Chapter 18 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
Chapter 18

Question 1

Type: MCMA

The nurse manager is completing employee evaluations. Which practices should the manager use when doing these appraisals?

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

Standard Text: 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.

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: 18-2: Discuss different methods used to evaluate performance.

Question 2

Type: MCSA

Which statement would be inappropriate for a manager to write on an employees performance appraisal?

1. The nurses attitude positively affects coworkers.

2. The nurse seeks learning experiences.

3. The nurse is frequently tardy.

4. The nurse is shy and quiet.

Correct Answer: 4

Rationale 1: The nurses 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 individuals 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.

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: 18-1: Describe criteria that can be used to evaluate staff performance.

Question 3

Type: MCSA

An ICU nurse manager prefers to use a results-oriented system when evaluating employees. Why would the manager prefer this system?

1. It allows for comparison between employees.

2. The employee knows in advance what is expected.

3. It is apparent when an employee stands out against peers.

4. 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.

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: 18-2: Discuss different methods used to evaluate performance.

Question 4

Type: MCSA

A nurse manager is discussing the hospitals changes to peer evaluation with nursing staff. Which comment by a staff nurse would the manager interpret as evidence of understanding this process?

1. Our evaluations will be more objective.

2. This must be a less expensive method of evaluation.

3. This should be quicker than our existing method.

4. This would be a good way to get back at the nurses who dont 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.

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: 18-2: Discuss different methods used to evaluate performance.

Question 5

Type: MCMA

An organization has changed its performance appraisal process and is conducting training for managers. What topics should the trainer include in the agenda for this session?

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

Standard Text: Select all that apply.

1. What a reasonable job performance should look like

2. How to conduct a disciplinary meeting

3. How to complete the evaluation form

4. How to give the employee feedback on evaluation

5. Use of anecdotal notes

Correct Answer: 1,3,4,5

Rationale 1: The manager must be able to differentiate reasonable job performance from unreasonable job performance.

Rationale 2: Discipline is not a part of the evaluation process.

Rationale 3: The evaluation form becomes a part of the employees permanent file and is legally discoverable. It must be completed accurately and completely.

Rationale 4: Feedback is important and must be offered and documented.

Rationale 5: Anecdotal notes or critical incident notes are a vital part of the evaluation process.

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: 18-1: Describe criteria that can be used to evaluate staff performance.

Question 6

Type: MCMA

A nurse manager has been terminated for failing to follow institutional policy and procedures. Upon reviewing the managers files, the supervisor discovers multiple unfinished employee evaluations from the last two years. The supervisor is faced with which concerns?

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

Standard Text: Select all that apply.

1. Finding someone with enough knowledge of the employees work to complete the evaluation processes

2. How to share evaluation information with employees

3. The legal steps necessary to invalidate the in-process evaluations and begin new evaluations

4. Whether the care provided on the unit has been safe and effective

5. How long it has been since employees have had a valid evaluation

Correct Answer: 1,2,4,5

Rationale 1: The evaluator must have direct knowledge of the employees work. The supervisor must find people who have that knowledge who are qualified to evaluate the work, whether the current evaluations are finished or new ones are started.

Rationale 2: Evaluations must be shared with the employee. If these evaluations were not finished, it is likely they were not shared.

Rationale 3: No legal steps are necessary to invalidate these in-process evaluations.

Rationale 4: Without a valid evaluation process, the care on the unit has not been assessed.

Rationale 5: Employees should be evaluated at least once a year.

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: 18-1: Describe criteria that can be used to evaluate staff performance.

Question 7

Type: MCSA

Adopting which strategy would be helpful in reducing recency error in staff appraisals?

1. Being careful not to overrate employees

2. Evaluating each behavior separately and fairly

3. Carefully defining performance standards

4. 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 employees work as they 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: 18-3: Describe problems to expect when evaluating performance.

Question 8

Type: MCMA

A nurse manager looks through a file that contains information regarding critical incident reports filed within the past year. For which reasons does the manager review and use this information?

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

Standard Text: Select all that apply.

1. To increase leniency

2. To decrease the possibility of lawsuits by the employee being evaluated

3. To increase manager-employee communication

4. To decrease recency error

5. To increase the accuracy of the evaluation

Correct Answer: 2,3,4,5

Rationale 1: The goal of evaluators is to decrease leniency errors.

Rationale 2: The reason the manager doing evaluations reviews the critical incident file is to collect information to help the manager do the best evaluation appraisal possible. This helps to decrease the possibility of a lawsuit being filed against the manager for inaccurate evaluation.

Rationale 3: Reviewing the critical incident file prior to the evaluation will refresh the managers memory of the employees overall performance and will increase and improve manager-employee communication.

Rationale 4: Looking back at the employees record for the evaluation period will help to decrease recency error.

Rationale 5: Reviewing the employees records over the evaluation period will help the manager write a more accurate evaluation.

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: 18-4: Explain how to use critical incidents to improve annual evaluations.

Question 9

Type: MCSA

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?

1. Provide education

2. Simplify tasks

3. Clarify expectations

4. 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.

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: 18-3: Describe problems to expect when evaluating performance.

Question 10

Type: MCSA

A nurse manager and an employee meet to discuss the employees appraisal. They disagree on the content of the employee evaluation. The disagreement turns into an argument. Which is the best managerial strategy in this situation?

1. Postpone the interview.

2. Agree on arbitration.

3. Seek input from employee peers.

4. Report the employee to the human resources manager.

Correct Answer: 1

Rationale 1: Postponing the interview allows both manager and employee to calm down and reflect on the disagreement.

Rationale 2: Suggesting arbitration is not the first step for this manager.

Rationale 3: It is inappropriate to seek input from peers as evaluation is a confidential interaction.

Rationale 4: Reporting the employee to human resources is not the first step. If problems continue, human resources should be advised.

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: 18-3: Describe problems to expect when evaluating performance.

Question 11

Type: MCSA

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?

1. Recency error

2. Leniency error

3. Ambiguity error

4. 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 nurses 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 nurses performance.

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: 18-3: Describe problems to expect when evaluating performance.

Question 12

Type: MCSA

The manager overhears a nurse say to a client, I am having trouble getting your IV started because you are so fat. The manager determines that a critical incident form should be completed. Which entry is appropriate to document on the form?

1. The nurse was rude to the client.

2. The nurse was rude and incompetent when caring for the client.

3. The client is obese, and intravenous catheter placement was attempted but unsuccessful due to the clients size.

4. Nurse _____ attempted to start an IV on this client and stated, Im having trouble getting your IV started because you are so fat.

Correct Answer: 4

Rationale 1: A statement that the nurse was rude is an opinion and should not be used in the critical incident form.

Rationale 2: Rudeness and incompetence are value statements and should not be used in critical incident forms.

Rationale 3: The facts of the incident are correct, but this statement makes no mention of why a critical incident form should be completed.

Rationale 4: The critical incident form must contain the event with accuracy and without judgment. Documentation should include the facts and the sequence of events.

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: 18-4: Explain how to use critical incidents to improve annual evaluations.

Question 13

Type: MCMA

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?

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

Standard Text: 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.

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: 18-4: Explain how to use critical incidents to improve annual evaluations.

Question 14

Type: MCSA

During appraisal interviews, the nurse manager defends the choice of rating by emphasizing the negative aspects of the nurses performance. What is the likely outcome of this strategy?

1. The nurse will clearly see the impact of attitude on performance.

2. The nurse will identify ways that performance can be improved.

3. The nurse will pay less attention to maintaining what is done well.

4. 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 nurses 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.

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: 18-2: Discuss different methods used to evaluate performance.

Question 15

Type: MCSA

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 nurses employee file and finds last years appraisal as exceptional. What is the managers best course of action during this years evaluation?

1. Tell the nurse that complaints about rudeness have been received and that additional complaints will result in termination.

2. Notify nursing administration of the issues and complaints.

3. Tell the nurse that other staff nurses have complained about rudeness and have been instructed to keep a log of incidents.

4. 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 nurses 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.

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: 18-2: Discuss different methods used to evaluate performance.

Question 16

Type: MCSA

An emergency department nurse manager is preparing for a night-shift nurses annual appraisal. The manager is apprehensive because there are issues to address regarding rudeness and unprofessional behavior. How should the manager prepare for conducting this appraisal?

1. Place the evaluation in an envelope with specific details addressing the nurses behavior and allow the nurse to review it during his or her next shift.

2. The manager should complete the evaluation and ask a peer to review it and provide feedback.

3. The manager should arrange a 2030 minute meeting with the nurse to discuss the evaluation privately.

4. The manager should allow the human resources manager to conduct the appraisal.

Correct Answer: 3

Rationale 1: Placing the evaluation in an envelope and allowing the nurse to review it during a shift is unprofessional and does not allow for dialogue between the nurse and the manager.

Rationale 2: Allowing a peer to review the managers evaluation of another employee is unethical, unprofessional, and illegal.

Rationale 3: The manager should control the environment in which the appraisal meeting is conducted. The meeting should be private and the manager should allow at least 2030 minutes for the interview.

Rationale 4: The human resources manager may give the appraisal but this does not allow for dialogue and questioning between the manager and the staff nurse.

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: 18-5: Explain how to conduct a performance appraisal interview.

Question 17

Type: MCSA

A nurse manager has discussed behavioral and unprofessional behaviors with a nurse. During the performance appraisal the manager addressed these issues and the two nurses have developed a specific plan to address the performance areas that can be strengthened. What should the managers next course of action be?

1. Take notes of the nurses behavior during the appraisal.

2. Inquire as to the nurses perception of the appraisal.

3. Schedule a follow-up session to determine if the nurse has made progress in the areas specified.

4. Schedule the next annual appraisal.

Correct Answer: 3

Rationale 1: The manager should have been taking notes all through the discussion. Notes taken now have a smaller impact.

Rationale 2: The manager should have been checking the nurses perception of the progress of the meeting throughout the meeting.

Rationale 3: At this point of the interview, the manager should schedule a follow-up session to determine if the nurse has made progress.

Rationale 4: The next annual appraisal will be scheduled closer to the time it will be held.

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: 18-5: Explain how to conduct a performance appraisal interview.

Question 18

Type: MCSA

A director has performed an annual appraisal of the ICU manager, which reflects several issues in regard to the managers attitude. At the end of the interview the manager expresses disagreement with the appraisal. The director instructs the manager to sign the appraisal and ends the interview. The manager reports this situation to the human resources director for which reason?

1. The interview was conducted in an unprofessional manner.

2. The appraisal could be interpreted as discriminatory.

3. The appraisal was not a fair evaluation of the managers work.

4. The director appraised the managers attitude which is unprofessional.

Correct Answer: 2

Rationale 1: There is not enough information to determine whether the interview was managed in an unprofessional manner.

Rationale 2: The appraisal could be discriminatory because the manager should be offered the time to add written comments to the appraisal form. The director failed to allow this time.

Rationale 3: There is not enough information to determine if the appraisal was a fair evaluation of the managers work.

Rationale 4: If there are attitude issues the director should address how they affect the work of the unit in the appraisal.

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: 18-3: Describe problems to expect when evaluation performance.

Question 19

Type: MCSA

A manager has conducted a nurses evaluation, focusing a large portion of the appraisal on the nurses 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?

1. The appraisal is incomplete.

2. The appraisal is unfair.

3. The appraisal is not valid.

4. The nurses 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 nurses personality, the appraisal is not valid. The focus of the appraisal should be how the nurses actions affect the work of the unit.

Rationale 4: There is not enough information to judge whether the nurses perception of the appraisal is justified.

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: 18-3: Describe problems to expect when evaluating performance.

Question 20

Type: MCSA

During the review of an organizations appraisal policies, a nurse consultant finds that the facility uses a traditional rating scale based on general performance. What would be the consultants greatest concern with this choice of appraisal style?

1. It is time consuming for the manager to write the evaluation essay required by this method.

2. Ratings are based on the supervisors idea of satisfactory performance.

3. The standards used are so specific that they do not allow for individual variation.

4. Since this style involves input from peers, there is room for problems with confidentiality.

Correct Answer: 2

Rationale 1: The length of time it takes to write an evaluation is not the primary concern.

Rationale 2: One of the problems with this style of appraisal is that the ratings are based on the supervisors idea of satisfactory performance rather than specific employee behaviors.

Rationale 3: The standards used in this type of evaluation are broad.

Rationale 4: There is no input from peers in this style.

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: 18-2: Discuss different methods used to evaluate performance.

Question 21

Type: MCSA

A hospital uses a results-oriented evaluation system. During a nurses hiring process, the manager states, Once you have been officially hired, I want to meet with you regarding evaluation. What will be the focus of this meeting?

1. The manager will give the nurse a set of work objectives for the next year.

2. The manager will explain how poor evaluations can lead to termination.

3. The nurse and the manager will work together to write work objectives for the nurse.

4. The manager will review the nurses previous job experiences.

Correct Answer: 3

Rationale 1: The manager should not just give the nurse a set of work objectives.

Rationale 2: The focus of the meeting will not be on termination.

Rationale 3: The nurse and the manager should work together to write these work objectives.

Rationale 4: This review should have been conducted prior to hiring.

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: 18-2: Discuss different methods used to evaluate performance.

Question 22

Type: MCMA

An organization has adopted the peer review process of evaluation. The manager shares which information with staff?

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

Standard Text: 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 models.

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: 18-2: Discuss different methods used to evaluate performance.

Question 23

Type: MCSA

The standard method of appraisal used by the facility rates a nurses performance as satisfactory, but the nurse manager feels the nurse has room for improvement in many areas. What action should be taken by the manager?

1. Ask another staff nurses opinion of the situation.

2. Address the situation with the chief nursing officer.

3. Submit the appraisal as computed by the standard form.

4. Focus on developing a plan to improve the areas concerned.

Correct Answer: 4

Rationale 1: It is not ethical to share this dilemma with another staff nurse.

Rationale 2: An astute nurse manager can address this issue without involving the chief nursing officer.

Rationale 3: If the nurse manager just submits the appraisal as computed by the standard form, the opportunity to improve the nurses practice is lost.

Rationale 4: In this situation, the nurse does not match the method of appraisal used by the facility. The nurse manager should go beyond the form and strive to help this nurse improve his or her practice.

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: 18-3: Describe problems to expect when evaluating performance.

Question 24

Type: MCSA

The staff nurse has challenged the appraisal rating given by a new nurse manager. What should the nurse manager do?

1. Do not change the rating as that will undermine the managers authority.

2. Change the rating immediately as the staff nurse has more experience than the manager.

3. Investigate the staff nurses challenge and change the rating if it is justified.

4. Ask another staff nurse to act as a mediator in the challenge.

Correct Answer: 3

Rationale 1: Not changing an error undermines the staffs confidence in the evaluation process.

Rationale 2: The manager should carefully consider the challenge and should not make an immediate decision.

Rationale 3: The manager should investigate the challenge and if there is merit should change the appraisal. Staff members respect a manager who admits a mistake and corrects it.

Rationale 4: It is inappropriate to ask another staff nurse to mediate. If necessary another manager may be involved.

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: 18-3: Describe problems to expect when evaluating performance.

Question 25

Type: MCSA

A nurse manager overhears a conversation in which staff nurses complain about the evaluation process. One nurse says, It really is just a waste of time. I get the same raise no matter what Im rated. Which is the best way for the manager to address this concern?

1. Lobby administration to implement raises based on merit.

2. Call the nurse aside and state agreement with the complaint.

3. Report the episode to the chief nursing officer.

4. Emphasize the practice development aspects of evaluation.

Correct Answer: 4

Rationale 1: The process of implementing merit raises is long and would probably not be feasible until the next budget cycle; lobbying for merit raises would not address this concern immediately.

Rationale 2: Calling the nurse aside and agreeing with the complaint does not address the concern, but rather validates the concern.

Rationale 3: The nurse manager may wish to report the episode in order to support the need for a merit system, but that action also does not address the immediate concern.

Rationale 4: All of these options are possible strategies for dealing with this complaint, but the best one is to emphasize the practice development aspects of evaluation.

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: 18-3: Describe problems to expect when evaluating performance.

Question 26

Type: MCMA

An organization has elected to use a behavior-oriented self-evaluation system for nurses. Which statement would be included on the evaluation form?

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

Standard Text: Select all that apply.

1. Becomes BLS (basic life support) instructor within 1 year of employment

2. Maintains confidentiality of information

3. Achieves certification in specialty

4. Demonstrates care, respect, and compassion in all interactions

5. Works well on multidisciplinary teams

Correct Answer: 2,4,5

Rationale 1: This is a results-oriented statement.

Rationale 2: This is a behavior-based statement.

Rationale 3: This is a results-oriented statement.

Rationale 4: This is a behavior-based statement.

Rationale 5: This is a behavior-based statement.

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: 18-1: Describe criteria that can be used to evaluate staff performance.

Question 27

Type: MCMA

An organization has begun using critical incidents as part of the evaluation process. The supervisor is meeting with a manager to review the managers use of critical incidents since training last week. Which finding would concern the supervisor?

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

Standard Text: Select all that apply.

1. Each nurse has one critical incident recorded and it is positive.

2. The manager is writing these notes in a handheld electronic device.

3. The managers notes are all written at the same time on the same day.

4. There is no indication that the critical incidents recorded have been shared with staff.

5. One note states, This nurse has an abrasive personality.

Correct Answer: 3,4,5

Rationale 1: The manager may be taking the advice of starting the process by writing and reviewing a positive critical incident with each nurse.

Rationale 2: Each manager will develop his or her own style of recording notes that works best for the individual.

Rationale 3: It is best that the note be recorded at the time of the occurrence.

Rationale 4: The reason for critical incident recording is to improve practice. If the note is not shared with the employee, this improvement is less likely to occur.

Rationale 5: Notes should focus specifically on what occurred, not on personal traits.

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: 18-4: Explain how to use critical incidents to improve annual evaluations.

Question 28

Type: MCMA

The supervisor is teaching managers about the use of critical incidents as part of the evaluation process. What information should the supervisor share?

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

Standard Text: Select all that apply.

1. Our primary focus for using these notes is to find out who is doing a poor job.

2. Using these notes will help you identify little problems before they become big problems.

3. You can expect some negative reactions from staff.

4. It is okay to tell your staff that you cannot remember all the details of each encounter for evaluation and the notes will help.

5. Having these notes will help you feel more confident in your evaluation of staff.

Correct Answer: 2,3,4,5

Rationale 1: The focus is on improving accuracy of the performance review.

Rationale 2: Using notes forces the manager to deal with problems when they begin, rather after they have caused additional issues to arise.

Rationale 3: When note taking is introduced, people tend to be suspicious and to react negatively.

Rationale 4: Managers should be encouraged to be honest with staff about the note-taking strategy.

Rationale 5: Having performance notes written across the evaluation period will help the manager have greater confidence in the evaluation process.

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: 18-4: Explain how to use critical incidents to improve annual evaluations.

Question 29

Type: MCSA

A nurse manager elects to ignore a nurses performance problem, hoping it will go away. What does this strategy indicate about the nurses management ability?

1. The nurse is a lazy manager.

2. The nurse is gullible.

3. The nurse is using a valid strategy.

4. The nurse needs an update on management strategy.

Correct Answer: 3

Rationale 1: This is not necessarily the case.

Rationale 2: This is not necessarily the case.

Rationale 3: Ignoring a performance problem may be a valid strategyfor instance, if a new nurse is late for report and a seasoned nurse tells the new nurse not to be late again.

Rationale 4: This is not necessarily the case.

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: 18-4: Explain how to use critical incidents to improve annual evaluations.

Question 30

Type: MCSA

The manager senses that a nurse is very anxious at the beginning of the performance interview. How should the manager proceed?

1. I have looked back over all of my notes and interactions with you to prepare for our interview.

2. I sense that you are very tense. Is there a reason you feel this way?

3. You are so tense! How about a cup of coffee to relax.

4. How are your children? Are you planning anything fun this summer with them?

Correct Answer: 1

Rationale 1: The manager should calmly start the interview, ignoring the nurses tension, which will likely pass as the interview continues.

Rationale 2: Drawing attention to the nurses feelings in this manner would not serve to ease the tension.

Rationale 3: The manager should not draw attention to the fact that the nurse is tense.

Rationale 4: The fact that the interview is going to happen will not be changed by social chit-chat and the nurse will still be nervous.

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: 18-5: Explain how to conduct a performance appraisal interview.

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

Copyright 2013 by Pearson Education, Inc.

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