Chapter 12 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
Chapter 12

Question 1

Type: MCMA

The nurse manager is facilitating the work of a collaborative team whose mission is to negotiate employment contracts with physicians. The nurse manager does not want to compromise the nurses concerns in favor of the doctors concerns. Which strategies would facilitate this outcome?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Accommodating

2. Compromising

3. Smoothing

4. Collaborating

5. Competing

Correct Answer: 4,5

Rationale 1: Accommodating is an unassertive tactic used when individuals neglect their own concerns in favor of others concerns.

Rationale 2: In a compromise, neither party gets what they want.

Rationale 3: Smoothing is usually only effective for small problems and does not protect the interests of one party against the other.

Rationale 4: Collaborating focuses on solving the problem and satisfying both parties concerns.

Rationale 5: Competing is a victory for one side and a loss for the other.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-5: Explain how to manage conflict.

Question 2

Type: MCSA

The nurse manager asks the staff nurse to work a double shift because the census is high. Although the nurse realizes the staffing for the night shift is low, the nurse has already made a family commitment for the same night. This is an example of which concept?

1. Intrapersonal conflict

2. Interpersonal conflict

3. Intragroup conflict

4. Intergroup conflict

Correct Answer: 1

Rationale 1: Intrapersonal conflict occurs when the consequence of real or perceived differences in mutually exclusive goals, values, attitudes, beliefs, feelings, or actions occurs within one individual. In this case, the nurses conflict is between personal plans and the need to help alleviate the low staffing issue.

Rationale 2: Interpersonal conflict occurs when the consequence of real or perceived differences in mutually exclusive goals, values, attitudes, beliefs, feelings, or actions occurs between two or more individuals.

Rationale 3: Intragroup conflict occurs when the consequence of real or perceived differences in mutually exclusive goals, values, attitudes, beliefs, feelings, or actions occurs within one group.

Rationale 4: Intergroup conflict occurs when the consequence of real or perceived differences in mutually exclusive goals, values, attitudes, beliefs, feelings, or actions occurs between two or more groups.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-1: Describe why conflict can be positive or negative.

Question 3

Type: MCSA

The nurse manager presents an issue to the nursing staff for a decision. The group assesses the problem, and a decision is made meeting the needs of both the nurse manager and the nursing staff. This is an example of which conflict management strategy?

1. Integrative decision making

2. Win-lose strategy

3. Accommodation

4. Consensus

Correct Answer: 4

Rationale 1: Integrative decision making is a strategy that focuses on the process of decision making, not the outcome.

Rationale 2: Win-lose strategies allow one party to win and the other to lose.

Rationale 3: Accommodation is an unassertive strategy used when individuals neglect their own concerns in favor of the other partys concerns.

Rationale 4: Consensus occurs when the problem is fully explored, the needs and goals of both parties are addressed, and a mutual decision is made.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 4

Type: MCSA

The nurse manager meets with the staff nurses to discuss ways to improve communication among the shifts. Which statement by the nurse manager best exemplifies the final stage of conflict management?

1. We need to clearly define the nature of the conflict.

2. I will evaluate the outcomes of our strategies on a monthly basis.

3. Lets create a time line for the implementation of our strategies.

4. Hopefully, each group can understand each others perceptions of the issue.

Correct Answer: 2

Rationale 1: Defining the nature of the conflict is a part of assessment. Assessment is the first step of conflict management.

Rationale 2: In any situation, the nurse manager should use the nursing process to intervene. The final step of the nursing process is evaluation, which is reflected in the statement, I will evaluate the outcomes.

Rationale 3: Creating a time line for the implementation of strategies is an intervention, which is one of the middle steps of conflict management.

Rationale 4: Understanding each others perceptions is part of assessment, which is the first step of conflict management.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 5

Type: MCSA

The staff nurses and nursing administration are attempting to construct a method of scheduling that meets the needs of both the clients and the nursing personnel. Because nurses and nursing administration have experienced conflict about the issue, their intent is to arrive at an agreeable solution between both parties. Which option does this process best exemplify?

1. Negotiation

2. Accommodation

3. Forcing

4. Consensus

Correct Answer: 1

Rationale 1: Negotiation involves a reciprocal give and take on issues among the parties. The desired outcome is to achieve agreement even though consensus will never be reached.

Rationale 2: Accommodation is a cooperative tactic used when the desired outcome is to preserve harmony when one party has a vested interest in an issue that is unimportant to the other party.

Rationale 3: Forcing is an inappropriate mode of responding to conflict, and although a solution is found, the conflict remains unresolved.

Rationale 4: Consensus implies that the solution meets everyones needs, which is often not the case in negotiation.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 6

Type: MCSA

A staff nurse has experienced disagreements with one of the medical residents about several issues. The resident reacts to this conflict by belittling the nurse in front of colleagues. This behavior is most characteristic of which type of conflict?

1. Competitive

2. Role

3. Perceived

4. Disruptive

Correct Answer: 4

Rationale 1: Competitive conflict occurs when there is a positive outcome for one side and a negative outcome for the opponent.

Rationale 2: Role conflict occurs when people have related responsibilities that may overlap and are ambiguous.

Rationale 3: Perceived conflict occurs when two parties misunderstand each others position and is often the result of a knowledge deficit. It does not necessarily result in irrational behavior.

Rationale 4: Both parties are engaged in activities to reduce, defeat, or eliminate the opponent, which result in irrational, unproductive behavior. This is disruptive conflict.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-3: Describe the components of conflict.

Question 7

Type: MCSA

The day shift nurses and night shift nurses are in clear opposition regarding the responsibilities that each shift should be assigned. This opposition has created a we-they distinction on the unit. This is an example of which phenomenon?

1. Distancing

2. Suppression

3. Group withdrawal

4. Unification

Correct Answer: 1

Rationale 1: Distancing mechanisms or differentiation serve to divide group members into small, distinct groups, which increases the risk for conflict.

Rationale 2: Suppression occurs when one group defeats the other. Only the dominant side is fully committed to the decision.

Rationale 3: Withdrawal occurs when one group simply removes itself from the conflict.

Rationale 4: Unification implies understanding and acceptance among members, which would not occur in a conflict situation.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-3: Describe the components of conflict.

Question 8

Type: MCSA

A conflict has arisen between two staff nurses who work on the same unit. Which strategy is most important for the nurse manager to consider?

1. Address the conflict in the break room.

2. Make a timely decision regarding if and when to intervene.

3. Accept full responsibility for developing a solution.

4. Redirect expressions of disagreement between the participants.

Correct Answer: 2

Rationale 1: It is generally best to address conflict management in a neutral and confidential territory.

Rationale 2: Conflict management begins with a decision regarding if and when to intervene. Failure to intervene can allow the conflict to escalate, whereas premature intervention can cause individuals to lose self-confidence and avoid risk taking.

Rationale 3: The responsibility for developing a solution to the problem falls on each of the participants, not the mediator.

Rationale 4: Full expression of positive and negative feelings is conducive to conflict resolution.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 9

Type: MCSA

A difference in opinion has arisen regarding methods to care for clients who are on mechanical ventilators. The nurse manager asks a group of nurses to meet and review evidence-based practice related to this client care situation. Each nurse volunteers to gather data prior to the next meeting. This is an example of which type of problem solving?

1. Negotiation

2. Collaboration

3. Compromise

4. Forcing

Correct Answer: 2

Rationale 1: Negotiation implies differences in opinions. There is no evidence that negotiation will be necessary in the work outlined.

Rationale 2: Collaboration occurs when all parties use their expertise to problem solve. The group focuses on problem solving as opposed to competition.

Rationale 3: Compromise means that neither party gets what he or she wants. Rewards are divided between both parties. There is not yet any compromise indicated in this scenario.

Rationale 4: Forcing provides an immediate end to the conflict but fails to resolve the cause of the conflict. An example of forcing would be the nurse manager making a decision on the client care and telling nurses that is how it is to be done.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 10

Type: MCSA

The nurse manager assesses that there is conflict between two of the charge nurses. The decision is made to postpone an intervention and allow the conflict to escalate. Why might the nurse manager make this decision?

1. Allow sufficient time for the problem to spontaneously resolve.

2. Motivate the participants to seek resolution.

3. Give the nurse manager time to identify problem-solving strategies.

4. Relieve the nurse manager of the time commitment necessary to intervene.

Correct Answer: 2

Rationale 1: The problem is unlikely to spontaneously resolve or just go away no matter how much time is allowed. It is the responsibility of the participants to identify problem-solving strategies.

Rationale 2: The nurse manager may delay intervention to allow the conflict to escalate because increased intensity can motivate participants to seek resolution. The nurses would still actively work to resolve the issue.

Rationale 3: The nurse manger would facilitate the identification of problem-solving strategies by the participants. The manager does not need to shoulder the responsibility of solving the problem.

Rationale 4: Preventing the nurse manager from intervening is incorrect because although conflict management does take time, at times it is beneficial to allow the parties to seek resolution. Delay is not designed to relieve the manager from the responsibility of intervening if necessary.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 11

Type: MCSA

The nurse manager assesses that two staff nurses are engaged in a conflict that is having a negative impact on client care. The manager meets with the nurses involved and identifies the conflict. An attempt is made to resolve the conflict through knowledge and reason. What strategy is this manager using?

1. Confrontation

2. Resolution

3. Negotiation

4. Forcing

Correct Answer: 1

Rationale 1: Confrontation is the most effective means of resolving conflict, in which the conflict is brought out in the open and deliberate attempts are made to resolve it through knowledge and reason.

Rationale 2: Resolution is the final stage of conflict management that occurs when a mutually agreed-upon solution is arrived at and both parties commit themselves to carry out the agreement.

Rationale 3: Negotiation is a technique in which the conflicting parties give and take on various issues.

Rationale 4: Forcing is a conflict management technique that forces an immediate end to conflict but the cause is not resolved.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-5: Explain how to manage conflict.

Question 12

Type: MCSA

A nurse manager states, I cannot stand all these conflicts in my department. Nothing good can come out of it. Which indicates the best reason the managers statement is untrue?

1. Conflict can stimulate more people to become involved in a situation, thus creating more innovative solutions to the issue.

2. When people are in conflict, they tend to work harder just to avoid the conflicting situation.

3. Groups in conflict spur competition, which is always beneficial to the units from which the groups emerged.

4. When there is conflict in an organization, people are more open to discussion, thus conflict can open the lines of communication.

Correct Answer: 1

Rationale 1: Conflict can be positive because as a conflict arises, individuals may become involved that might not have otherwise. Getting more people involved usually results in more creative solutions.

Rationale 2: Those in conflict do not necessarily work harder to avoid the situation.

Rationale 3: The competition spurred by conflict is often negative and not beneficial to those involved.

Rationale 4: It is more likely that conflict will damage the lines of communication.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 12-1: Describe why conflict can be positive or negative.

Question 13

Type: MCSA

A nurse has a longstanding conflict with another nurse working the same shift. Over the last few days the first nurse has made an effort to smooth over the conflict. Which statement would the nurse manager evaluate as an example of a smoothing comment?

1. We are never going to agree because I am from Generation X and you are a baby boomer.

2. Im tired of this fight and Im not going to argue with you anymore.

3. Even though we dont agree on much, I do think you are correct about enforcing the length of lunch breaks.

4. I think everything is fine and that we can get along.

Correct Answer: 3

Rationale 1: A comment on generational differences could actually promote conflict.

Rationale 2: Being tired of the fight is a statement of withdrawal.

Rationale 3: Smoothing includes statements or actions such as complementing ones opponent, downplaying differences, and focusing on minor areas of agreement. Agreeing about the length of lunch break is one such minor area.

Rationale 4: The statement the we can get along is a statement of avoidance.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 14

Type: MCSA

The hospital has an annual campaign in which the staff is divided into two teams to raise money for hospital special events. The team raising the most money gets possession of a trophy designed by the administrative staff. This is an example of which type of conflict?

1. A conflict that is disruptive to the work of the hospital

2. A competitive conflict that is positive to the work environment

3. An intragroup conflict that is not appropriate in health care

4. A felt conflict that will result in unresolved feelings of frustration

Correct Answer: 2

Rationale 1: There is no indication that the conflict will be disruptive.

Rationale 2: This is an example of a competitive conflict and is an example of how conflict can be positive in an organization.

Rationale 3: This is an intergroup conflict, not an intragroup conflict and there is no indication that anything about the competition is inappropriate.

Rationale 4: There is no indication that this conflict will result in unresolved feelings of frustration.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-1: Describe why conflict can be positive or negative.

Question 15

Type: MCMA

Why does conflict help generate change?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Conflict assists change to occur more rapidly than it would otherwise.

2. It brings more attention to an issue in need of change.

3. People get involved because conflict breeds curiosity.

4. If there is an existing conflict, a change must occur to stop the conflict.

5. Change is inevitable, and some people refuse to change, which causes conflict.

Correct Answer: 2,3

Rationale 1: Conflict does not necessarily speed up the change process. It may slow the process.

Rationale 2: When conflict around a change occurs, more people become aware of the issue, and because of curiosity or interest, more people become involved in the process.

Rationale 3: When conflict around a change occurs, more people become aware of the issue, and because of curiosity or interest, more people become involved in the process.

Rationale 4: Conflict does not always occur as a resolution of conflict. In some instances, things stay the same.

Rationale 5: The question asks about conflict causing change, not change causing conflict.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-2: Discuss how conflict can help generate change.

Question 16

Type: MCSA

A new triage area has been built in the emergency department causing conflict between the nurse manager and the nurses who think the design is not user friendly. After repeated complaints the nurse manager asks maintenance to change the arrangement of the room. What is the most important reason this change occurred?

1. The complaints motivated the nurse manager to make the change to increase unit effectiveness.

2. The room design was uncomfortable for the nurses, which convinced the nurse manager to change the design.

3. The nurse manager was afraid the nurses would refuse to work in the room so the room had to be changed.

4. The nurses would keep complaining so the nurse manager changed the room to stop the griping.

Correct Answer: 1

Rationale 1: As the nurse manager, unit effectiveness is paramount. If the nurses are complaining, it is probably a legitimate problem in need of change.

Rationale 2: It is true that the room design was uncomfortable for the nurses, but it was the complaints that triggered the change.

Rationale 3: If the nurses had not complained about the room, the nurse manager would not have known about the situation.

Rationale 4: It might be correct that the nurses would keep complaining, but it was the fact that they were complaining in the first place that caused action by the nurse manager.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-2: Discuss how conflict can help generate change.

Question 17

Type: MCSA

The medical residents on a particular unit do not answer pages very quickly, and sometimes do not answer them at all. The nursing staff complains to the nursing supervisor. After several weeks, this conflict has spiraled into a heated disagreement. Which is the most important reason to make the necessary changes to settle this conflict?

1. Client care and satisfaction will suffer should it be allowed to continue.

2. The residents cannot be allowed to continue such unprofessional behavior.

3. Residents who do not answer pages do not get the most out of the experience.

4. Physicians do not know what is going on with clients if the residents do not tell them.

Correct Answer: 1

Rationale 1: Client care and satisfaction must take precedence over other reasons for settling the conflict.

Rationale 2: This is unprofessional behavior on the part of the residents, but this does not answer why it is important to settle the conflict.

Rationale 3: It is true that residents must fully participate in training in order to get the most out of it, but this does not answer why it is important to settle the conflict.

Rationale 4: Physicians may be slower in getting client information if residents are not professional, but this is not the best answer to this question.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-2: Discuss how conflict can help generate change.

Question 18

Type: MCSA

The nurse and a client are discussing instructions for self-care after discharge. The clients husband says, I cant take care of her by myself. We need home health like we had before she came to the hospital. This statement reflects which antecedent condition?

1. Task interdependence

2. Resource competition

3. Structural conflict

4. Differences in values and beliefs

Correct Answer: 4

Rationale 1: Task interdependence occurs when one groups success in completing tasks is dependent on another groups work.

Rationale 2: The statement that the husband wants home health is not a clear example of resource competition.

Rationale 3: Structural conflict has to do with structured relationships in which one person in the conflict is subordinate to the other.

Rationale 4: This situation is a potential conflict between the health care workers who believe that the husband can take care of the wife and the husband who believes that he cannot.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-3: Describe the components of conflict.

Question 19

Type: MCSA

The nursing staff is continually upset about inability to provide clients with supplies needed because third-party payers will not reimburse for those items. This is an example of which conflict antecedent?

1. Task interdependencies

2. Distancing

3. Role

4. Incompatible goals

Correct Answer: 4

Rationale 1: Task interdependencies occur when one group is dependent upon another group to complete a task.

Rationale 2: Distancing divides a groups members into small, distinct groups and increases chance for conflict.

Rationale 3: Roles are defined as other peoples expectations regarding behavior and attitudes.

Rationale 4: The nurses in this situation have the goal to provide the best possible care to clients. The third-party payers have the goal of providing care at the least cost. These two sets of goals are often incompatible and result in conflict.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-3: Describe the components of conflict.

Question 20

Type: MCSA

Which is the most important factor in whether a conflict will be perceived or felt between two nurses?

1. How well the nurses know and trust each other

2. If the nurses are on the same job level

3. The congruence of the nurses values and beliefs

4. Whether or not the nurses perform the same roles

Correct Answer: 1

Rationale 1: Perceived versus felt conflict depends on whether or not the involved parties know and trust each other. If past problems have been handled calmly and rationally, and each knows what to expect from the other, it is considered a perceived conflict.

Rationale 2: Job level is not as important in determining whether a conflict is felt or perceived.

Rationale 3: Congruence of values and beliefs is not as important as another factor in determining whether a conflict is felt or perceived.

Rationale 4: Whether or not the nurses perform the same roles will not be useful in determining whether a conflict is perceived or felt.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 12-3: Describe the components of conflict.

Question 21

Type: MCMA

Which statements would alert a nurse manager that a unit conflict has become disruptive?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. I wont stop until I have gotten her fired.

2. He doesnt fight fairly.

3. Ive almost forgotten what started this, I just focused on beating her.

4. I am going to win this argument.

5. He is so wrong, he just has to go.

Correct Answer: 1,2,3,5

Rationale 1: Conflict that is focused on reduction, defeat, or elimination of the opponent is disruptive.

Rationale 2: Competitive conflict follows a set of rules. When rules are ignored, the conflict becomes disruptive.

Rationale 3: Focus on defeating the opponent is disruptive.

Rationale 4: In competitive conflict the focus is on winning, not on defeating or eliminating the opponent.

Rationale 5: An urge to eliminate the competitor is reflective of the competition becoming disruptive.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 12-1: Describe why conflict can be positive or negative.

Question 22

Type: MCMA

A nurse and a physician are in conflict over the treatment of a client. Which statements by the nurse reflect the best way to handle interprofessional conflict?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. I think it would be better for the client to stay another day.

2. This client needs an additional day to learn how to care for a complex wound.

3. It will help this client manage her diabetes more effectively if she is assigned a diabetic educator.

4. Research has shown that early ambulation helps to reduce the likelihood of pulmonary embolism.

5. Do you not remember what happened when you sent that other client home too early?

Correct Answer: 2,3,4

Rationale 1: I statements of what the nurse wants are not the best way to discuss options in an interprofessional disagreement.

Rationale 2: Speaking from the vantage point of the client helps to support the nurses position in this conflict.

Rationale 3: Explaining what will best help the client helps to support the nurses position in this conflict.

Rationale 4: Using facts to support the nurses point in the conflict is an important strategy.

Rationale 5: This statement is confrontational and is unlikely to support the nurses position in this conflict.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-1: Describe why conflict can be positive or negative.

Question 23

Type: MCMA

A physician criticizes the care provided by a nurse in an area where others are present. Which actions by the nurse would the manager interpret as a covert conflict behavior resulting from this situation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The nurse says, You cant talk to me like that.

2. The nurse avoids the physician in the hallway.

3. The nurse refuses to care for the physicians clients.

4. The nurse is no longer as careful in caring for this physicians clients.

5. The nurse is apathetic about the care of clients.

Correct Answer: 2,4,5

Rationale 1: Aggression is an overt conflict behavior.

Rationale 2: Avoidance is a covert behavior.

Rationale 3: Refusal is an overt act of conflict.

Rationale 4: Not being as careful is a covert action.

Rationale 5: Apathy is a covert conflict behavior.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 12-3: Describe the components of conflict.

Question 24

Type: MCMA

Two staff nurses are in conflict about the summer vacation schedule. The nurse manager is contemplating assigning both nurses to a task that will require frequent contact with each other, hoping that they will resolve the issue themselves. What should the manager consider before making this assignment?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. What is the anxiety level of the nurses in regard to the vacation schedule?

2. Have the nurses ever worked together before on a project?

3. Will the conflict decrease the efficiency of the unit while the nurses are self-solving the issue?

4. How intense is the conflict about vacation scheduling?

5. Are the nurses talking to the rest of the staff about the conflict?

Correct Answer: 1,3,4

Rationale 1: If there is high anxiety about the issue, assigning the nurses to a task together is likely not a good idea.

Rationale 2: Whether or not the nurses have worked together before is not a critical consideration.

Rationale 3: If the efficiency of the unit is in jeopardy, the manager should intervene.

Rationale 4: If the conflict regarding vacation scheduling is intense, the nurse manager should abandon this plan.

Rationale 5: It is likely that the rest of the staff already knows about the conflict and that the nurses involved have discussed it. This is not a factor in deciding on a plan.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 12-4: Identify different approaches that can be used to manage conflict.

Question 25

Type: MCSA

A nurse manager and a staff nurse are in conflict. The nursing supervisor has decided to use mediation to arrive at a solution. The supervisor should be most concerned about which persons level of comfort when choosing a place for the mediation meeting?

1. The manager

2. The staff nurse

3. The supervisor

4. There should be equal concern for all participants.

Correct Answer: 2

Rationale 1: The manager is in a power position over the staff nurse. The supervisor should not be most concerned about the managers level of comfort.

Rationale 2: The staff nurse has the lowest ranking of all involved in this mediation. The most concern should be with the staff nurses level of comfort.

Rationale 3: The supervisors level of comfort is not the most important in this situation.

Rationale 4: The lowest ranking person should receive the most consideration when planning a place for this meeting.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 12-5: Explain how to manage conflict.

Question 26

Type: MCMA

A serious conflict between a nurse and a nursing assistant erupted into a shouting match in the hallway. The nurse attempted to slap the nursing assistant. What conflict responses are appropriate for the assistant?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Accommodating

2. Withdrawal

3. Avoiding

4. Smoothing

5. Negotiation

Correct Answer: 2,3

Rationale 1: When the conflict becomes violent, accommodation is no longer appropriate.

Rationale 2: When safety is at risk, withdrawal is a valid response.

Rationale 3: When safety is at risk, avoiding is a valid response.

Rationale 4: When the conflict becomes violent, smoothing is no longer appropriate.

Rationale 5: When tempers are high and the situation is dangerous, negotiation is not possible.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-5: Explain how to manage conflict.

Question 27

Type: MCMA

Conflict has arisen within the hospital regarding who will staff a proposed high-acuity unit. The nurse executive and other administrators have purposefully not intervened in this conflict. Why is that strategy appropriate?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Conflict draws attention to an issue.

2. The administrators do not like conflict management.

3. Conflict can stimulate new ideas about how to manage the high-acuity unit.

4. Conflict about the unit will help to identify the compromises necessary to make it a viable part of the hospital system.

5. Conflicts about staffing may make current staff members reexamine their own performance.

Correct Answer: 1,3,4,5

Rationale 1: There may be a reason that administration would desire that attention be brought to the new unit. Conflict will bring that attention.

Rationale 2: Whether or not the administrators like conflict management probably has little to do with their decision.

Rationale 3: Conflict can stimulate thought and new ideas.

Rationale 4: Any new program or unit comes at a cost and the cost-benefit ratio must be explored. Conflict can help others identify the compromises and costs associated with starting this unit.

Rationale 5: Staff members who wish to be considered for staffing the new unit may improve their own performance and effectiveness.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-2: Discuss how conflict can help generate change.

Question 28

Type: MCSA

A nurse manager is trying to manage a conflict between a staff nurse and a medical student. Which statement by the manager would the nursing supervisor interpret as following the rules of basic mediation?

1. Both parties need to grow up. They are so immature.

2. The problem is partially the fault of both parties.

3. I stopped the conversation frequently to have the parties summarize what was being said.

4. They just went on and on. I had to stop the discussion because I was out of time.

Correct Answer: 3

Rationale 1: The manager should protect the partys self-respect. Characterizing them as immature is not appropriate.

Rationale 2: The manager should not put the blame for the problem on the parties involved, but should make them responsible for finding a solution.

Rationale 3: Having the parties summarize the discussion helps to ensure active listening.

Rationale 4: The manager should encourage full discussion and should plan adequate time for this to occur.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 12-5: Explain how to manage conflict.

Question 29

Type: MCSA

Which statement by the nurse managing a unit conflict indicates that the integrative decision-making strategy is being used?

1. Ive heard all I need to hear. Ill have a decision tomorrow.

2. Once you have signed this informed consent, the issue will go to mediation.

3. This will all blow over if everyone just tries to get along better.

4. Both parties should come up with as many alternative solutions as possible before our next meeting.

Correct Answer: 4

Rationale 1: If the manager makes the decision, positional power has been used. This is not integrative decision making.

Rationale 2: Integrative decision making does not require informed consent. Mediation is a different strategy.

Rationale 3: Waiting for everyone to get along and the problem to blow over are characteristic of smoothing or avoiding behaviors.

Rationale 4: In integrative decision-making, both parties conduct an exhaustive search for acceptable alternatives.

Global Rationale: 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-5: Explain how to manage conflict.

Question 30

Type: MCSA

In order to come to a solution for an ongoing conflict among several nursing units, the nursing supervisor says, Your managers will meet to create a voting form representing both sides of this issue. Each of you will vote and the majority will rule. What kind of a solution is the supervisor seeking?

1. Consensus

2. Win-win

3. Forcing

4. Win-lose

Correct Answer: 4

Rationale 1: Consensus occurs when all parties come together and decide the best solution to the issue.

Rationale 2: In a win-win solution, no one loses. That is not the case in this situation.

Rationale 3: The supervisor is not forcing an immediate end to the conflict, but is calling for a majority vote.

Rationale 4: Someone will win in this case and someone will lose.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12-5: Explain how to manage conflict.

Sullivan, Effective Leadership and Management, 8/e Test Bank

Copyright 2013 by Pearson Education, Inc.

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