoys the project and attention she is receiving and begins to prolong the conclusion of the project. Although she constantly adds new information, she filters this out slowly to others. The student nurse is subject to the time management obstacle of: a. need for perfection b. fear of losing creativity c. unclear goals d. fear of completion
D
Sarah, RN, is one of your most enthusiastic staff and has been to a workshop on preparing educational materials for patients. On the basis of this workshop, she would like to develop an information website for patients who are being admitted to the ward. An appropriate response to Sarah's suggestion would be: a. "That is a great suggestion, but we have no resources for such an expensive undertaking right now." b. "perhaps you can keep that in mind as we redesign our charting system." c. "We have too many seniors as patients, and you know that they don't use technology." d. "There is a great group here that meets to look at technology pilots. Let's see if you can join them and discuss your idea further."
D
When planning, a nurse should: a. delay planning until the "first task of the morning" has been completed b. recognize that rewarding oneself has a negative consequence c. rotate between several tasks to stimulate creativity d. remember that most tasks take longer than anticipated to complete
D
an example of one strategy to improve participation in the change process by staff fitting the behavioral descriptions of laggards, early majority, late majority, and rejectors is to: a. encourage teamwork b. transfer to a different unit c. require attendance at staff meetings d. delegate the roles and tasks of change
D
as the unit manager, you spend a day performing direct patient care and work with a new system that is designed to capture patient documentation at the bedside. During discussions with staff while giving care, you discover that the number of screens that need to be opened during documentation makes charting more complex and time-consuming than traditional manual charting approaches. On the basis of this feedback, you: a. assume that the system is doing what it needs to do b. provide reassurance to staff that the unit has achieved its goals in implementation of the system c. ask some of the staff if they have had similar experiences with the system d. consult chart audit data and end user consultation reports to determine if errors and problems are occurring
D
elizabeth, an RN with approx 15 yrs of service on your unit, walks away fron one of the learning sessions on IV care, and you overhear her telling a colleague that she thought the session was a waste of time because "the unit has been using heparin for years and there has never been any adverse effect." According to Havelock (1973), this comment may originate from failure in which phase of the 6 phases? a. general self-renewal b. choosing the solution c. diagnosing the problem d. building a relationship
D
sue, a nurse manager, has a staff nurse that has been absent a great deal for the past 3 months. a whistleblower gives some information to Sue indicating that the staff nurse will be resigning and returning to school. because of this, Sue decides to do which of the following? a. immediately fire the staff nurse b. speak to the whistleblower and elicit more information c. speak to the staff nurse and ask her to resign d. do nothing
D
the wound care nurse decided to involve those to be affected by change early in the change management process. This can positively result in: a. coordination b. resistance c. anticipation d. participation
D
to effectively achieve a change goal/outcome in a change situation, the wound care specialist will: a. preserve the status quo b. diminish facilitators and reinforce barriers c. weigh the strength of forces d. strengthen facilitating forces
D
you follow up with Elizabeth and discover that she is really quite angry about the information sessions because she feels that you are implying that "what she has been doing all of these years means that she is incompetent and doesn't care about her patients." your response to her indicates that: a. elizabeth will never adopt the change b. elizabeth is insecure in her practice c. elizabeth requires more information about the practice d. change involves emotions rather than intellect
D
positive time management skills include: a. maintaining an open-door policy b. retaining all paperwork c. returning all phone calls immediately d. scheduling daily activities
D planning is the most important step in time management. planning allows people to better use their time and can lead to closure in relation to those goals that will produce the greatest internal satisfaction
a nurse realizes that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction? a. "let's only talk about one movie you recently watched." b. "I like to know about department store sales but we need to get through this report, so lets talk about sales as we walk between patient rooms." c. "I know your shift has been busy. What went wrong?" d. "I have the list of patients; let's start with revisions to the plan of care and schedule activities for the next shift."
D. "I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift."
you note that unit 64 has had a high turnover rate of staff during the past year. In addressing the staff turnover rate, you are:
Demonstrating awareness that workplace violence, if present, has significant costs
Which of the following healthcare employees is most at risk for violence?
Donna, who works the evening shift, cleans rooms each night in the administrative wing and business offices, which are largely empty. The wing is near an outside access door.
Residents in a new long-term care facility attend a large dining hall for meals. In reviewing reports of aggression and violence, you note that behaviors such as hitting, or attempting, to hit staff are increasing. Further investigation suggests that this behavior occurs most often at mealtimes.
Establish a smaller dining area that is away from the main area that is for residents who have potential for aggression/violence.
The chief nursing officer plans a series of staff development workshops for the nurse managers to help them deal with conflicts. The first workshop introduces the four stages of conflict, which are:
Frustration, conceptualization, action, and outcomes
the nurse manager decides to use a mediator to help resolve the staff's conflict. A basic strategy for truly addressing this conflict is to:
Have a clear understanding of the differences between the parties in conflict
During coffee and other breaks, Rosalie, the new RN, is shut out of conversations with the other staff. When she approaches other staff on the unit to ask questions, they turn and walk off in the other direction. The behavior of the staff is characteristic of:
Horizontal violence
Which of the following best exemplifies the predominant style of conflict management for staff nurses?
Lara asks Stacey to switch sifts with her because Lara wants to attend a concert. Stacey would prefer not to but does to enable Lara, who is new in town, to be with her friends.
Kala, a unit manager, "I will sit on the hospital taskforce on improving morale if you send me to the hospital's leadership training, so i can further develop my skills and thus be more effective." Which of the following conflict management styles is Kala using?
Negotiating
Linda, a staff nurse on nights, yells at Ali, another RN, and tells Ali that she is stupid and can't get anything right. In responding to this situation as head nurse, it is critical that you:
Respond to Linda in a way that is consistent with organizational processes and with similar situations.
you are part of a multidisciplinary team that is charged with designing a workplace safety plan for your healthcare organization. This team has been established in response to increases in reports of violence and aggression. You begin by:
Surveying staff about levels of satisfaction with the workplace and management, collegial, and patient relations
"stress-buffering" behaviors can be elicited to reduced stress. all of the following behavioral coping responses can be used by nurse managers to reduce and manage stress except: a. distancing oneself from work b. using cognitive reframing to change irrational thoughts c. journaling and keeping an informal diary of daily events and activities d. exercising regularly
a
Mr. jones and mr smith are both going to become residents in Sunny Have Lodge. Mr. Jones views it as an opportunity to socialize and meet new friends. Mr. Smith views this as abandonment by his family and is worried that the care will be inadequate. Each senior perceives the situation differently. this is a good example of stress that is: a. both a positive stressor and a negative stressor b. occurring only because of age c. both positive in both cases d. harmful in both cases
a
Rama, a psych nurse, is assigned to four patients, the patient that would be at greatest risk for psychosocial compromise is the patient who has experienced: a. death of a spouse b. death of a distant friend c. recent job layoff d. divorce
a
a functional resume focuses on: a. experience and skills gained in positions b. positions held and specific roles in the positions c. academic qualifications and achievements d. relating skills and experience to qualifications in a specific position
a
a good nursing decision maker is one who: a. uses various models to guide the process based on the circumstances of the situation b. adopts one model and uses it to guide all decision making c. decides not to use any models because they are all useless d. develops a new model each time a decision has to be made
a
a hospice nurse has been feeling very stressed at work because of both the physical strain and the emotional drain of working with clients with AIDS. She tries to walk 1-2 miles 3x a week and to talk regularly with her husband about her work-related feelings. one reasonable stress management strategy would be to: a. start taking yoga lessons b. make an appointment to meet with a psychiatrist c. start jogging 5-6 miles every day d. plan to go out for a drink with fellow nurses after work each day
a
after speaking with elizabeth, a few days later, you consider that she is now fine with the change but is concerned that other areas of the organization might resist the change because of perceptions related to patient safety and cost. She suggests that it is important to bring pharmacy on board as they have had previous concerns about the use of heparin. This type of campaign is best described as: a. political b. marketing c. military d. cooptation
a
in a job interview for a nursing position, Marley can be assured that which of the following will occur? a. both eustress and distress b. only eustress c. only distress d. neither eustress nor distress
a
sources of occupational stress in nursing include all except which of the following? a. authoritarian leadership b. concern about moral wrongdoing by colleagues c. multiple changes in a short time d. job insecurity
a
the maintenance department wishes to have the nursing lounge renovated, so the lounge will be more "user-friendly." the department asks the nursing staff to make a wish list of everything that they would like to see in the new lounge. This process is an example of which part of the decision- making process? a. assessment/data collection b. planning c. data interpretation d. generating hypotheses
a
the nurse manager of a unit has lost many staff members, and the unit is now staffed with a large number of agency and traveling nurses. She knows that the agency and traveling nurses are all contracted to stay on the unit for the next 3 months. One way to improve morale and decrease stress in the unit would be to: a. plan a social event and include the agency and traveling nurse staff members b. plan unit-based social events for your remaining permanent staff members c. request hospital-based "floating" nurses to substitute for the temporary staff d. implement team nursing
a
the staff development educator presents a series of programs on stress management to the nurse managers. research has indicated that an individual's ability to deal with stress is moderated by psychological hardiness. Psychological hardiness is a composite of: a. commitment, control, and challenge b. commitment, powerlessness, and passivity c. commitment, control, and passivity d. decreased isolation, challenge, and passivity
a
you need to terminate Gregory, who has had a long-standing history of conflict with you and the staff, and who recently was charged with theft of patient belongings. you consult HR and together you develop a plan, which includes:
a private meeting with Gregory, a HR rep, and you to deliver the news and deliver the termination notice and all other documents that are related
high levels of work-related stress affect all but which of the following? select all that apply. a. job satisfaction b. absenteeism and turnover c. nurses health d. client welfare
a, b, c, d, ---does this question mean all of the following?
Time can be maximized to produce the best outcome by: a. making the first hour of each workday productive b. completing trivial tasks before performing important tasks c. eliminating all recreational activities d. omitting breaks until the entire task has been completed
a. making the first hour of each workday productive
at 3 am, a man walks into the ED. He paces back and forth in the waiting area before he approaches staff to ask if he van see his wife, who is a patient on another floor. He speaks rapidly, his face is flushed, he glances around often, and he keeps his hand in his jacket pocket. Best response:
assess your situation and your surroundings
Sarah is involved in intervening when a patient attempts to harm herself on the unit. During the interaction, the patient slaps Sarah across the face. As a head nurse, it is important that you:
assist with follow-up documentation and offer access to counseling
Lee, the head nurse, has attempted to meet Jillian, a staff RN. Lee hopes to offer Jillian coaching so that Jillian's relationships can be more satisfying for Jillian and her team members. Each time Lee and Jillian set a time to meet, Jillian phones in sick. Lee and Jillian are demonstrating:
avoidance and compromise strategies
factors that influence the ease with which conflict is resolved include all except which of the following?
avoidance of the issue or concern
John Smith, one of the three managers at BSG Labs, drafted a policy that would allow his department to do more testing in his lab. This policy included the times for regular collection as well as a new process for emergency lab testing. The policy and procedures were never followed. The reason was that: a. the policy was too lengthy and inundated readers with too much detail b. the policy made decisions for other departments in the company c. the staff did not believe that the new policy would be effective d. testing should not be done in the lab
b
The emergency department staff members are concerned that working long hours without rest puts patient safety at risk. One staff member decides that she will risk her job and become a whistleblower. Whistle-blowing is an appropriate recourse when management: a. disregards due process when disciplining a nurse b. delays responding to repeated efforts to provide safe care c. hires nurses who are not a part of the union during a strike d. refuses to bargain in good faith with the elected bargaining agent
b
a nurse is applying for a new position. this position is one in which she will serve as a liaison between a hospital and a school of nursing. the nurse has to update her resume to include her teaching experience. the goal of creating a curriculum vitae is to: a. have a listing of facts about your professional life b. create an opportunity to be interviewed c. respond quickly whenever a position becomes available d. be certain you can recall facts for a prospective position
b
amy has worked in the dialysis unit on staff for about 12 years. she is frequently consulted by other nursing staff regarding protocols and policies on the unit. What type of power is amy using? a. position power b. expert power c. personal power d. competency power
b
an example of role conflict occurs when: a. the director of ICU and the manager of the surgical unit wish to hire the same new employee b. two part-time staff members are hired to work in a unit, but the job expectations for them are not clear, and the head nurse expresses disappointment in their performance. c. the nurse manager for ICU believes he does not receive as many resources as the nurse manager for nephrology d. line managers believe that support staff use their technical knowledge to intrude on their authority
b
an outpatient surgery manager is evaluating infusion pumps for the operating room. the manager should: a. select the least expensive brand. a. use a decision-making tool to evaluate brands c. ask the nursing staff which brand they prefer d. select the vendor the institution usually buys from
b
as a nurse manager, the one activity you should not overlook is: a. posting the yearly rotation schedule b. reviewing vacation requests c. scheduling staffing for holidays 6 months in advance d. anticipating staff sick days
b
decision making is described by the nursing educator as the process one uses to: a. solve a problem b. choose between alternatives c. reflect on a certain situation d. generate ideas
b
jeff, an RN in his 30s, has lost a parent, just purchased a new home, and is laid off with 6 months' severance pay. At the same time, Jerry, an RN in his 50s, is financially secure and is asked to take early retirement with a buyout. How will the two men react to the emotional and physical influences and the sequence of stress? a. the younger man will feel more stress b. the two men may or may not feel the same amount of stress c. the older man will feel more stress d. neither man will experience any stress
b
knowing when to have the entire team participated in the decision-making process or when to have only the team leader make the decisions depends upon the situation and the desired outcomes. The autocratic process is used in which of the following situations? a. the task and the outcome are relatively simple b. it is unlikely that the group will reach a consensus c. a decision has to be discussed thoroughly d. a number of options need to be considered
b
the chief nursing officer listens to nurse managers verbalize their feelings of internal stress. One common source of internal stress seems to be: a. the death of a loved one b. perfectionism c. getting married d. losing a job
b
the chief nursing officer understands that a nurse manager can exhibit stress that is related to management mistakes. an example of a management mistake is: a. achieving excellence on the job b. following others expectations c. organizing the desktop d. organizing calendar events
b
the education consultant at st joseph's hospital is giving a workshop on cognitive reframing. the consultant explains that cognitive reframing reduces stress by: a. aiding individuals in identifying positive stressors b. helping people realize that negative thinking causes emotional distress c. eliminating negative stressors d. replacing positive self statements with negative irrational beliefs
b
A nurse is having difficulty managing assignments at work, which results in a feeling of "failure" and tasks that are not completed or that are not completed satisfactorily. The mentor suggests some tips for time management; these include: (select all that apply) a. focusing on activities to be completed rather than on objectives b. planning for tomorrow today c. making certain that the last hours are the most productive in tying up loose ends d. maintaining a log of how the nurse spends time (no need to worry about using complete sentences) e. picking 5 major objectives for the day and not stopping until they are achieved
b, d planning for the future is an effective time management strategy maintaining a log of how you spend your time is an effective time management strategy
an experienced nurse volunteers to serve on a task force intended to improve the quality of care because she possesses excellent patient care skills and has selected a career goal of working in quality management. However, the nurse is unable to concentrate on any one task or issue and is unable to view the health care milieu sensibly. What source of energy is missing in this nurse? a. physical b. mental c. spiritual d. emotional
b. mental
The head nurse an a staff nurse are having a conflict over how to use and apply a new procedure for dressings in the med/surg unit. the head nurse later makes comments to other staff on her unit about the credibility of the staff nurse. This behavior is associated with:
bullying
delaney, staff nurse, confides that Marjorie, another nurse, has been actively telling others that you are incompetent and do not know what you are doing in relation to patient care, and that you lie to the staff about attempts to get more staffing. Marjorie's behavior can best be characterized as
bullying
The clinical coordinator expects the position description of the new wound care specialist to change nurses' responsibilities in caring for clients with skin integrity problems. The best approach to address this need for change, yet to have the best outcomes for clients, staff nurses, and the organization, it to: a. select one of the change models b. use lewin's model and principles of change c. apply both planned and nonlinear approaches d. form a task force of nursing staff and wound care specialists
c
as a nurse manager, you observe a staff nurse who over the past few weeks has become withdrawn and has had several absences due to minor ailments. your best action would be to: a. ask the nurse if she is okay during report b. refer the nurse to the employee assistance program c. ask the nurse to meet with you for a few minutes before she leaves for the day d. write a note to the nurse advising her that her work attendance must improve
c
from the information supplied in this chapter, which statements best defines critical thinking? Critical thinking is a: a. high-level cognitive process b. process that helps to develop reflective criticism for the purpose of reaching a conclusion c. high-level cognitive process that includes creativity, problem solving, and decision making d. discussion that guides the nursing process
c
high-quality decisions are most likely to be made in nursing situations when: a. team leaders make the crucial decisions b. individuals are advised of the problems c. group size is neither too small nor too large d. members are passively involved
c
select the statement that best defines the difference between problem solving and decision making: a. decision -making skills require critical thinking, problem solving skills do not b. problem-solving skills require critical thinking, decision-making skills do not c. decision making is a goal-directed effort, problem solving is focused on solving an immediate problem d. problem solving is a goal-directed effort, decision-making is focused on solving an immediate problem
c
several nurses on an adolescent psychiatric unit complain that the teens are becoming unmanageable on the 11-7 shift. to resolve this problem the nurse manager decides that the staff should have a brainstorming session. the goal of brainstorming is to: a. evaluate problem solutions b. critique the ideas of others c. generate as many solutions as possible d. identify only practical and realistic ideas
c
the clinic nurse understands that problem solving is best defined as: a. a higher-order thinking process b. selecting the best option for reaching a predefined goal c. identifying the gap between "what is" and "what should be" d. determining creative approaches to resolving a problem or issue
c
which of the following statements would best define stress? stress is: a. the comfortable gap between how we like our life to be and how it actually is b. everyday life, both the highs and the lows c. a consequence or response to an event or stimulus that can be positive or negative d. identical to distress
c
while making rounds, a night supervisor finds a unit with a low census and too many staff members. The night supervisor is performing as a statutory supervisor when he or she: a. assigns nurses to care for specific clients b. develops a protocol for unlicensed personel c. recommends transferring a nurse to another service d. teaches a nurse to use a new piece of equipment
c
Jill is the head nurse on a unit in a large hospital. Two of the staff nurses are constantly arguing and blaming each other, and a resolution has not occurred in months. To solve the existing conflict, which is the most creative conflict resolution?
collaborating
john is usually assigned to general surgery, but on this day he is assigned to the orthopedic room. The surgeon prefers another solution. Immediately corrects him by rudely insulting john. Which of the following is the most appropriate approach to conflict resolution in this example?
compromising
you note that unit 64 has had a high turnover rate of staff during the past year. In selecting the appropriate action, it is important that:
confidentiality is assured
Jane, an experienced head nurse, is giving the task of completing the summer vacation schedule for the pediatric unit. She is fully aware of the hospital's restrictions on time off and the number of staff on vacation at any given time, as well as its issues regarding seniority. She weighs the options of allowing staff choice, such as it takes more time but gives employees options. However, if choice is allowed, this could cause arguments. Which of the following is the best alternative? a. ask for requests for vacation time in advance, and post the times b. post the completed vacation schedule c. post a tentative schedule, and request feedback d. post a blank schedule and ask staff members to fill in their times by a given date
d
Justin is a nurse manager in a rehabilitation unit in a small urban center. There is a high turnover rate among rehab-assistants because of the heavy work assignments. Justin decides to hire new staff in the order that applications are received until all vacant positions are filled. Which of the following decision-making models did justin use in making his decision? a. subjective model b. objective model c. optimizing model d. satisficing model
d
The risk manager informs the nurse manager of an orthopedic unit that her unit has had an increase in incident reports about patients falling during the 11-7 shift. the nurse manager knows that the best way to resolve the problem is to: a. use creativity b. obtain support from the 7-3 shift c. use institutional research d. identify the problem
d
a clinic nurse has observed another nurse deviating from agency policy in performing would care. The best approach for the clinic nurse to take is to: a. stay out of it b. inform the nursing supervisor c. fill out a notification form (incident report) d. assess the risk to the client and the agency before proceeding
d
a nurse manager has decided that she must institute some personal time management steps to survive work and home life. Her first step should be to: a. determine what takes up so much of her time and energy b. organize her personal and work spaces c. purchase a handheld personal digital assistant to help remind her of important meetings d. determine her personal and professional goals
d
a staff nurse approaches the unit manager and indicates to her that because of her father's death in the previous month, she is now feeling it very difficult to do her work effectively. this would be considered a(n) _____ stress. a. internal source b. familial c. burnout d. external
d
after the nurses who work on an adolescent psychiatric unit have had a brainstorming session, they are ready to resolve the problem of teenagers who are unmanageable. to maximize group effectiveness in decision making and problem solving, the nurse manager has: a. prevented conflict b. formed highly cohesive groups c. used majority rule to arrive at decisions d. encouraged equal participation among members
d
in helping nurse managers to manage their time, the chief nursing officer suggests that they: a. maintain a perfectionistic attitude b. set up a complaint list c. have good negotiation skills d. have good information literacy skills
d
resistance is most likely when change: a. is not well understood b involves many layers in an organization c. involves nonprofessional workers. d. threatens personal security
d
social stressors are considered a major factor in the stress nurses experience in the healthcare system. which of the following is not considered to be a social stressor? a. high amounts of stress in the nurse home environment b. changes in the current healthcare system such as nursing strategies c. disruptive behavior coming from physicians and other healthcare workers d. personal stress triggers such as self-criticism and overanalyzing
d
the nurse manager is implementing a shared governance model to help with communication and decision making. although staff members like the concept, change is difficult. Staff nurses feel: a. more empowered b. more communicative c. less stressed d. more powerless and devalued
d
time management is very essential for the nurse manager. which of the following is not a good time-management technique? a. decide what not to do b. learn to say no c. learn to delegate d. break down your workload into large manageable tasks
d
when confronted with the controversy and the apparent poor morale of the evening staff, the unit manager decided the staff needed to take some time off. he scheduled holidays for the staff without consulting them a could of the staff nurses approached the manager and indicated the problem was not scheduling, but rather the team leader and her patient assignments. What was the unit manager's first missed step in problem solving? a. not using a problem-solving model b. not considering a number of alternatives c. poor evaluation of outcomes d. incorrect problem identification
d
when decision making, critical thinking, and problem solving are considered, which of the following statements are accurate and valid points? a. the professional decision maker approaches problem solving by beginning with an outcome already in mind b. involvement in decision making is of little use unless you are an expert decision maker c. many models aid the nurse in improving his or her decision making skills d. the nursing decision maker who is successful recognizes that only those with similar experiences should be involved in decision making
d
which of the following decision-making solutions should Justin consider to have a more efficient department? a. replace staff only with qualified applicants b. determine what the problem or problems are before hiring new staff c. consult the new human resourced department and develop a plan for hiring new staff d. consider all the options listed
d
which one of the following statements has been proven to be true? a. recent research has found that women do not have a unique physiologic response to stress b. both men and women interpret the same stressor in the same manner without regard to past experiences c. stress influences the immune system in one complex manner d. stressors that are identical do not have the same effect on each individual
d
Sarah is a nurse manager in a surgical unit. She is concerned about a conflict between Lucy (a staff nurse) and one of the maintenance personnel. Sarah explains to Lucy that unsatisfactory resolution of conflict is typically destructive and will result in:
decreased productivity on her part
Mrs. Hill, age 68, was hospitalized after a stroke. Recommended that oral feeding be stopped because of her dysplasia. Mr. Hill fed his wife some noodles. The outcome as depicted by Thomas' conflict stages can be considered to be:
destructive
a safety and security plan is important to a healthcare organization because it
establishes policies and practices that guide prevention of violence and expectations in the workplace
you note that unit 64 has had a high turnover rate of staff during the past year. In investigating this situation, an important source of data might include:
exit interviews with staff
Joe and Carol, 2 RNs, are discussing recent incidents on the unit that have involved patients and visitors uttering threats or making demeaning remarks to staff during evening hours. Joe observes that unless someone shoots at him, he is not concerned because "words can't hurt you" joe's remarks:
illustrate common misperceptions about the nature of violence
Staff are concerned that recent staffing cuts will affect their ability to provide quality care, they express their concerns to management. CEO statement: "We need to contain costs because our funding has been decreased." Example of which of the following that propel the situation toward conflict?
incompatible goals
as manager, several resignations on a unit where a new charge nurse has been hired. the new charge nurse may be demonstrating bullying behaviors, staff say little about their relationship with the charge nurse. your decisions about interventions would be based on which assumptions?
initiating confidential exit interviews will assist in determining if leader violence of bullying is occurring
Jane has transferred from the ICU to the CCU. She is very set in the way she makes assignments and encourages her new peers to adopt this method without sharing the rationale for why it is better. This is a good example of a process and procedure that creates which type of conflict?
interpersonal
Sarah, a staff nurse on your unit, witnesses another nurse striking a patient. Sarah wants to remain friends with her colleague and worries that confrontation with her colleague or reporting her colleague will destroy their relationship. Sarah is experiencing which type of conflict?
intrapersonal
nurse asks family members to leave while she cares for 16 yr old. The father says she has no right to ask them to leave, and if she continues, he will "throw her out of the room." Nurse tells her head nurse, who tells her that this kind of thing is just part of the job. The head nurse:
is related to why statistics on violence in healthcare are likely underreported.
after using a mediator to resolve a conflict between the nurse manager and two staff nurses, the chief nursing officer decides to:
observe to make sure the conflict has been resolved
two staff nurses are arguing about whose turn it is to work on the upcoming holiday. In trying to resolve this conflict, the nurse manager understands that interpersonal conflict arises when:
people see events differently
A group of staff nurses is dissatisfied with the new ideas presented by the newly hired nurse manager. The staff wants to keep their old procedures, and they resist the changes. Conflict arises from:
perceptions of incompatibility
while working with an aggressive patient, it is important for the nurses to:
place herself between the patient and the door.
The most important step in time management is ____________.
planning
which of the following is NOT a factor in patient-and/or family-generated violence in healthcare settings?
staff rudeness
The nurse manager is aware that conflict is occurring on her unit; however, she is focused on preparing for a state health department visit, so she ignores the problem. A factor that can increase stress and escalate conflict is:
the use of avoidance
your healthcare organization places a high value on workplace safety and integrates this into all aspects of administrative and patient care processes. As a unit manager, you thoroughly endorse this direction, and during the selection and hiring of new staff, you consistently:
thoroughly follow up with all references before offering a position
in trying to achieve Magnet status, the chief nursing officer establishes a shared governance model. Some nurses resist this change. The comments are ignored because those who are making them are well-established nurses who are vocal. Organizational conflict is arising form which of the following?
tolerance of incivility
as a nurse manager, you realize that your unit has become a toxic environment in which horizontal violence and incivility has become common. in addressing the problem, you decide to implement which of the following?
training in conflict resolution and team-building
Jenny tells you that she is always able to tell when others are about to become violent because they yell. Your response to Jenny is based on your understanding that:
violence is signaled by a variety of behaviors
