Chapter 19 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
Chapter 19

Question 1

Type: MCMA

The nurse manager is coaching an employee who has been late for work three mornings this week. What statements and questions should the manager include in this coaching 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 is causing you to be late?

2. When you are late it throws the pace of the entire unit off and client care suffers.

3. Does it not bother you that your lateness makes everyone elses job more difficult?

4. You have been late three times this week and that is not acceptable.

5. What are you going to do to avoid being tardy again?

Correct Answer: 1,2,4,5

Rationale 1: The manager should investigate why the nurse is being tardy.

Rationale 2: The impact on client care is always the most important aspect of meeting job expectations.

Rationale 3: Accusing the nurse of not caring about others in the workplace is not appropriate at this point.

Rationale 4: The employee must first know that the tardy behavior is unacceptable.

Rationale 5: The manager should develop a plan for behavior change that the nurse can agree to.

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: 19-1: Describe how to coach an employee.

Question 2

Type: MCSA

What is the primary reason a nurse manager would confront a nurse who has been reported for violating infection control policy?

1. To punish the guilty

2. To protect the institution from liability

3. To set an example for other employees

4. To encourage the correct behavior

Correct Answer: 4

Rationale 1: The manager does not confront policy violations as a means of punishment.

Rationale 2: The primary reason for confrontation is not as a protection from liability.

Rationale 3: The manager does not confront policy violators to set an example for others.

Rationale 4: The primary reason a manager confronts policy violation or inappropriate behavior is to encourage correct behavior.

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: 19-2: Discuss positive coaching.

Question 3

Type: MCSA

An employee has consistently violated policy and has not responded to coaching. The manager has decided that discipline is required. What should the manager do first?

1. Plan a private meeting for the disciplining.

2. Wait for one more infraction to occur and discipline immediately afterward.

3. Make certain that the information regarding policy violations is correct.

4. Keep the human resources department informed.

Correct Answer: 3

Rationale 1: Planning a private meeting is not the first step in the process.

Rationale 2: The manager has decided discipline is required. There is no need to wait for another infraction to occur.

Rationale 3: The manager must first be certain that the facts about infraction are complete and correct.

Rationale 4: Human Resources should be informed, but this is not the first step.

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: 19-4: Discuss how to discipline an employee.

Question 4

Type: MCSA

Which statement by the nurse manager is the best example of day-to-day coaching?

1. Can we meet this afternoon for about 30 minutes to discuss your progress?

2. I think you need to get different day care that would allow you to be on time.

3. Over the past 6 months the narcotics count has been off on several days that you have worked.

4. Let me show you a method I have found to be effective in making patient assignments.

Correct Answer: 4

Rationale 1: This is not a good example of coaching, because 30 minutes is too long for a coaching session.

Rationale 2: Giving advice about day care assumes the manager knows the employees problem.

Rationale 3: This statement is accusatory and would not set up a good coaching opportunity.

Rationale 4: Coaching is a mentoring relationship. It is a brief interaction.

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: 19-1: Describe how to coach an employee.

Question 5

Type: MCSA

A certified nurses aide (CNA) has been reported to the nurse manager for refusing to perform hand hygiene between clients when providing morning care. Which statement by the nurse manager would be the most effective?

1. Do you need a class on hand hygiene?

2. Forgetting to perform hand hygiene between clients can spread infection.

3. Why do you refuse to perform hand hygiene?

4. If I hear of any more instances of you not performing hand hygiene, I will write you up.

Correct Answer: 2

Rationale 1: Asking if the CNA needs a class on hand hygiene is demeaning.

Rationale 2: The employee needs to realize the unwanted behavior has consequences for the client. A better understanding may prevent the behavior in the future.

Rationale 3: There is no choice except for the CNA to perform hand hygiene. Why it is not being performed is not as important as reinforcing the need.

Rationale 4: The employee must understand the consequences if the behavior does not change but this should not be communicated in a threatening manner.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 6

Type: MCSA

Coaching and discipline have failed and the nurse manager is faced with no alternative but to terminate an employee. Which aspect of this situation requires the most careful planning?

1. When the termination will occur

2. How to keep the human resources department informed

3. Accurately documenting all stages of the situation

4. Whether the termination will adversely affect unit staffing

Correct Answer: 3

Rationale 1: When the termination will occur is important but is not the most important aspect.

Rationale 2: Notifying the human resources department and keeping them up to date is very important but is not the most important aspect.

Rationale 3: Before termination there must be sufficient and accurate documentation to support the termination. This not only protects the employee from wrongful termination, but also protects the manager and the institution.

Rationale 4: Hopefully, terminating a poor employee will not adversely affect unit staffing, but this is not the most important consideration.

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: 19-5: Describe how to terminate an employee.

Question 7

Type: MCMA

A terminated employee files a grievance against the nurse manager. Which situations would benefit the employees claim?

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 manager wrote notes on the expectations discussed during disciplinary sessions.

2. The terminated employees last evaluation discusses problems with performance, but no coaching is described.

3. When problems with the employee arose, the managers average time of intervention was less than 1 day.

4. There are notes in the employees record from human resources indicating the nurse manager had discussed issues with the HR director.

5. In one note, the manager describes the employee as petulant, immature, and uncaring.

Correct Answer: 2,5

Rationale 1: The manager should keep notes on everything discussed regarding discipline. This would benefit the institution.

Rationale 2: Even though coaching is done in short sessions, it should be documented.

Rationale 3: Intervention in less than 1 day shows that the manager was aware of and quickly handling problems.

Rationale 4: The HR director would be party to problems with employees. This does not violate confidentiality.

Rationale 5: This note could be a problem for the institution as it is the managers opinion, not a defensible fact.

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: 19-5: Describe how to terminate an employee.

Question 8

Type: MCSA

It has been reported to the nurse manager that an employee is repeatedly parking in the patient/visitor parking area. What action should the manager take?

1. Confront the employee.

2. Check the parking lot each morning.

3. Discuss the issue at the next employee appraisal.

4. Provide an education session for all staff regarding parking policy.

Correct Answer: 1

Rationale 1: When there is a policy violation, it is necessary to confront the employee. The steps of confrontation are similar to those of coaching.

Rationale 2: It is not necessary for the manager to use valuable time checking the parking lot.

Rationale 3: The problem cannot wait until the next employee appraisal.

Rationale 4: It is not necessary to involve the entire staff in an education session.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 9

Type: MCMA

A nursing assistant has taken long lunch breaks for the last 2 days and today is 15 minutes late returning from the cafeteria. What should the manager do?

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

Standard Text: Select all that apply.

1. Go to the cafeteria and confront the assistant.

2. Send a message with a nurse going to lunch for the assistant to return to the unit immediately.

3. Call the cafeteria and ask that they send the assistant back to the unit.

4. Meet with the assistant and calmly say, You have been late back from lunch for 3 days this week.

5. Anticipate that the assistant will give an explanation for the lateness.

Correct Answer: 4,5

Rationale 1: The manager should take a few moments to prepare before this meeting occurs.

Rationale 2: The manager should not include other staff in this issue.

Rationale 3: The manager should not get cafeteria workers involved in this confrontation.

Rationale 4: It is important to stay calm and to relate the facts. This assistant has been late twice already this week and is late again today.

Rationale 5: The manager should anticipate that the assistant will offer a reason for the lateness. It will be up to the manager to decide if the explanation is reasonable.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 10

Type: MCSA

A newly hired certified nurses aide (CNA) has been 15 minutes late returning from mealtime 4 days this week. The nurse manager coaches the employee and finds the CNA thought meal breaks were 45 minutes. What is the most appropriate response from the nurse manager?

1. Document the tardy behavior in the CNAs record.

2. Show the CNA the break hours in the employee handbook.

3. Warn the CNA tardiness is not tolerated and follow up in 2 weeks.

4. Warn the CNA that the charge nurse will be timing future meal breaks.

Correct Answer: 2

Rationale 1: Since the CNA was misinformed regarding the length of meals, the coaching should be documented, but not as tardiness in the real sense of the word.

Rationale 2: The first step is to determine whether the employee is aware of the policy. It seems this employee was not. It would be most appropriate to show the employee where the policy is written.

Rationale 3: Warning the employee is not justified at this time.

Rationale 4: Threatening the employee is not justified.

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: 19-2: Discuss positive coaching.

Question 11

Type: MCSA

A manager has been informed by a reliable registered nurse that an assistant lied about bathing a client. The manager calls the assistant into the office with a written warning. Why is this action inappropriate?

1. The registered nurse should issue the warning.

2. The first warning should be verbal.

3. The assistant should be allowed to discuss the matter.

4. This type of action should be conducted by the human resources department.

Correct Answer: 3

Rationale 1: It is inappropriate for the registered nurse to issue a warning.

Rationale 2: While many hospitals have a policy of verbal warning or coaching as a first step, the real issue is that the assistants due process was not followed.

Rationale 3: The manager should investigate the matter and listen to the assistants reasons for the registered nurses complaint. If a written warning is appropriate, it should not be written until after the complaint has been investigated and the assistant has had an opportunity to discuss the issue.

Rationale 4: It is inappropriate for the human resources department to issue a warning.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 12

Type: MCSA

A charge nurse on the night shift did not notify the anesthesiologist regarding an emergency case. The manager investigated the matter and learned the charge nurse thought the primary care nurse would call the anesthesiologist. Which response by the manager would be most appropriate?

1. It is in your job description and your duty.

2. It is your responsibility. In the future, call anesthesia and transfer the call to the primary nurse.

3. Its not the surgery nurses responsibility to call anesthesia!

4. Why was this considered an emergency case?

Correct Answer: 2

Rationale 1: While this is probably a true statement, it is not the best response to the situation.

Rationale 2: The manager should obtain information; ask questions in a calm manner and offer instruction or solutions so the supervisor learns from the experience.

Rationale 3: The manager should remain calm while coaching.

Rationale 4: The question regarding the urgency of the case is not applicable to the 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: 19-2: Discuss positive coaching.

Question 13

Type: MCSA

The nurse manager identifies a minor problem with the way a staff nurse documents client care. The manager meets with the nurse and discusses the issue, but does not issue a warning. What is the managers next action?

1. Report the meeting to human resources.

2. Enlist the aid of a more experienced nurse to help monitor the documentation.

3. Record the specific behavioral steps discussed for future reference.

4. Tell the nurse that failure to comply with steps discussed will result in a written warning.

Correct Answer: 3

Rationale 1: There is no need to report the meeting to human resources.

Rationale 2: Involving another nurse is not professional.

Rationale 3: Even when the discussion does not lead to a formal warning, the manager should record the specific behavioral steps discussed with the nurse for future reference. If there is absolutely no record of what was said, the manager may forget and be unable to evaluate the nurses progress.

Rationale 4: Telling the nurse that a warning may occur is a threat and could negate the atmosphere of trust established by the meeting.

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: 19-1: Describe how to coach an employee.

Question 14

Type: MCSA

The staff has complained that a nurse receives frequent personal phone calls, which is a violation of policy. In what manner should the manager address this nurse?

1. Meet with the nurse privately and inquire as to the necessity of personal phone calls.

2. Meet with the nurse and give a verbal warning.

3. The manager should inform the nurse the other nurses are complaining about the phone calls.

4. Tell the complaining nurses to handle the situation with peer pressure.

Correct Answer: 1

Rationale 1: The manager should address the behavior in private and investigate the situation.

Rationale 2: It may or may not be appropriate to give a warning.

Rationale 3: It is not necessary to tell the nurse that peers are complaining about the phone calls if it is a violation of policy.

Rationale 4: It is inappropriate to have nursing staff address the issue.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 15

Type: MCSA

A nurse who receives frequent phone calls informs the manager the phone calls are related to a health crisis concerning a family member. Other nurses also receive personal calls, but not as many as the first nurse. Which action by the manager is appropriate?

1. Tell the nurse to have family call the managers office if there is a crisis.

2. Discuss with the nurse how personal phone calls may affect client care and should be limited.

3. Inform the nurse the phone calls are causing morale issues among the staff.

4. Lift the policy against staff carrying personal cell phones for this nurse while the crisis continues.

Correct Answer: 2

Rationale 1: The manager should not get involved in the personal family issues of this nurse.

Rationale 2: The manager should discuss how personal phone calls are affecting client care, perhaps by taking this nurse away from duties. The fact that calls should be limited should be stressed.

Rationale 3: The manager should not bring the morale of other staff into this conversation.

Rationale 4: If the manager allows one nurse to carry a personal cell phone, the rest of the nurses must be afforded the same right.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 16

Type: MCSA

A nurse has frequent visitors while working. The manager has discussed with the nurse the negative effect of these visits on client care. What should the manager do next?

1. Ask staff if the visits have decreased.

2. Arrange a follow-up meeting with the nurse.

3. Counsel all nursing staff regarding the limitations of personal visitors.

4. Arrange to be visible on the nursing unit when this nurse is working.

Correct Answer: 2

Rationale 1: Having staff monitor the actions of a nurse is not appropriate.

Rationale 2: Arranging for a follow-up meeting allows for evaluation and communication regarding the issue.

Rationale 3: There is no reason to talk to all staff concerning personal visitors.

Rationale 4: Being visible on the unit when this nurse is working may adversely impact the managers productivity. It is also a transparent method of watching the nurse.

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: 19-1: Describe how to coach an employee.

Question 17

Type: MCMA

A nurse has been pulled from the surgical unit to the ICU unit and is asked by an ICU nurse to administer a medication that requires monitoring the cardiac rhythm. When asked about the clients cardiac rhythm after the medication was administered, the surgical nurse states, I dont know. What actions should be taken by the units nurse manager?

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

Standard Text: Select all that apply.

1. Meet with the ICU nurse to discuss the situation.

2. Meet with the surgical nurse to discuss the situation.

3. Give a written warning to the surgical nurse for not following policy.

4. Give a written warning to the ICU nurse for not following policy.

5. Meet with the nurses together and issue an informal verbal warning to both.

Correct Answer: 1,2

Rationale 1: The manager should meet with the ICU nurse to determine if policy was followed in delegating medication administration.

Rationale 2: The manager should meet with the surgical nurse to determine if the nurse was aware of the policy requiring monitoring the cardiac rhythm.

Rationale 3: Until the manager meets with this nurse, it is unclear if a warning is indicated.

Rationale 4: Until the manager meets with this nurse, it is unclear if a warning is indicated.

Rationale 5: Until the manager has more facts, it is unclear whether a warning is necessary and, if so, what kind of warning is required.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 18

Type: MCSA

An ICU nurse does not follow policy when administering a medication intravenously. Which would be the most appropriate action by the manager to assist the employee?

1. Provide written instructions for administering the medication.

2. Remediate the situation with the ICU staff.

3. Provide a copy of the policy and discuss the rationale for the policy as it relates to client care.

4. Reprimand the ICU nurse for giving the medication.

Correct Answer: 3

Rationale 1: Providing written instructions for the medication is not as constructive as providing and discussing the policy.

Rationale 2: The ICU staff does not need remediation or reprimand.

Rationale 3: This strategy helps to educate the nurse and improve practice. Documenting this action also sets the scene for further action if the policy is not followed in the future.

Rationale 4: Reprimanding is not the first step in this process.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 19

Type: MCSA

An OB nurse has violated a unit policy. The OB manager is discussing the incident with the nurse. During the discussion the nurse informs the OB manager of the actions of other staff and the physicians attitude leading up to the event. How should the manager address these issues?

1. Tell the nurse that physicians attitude is none of the nurses business.

2. Inform the nurse of the policy violation.

3. Inquire about the physicians attitude and the staff actions during the incident.

4. Redirect the nurse to focus on the issue.

Correct Answer: 4

Rationale 1: The physicians attitude is not the issue the manager is addressing at this moment.

Rationale 2: The nurse is already aware of the policy violation because it has been discussed.

Rationale 3: The physicians attitude and the staffs actions are not the issue the manager is addressing at this moment.

Rationale 4: The nurse may be attempting to divert the managers focus from the nurse to others. The focus of this discussion is the nurses violation of policy.

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: 19-3: Explain how to confront an employee about a policy violation.

Question 20

Type: MCSA

The nurse was reported for not following unit policy in relaying a clients complaint regarding another staff member. During a meeting, the nurse insists he managed the situation appropriately. How should the manager respond?

1. Lets schedule another meeting for later in the week after you have had time to reflect on the situation a little more.

2. Lets explore some alternative solutions to what happened.

3. I am going to request a meeting for both of us and the human resources director.

4. As I see it, the problem is your inability to follow the simplest of unit policies and to take direction.

Correct Answer: 2

Rationale 1: There is no reason to let the nurse reflect further on the situation.

Rationale 2: Exploring alternatives allows the nurse to develop problem-solving skills and assist in the prevention of future problems related to the situation.

Rationale 3: There is no evidence to suggest that a meeting with HR is indicated.

Rationale 4: This statement is inflammatory and will likely make it more difficult for the manager to improve the nurses 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: 19-3: Explain how to confront an employee about a policy violation.

Question 21

Type: MCSA

An ICU nurse manager has been struggling to correct client care issues on the unit and has asked the unit director for assistance. The director says, Training and discipline on your unit is your responsibility. I have other things to do. Now, the manager is faced with disciplining a nurse regarding another client care issue. What is the most significant reason this manager is hesitant to administer this discipline?

1. The nurse may quit.

2. The nursing staff is a cohesive group and might retaliate.

3. The manager is not comfortable with confrontation.

4. The manager does not feel supported by the director.

Correct Answer: 4

Rationale 1: The fact that this nurse might quit is an issue with which managers deal every day.

Rationale 2: The fact that the nurses are a cohesive group is an issue with which managers deal every day.

Rationale 3: It may be that the manager is not comfortable with confrontation, but another option suggests a more significant problem.

Rationale 4: The job of managing others is difficult without the full support of superiors.

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: 19-4: Discuss how to discipline an employee.

Question 22

Type: MCSA

An emergency department (ED) manager is disciplining a nurse with a history of multiple client and staff complaints. The last disciplinary action was a verbal warning. If the institution follows the progressive method of addressing disciplinary issues, the manager would prepare for which action?

1. A written warning

2. A counseling session

3. Another verbal warning

4. Termination

Correct Answer: 1

Rationale 1: A written warning is the next step in progressive discipline.

Rationale 2: A counseling session is part of the verbal warning process.

Rationale 3: The progressive discipline method does not have provision for a second verbal warning.

Rationale 4: Termination does not occur until there has been a verbal warning, a written warning, and a suspension.

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: 19-4: Discuss how to discipline an employee.

Question 23

Type: MCMA

A nurse has complained to the human resources (HR) director regarding unfair treatment by the nurses manager. The nurse describes receiving a written warning, unlike other nursing staff who exhibit similar behaviors but are not reprimanded. Which concerns would the HR director discuss with the hospital chief nursing officer?

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

Standard Text: Select all that apply.

1. The unusual management styles within the department

2. Confronting the managers direct supervisor about allowing this situation to occur

3. The apparent inconsistencies in discipline within the unit

4. The potential for litigation that arises from this complaint

5. The need to terminate this problem employee

Correct Answer: 3,4

Rationale 1: This is not just an unusual management style.

Rationale 2: The managers direct supervisor may be unaware that the incident happened. The supervisor should be apprised of the complaint, but not confronted with an accusation of allowing the behavior.

Rationale 3: There is apparently an inconsistency in discipline that should be investigated.

Rationale 4: If this situation goes to court, the hospital could be found liable for the actions of the manager.

Rationale 5: The HR director should not categorize this employee as a problem until a full investigation of the situation has been conducted.

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: 19-4: Discuss how to discipline an employee.

Question 24

Type: MCSA

A director must discipline an ICU manager. The director and manager have become friends. When disciplining the manager, what is the best approach by the director?

1. Notify the human resources director that the meeting will occur.

2. Include the chief nurse officer (CNO) in the session.

3. Ask a manager from another department to sit in on the meeting.

4. Discuss the issue, concentrate on the issue, and do not make it personal.

Correct Answer: 4

Rationale 1: The HR director does not need to be included at this stage.

Rationale 2: The CNO does not need to be included at this stage.

Rationale 3: Asking another manager, even from a different department, to sit in on the meeting violates confidentiality.

Rationale 4: The director should focus on the issues and not allow the discussion to become personal. The manager should be treated as any other manager would.

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: 19-4: Discuss how to discipline an employee.

Question 25

Type: MCSA

An OB manager discusses a nurses performance with the chief nurse officer (CNO). The CNO learns the nurse has had multiple client and physician complaints that the manager investigated and for which counseling was provided. The behavior continues even though the nurse has received verbal and written warnings. Which course of action would be most appropriate at this time?

1. Issue a written warning from the CNO.

2. Place the nurse on suspension pending a new investigation into the complaints.

3. Terminate the nurse.

4. Transfer the nurse to another department under another manager.

Correct Answer: 3

Rationale 1: Written warnings have already been issued. There is no evidence that another warning will improve the nurses performance.

Rationale 2: The complaints have already been investigated. Suspension is not indicated.

Rationale 3: Since these complaints have been ongoing, even after investigation, counseling, and warnings, termination is likely the best alternative.

Rationale 4: Transferring the nurse to another department does not address the issues.

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: 19-5: Describe how to terminate an employee.

Question 26

Type: MCMA

The hospitals new management company has assigned a leadership coach to groups of current nurse managers. Which statements made by a manager would the coach interpret as indicating the manager does not value this opportunity?

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

Standard Text: Select all that apply.

1. Why do I need a coach?

2. Ive been a manager longer than our coach has been a nurse.

3. Im getting burned out with the way we manage.

4. Another new program to waste our time.

5. Coaching has helped my nurses improve their practice.

Correct Answer: 2,4

Rationale 1: This question would allow the coach to list the benefits of coaching. It does not indicate that the nurse doesnt value the experience.

Rationale 2: A statement like this may well indicate that the manager does not think that the coach has any information that will be of benefit.

Rationale 3: A manager who is burned out with current methods may be very willing to learn new methods.

Rationale 4: When people go into a program thinking it is a waste of time, they often do not see its value.

Rationale 5: If the manager has seen improvement in practice as a result of coaching, the manager is more likely to have a positive attitude toward the program.

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: 19-2: Discuss positive coaching.

Question 27

Type: MCMA

The manager is contemplating terminating a nurse. What should the manager consider regarding the expectations of the job prior to proceeding with termination?

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

Standard Text: Select all that apply.

1. Did the nurse receive and sign for a copy of the appropriate job description when hired?

2. Was the nurse apprised of the criteria on which evaluation would be based?

3. Have any changes to policy and procedure been discussed with the nurse and made available in writing?

4. Was the nurse hired using the same documentation as others hired at the same time?

5. Have others hired during the same time period been successful?

Correct Answer: 1,2,3

Rationale 1: The manager must have documentation that the nurse knew the expectations of the job. Documentation that the nurse received the job description is required.

Rationale 2: The nurse must be told in advance of the criteria on which evaluation will be based.

Rationale 3: Changes to policy and procedures change practice. These changes must be made known to the staff.

Rationale 4: Just because the documentation is commonly used doesnt make it legal or correct.

Rationale 5: While the success of others hired at the same time is interesting, it is not essential knowledge for the manager.

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: 19-5: Describe how to terminate an employee.

Question 28

Type: MCSA

The manager has disciplined a nurse with a written warning. At the end of the session, the manager asks the nurse to sign the warning and the nurse refuses. What should the manager do?

1. Tell the nurse that signing the form in mandatory.

2. Indicate on the form that the nurse declined to sign.

3. Sign the nurses name to the form and include the managers initials.

4. Complete a second warning for the nurses failure to follow procedure.

Correct Answer: 2

Rationale 1: It is not mandatory for the nurse to sign the form.

Rationale 2: The written disciplinary form should have an area to indicate that the employee refused to sign. If not, this should be written in by the manager.

Rationale 3: The manager should not sign the nurses name to the form.

Rationale 4: A second warning is not indicated. The nurse has the right to refuse to sign the form.

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: 19-4: Discuss how to discipline an employee.

Question 29

Type: MCMA

The manager has just terminated a nurse. What statement by the manager is appropriate?

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

Standard Text: Select all that apply.

1. You may go back to the unit to say good-bye to your coworkers.

2. We have cleaned out your locker and have your personal belongings ready for you.

3. I have notified security to escort you as you leave the building.

4. As of this time, you are no longer an employee of this institution.

5. Please do not discuss your termination with any other nurses.

Correct Answer: 3,4

Rationale 1: Directing the nurse back to the unit for good-byes is not a good idea.

Rationale 2: The hospital should not be involved in cleaning out the employees locker.

Rationale 3: The terminated employee should be attended by the manager or by security at all times.

Rationale 4: It must be very clear that termination has occurred and that the nurse is no longer an employee.

Rationale 5: Once termination has occurred, the manager has no control over the employees actions.

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: 19-5: Describe how to terminate an employee.

Question 30

Type: MCMA

A nurse is being terminated due to continued violation of hospital policy. What statements by the manager are appropriate?

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

Standard Text: Select all that apply.

1. Your actions have been degrading to the profession.

2. You may wish to resign rather than being terminated.

3. Human resources will answer any questions you may have about benefits.

4. Im sorry you could not be happy here.

5. You are being terminated for the policy violations I have just outlined.

Correct Answer: 2,3,5

Rationale 1: The nurse manager should not make statements of opinion during the termination process.

Rationale 2: In many cases, the nurse will choose to resign rather than being terminated.

Rationale 3: The terminated employee may have rights to some benefits. The HR department should handle those questions.

Rationale 4: The manager has no idea if the nurse was happy or not and should not be personally involved in the situation.

Rationale 5: The manager should outline the violations that led up to the termination and should make it clear that the violations are the reason for the termination.

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: 19-5: Describe how to terminate an employee.

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

Copyright 2013 by Pearson Education, Inc.

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