NURS420 Exam3
The nurse manager has planned a meeting that all staff nurses have to attend. Which method would most efficiently notify the staff members of the meeting time? A. E-mail B. Voice mail C. Memo D. Telephone call
Correct Answer: 1 Rationale 1: E-mail minimizes time wasted trying to contact individuals and the urgency of the message can be coded. Rationale 2: Voice mail is time consuming because the caller must place the call. There is also the possibility the person will answer the call, which entails a greater investment of time. Rationale 3: There is a risk that the memo will be placed where it is not accessible to all staff members. Rationale 4: A telephone call may lead to socializing and small talk, which are time wasters.
The nurse manager identified that the census was higher than anticipated and the patient acuity level was also high; however, there were fewer nursing hours paid. This variance is an example of which budgetary variance? A.Efficiency B. Nonsalary expenditure C. Rate D. Volume
Correct Answer: 1 Rationale 1: Efficiency variance is a reflection of the difference between budgeted and actual nursing care hours provided. Rationale 2: Nonsalary expenditure variance is a deviation from the budget as a result of changes in client volume, supply quantities, or prices paid. Rationale 3: Rate variance is the difference between budgeted and actual hourly rates paid. Rationale 4: Volume variances are the differences in the budget as a result of increases or decreases in patient volume.
A nurse manager has identified that a major time waster is the amount of time spent on the telephone each day. Which strategy would help reduce this time? A. Answer the phone, "Hello, how are you?" B. Send all calls to voice mail. C. Use e-mail for potentially troublesome issues. D. Set a specific block of time to return calls.
Correct Answer: 4 Rationale 1: Answering the phone this way encourages socializing and small talk. Rationale 2: There are situations in which issues must be dealt with immediately and face-to-face. Rationale 3: Troublesome issues should be addressed face-to-face. Rationale 4: The nurse manager should set time aside to handle routine phone calls and to return calls.
An experienced nurse often answers less experienced nurses' questions about client care and teaches hemodynamics during orientation to the unit. The nurse has also participated in research into hemodynamic monitoring of ICU clients. Which clinical ladder designation does this nurse best exemplify? A. Clinical colleague B. Clinical mentor C. Clinical leader D. Clinical expert
Correct Answer: 4 Rationale 1: Clinical colleagues are full partners in care, but do not teach or do research. Rationale 2: A clinical mentor demonstrates preceptor abilities. Rationale 3: A clinical leader demonstrates leadership in practice. Rationale 4: The clinical expert combines teaching and research with practice.
The nurse manager tells the staff that this year's budget numbers will not change, even if census drops over the rest of the year. How should the staff interpret this information? A. The budget is a fixed one B.The hospital uses incremental budgets C. The hospital uses a variable budget D. The hospital; starts the budgeting process with a zero-based budget
Correct Answer: 1 Rationale 1: A fixed budget is one in which budgeted amounts are set regardless of changes that occur during the year, such as patient volume or program activities. Rationale 2: An incremental or line-by-line budget lists each expense item or category on a separate expense line. It is not possible to tell from this description if the budget is incremental. Rationale 3: A variable budget is developed with the understanding that adjustments to the budget may be made during the year based on changes in revenue, patient census, utilization of supplies, and other expenses. Rationale 4: A zero-based budget assumes the base for projecting next year's budget is zero. It is not possible to tell if the budget being described is a zero-based budget.
A nurse manager is discussing the hospital's changes to peer evaluation with nursing staff. Which comment by a staff nurse would the manager interpret as evidence of understanding this process? A. "Our evaluations will be more objective." B. "This must be a less expensive method of evaluation." C. "This should be quicker than our existing method." D. "This would be a good way to get back at the nurse who don't work as hard."
Correct Answer: 1 Rationale 1: A benefit of peer evaluations is that more than one person writes the evaluation. This increases objectivity. Rationale 2: There is no information to indicate that peer evaluation is more economical. Rationale 3: Peer evaluation may actually be more time consuming because more people are involved. Rationale 4: Revenge or getting back at nurses is not the focus of peer evaluation
There is substantial unrest among the staff of an intensive care unit that has resulted in negative client outcomes. Which employee factors should the manager assess first? A. Motivation and ability to be effective in the job. B. The age of employees and their social background. C. Gender and educational preparation of staff. D. Experience base of employees and their attitude toward the job.
Correct Answer: 1 Rationale 1: Research has found an employee's ability and motivation to be the two major dimensions that most affect the employee's effectiveness. Rationale 2: The age of employees and their social background may influence job performance but are not as significant as other factors. Rationale 3: Educational preparation and gender may influence job performance but are not as significant as other factors. Rationale 4: The experience base of employees and their attitude toward the job may influence job performance but are not as significant as other factors.
A nursing supervisor has a report due and just cannot seem to find the time to get it completed. One day before it is due, the supervisor turns it in. This situation best exemplifies which time waster? A. The supervisor waited for the deadline pressure to increase the priority. B. The report was one of the last tasks on the "to-do" list C. The supervisor has no interest in the topic of the report. D. The report format is unfamiliar to the nursing supervisor.
Correct Answer: 1 Rationale 1: This is a classic example of procrastination, and the manager waited until it absolutely had to be done because of the looming deadline. Rationale 2: Being the last task on the "to-do" list is a plausible reason for the wait, but is not the most likely reason. Rationale 3: Lack of interest on the supervisor's part is a plausible reason for the wait, but is not the most likely reason. Rationale 4: The supervisor could be unfamiliar with the report format, but this is not the most likely reason for the delay.
A nurse frequently has to work late and has no time to do required training while at work. She has to do it on her days off. Choose the work-related time waster that commonly puts nurses in this position. A. Unscheduled tasks delaying those that are scheduled. B. An overwhelming amount of work to do C. Taking longer-than-scheduled breaks D. Volunteering for extra responsibilities
Correct Answer: 1 Rationale 1: While working with different disciplines, work days are in a constant state of flux, unscheduled tasks and events occur, and sometimes nurses get behind. Rationale 2: While the amount of work can be daunting at times, it is generally not overwhelming consistently if time is managed effectively. Rationale 3: While taking longer breaks does occur, it is not a common reason for having to work late. Rationale 4: Volunteering does occur, but the nurse who is having difficulty keeping up with work days would generally not volunteer for extra responsibilities.
A nurse manager is investigating the application of the principles of equity theory to rewarding staff. Which options are rewards that the manager could influence? Select all that apply. A. 1. Job satisfaction B. Prestige C. Pay D. Ability E. Effort
Correct Answer: 1,2 Rationale 1: Job satisfaction is a reward that the manager could influence. Rationale 2: The prestige associated with a job is a reward the manager could influence. Rationale 3: Pay is a reward the manager could influence. Rationale 4: Ability is typically seen as a contribution to the job by the employee. Rationale 5: Effort is a job contribution by the employee.
What are reasons that nurses fail to manage time effectively? Select all that apply A. Nurses do tasks they enjoy doing before the ones they do not enjoy. B. Nurses do things that bring the most immediate closure first. C. Nurses respond on the basis of who wants something. D. Nurses do uninteresting jobs before interesting jobs. E. Nurses work on things in the order of their arrival.
Correct Answer: 1,2,3,5 Rationale 1: Nurses are like anyone else in that they tend to do things they enjoy before they do things they do not enjoy. Rationale 2: Nurses (and others) often do those things that they can get done most quickly first. They feel satisfaction with having one thing done and out of the way. Rationale 3: Nurses tend to prioritize based on who wants something done—for example, if a client wants something that is a priority over the nurse manager needing a report. Rationale 4: It is generally more time efficient to tackle uninteresting jobs first and get them completed before starting interesting jobs that may absorb more of the nurse's time. Uninteresting jobs are likely to be completed as quickly as possible. However, it is not human nature to do what is not interesting first. Rationale 5: Nurses tend to work on things "as they come up" and often end up working on unplanned tasks before planned tasks. This is related to the unpredictable nature of working with people who are ill.
A hospital's budget is incremental. Which statement by the nurse manager reflects use of this type of budget? Select all that apply A. "The finance department sent me the budget worksheet with last year's expenses." B. "We have $1000 left in our education account that we need to spend before the year is over. Who has an idea for a class to attend?" C. "I have to justify all our activities as if we have never done them before." D. "I like this type of budget preparation because it is fairly simple and straightforward." E. "In order to create next year's budget, I am to start at 80 % of what we budgeted last year.
Correct Answer: 1,2,4 Rationale 1: Developing an incremental budget may begin with documentation of the previous year's actual expenses. Rationale 2: The disadvantage of an incremental budget is that managers quickly learn to spend all that is in their budget for a specific line item. If budgets are based on the previous year's performance, having budgeted money left over means it is likely that the current year's budget will be cut. Rationale 3: Justification of all activities and expenditures is a characteristic of a zero-based budget. Rationale 4: Incremental or line-item budgeting is fairly simple and straightforward. Rationale 5: Starting with a decreased budget is a form of zero-based budget.
A nurse executive is trying to convince the hospital management team that a clinical ladder system would work well in nursing. Which points should the nurse include in this argument? Select all that apply 1. Clinical ladders keep very good nurses at the bedside. 2. These programs prove to be worth their cost. 3. These programs reveal substandard nurses quickly so they can be terminated. 4. Similar programs have been shown to improve nurse job satisfaction. 5. Quality of client care increases with these programs
Correct Answer: 1,2,4,5 Rationale 1: Nurses with excellent clinical skills are promoted, but not into management. They stay at the bedside. Rationale 2: Evaluation of established programs has shown substantial positive fiscal impact. Rationale 3: Terminating nurses is not the focus of the clinical ladder program. Rationale 4: Improvement of job satisfaction has been shown to be a result of clinical ladder programs. Rationale 5: The programs have been shown to increase quality of client care
An experienced ICU nurse manager is orienting a newly hired nurse manager to the organization. The ICU manager makes occasional notes in a small notebook. The new manager asks why the ICU manager is taking notes. What are the most likely rationales for this behavior? Select all that apply 1. "It saves me time in the long run," 2. "Taking notes helps me to address issues immediately so they do not escalate." 3. "Although this looks time consuming, it is just how I learned to manage." 4. "It helps me to remember what to address in staff meetings." 5. "Having notes helps protect me when evaluations are written."
Correct Answer: 1,2,4,5 Rationale 1: Taking notes does save time for the manager when evaluations are written or if other issues come up on the unit. Rationale 2: On a busy unit, the manager must rely on written notes as a reminder of issues that should be discussed with staff. Rationale 3: Note taking is quick and this statement does not provide rationale for why notes are taken. Rationale 4: Notes will help the manager remember what should be addressed in staff meetings. Rationale 5: Having notes about the incidents cited in evaluations helps to protect the manager in case a staff member disputes the situation.
Which job behaviors would the nurse executive consider troublesome no matter which unit employed the nurse? Select all that apply 1. The nurse made two medication errors today that resulted in poor client outcomes. 2. A nurse was tardy twice last month due to car trouble. 3. A manager reports that a nurse used a piece of equipment that had been taken out of service for malfunction. 4. A nurse did not report to work for 2 days and did not call in the absence. 5. A physician calls to complain that a nurse was rude.
Correct Answer: 1,3,4 Rationale 1: Medication errors are serious no matter where they occur. Rationale 2: This might or might not be a problem, depending on the unit. Rationale 3: Using malfunctioning equipment is a serious problem, no matter where it occurs. Rationale 4: Not calling to report intended absence is a serious problem. Rationale 5: This might or might not be a problem, depending on the situation
The chief nurse officer is planning the budget for a coming year. A new position has been added to the nursing administration cost center. The CNO is determine how many benefit hours should be allocated for this new position. Which days should be included in this calculation? A. Sick days B. Weekend days C. Vacation days D. Holidays E. Bereavement days
Correct Answer: 1,3,4,5 Rationale 1: Sick days are benefit days. Rationale 2: Weekend days are not benefit days. Rationale 3: Vacation days are benefit days. Rationale 4: Holidays are benefit days. Rationale 5: Bereavement days are benefit days.
An organization has adopted the peer review process of evaluation. The manager shares which information with staff? Select all that apply 1. "Begin to work on a portfolio that shows how you have met your work goals for this year." 2. "All of you will be called on to review each of the other nurses working on the unit." 3. "If you are a member of a peer review committee, you will submit a written evaluation to me." 4. "The evaluation will be based solely on the input of the peer committee." 5. "This change has occurred as a result of our move to self-governance."
Correct Answer: 1,3,5 Rationale 1: The portfolio is a part of the peer review system of evaluation. Rationale 2: Generally, the peer review process involves two to four nurses reviewing the work of a peer. All nurses may be involved at some point, but not all nurses will review the work of every nurse. Rationale 3: The members of the peer review committee submit a written evaluation to the manager. Rationale 4: The manager also completes an evaluation. Rationale 5: Peer review is often used in self-governance model
Which step should be taken first when recruiting and selecting nursing staff? A. Develop a structured interview guide B. Become familiar with the position description for the jobs available. C. Develop a recruitment strategy to attract qualified applicants D. Identify potential applicants who would meet the job description
Correct Answer: 2 Rationale 1: Before an interview guide can be developed, knowledge of the position is necessary. Rationale 2: Prior to beginning recruitment efforts, those involved in the hiring process must be familiar with the position descriptions for jobs that are available. Rationale 3: Development of a recruitment strategy is effective only after the recruiters understand what is required for the jobs offered. Rationale 4: Identifying potential applicants is part of a recruitment strategy or guides it.
An ICU nurse manager prefers to use a "results-oriented system" when evaluating employees. Why would the manager prefer this system? A. It allows for comparison between employees. B. The employee knows in advance what is expected. C. It is apparent when an employee stands out against peers. D. It eliminates the category of "excellence" from the system
Correct Answer: 2 Rationale 1: Comparative judgments measure employees against peers. Rationale 2: A results-oriented system evaluates the employee based upon outcomes and the employee knows what is expected. This appraisal system is quantifiable, objective, and easily measured. Rationale 3: Comparative judgments measure employees against peers. Rationale 4: Systems have different scales, but "excellence" is almost universally included and is not excluded simply because the system is "results oriented."
The nursing administration has instituted a "horizontal promotion" system within the nursing department. What benefit is this program to the staff nurse? A. The most competent nurses will rise to managerial positions. B. It rewards the nurse's clinical excellence. C. Over time the nurse will move steadily upward through the levels. D. The process is practice based rather than research based.
Correct Answer: 2 Rationale 1: In horizontal promotion, the system rewards clinical excellence by moving clinically superb nurses upward on a clinical ladder, but they remain at the bedside. Rationale 2: Horizontal promotion is a reward for clinical excellence. Rationale 3: This promotion process is based upon the nurse's clinical excellence, not longevity. Rationale 4: The process is based on Patricia Benner's novice-to-expert concepts.
As a member of the budgeting committee, the nurse manager reviews the salaries for file clerks in the accounting department. These salaries should be included in which budget item? A. The fixed cost B. The variable cost C. The indirect cost D. The direct cost
Correct Answer: 3 Rationale 1: Fixed costs are costs that will remain the same for the budget period regardless of the activity level of the organization. Rationale 2: Variable costs depend on and change in direct proportion to client volume and acuity. Rationale 3: Indirect costs are expenditures that are necessary but do not affect client care directly. Rationale 4: Direct costs are expenses that directly affect client care such as nursing personnel who provide hands-on client care.
A nurse manager gives a staff nurse an exceptional appraisal. The other nurses learn of the appraisal and are upset because this nurse has had numerous complaints from peers regarding laziness. The manager informs a colleague the nurse obtained an exceptional appraisal because the nurse "will always work for me when I need extra help to come in." This is an example of which problem in evaluating? A. Recency error B. Leniency error C. Ambiguity error D. Halo error
Correct Answer: 2 Rationale 1: Recency error indicates the manager is evaluating the nurse based on recent events. Rationale 2: Leniency error indicates the manager is allowing tolerance, which may not provide an accurate account of the nurse's performance. In this case, the manager is lenient with the nurse who is always eager to work extra if needed. Rationale 3: Ambiguity is related to the rating scale itself not being specific enough. Rationale 4: Halo error occurs when the manager evaluates an employee based on overall impression and is not specific to different functions of the nurse's performance
With the current health care industry focus on managed care, nurses must be more cost-conscious. Which option is an example of a nurse being cost-conscious. A. The nurse reviewing the patient's itemized bill each day B. The nurses' decision to use fewer supplies when changing a dressing C. The nurse manager reviewing patient costs on a daily basis D. The nurse manager requesting that the material management director obtain quotes for less expensive items.
Correct Answer: 2 Rationale 1: The nurse and the nurse manager do not have time nor is it their responsibility to review a client's hospital bill. Rationale 2: The nurse can use resources wisely to decrease costs to the client and the hospital. Rationale 3: The nurse manager does not review client costs on a daily basis. Rationale 4: The materials management director does look for less expensive materials to provide client care supplies and hospital supplies, but it is not the responsibility of the nurse manager to direct this person's work.
The nurse manager is reviewing the current staff to determine who should precept a newly licensed nurse. Which nurse is the most logical choice? A. A nurse who needs the temporary pay increase that accompanies precepting. B. A nurse who is clinically competent and has the desire to assume the responsibility to train new staff. C. A nurse who has expressed the desire for additional training and unit responsibilities D. The nurse who needs to work and 8-hour schedule for a few weeks while recovering from a work-related accident.
Correct Answer: 2 Rationale 1: The preceptor role may offer a financial incentive, but this is not sufficient reason to choose this nurse. Rationale 2: Clinical competence and concern for effective orientation of new nurses are critical attributes for the preceptor. Rationale 3: While precepting will be an additional unit responsibility, the focus is on orienting the new nurse, not on increasing a staff nurse's skills. Rationale 4: Preceptorship may or may not be based on an 8-hour schedule. Also, a nurse recovering from an accident may not have the focus and energy necessary for precepting.
A nurse manager wishes to use a model of job performance to help match employees and tasks to achieve the greatest effectiveness. What should the manager do first? A. Evaluate each employee's education and experiential background B. Establish, in writing, the expectations of each task C. Consider how much variation from standard is acceptable. D. Review unit statistics for incidents, errors, and accidents.
Correct Answer: 2 Rationale 1: This evaluation is not the first step of this process. Rationale 2: In order to know which employee can do the task, a description of how the task looks when it is done correctly must be established. Rationale 3: Variation from standard cannot be assessed until the acceptable standard is established. Rationale 4: Using a job performance model focuses on specific individuals, not unit wide statistics.
The nurse manager is completing employee evaluations. Which practices should the manager use when doing these appraisals? Select all that apply 1. Appraising staff nurses every 18 to 24 months 2. Sharing the appraisal with staff nurses verbally and in writing 3. Requiring the staff nurse to sign the appraisal 4. Allowing the nurse to make written comments on the appraisal 5. Advising the nurse of the right to appeal the appraisal
Correct Answer: 2,3,4,5 Rationale 1: A staff nurse should be appraised at least every 12 months. Rationale 2: The appraisal should be shared with the staff nurses both in writing and face-to-face discussion. Rationale 3: The nurse should sign the appraisal to indicate that it has been received. Rationale 4: The nurse should be allowed to make written comments on the appraisal. Rationale 5: The nurse does have the right to appeal the findings of the appraisal and should be advised of this right
Which findings associated with an employee are likely to be considered when discussing performance? Select all that apply. 1. The employee states, "I have to work so that we can have insurance coverage for our disabled child." 2. The employee has been tardy on one occasion when an unexpected snow fell just before shift change. 3. The employee was involved in a motor vehicle accident last fall. 4. The employee found a purse containing $200 in the cafeteria and turned it in to security. 5. The employee made two work errors requiring incident reports in the last year.
Correct Answer: 2,4,5 Rationale 1: This statement relates more to motivation rather than to performance. Rationale 2: Punctuality is a performance measure. Rationale 3: Personal accidents that occur when the employee is not on shift are not considered as part of performance. Rationale 4: Honesty and trustworthiness are considered performance measures. Rationale 5: Work errors are considered performance measures.
During a job interview the nurse manager asks, "What are your short-term goals?" Which statement by the applicant addresses this question? A. "I want to become a nurse anesthetist within 10 years." B. "I will be available to come in for extra shifts if needed." C. "My brother and I want to go to on a mission trip in the next year." D. "I want to get this job so I can move on to the next part of my life."
Correct Answer: 3 Rationale 1: Becoming a nurse anesthetist in 10 years is a long-term goal. Rationale 2: Being available to come in for extra shifts is not measurable and is not a goal. A short-term goal statement would be, "I hope to work at least three extra shifts each month." Rationale 3: Going on a mission trip is a short-term goal because it involves a time frame of the next 6 months to a year. Rationale 4: Getting a job and moving on with life are not goals. A short-term goal statement would be, "I want to work and save $5,000 in the next year."
The nurse manager is concerned about the apparent lack of staff motivation to improve client care on a unit. How should this manager use motivational theories to help improve this situation? A. Choose one theory that the manager thinks best suits the situation. B. Review several theories but use no more than two. C. Combine theories to develop a plan for this specific unit. D. Review the motivational theories, but don't depend on any of them to work in "the real world."
Correct Answer: 3 Rationale 1: Limiting motivation to one theory will narrow the manager's influence. Different workers are motivated in different ways. Rationale 2: It is important for the manager to be aware of many theories. Using only two theories narrows the manager's ability to be influential. Rationale 3: The manager will encounter workers who are motivated in a variety of ways. The manager should learn about as many theories as possible and combine them to suit the specific population of the unit. Rationale 4: There is a significant amount of research that supports the use of these theories in "the real world."
A registered nurse is dissatisfied with the wages and health benefits available in his current position and decides to seek other employment. This employee's frustration is most linked to which motivational theory? A. Reinforcement theory B. Process theory C. Content theory D. Equity theory
Correct Answer: 3 Rationale 1: Reinforcement theory deals with behavioral modification and the person's response to positive or negative reinforcement. Rationale 2: Process theories emphasize how the motivation process works to direct an individual's effort into performance. Rationale 3: Content theories explain why a person behaves in a particular manner, emphasizing the individual's needs or the rewards that satisfy those needs—in this case, wages and health benefits. Rationale 4: Equity theory suggests that effort and job satisfaction depend on the degree of equity, or perceived fairness, in the work situation.
A manager has conducted a nurse's evaluation, focusing a large portion of the appraisal on the nurse's personality. The nurse does not agree with the appraisal and contacts the human resources director. What is the soundest basis on which to dispute the appraisal? A. The appraisal is incomplete. B. The appraisal is unfair. C. The appraisal is not valid. D. The nurse's perception of the appraisal is unjustified
Correct Answer: 3 Rationale 1: The appraisal is technically not incomplete, but it is insufficient. Rationale 2: There is not enough information to judge the fairness of the appraisal. Rationale 3: Because the majority of the appraisal focused on the nurse's personality, the appraisal is not valid. The focus of the appraisal should be how the nurse's actions affect the work of the unit. Rationale 4: There is not enough information to judge whether the nurse's perception of the appraisal is justified
After the second week of orientation the new nurse witnesses the death of a child in the ED. Which role should this nurse's preceptor focus on at this time? A. Orientation of the nurse to protocols associated with this death. B. Socialization of the nurse to the staff. C. Counseling the new nurse. D. Serving as a role model.
Correct Answer: 3 Rationale 1: The new nurse should be oriented to protocols, but this is not the most important role at this time. Rationale 2: The new nurse should be socialized to the staff, but this is not the most important role at this time. Rationale 3: In this situation the most important role is counseling. Rationale 4: The preceptor should always act as a role model for the new nurse, but this is not the most important role at this time.
The registered nurse has had recent difficulty finishing and documenting client care during the assigned shift. The nurse has historically had very good appraisals, and the climate of the unit has not changed. Which would be the best approach to correct recent behaviors? A. Provide education B. Simplify tasks C. Clarify expectations D. Reassign the nurse to another unit
Correct Answer: 3 Rationale 1: The nurse performed well in the past, so the problem is more likely due to motivation, not skills. Rationale 2: If the climate of the unit had changed in such a way that the nurse was not overloaded with work, simplifying tasks might be a valid option. Since this has not occurred, motivation is the most likely cause for this issue. Rationale 3: The nurse may lack the motivation to do the job on time. The manager should first clarify the expectation that the nurse will have work completed by the end of the shift. If the problem continues, additional intervention may be necessary. Rationale 4: There is no indication that assigning the nurse to another unit would solve this problem
During appraisal interviews, the nurse manager defends the choice of rating by emphasizing the negative aspects of the nurse's performance. What is the likely outcome of this strategy? A.The nurse will clearly see the impact of attitude on performance. B. The nurse will identify ways that performance can be improved. C. The nurse will pay less attention to maintaining what is done well. D. The nurse will ignore the negative statements and focus only on the positive.
Correct Answer: 3 Rationale 1: The nurse will not see the relationship between attitude and performance just because negative statements were made. Rationale 2: The nurse is less likely to identify ways that performance can be improved if making only negative statements. Rationale 3: Focusing only on the negative aspects of a nurse's performance can result in the nurse discounting the importance of the things the nurse does well. If this is the case, the nurse may pay less attention to those areas in the future and may not do them as well. Rationale 4: The nurse is unlikely to simply ignore the negative statements and will probably not focus on ways to improve as well as if positive statements had also been made
The nurse manger is conducting an interview for a position as a full-time RN in a critical care unit. Which statements by the nurse manger would be most effective in selecting a qualified nurse for this position? Select all that apply A. "I have 20 years of experience as a critical care nurse and I am an advanced practice nurse in adult medical-surgical nursing." B. "We do lots of patient teaching. Do you like doing patient teaching? C. "Tell me about your past work experience." D. "Please tell me about your most rewarding experience as a nurse." E. "Have you ever card for a patient on a ventilator?"
Correct Answer: 3,4 Rationale 1: Questions should be focused on the candidate, not the person conducting the interview. Rationale 2: This is a leading question, which should be avoided. The obvious "correct" answer is "yes." Rationale 3: Information about past work experience is helpful in determining qualifications for the prospective job. Rationale 4: Asking about the most rewarding experience as a nurse may reveal much about the nurse's past. Rationale 5: Whether or not a candidate has cared for a client on a ventilator does not prove the applicant's ability.
A nurse manager has planned orientation activities for a new registered nurse. The new nurse is required to observe shift report and UAP delegation for a week. Then the new nurse is required to take shift report and delegate UAP assignments for a week. What is the rationale for making this orientation assignment? A. Delegation is not taught at all nursing schools. B. Shift report differs in all hospitals. C. Shift report and UAP delegation are minimal tasks and good for novice nurses. D. The manager should focus on those skills specific to the new nurse's role.
Correct Answer: 4 Rationale 1: Delegation is taught in nursing schools, but must be practiced. Rationale 2: The fact that shift report may differ in all hospitals is not relevant to this situation. Rationale 3: Shift report and UAP delegation are not minimal assignments. Rationale 4: Successful orientation requires that the nurse understand job responsibilities. The manager should focus on those items unique to the employee's specific job. Learning how to delegate staff will take time, and orientation is a good opportunity to allow the employee to learn this role.
A medical unit nurse manager is conducting an interview of a potential employee. Which strategy should the manager use? A. Document first impressions of the applicant. B. Review the resume during the interview C. Use closed questions to elicit more information D. Use work sample questions to determine knowledge
Correct Answer: 4 Rationale 1: First impressions may lead to premature judgments and hasty decisions. Rationale 2: The résumé should be reviewed alone prior to the initiation of the interview. Rationale 3: Closed questions elicit yes or no answers and do not provide much information. Rationale 4: Work sample questions are used to determine an applicant's knowledge about work tasks and ability to perform the job.
Adopting which strategy would be helpful in reducing recency error in staff appraisals? A. Being careful not to overrate employees. B. Evaluating each behavior separately and fairly. C. Carefully defining performance standards. D. Recording critical incidents as they occur
Correct Answer: 4 Rationale 1: Overrating employees is leniency error. Recency error can result in either overrating or underrating an employee. Rationale 2: This strategy is not helpful if the manager remembers only behaviors that occurred recently. Rationale 3: Carefully defining performance standards is a good idea but is not helpful to the manager who does not remember facts about a particular employee. Rationale 4: Recency error is the tendency of a manager to remember only what has occurred with an employee recently. To combat recency error, the manager should keep notes on critical incidents in the employee's work as they occur.
The nurse manager has identified physical assessment skills lacking in a new registered nurse. Using goal-setting theory, which statement by the manager would be the most effective in enhancing the nurse's assessment skills? A. "You need to work on your health assessment skills before your next employee evaluation." B. "Get someone to help you with your health assessment skills by the end of the month." C. "read a health assessment book and practice your skills." D. "Plan to study one body system a week and demonstrate your assessment skills to me every week."
Correct Answer: 4 Rationale 1: Telling the nurse to develop skills without offering a plan will not motivate the nurse. Rationale 2: Saying "Get someone to help you" is not managing the process of development. Rationale 3: Reading and practicing skills is a good plan, but there is no component of review by the manager to motivate the nurse. Rationale 4: A measurable, realistic, and obtainable goal with a component of follow-up will be more motivating to the nurse.
Which statement would be inappropriate for a manager to write on an employee's performance appraisal? A. "The nurse's attitude positively affects coworkers." B. "The nurse seeks learning experiences." C. "The nurse is frequently tardy." D. "The nurse is shy and quiet."
Correct Answer: 4 Rationale 1: The nurse's attitude is important because of its effect on coworkers, which the manager can see or measure. Rationale 2: Seeking learning experiences is something the manager can see or measure. Rationale 3: Tardiness is something that can be measured. Rationale 4: A performance appraisal must focus on an individual's job performance and not personal characteristics. Shy and quiet are personal characteristics. If the nurse has impaired communication skills because of being too shy and quiet, then that is related to job performance.
A nurse manager believes that a staff nurse is rude to clients. In the past year, other nurses and staff from other departments have reported that the nurse has treated them rudely. The manager reviews the staff nurse's employee file and finds last year's appraisal as exceptional. What is the manager's best course of action during this year's evaluation? A. Tell the nurse that complaints about rudeness have been received and that additional complaints will result in termination. B. Notify nursing administration of the issues and complaints. C. Tell the nurse that other staff nurses have complained about rudeness and have been instructed to keep a log of incidents. D. Include documentation of these issues in the evaluation that is discussed with the nurse and provide a plan of action
Correct Answer: 4 Rationale 1: Unless the nurse has done something outrageous or illegal, there is not enough information to warrant termination. Rationale 2: The manager may elect to notify administration, but this is not the best answer to this question. Rationale 3: Other staff nurses should not be involved in keeping a log regarding this nurse's behaviors. Rationale 4: Documenting the issues, a one-on-one conference with the nurse, and providing a specific plan of action with a specific time frame is the best course of action
Which strategies would decrease the amount of time the nurse manager spends with "drop-in" visitors to the manager's office? Select all that apply A. Set office hours to eliminate those visits. B. Keep the office door closed. C. Arrange furniture so the desk faces the door. D. Stand up to greet the visitor and remain standing. E. Encourage appointments for routine matters.
Correct Answer: 4,5 Rationale 1: Office hours should be established to decrease drop-in visits, but the intent is not to totally eliminate them Rationale 2: Keeping the door closed is incorrect because a block of time when the door is open for accessibility and availability is needed. Rationale 3: If the desk faces the door, eye contact is made with passersby and anyone who is standing in the doorway, which invites interruption. Rationale 4: In order to redirect the drop-in visit, the nurse manager should stand up and remain standing throughout the encounter. This gesture is gracious yet obvious enough to encourage a short visit. Rationale 5: Encouraging appointments for routine matters is an effective solution. The manager should indicate that in order to have sufficient time to address the question, a block of time will be needed.
