Leadership & Management Final Questions

When responding to conflict select all that apply: A. Avoid emotion-based discussions B. Use I-Messages C. Be aggressive D. Be aware of body language

A, B, and D

Two male nurses have just been hired to a unit with a previously all female staff. Based on the nurse's knowledge of male communication styles, the female staff would take the following into consideration when communicating with the new male hires. (Select all that apply) A. Men are more assertive & blunt B. Men give extra details C. Men favor brief, concise informational exchange D. Men use indirect channels, such as questions to guide conversation E. Men use communication as a tool to deliver information.

A, C, E

Role confusion, question was something like: the care staff on the floor consists of an RN, LPN, and a PCA. Which task(s) should not have been assigned? A. Collection and interpretation of vital signs by the PCA. B. Sterile dressing change by the LPN C. IV push pain medication by the RN D. Bed bath by the RN E. Discharge teaching by the LPN

A, and E are out of the scope of practice of those professions.

"A newly graduated nurse is hired to your floor. While charting in the nurse's station, you hear your coworkers making sarcastic and belligerent comments about the new nurse. This is an example of what?

A. Horizontal Violence"

Which statement about rules is correct? A) If a rule or regulation is worth having, it should be enforced B) Most rule breaking is a result of the actions of a few employees C) Organizations should have as many rules and regulations as possible so employees are clear about what they are to do 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 is true regarding chemical addiction among nursing professionals? A) Most chemically impaired nurses obtain drugs by stealing them from work B) Morphine is the most commonly abused drug by nurses C) Most nurses obtain their drugs on the street and avoid taking drugs from work 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.

Which is a management function associated with dealing with a problem employee? A) Forewarns the employee of the consequences of breaking a rule B) Encourages employees to be self-disciplined in conforming to rules C) Serves in the role of coach in performance deficiency coaching D) Recognizes and reinforces the intrinsic self-worth of each employee

Ans: A Feedback: Clearly identifies performance expectations for all employees and confronts employees when those expectations are not met. The other options are leadership roles.

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? A) Provide a verbal warning that includes the rules related to personal telephone calls B) Determining whether there is a legitimate personal problem that justifies the telephone calls C) Presenting the nursing aide with a formal written reprimand 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 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 employees 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.

What is the most common initial response of an employee to a managers confrontation regarding suspected chemical impairment? A) Emphatic denial and defensiveness B) Reluctant acceptance C) Gratefulness for finally being discovered 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.

Which statement accurately describes a disciplinary conference? A) It is generally a highly charged emotional event, so the manager should try to soften criticisms to reduce the employees defensiveness B) It should be scheduled in advance at a time agreeable to both the employee and the manager C) When it is held in front of peers it can be used as a teaching tool 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 situations 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 principle that guides constructive discipline? A) Constructive discipline is punitive in its nature B) The focus of constructive discipline is employee growth C) Constructive discipline employs the manager as a resource not a helper D) Behavior modification is the desired outcome of constructive discipline

Ans: B Feedback: Constructive discipline uses discipline as a means of helping the employee grow, not as a punitive measure.

Which statement accurately describes the initial deterrent against breaking a rule according to McGregors Hot Stove Rules? A) All discipline should be administered immediately after rules are broken B) Each time the rule is broken; there are immediate and consistent consequences C) All employees must know the rule beforehand and be aware of the punishment D) Everyone must be treated in the same manner when the rule is broken

Ans: C Feedback: All employees must be forewarned that if they break a rule, they will be punished or disciplined. They must know the rule beforehand and be aware of the punishment.

Which statement concerning self-discipline is true? A) It is one of the least effective forms of discipline B) It decreases as an awareness of the rules and regulations that govern behavior increases C) It increases when employees identify with the goals of the organization 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 should an employee expect when a manager terminates his/her employment for continuous rule breaking? A) The employee will be escorted from the building by security staff B) The employee will be allowed to work out a 2-week termination period C) The manager will describe what, if any, references will be supplied to future employers 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 would be the most appropriate level of employee discipline for a first infraction of gross mistreatment of a patient? A) Suspension with pay B) Suspension without pay C) Termination 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 organizations first responsibility is in the protection of patients.

Which statement concerning the recognition of chemical impairment in an employee is correct? A) It is relatively easy to identify employees who are chemically impaired B) It is easier to recognize if the employee is impaired by alcohol than by drugs C) Impairment should result in an immediate intervention by the manager 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.

Which statement represents a correct statement regarding the identification and assisting interventions provided employees with substance abuse problems? A) It is done as an altruistic and benevolent action by the organization B) It should not be undertaken by management or the personnel department C) It should include screening that focuses on early detection D) Is best handled through disciplinary action of the personnel department

Ans: C Feedback: The personal and professional cost of chemical impairment demands that nursing leaders and managers recognize the chemically impaired employee as early as possible and provide intervention since such behavior is a serious safety issue associated with patient care. The remaining options are not correct.

What is the managers initial progressive initial response when a staff member is caught stealing $3.00 from a patients bedside stand? A) Dismissal B) Suspension C) Written notice D) Verbal notice

Ans: C Feedback: An employee caught stealing is initially presented with a written warning.

What does the filing of a grievance by an employee do? A) It serves as evidence that a managers 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 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 identifies a truth regarding the generally accepted plan for the reentry of the chemically impaired employee into the workplace? A) It is successful in only a small number of cases despite active treatment programs B) It is discouraged by the board of registered nursing C) It should not occur until 3 years after the employee has completed the treatment program D) It often includes an employer requirement that the employee agree to random urine screening on request by the employer

Ans: D Feedback: Most nurses successfully return to work following a treatment program, and this generally takes 1 year. Often, the conditions that the employee has successfully changed his or her lifestyle and will submit to random drug tests must be met before the employee can be allowed to return to work.

Which statement most accurately describes how discipline in a unionized organization may vary from one that is nonunionized? A) Nonunionized organizations require a demonstration of just cause, whereas unionized organizations do not B) Discipline in nonunionized organizations tends to entail more procedural, legalistic safeguards than unionized organizations C) Only unionized organizations have grievance procedures 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.

What is the fundamental rational for conducting a disciplinary conference for a staff member who has failed to significantly modify the practice of arriving late for assigned shifts? A) This behavior disrupts the efficiency of the nursing team B) The tardiness is costing the facility money C) This behavior encourages other staff to disregard rules D) The problem will get worse if it is ignored

Ans: D Feedback: Disciplinary problems, if unrecognized or ignored, generally do not go away; they only get worse. The other options are likely outcomes of the staff members unacceptable behavior but not the fundamental rational for the disciplinary action.

Which statement is true concerning the management of an employee who performs at the marginal level? A) Marginal performance is generally a result of employee burnout B) Poor motivation is the most common reason for marginal performance C) Improving skill should be the focus when assisting the marginal employee D) Some marginally performing employees will never improve their function levels

Ans: D Feedback: It is important for the manager to remember that each person and situation is different and that the most appropriate strategy depends on many variables. Looking at past performance will help to determine if the employee is merely burnt out, needs educational or training opportunities, is unmotivated, or just has very little energy and only marginal skills for the job. If the latter is true, then the employee may never become more than a marginal employee, no matter what management functions and leadership skills are brought into play.

How do managers view their responsibility to discipline staff? A) It is a necessary means for controlling an unmotivated and self-centered workforce B) It is a iBig sticki that management can use to eliminate behavior that conflicts with organizational goals C) It is a means to assist in the development of self-discipline in an employee 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 is the process involved in progressive discipline? A) A written warning precedes verbal warnings B) Formal warnings are followed up with informal warnings C) Written warnings are advocated only in the most serious of offenses 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 is the managers role when dealing with employees who break the rules? A) To terminate their employment B) To be a good listener C) To act as counselor 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.

In which of the following situations would you, as the head nurse, be concerned about potential safety issues? a.) Henry, a longstanding RN on the unit, has begun to miss work regularly. He calls in but is vague about his absences. b.) Sarah, is very quiet & says almost nothing in team meetings. Lately, she has been much more animated since becoming friendly with a couple other RNs on the unit. C.) Carla, RN has just ended an abusive relationship with Jake, RN, & he will not leave her alone. You are meeting with Jake today because colleagues on night have reported that Jakes seems to have been intoxicated last night & the previous night. d.) Jordan come to your office to complain about inadequate staffing on the unit. He says that he is concerned because he attributes a recent incident to the staffing levels.

Answer: C.) Carla, RN has just ended an abusive relationship with Jake, RN, & he will not leave her alone. You are meeting with Jake today because colleagues on night have reported that Jakes seems to have been intoxicated last night & the previous night.

Which statement indicates an assessment of a learning need? a.) "The nurses on this unit state that they have never worked with unlicensed assistive personnel before & they need a class on appropriate delegation skills". b.) "Our quality review identifies 10 medication errors this month, indicating a need for a class on medication administration". c.) "We must teach the staff to use the patient care assignment sheets at the beginning of each shift". d.) "Due to an increased in the state's rate of TB cases, a learning activity on TB transmission is required".

Answer: a.) "The nurses on this unit state that they have never worked with unlicensed assistive personnel before & they need a class on appropriate delegation skills".

Which of the following would be considered sentinel events that should be reported to The Joint Commission (TJC)? SATA. a.) A client experiences a transfusion reaction after receiving the wrong-type of packed red blood cells. b.) A client with ischemic heart disease dies of a MI. c.) A client files a formal complaint about the inattention of staff because of a medication error. d.) A client with dementia falls & suffers a hip fracture while trying to walk to the bathroom.

Answer: a.) A client experiences a transfusion reaction after receiving the wrong-type of packed red blood cells., c.) A client files a formal complaint about the inattention of staff because of a medication error., d.) A client with dementia falls & suffers a hip fracture while trying to walk to the bathroom.

Benchmarking creates objective measures of performance that are based on: a.) All of the above. b.) Past performance within an organization. c.) Some external universal performance target established by the industry. d.) Performance of a competing external organization.

Answer: a.) All of the above.

How can the nurse manager best promote the development of self-discipline in employees? a.) Clearly communicate expectations, rules, & policies to employees. b.) Allow employees full autonomy in choosing tasks & the means for carrying out those tasks. c.) Eliminate punishment from the unit's culture & procedures. d.) Hire employees who have a history of being compliant & collaborative.

Answer: a.) Clearly communicate expectations, rules, & policies to employees.

What variable should the nurse-manager prioritize when dealing with employees who break rules? a.) Ensuring organization goals are met. b.) Terminating employment when necessary. c.) Counseling employees to promote their personal & professional growth. d.) Modeling empathy.

Answer: a.) Ensuring organization goals are met.

Root causes of sentinel events: a.) Identifies factors & performance that led to the event. b.) Focuses primarily on individual performance not on systems & processes. c.) Only identifies special causes & common causes. d.) All of the above.

Answer: a.) Identifies factors & performance that led to the event.

A nursing student is experiencing horizontal violence from a staff nurse at her clinical site. Which step should the student take in addressing the problem? a.) Inform her instructor or floor manager & ask for assistance in handling the issue. b.) Ignore it & go on about your day. c.) Avoid staff for the rest of the day. d.) Confront the nurse in front of the floor staff.

Answer: a.) Inform her instructor or floor manager & ask for assistance in handling the issue.

The nurse manager oversees an experienced employee who is earnest & pleasant, but who struggles to maintain minimum performance standards. What is the manager's best initial approach to this employee? a.) Provide coaching that addresses the employee's main deficiencies. b.) Arrange for the nurse to complete extra continuing education. c.) Affirm the nurse's strengths in an effort to encourage excellence. d.) Provide interventions that will increase the nurse's motivation.

Answer: a.) Provide coaching that addresses the employee's main deficiencies.

A hospital is using the guidelines of the Leapfrog Group to inform safety improvements in the organization. What action will best incorporate these guidelines? a.) Purchasing a computerized-physician-provider order entry system. b.) Converting shared rooms to single-occupant rooms. c.) Replacing practical nurses with registered nurses whenever possible. d.) Eliminating the use of high-risk medications & increasing the role of the pharmacist.

Answer: a.) Purchasing a computerized-physician-provider order entry system.

Which action should the nurse-manager perform to increase the likelihood that performance appraisals motivate employees & be seen as fair? a.) Reflect carefully on his or her own biases & values & their possible effect on appraisals. b.) Avoid getting to know employees on an individual level to ensure objectivity. c.) Offer rewards to employees who have the best performance appraisals. d.) Include no more than one deficiency in an employee's appraisal.

Answer: a.) Reflect carefully on his or her own biases & values & their possible effect on appraisals.

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: a.) Surveying staff about levels of satisfaction with the workplace and management, collegial, and patient relations. b.) Offering training sessions in self-defense. c.) Developing a policy that outlines zero tolerance for bullying. d.) Offering education sessions on recognizing behaviors with potential for violence.

Answer: a.) Surveying staff about levels of satisfaction with the workplace and management, collegial, and patient relations.

Which is a management function associated with dealing with a problem employee? a.) Examines the work environment for stressors that contribute to substance abuse. b.) Applies a progressive discipline model when employees fail to meet standards. c.) Ensure that the rights & responsibilities of both the manager & the employee are considered in addressing worker grievances. d.) Understand group norms & is able to work within those normal to mold group behavior.

Answer: b.) Applies a progressive discipline model when employees fail to meet standards.

One of the experienced nurses on a unit frequently approaches the manger to provide feedback on a recently hired nurse's performance. When preparing the new nurse's performance appraisal, how should that manager integrate the experienced nurse's feedback? a.) Ask the experienced nurse to put the feedback in writing so that it can be included in the new nurse's performance appraisal. b.) Consider the nurse's feedback but supplement it extensively with data from several other sources. c.) Disregard the nurse's feedback because it is likely that the nurse has ulterior motives. d.) Educate the experienced nurses about the fact that performance appraisal is the manager's exclusive responsibility.

Answer: b.) Consider the nurse's feedback but supplement it extensively with data from several other sources.

Interviews at large healthcare organization are conducted to various individuals & group, due to the higher number of positions & applicants. Which action will best ensure interrator reliability when different individuals are conducting interviews? a.) Use a semi-structured format & have interviews practice with one another. b.) Create a structured interview format & adhere to it closely. c.) Use yes-no questions whenever possible, rather than open-ended questions. d.) Have at least two, but not more than 4 interviewers conduct each interview.

Answer: b.) Create a structured interview format & adhere to it closely.

In order to adhere with the recommendations of The Joint Commission around employee performance appraisals, the manager should: a.) Ensure there is a witness present when conducting an employee's appraisal. b.) Ensure the appraisal is based on employee's job descriptions. c.) Base appraisals on employees' personal goals. d.) Conduct appraisals at least every 6 months & more often with new employees.

Answer: b.) Ensure the appraisal is based on employee's job descriptions.

The nurse manager is working in a unionized healthcare organization. When administering discipline to employees, the manager should: a.) Assist employees with filing grievances. b.) Follow specific steps & penalties within an established time frame. c.) Communicate with the union's attorneys rather than directly with the employees. d.) Defer the organization's personnel department rather than administer discipline directly.

Answer: b.) Follow specific steps & penalties within an established time frame.

New mechanical lifts for client transfers are being introduced at a healthcare facility. The manager plans to implement the principles of social learning theory in the necessary training. What actions should the manager facilitate? SATA. a.) Uploading a video for staff to watch on their own time. b.) Having an expert demonstrate the correct use of the mechanical lift. c.) Distributing the information packet to staff 1 week before education sessions. d.) Providing opportunities for hands-on practice. e.) Encouraging staff to work in groups during education sessions.

Answer: b.) Having an expert demonstrate the correct use of the mechanical lift., d.) Providing opportunities for hands-on practice., e.) Encouraging staff to work in groups during education sessions

A nurse manager has referred staff members to a clinical practice guide (CPG) that address the prevention of pressure ulcers. What is a characteristic of this CPG? a.) The CPG will layout the criteria that healthcare organizations must meet in order to be reimbursed for treating pressure ulcers. b.) It will describe interventions for nurses to follow in order to provide evidenced based care. c.) It will describe the treatment for pressure ulcers that is provided at the best performing organizations. d.) The CPG will summarize the etiology & diagnosis of pressure ulcers.

Answer: b.) It will describe interventions for nurses to follow in order to provide evidenced-based care.

As part of a quality improvement initiative, administrators are conducting outcomes analysis & have included nursing-sensitive outcome measures. These outcomes measures will: a.) Cause the quality improvement process to prioritize nurses over other providers. b.) Separate out the unique contributions that nurses make to client outcomes. c.) Highlight the aspects of nursing that are contentious or controversial. d.) Require other members of the healthcare team to rate nurses' contribution.

Answer: b.) Separate out the unique contributions that nurses make to client outcomes.

The nurse is admitting a new client & is reviewing the results of the medication reconciliation. What data will be included in the client's medication reconciliation? SATA. a.) The client's expectations for treatment with medication during admission. b.) The list of medications the client has been prescribed by the admitting physician. c.) The mediations that the client was taking prior to admission. d.) The results of the nurse manager's review of the client's treatment plan. d.) The client's medication admission record from any previous admissions.

Answer: b.) The list of medications the client has been prescribed by the admitting physician. & c.) The mediations that the client was taking prior to admission.

An applicant has disclosed a criminal record during an interview. When considering the implication of this discourse on the hiring decision, the manager should consider what factors? a.) The geographic location where the offense occurred. b.) The severity or gravity of the criminal offense. c.) The relationship of the offense to the job duties. d.) The applicants' collaboration with other persons during the offense. e.) The time that has elapsed since the offense.

Answer: b.) The severity or gravity of the criminal offense., c.) The relationship of the offense to the job duties., e.) The time that has elapsed since the offense.

The nurse manager is implementing strategies to maintain adequate staff in the health care organization. What action by the manager will best achieve this goal? a.) Proactively plan to hire two RNs for each unit each year. b.) Use knowledge of turnover rates on their units for planning & hiring. c.) Hire consultants to study national turnover rates to determine recruitment needs. d.) Look at staff-to-client ratios at other health care organizations in the area.

Answer: b.) Use knowledge of turnover rates on their units for planning & hiring.

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

Answer: c.) As a necessary part of fostering excellence in the organization.

What is the goal of professional socialization in nursing? a.) Meet other nurses with similar likes & interests & promote networking opportunities. b.) Incorporate social media in a professional way for nurses, providers, & other medical providers to socialize with patients. c.) Assist new nurses in identifying as nurses by thinking them think, act, & care like nursing professionals. d.) Encourage the socialization amount of new nurses & old nurses.

Answer: c.) Assist new nurses in identifying as nurses by thinking them think, act, & care like nursing professionals.

As a young manager, she knows that conflict occurs in any organization. Which of the following statement regarding conflict is not true? a.) May result in poor performance. b.) May be related to poor communication. c.) Is not beneficial hence it should be prevented it all times. d.) Can be destructive if the level is too high.

Answer: c.) Is not beneficial hence it should be prevented it all times.

The major difference between "quality assurance" activities (i.e., rates of adverse outcomes) & "quality improvement" activities is that quality improvement also focuses on: a.) Analysis of data. b.) Performance measures. c.) Systems & processes. d.) People & competency.

Answer: c.) Systems & processes.

Which interview question would be considered illegal? SATA. a.) What university did you attend? b.) What city do you live in? c.) What is your current marital status? d.) In what year were you born? e.) Which languages are you able to speak?

Answer: c.) What is your current marital status? & d.) In what year were you born?

A nurse manager & several colleagues are reviewing the results of the Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS) survey. These results will allow the team to make what assessment? a.) Consumer's health outcomes at 3 & 6 mo after discharge. b.) The root cause of adverse incidents. c.) Clients' health status at admission versus at discharge. d.) Clients' perspective on the care they received.

Answer: d.) Clients' perspective on the care they received.

The nurse manager is attempting to promote closer adherence to the principles of evidenced-based practice. What is the manager's best action? a.) Arrange for easy online access to academic databases. b.) Impose sanctions on nurses who do not use research during the annual evaluation. c.) Stress the need to base practice on research findings during orientation of new graduates. d.) Include a statement of the need for evidence based practice in the unit vision statement.

Answer: d.) Include a statement of the need for evidence based practice in the unit vision statement.

A nurse manager is attempting to help a group of staff members reach a consensus on a sensitive issue. What is a consequence of using a consensus-based approach? a.) One group will be perceived as the "winner" & one group as the "loser". b.) A solution that is ideal to both groups will be selected. c.) There is an increased risk for similar conflict in the future. d.) It is likely that neither group will achieve their desired "ideal" outcome.

Answer: d.) It is likely that neither group will achieve their desired "ideal" outcome.

Which statement describes the induction phase of the employee indoctrination? a.) It includes the activities performed by the personnel department. b.) It relates to information included in the employee's handbook. c.) It is the responsibility of the staff development department. d.) It occurs after hiring, but before performing the role.

Answer: d.) It occurs after hiring, but before performing the role.

The nurse has observed a coworker arriving to work intoxicated at least three times in the past month. Which action by the nurse would best ensure client safety & obtain necessary assistance for the co-worker? a.) Ignore the co-worker's behavior & frequently assess the clients assigned to the co-worker. b.) Make general statements about safety issues at the next staff meeting. c.) Warn the co-worker that this practice is unsafe. d.) Report the co-worker's behavior to the appropriate supervisor.

Answer: d.) Report the co-worker's behavior to the appropriate supervisor.

Which of the following is the most likely the root cause of medication errors in healthcare entities? a.) Look alike, sound alike drugs. b.) Carelessness or nurses. c.) Manual medication delivery systems. d.) Systems failure.

Answer: d.) Systems failure.

The nurse manager is contributing to the plan for the workplace reentry of an employee with a history of chemical abuse. What should be included in the reentry plan? a.) Clients & families should be made aware of the nurse's history. b.) The nurse should have 50% work assignment for the first several months. c.) Reentry should not occur until the nurse has been chemical-free for at least 18 months. d.) The employee should agree to random urine screening.

Answer: d.) The employee should agree to random urine screening.

A nurse calls the PCA to ask them to do a sponge bath in room 468, the PCA gets supplies for a foley cath because they though that was what the nurse asked for. This is an example of A. Not verifying orders B. Proper delegation C. Miscommunication D. Effective communication

C

According to The Joint Commission, which form of communication style is unacceptable to transfer patient information to another Health Care Provider? A. Verbal B. E-mail C. Text message D. Phone E. Written

C

During shift change report the oncoming RN is repeatedly interrupting and criticizing the outgoing RN's report. What is the best response using communication techniques to diffuse the situation? A. "Why do you keep interrupting me?" B. "Oh, I am sorry. My kids kept me up yesterday and I didn't get enough sleep." C. "I understand your concerns. Could we address them after we finish report?" D. "It seems this is frustrating for you, but I need to get this report done."

C

Which of the following is true regarding passive-aggressive communication? A. Allowing others to make decisions B. Active listening and reflecting C. Undermines other individuals through gossip, pouting, and playing the victim D. Making all the decisions

C

You are a new graduate nurse and are admitting a new patient for COPD exacerbation. He is concerned that his COPD will worsen and that he will never be able to go home. What is and example of a good communication strategy that will help the nurse build a report with the patient and family? A. "Mr. Smith, you need to do your breathing treatment at home more so that you don't have to come back to the hospital." B. "I'm very sorry that you are feeling this poorly" C. While talking to the patient, the nurse places her hand on the patients shoulder to try to reduces the patients anxiety. D. The nurse acts very distracted and is in and out of the room when trying to admit the patient.

C

You notice a CNA displaying forceful conflict resolution styles with all RN's, as the charge nurse how would you best resolve the situation? A. You would approach the CNA in front of the other RN's and point out their resolution style is unacceptable B. You ask another nurse to speak with the CNA to discuss other forms of conflict resolution C. You speak with the CNA in private, and discuss other forms of conflict resolution D. You penalize the CNA and do not offer constructive feedback

C

26. The nurse-manager works at a unionized health-care facility and is preparing for a disciplinary conference for an employee with a history of unexcused absences. What activity should the manager prioritize in this conference? A) Promoting rapport with the employee in order to protect their future working relationship B) Requiring the employee to present compelling evidence to prove that he or she is innocent of rule breaking C) Presenting a grievance that summarizes the way that the employee has failed to meet organizational standards D) Presenting objective evidence that demonstrates the employee's deficient performance

D) Presenting objective evidence that demonstrates the employee's deficient performance

A nurse-manager needs to discipline an employee and wants to ensure that it leads to constructive outcomes. What is the primary difference between constructive and destructive discipline? Select one: a. Constructive discipline excludes punishment, but destructive discipline is primarily focused on punishment. b. The manager is more empathetic to the employee in constructive discipline than in destructive discipline, so that their relationship becomes closer. c. Constructive discipline helps the person grow to meet organizational goals; destructive discipline focuses more on punishment. d. The person who has received constructive discipline always appreciates it, whereas destructive discipline is always resented.

The correct answer is: Constructive discipline helps the person grow to meet organizational goals; destructive discipline focuses more on punishment.

A manager is preparing to confront an employee regarding suspected chemical impairment. What response should the manager anticipate? Select one: a. Silence b. Reluctant acceptance c. Emphatic denial and defensiveness d. Gratefulness for finally being discovered

The correct answer is: Emphatic denial and defensiveness

Which statement is correct regarding the distinction between legal and ethical obligations in decision making? Select one: a. Ethical controls are much clearer and individualized. b. Ethical controls are clearer and philosophically impartial. c. Legal controls are much less clear and individualized. d. Legal controls are clearer and philosophically impartial.

The correct answer is: Legal controls are clearer and philosophically impartial.

A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically impaired. What is the manager's most appropriate action? Select one: a. Document this finding and communicate with the personnel department b. Promptly confront the nurse to discuss this suspicion c. Ask the other nurses and staff members on the unit if they have noticed the same thing d. Monitor the nurse's behavior closely for the remainder of the shift

The correct answer is: Promptly confront the nurse to discuss this suspicion

What action should the nurse-manager perform when preparing for and conducting a disciplinary conference? Select one: a. Ask a small number of trusted employees to join the conference so it can be used as a teaching tool b. Adopt a nurturing and counseling role to ensure the conference ends on a positive note c. Schedule the conference in advance at a time agreeable to both the employee and the manager d. Soften criticisms to reduce the employee's defensiveness and emotional response

The correct answer is: Schedule the conference in advance at a time agreeable to both the employee and the manager

A state Nurse Practice Act is an example of which source of law? Select one: Statutes Judicial Constitution Administrative

The correct answer is: Statutes

An employee is found to have grossly mistreated a client, which the employee has never done before. What consequence should be administered to the employee? Select one: a. Suspension without pay b. Written admonishment c. Termination d. Suspension with pay

The correct answer is: Termination

A nurse is facing an ethical dilemma about whether to report a colleague's offensive comment, an action which is likely to jeopardize their relationship. What is a characteristic of this nurse's ethical dilemma? Select one: a. The dilemma has no realistic solution. b. The dilemma can be solved by applying empirical data. c. The situation involves two or more undesirable alternatives. d. The situation involves a breach of the law.

The correct answer is: The situation involves two or more undesirable alternatives.

Which statement best describes ethics? Select one: a. The conflict, power, and interdependency associated with the way we live b. How people make decisions they see as legally and morally appropriate c. What our conduct and actions should be regarding what is right and good d. How our lives and relationships are led in day-to-day circumstances

The correct answer is: What our conduct and actions should be regarding what is right and good

When conflict arises, regardless of the situation, what is the 1st step in finding a successful resolution? A. Avoiding the situation at hand B. Be self aware of your own feelings and emotions C. Involving a 3rd party to mediate the situation D. Finding faults in the other persons argument

B

The charge nurse uses the conflict resolution style of accommodation when he/she states the following: 1. We're sticking to the regular work schedule as stated in the policy and procedures. 2. I will give all three of you off and work the shift myself. 3. We will split Christmas time off by each of you doing eight hours shifts 4. Sorry, but no one is getting any time off.

3

A physician angrily comes to the charge nurse after finding out that a patient has not been appropriately cared for on the previous shift. The charge nurse is in the middle of passing medication and tells the physician "I don't have time for this, It wasn't my fault anyway." Which conflict resolution style did the charge nurse implement? A. Avoidance B. Force C. Accommodation D. Acknowledging

A

What action will the manager take when implementing the second step in the progressive disciplinary process? A) Suspend the employee from work for a specified period of time B) Explain in detail the nature of the inappropriate behavior C) Complete a formal written reprimand 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.

"It's not my work that you're really mad about. It's that I'm a guy. You just don't like males nurses." This is an example of which type of logical fallacy? A. Appeal to tradition B. Hasty generalization C. Red herring D. Straw man

C

What event is most likely to result in an employee filing a grievance? Select one: a. The employee believes he or she has been disciplines unjustly. b. An employee wants to have an impartial third party impose a solution. c. An employee knowingly breaks an established rule. d. The manager and employee have a relationship that precedes an episode of discipline.

The correct answer is: The employee believes he or she has been disciplines unjustly.

The nurse-manager is contributing to the plan for the workplace reentry of an employee with a history of chemical abuse. What should be included in the reentry plan? Select one: The employee must agree to random urine screening. Reentry should not occur until the nurse has been chemical-free for at least 18 months. The nurse should have a 50% work assignment for the first several months. Clients and families should be made aware of the nurse's history.

The correct answer is: The employee must agree to random urine screening.

A nurse-manager discovered that a nurse was retrieving narcotics from sharps containers and has been abusing these medications for several months. When addressing this behavior and assisting the nurse, what factor should the manager prioritize? Select one: The nurse's well-being The nurse's personal growth The integrity of the unit The safety of clients and families

The correct answer is: The safety of clients and families

An employee is found to have grossly mistreated a client, which the employee has never done before. What consequences should be administered to the employee? a.) Termination. b.) Written admonishment. c.) Suspension w/out pay. d.) Suspension w/ pay.

Answer: a.) Termination.

The nurse manager can begin to promote the needs of a culturally diverse staff by: a.) Viewing diversity as an opportunity rather than a threat. b.) Adopting a neutral teaching style that is equally accessible to all cultures. c.) Clustering staff members according to their culture whenever possible. d.) Fostering educational activities on the needs of staff from minority groups.

Answer: a.) Viewing diversity as an opportunity rather than a threat.

The charge nurse uses conflict resolution style of accommodation when he/she states the following: a.) "Sorry, but no one is getting any time off". b.) "We will split Christmas time off by each of you doing eight-hour shifts". c.) "We're sticking to the regular work schedule as stated in the policy & procedures". d.) "I will give all three of you off & work the shift myself".

Answer: b.) "We will split Christmas time off by each of you doing eight-hour shifts".

What action should the manager take when implementing the second step in the progressive disciplinary process? a.) Verbally instruct the employee not to repeat the infraction. b.) Explain in detail the nature of the inappropriate behavior. c.) Complete a formal written reprimand. d.) Suspend the employee from work for a specified period of time.

Answer: c.) Complete a formal written reprimand.

Which factor should the nurse manager prioritize when writing an employee's performance evaluation? a.) Knowledge level. b.) The employer's level of experience. c.) History of completing required tasks. d.) Individual skills related to providing care.

Answer: c.) History of completing required tasks.

Kaleesi is an RN and Daryl is a CNA. Chalice has been attempting to delegate tasks to Daryl but he hasn't been completing the tasks or has been waiting until the last minute. The best way to handle this situation would be to: A. Kaleesi chooses to not "rock the boat" and does the tasks herself if Daryl doesn't B. Kaleesi chooses to cooperate with Daryl by giving him less tasks but she still is overwhelmed with the tasks that she is left with C. Kaleesi tells Daryl, "you will take these vitals when I tell you to because you have to do what I say" D. Kaleesi approaches Daryl about the situation and works with him to come up with a plan to get all of the tasks done in a timely manner

D

The patient is expressing serious concerns about their recent diagnosis of Liver Cancer. The nurse responds with "Don't worry, you'll be fine." What form of communication is this? A. Blocking B. Keeping Promises C. Expressing Empathy D. False Assurance

D

You are a new nurse to the unit, you have a procedure ordered to perform that you are not familiar with and not confident you could maintain patient safety. When you ask an experienced nurse to assist you with the procedure, her response is "Did you not learn anything in nursing school?" How should you respond? A. Tell your supervisor immediately B. Look up the P & P and perform the procedure C. Ask the UAP to show you how to do it D. Use positive communication techniques with the nurse

D

When monitoring medication inventories for possible diversion or theft by nurses who abuse chemicals, what medication classifications should the manager monitor most closely? Select all that apply. Select one or more: a. Antidepressants b. Benzodiazepines c. Central nervous system stimulants d. Opioid analgesics e. Nonsteroidal anti-inflammatories f. Anticholinergics

The correct answers are: Opioid analgesics, Central nervous system stimulants, Benzodiazepines

Two nurses are not getting along and one of them complaining to you about it. What should you do?

The answer was to suggest they discuss it with the other nurse in question and offer to be the neutral mediator.

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? Select one: 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

The correct answer is: As a necessary part of fostering excellence in the organization

A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action? Select one: Write a memo to the nurse who made the error requesting an incident report be written Document in the client's chart that an incident report will be completed Share that information with the charge nurse on the previous shift Document the incident and follow it up as per hospital policy C

The correct answer is: Document the incident and follow it up as per hospital policy

Which action should the nurse manager perform to increase the likelihood that performance appraisals motivate employees & be seen as fair? a.) Avoid getting to know employees on an individual level to enhance objectivity. b.) Offer rewards to employees who have the best performance appraisals. c.) Reflect on his or her own biases & values & their possible effect on appraisals. d.) Include no more than one deficiency in an employee's appraisal.

c.) Reflect on his or her own biases & values & their possible effect on appraisals.