Chapter 20 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
Chapter 20

Question 1

Type: MCSA

The nurse executive and the human resources manager of a hospital meet to discuss the recent increase in nursing turnover. Which statement reflects the best source of information about this increase?

1. What have the exit interviews shown as reasons for the resignations?

2. Were the reports from nurse managers on resignations completed accurately?

3. What are the reasons given in the survey mailed out 6 weeks after resignation?

4. Has the human resources staff been making telephone calls to employees when they turn in their resignation?

Correct Answer: 3

Rationale 1: Although an exit interview is usually done, it may not be the most effective method of evaluating the employees satisfaction. An employee may not be fully truthful if he or she intends to use the previous employer as a reference for a future job.

Rationale 2: The nurse manager may or may not be aware of the reasons for nurses leaving their positions and may have a bias toward an unhappy employee.

Rationale 3: A survey mailed weeks after the employee resignation may be the most effective method to measure nursing turnover. Several weeks later an employee may be in a new job, which could allow for a more honest reflection on reasons for leaving the previous position.

Rationale 4: A telephone call from someone in human resources has the same limitations as the person-to-person exit interview.

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: 20-5: Discuss what organizations can do to improve retention of nurses.

Question 2

Type: MCSA

When the unit manager is on vacation, the charge nurse fills in the leadership role. While in this role the charge nurse senses a change in the nursing staffs morale. The staff appears happier, more energetic, and productive. The charge nurse believes this change is a direct effect of which variable?

1. The staffs relationship with the nurse manager

2. The environment of the organization

3. Level of compensation

4. The shifts they are working

Correct Answer: 1

Rationale 1: Job satisfaction is affected by various facets, one of them being the relationship with the nurse manager.

Rationale 2: The overall environment has not changed.

Rationale 3: The level of compensation has not changed.

Rationale 4: It is unlikely that the substitute manager has changed the shifts nurses are working.

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: 20-6: Discuss what managers can do to help retain nurses.

Question 3

Type: MCSA

A nurse is frequently absent on Fridays. The nurse phones and reports as sick, but the manager discovers that the absences are due to child care issues. How should the manager document this on the critical incident form?

1. Voluntary absence on multiple Fridays due to child care issues

2. Absence frequency on Fridays

3. Total time lost includes Fridays

4. Involuntarily absent due to family circumstances

Correct Answer: 1

Rationale 1: Voluntary absenteeism is not coming to work due to a problem that is under the employees control. Child care problems are under the employees control.

Rationale 2: Absence frequency is the total number of distinct absence periods that an employee has been absence and is not tied to a specific day.

Rationale 3: The fact that Friday is included in the total time lost is not significant.

Rationale 4: Involuntary absence is due to something outside the employees control such as illness.

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: 20-1: Explain absenteeism.

Question 4

Type: MCMA

The night nurse on the pediatric unit has resigned. The night staff is pleased, because this nurse constantly complained about workload and alienated most staff members. What consequences may result from the loss of this nurse?

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

Standard Text: Select all that apply.

1. Use of agency nurses.

2. Opportunity for overtime.

3. Increase in enthusiasm.

4. A resignation spiral in which more nurses resign

5. Unit performance improves.

Correct Answer: 1,2,3,5

Rationale 1: Unfortunately, agency nurses may need to be used if the position goes unfilled. This is a costly problem.

Rationale 2: There may be an opportunity for overtime work for those who desire it.

Rationale 3: Without the constant distraction of a complaining nurse the enthusiasm for the job may increase.

Rationale 4: Since the nurse who resigned was not liked and was classified as a complainer it is unlikely that this resignation will trigger a resignation spiral.

Rationale 5: When a nurse who alienates coworkers and complains frequently leaves, the performance of the unit may improve.

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: 20-3: Describe how nursing turnover affects the organization.

Question 5

Type: MCSA

During a 3-month period, a nurse has missed work on six occasions due to unreliable child care. Another nurse has missed 10 days due to a minor foot surgery. How should the manager categorize the reliability of these nurses?

1. The nurse with the voluntary absence is more reliable.

2. The nurse with involuntary absences is more reliable.

3. It depends on other factors such as job performance when present.

4. Both nurses are unreliable due to excessive absences during this time period.

Correct Answer: 2

Rationale 1: The nurse who had voluntary absence had fewer days absent but could have controlled the absences by obtaining reliable transportation and back up child care.

Rationale 2: The nurse with the involuntary absence is more reliable because the absence is less frequent and due to something outside the nurses control.

Rationale 3: The nurse who voluntarily misses work on six occasions in a 3-month period is not a reliable employee even if job performance when at work is good.

Rationale 4: Involuntary absences do not affect reliability in the same manner as voluntary absences. Typically involuntary absences for surgery are scheduled in advance and the manager can schedule for the absence.

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: 20-1: Explain absenteeism.

Question 6

Type: MCSA

What is the best strategy the nurse manager can use to help retain nursing staff?

1. Relieve staff of the need to serve on committees in the institution.

2. Hire younger employees.

3. Require that the nurse sign a contract for at least 1 year of service.

4. Closely review applicants previous job history for length of commitment

Correct Answer: 4

Rationale 1: Nursing must be represented on committees to retain a sense of ownership of the organization.

Rationale 2: Age of the employee has less to do with commitment than the persons mobility, which may be affected by age and responsibilities.

Rationale 3: Contracts are easily broken. Making the nurse feel that there is a 1-year commitment may result in a nurse who is unhappy and ineffective in the job. A one-year commitment does not reduce turnover.

Rationale 4: A review of a job applicants history of employment will give the nurse manager an idea of his or her past commitment to the workplace.

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: 20-4: Explain voluntary turnover.

Question 7

Type: MCSA

A nurse who has been working the evening shift on the hospice unit for 5 years resigns. The nurse says, I just cant work here anymore. These clients are so sad. What is the best strategy for retaining this nurse?

1. Increasing the nurses salary

2. Facilitating a transfer to another nursing unit

3. Offering the nurse a position on the day shift

4. Rewrite the nurses job description

Correct Answer: 2

Rationale 1: Increasing the nurses salary is unlikely to make a difference if the nurse is truly unable to stay due to client conditions.

Rationale 2: This nurse is experiencing burnout. The best strategy to retain the nurse for the organization is to transfer the nurse to a new unit with different job responsibilities. This will be a loss to the unit, but a savings for the organization.

Rationale 3: The nurse has not indicated that the night shift is the problem.

Rationale 4: Changing the job description will not change the fact that the nurse is experiencing burnout from working with dying clients.

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: 20-6: Discuss what managers can do to help retain nurses.

Question 8

Type: MCSA

The hospital is hiring several new nurses for an expanded OB unit. The manager explains to the current staff that due to a shortage of nurses, salary compression is occurring. How should the current nurses interpret this statement?

1. There will be no raises in the near future.

2. The new nurses starting salaries will be close to what the current nurses are making.

3. All nurses will receive a merit raise for training new staff.

4. Review of salary structure done while hiring these nurses will result in raises for all current nurses.

Correct Answer: 2

Rationale 1: Salary compression is not linked to raises.

Rationale 2: Salary compression is the effect of higher starting pay of new nurses resulting in lower salaries for long-term employees. This results in the wages of new nurses being just below or even higher than that of current nurses. This is a quick fix to a nursing shortage, but a dangerous strategy, and it may result in dissatisfaction and turnover of more experienced nurses.

Rationale 3: Salary compression is not linked to merit raises for training staff.

Rationale 4: Salary compression is not linked to raises for current employees.

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: 20-5: Discuss what organizations can do to improve retention of nurses.

Question 9

Type: MCMA

A hospital is experiencing a high nursing turnover rate. One manager suggests offering sign-on bonuses to fill positions. Why would the nurse executive veto this suggestion?

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

Standard Text: Select all that apply.

1. Sign-on bonuses only attract newly licensed nurses.

2. The bonus schedule adversely impacts the current salary schedule.

3. Current nurses can be discouraged by this program.

4. Sign-on bonuses do not recognize achievement and loyalty.

5. Sign-on bonuses do not attract enough nurses to make it worth the time to set them up and advertise them.

Correct Answer: 3,4

Rationale 1: Sign-on bonuses are attractive to many nurses, both newly licensed and experienced.

Rationale 2: Sign-on bonuses do not affect the current salary schedule.

Rationale 3: Nurses currently working at the facility can be discouraged when newly hired nurses are given big amounts of money just for taking the job.

Rationale 4: Sign-on bonuses are awarded just for taking the job. They do not recognize such attributes as experience, achievement, and loyalty.

Rationale 5: Sign-on bonuses can attract a significant number of applicants and are a quick fix for shortages.

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: 20-3: Describe how nursing turnover affects the organization.

Question 10

Type: MCMA

The human resources (HR) department is considering motivating employees to maintain good attendance by changing some organizational practices. Which items should HR consider?

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

Standard Text: Select all that apply.

1. Offering a discount on the cost of on-site child care for employees with good attendance records

2. Encouraging managers to involve employees in the decision making on the unit

3. Banning an employee with more than two absences in a pay period from working overtime in the next pay period

4. Working with managers to change the culture of the units on which absences are frequent

5. Entering the names of employees who have no absences in a 3-month period in a drawing for a paid day off

Correct Answer: 1,3,5

Rationale 1: On-site child care is a motivating factor in itself. Adding a discount to those with good attendance is an additional motivating factor.

Rationale 2: Shared decision making is a change to the job itself.

Rationale 3: This policy would serve as punishment for those seeking overtime wages and is a change in organizational practice.

Rationale 4: This is an example of changing the absence culture.

Rationale 5: A reward for having no absences is a change in organizational practice.

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: 20-2: Discuss ways to manage absenteeism.

Question 11

Type: MCMA

A nurse manager has reduced absenteeism by increasing each nurses job responsibilities. Why is this strategy effective?

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

Standard Text: Select all that apply.

1. Nurses who feel their job is important realize that others depend upon their presence at work.

2. A nurse who is given additional work responsibilities must work harder to prevent termination.

3. Nurses who have greater responsibilities do not stress over minor responsibilities any longer.

4. A nurse with less responsibility is always less motivated.

5. Having greater responsibilities enriches the job experience.

Correct Answer: 1,5

Rationale 1: When employees feel they are making a real contribution they take greater ownership in their work.

Rationale 2: Preventing termination is not the reason this strategy is effective.

Rationale 3: Generally, the greater the responsibility, the greater the stress over all aspects of the job.

Rationale 4: Many nurses are very motivated even though they may not have as much responsibility as others.

Rationale 5: Greater responsibilities often change the flavor of the job so that the nurse enjoys it more.

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: 20-2: Discuss ways to manage absenteeism.

Question 12

Type: MCSA

Despite the nurse managers best efforts to retain an experienced nurse, the nurse leaves for a job in a competing hospital. Which option reflects the most important thing the manager must do now?

1. Find a replacement to hire.

2. Have human resources interview the nurse who left.

3. Manage personal feelings of defeat.

4. Decrease the impact of the hospital grapevine.

Correct Answer: 4

Rationale 1: While finding a replacement for the nurse is important, it is not the primary concern.

Rationale 2: An exit interview is important, but is not the managers primary concern.

Rationale 3: The manager may feel defeated by losing this nurse, but this is not the primary concern.

Rationale 4: This nurse is gone, so the managers next task it to decrease the impact of the hospital grapevine. This informal, but powerful, information superhighway can spread inaccurate and inflammatory information rapidly and could influence other nurses to leave.

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: 20-6: Discuss what managers can do to help retain nurses.

Question 13

Type: MCMA

Hospital management is brainstorming ways to reduce absenteeism. Which suggestions from this session deserve further investigation?

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 we should define excessive absenteeism by total time lost instead of absence frequency.

2. Lets offer a salary increase for those with good attendance.

3. Why not include attendance as part of the employee performance appraisal?

4. I dont think we are enforcing the absence policies we have now. That is the logical place to start.

5. We need to start at the top and be certain all of our management employees maintain good attendance.

Correct Answer: 2,3,4,5

Rationale 1: Total time lost is not as sensitive an indicator of excessive absenteeism as absence frequency. For example, an employee might miss 30 days of work due to a scheduled surgery for which the manager could make scheduling adjustments. Another employee could miss a total of 30 days due to oversleeping, car trouble, or just deciding not to come to work. The difference in impact on the unit is obvious.

Rationale 2: The idea of offering a salary increase should be further investigated.

Rationale 3: The idea of using attendance as part of the employee performance appraisal may work, especially if the appraisal is tied to merit raises.

Rationale 4: If absence policies currently in place are not being followed, employees develop the idea that absences are not a serious issue.

Rationale 5: Employees model what they see in managerial staff. If the management level employees do not have good attendance, the staff begins to believe that absences are not a problem.

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: 20-2: Discuss ways to manage absenteeism.

Question 14

Type: MCMA

The management staff is investigating ways to decrease absenteeism that will also help to promote greater job satisfaction over the long term. Which suggestions should they consider?

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

Standard Text: Select all that apply.

1. We could convert a specified number of unused sick days to vacation days.

2. Is there a way we could convert unused sick time to retirement credit?

3. I think we should stop putting a limit on how many sick days an employee can accumulate.

4. We should think up some penalty for using more than a given number of sick days in a year.

5. I think we should stay with our policy of taking away holiday time if the employee uses a sick day in the same week.

Correct Answer: 1,2,3

Rationale 1: Conversion of unused sick days to vacation days eliminates the feeling that employees are going to lose sick days, which they consider a benefit.

Rationale 2: Converting unused sick time to retirement credit helps to eliminate the feeling that employees are going to lose sick days, which they consider a benefit.

Rationale 3: When there is a limit on how many sick days can be accumulated, the employee may feel that a benefit has been taken away and may take unneeded sick days to prevent losing that benefit.

Rationale 4: Penalties may work to discourage the use of sick time, but will not promote job satisfaction.

Rationale 5: A policy of taking away holiday time based on a sick day being taken is punitive to good employees. It may also encourage an employee to come to work when sick. It is not a good way to promote job satisfaction.

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: 20-2: Discuss ways to manage absenteeism.

Question 15

Type: MCSA

Which employee is eligible for leave under the Family and Medical Leave Act (FMLA)?

1. A female employee who has worked at the community hospital full time for 5 months and requests 12 weeks of maternity leave

2. A male employee who has worked two 12-hour shifts for a rural hospital on weekends for 12 months and requests a 12-week leave to care for a newly adopted child

3. A female employee who has worked for a large metropolitan hospital full time for 1 year and requests 3 months leave to care for her dying mother

4. A male employee who has worked full time at a small private clinic with 20 employees for the last 8 years and requests 12 weeks of leave to care for a new foster child

Correct Answer: 3

Rationale 1: The employee must have worked for the employer for at least 12 months.

Rationale 2: The employee must have worked at least 1,250 hours in the last 12 months.

Rationale 3: This employee has worked 12 months, at least 1,250 hours, and the hospital is large and therefore likely employs over 50 people.

Rationale 4: The employee must be at a work site with 50 or more employees, or at a site where 50 workers are employed within 75 miles of the work site. A small private clinic with 20 employees does not meet this requirement.

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: 20-1: Explain absenteeism.

Question 16

Type: MCSA

The chief nursing officer notes that the nursing department has exceeded budget in salary expenses for the last 3 months and asks the hospital nurse managers why this occurred. Which would be a cause for increased salaries?

1. Low client acuity for the past year

2. The increase in the amount of tuition reimbursement

3. A high turnover rate in nursing staff

4. The cost-of-living raise given

Correct Answer: 3

Rationale 1: Low client acuity does not cause salary cost to increase.

Rationale 2: Tuition reimbursement is a benefit, not salary.

Rationale 3: High turnover rate would increase salaries because of overtime wages to cover when nurses leave and additional staff hours for orienting newly hired nurses, as well as the cost of agency nurses.

Rationale 4: A cost-of-living raise would have been figured into the budget.

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: 20-3: Describe how nursing turnover affects the organization.

Question 17

Type: MCSA

A manager is preparing to write a critical incident regarding a nurse who has voluntary absences for several scheduled shifts. What information should the manager determine first?

1. How many hours were missed per pay period?

2. What was the frequency and time period of the absences?

3. What was the reason for these absences?

4. Who did the nurse notify of the impending absences?

Correct Answer: 2

Rationale 1: The number of hours missed per pay period is interesting information, but is not the most critical statistic for this critical incident.

Rationale 2: The number of absences and the time periods of the absences are critical pieces of information for the critical incident documentation.

Rationale 3: It is already clear that these absences were excessive and voluntary, so a critical incident form will be completed. The reason why the absences occurred is of secondary importance.

Rationale 4: It is important to determine if the nurse followed policy when notifying the institution about the absences, but this is not the most critical information.

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: 20-2: Discuss ways to manage absenteeism.

Question 18

Type: FIB

A nurse manager is completing a critical incident form regarding a nurse who has missed two 12-hour shifts, three 8-hour shifts, was 2 and 1/2 hours late to one shift, and left 3 hours early from another shift. The manager should document the total time lost as ______ hours.

Standard Text: 

Correct Answer: 53 1/2

Rationale : Total time lost is figured by adding up the amount of hours the nurse did not come to work. In this case 12 + 12 + 8 + 8 + 8 + 2 + 3 = 53.

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: 20-2: Discuss ways to manage absenteeism.

Question 19

Type: MCMA

A nurse who is obtaining a bachelors degree in nursing is formulating a project regarding nurses job satisfaction. The nurse is aware that research has shown job satisfaction is related to which factors in the working environment?

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

Standard Text: Select all that apply.

1. Appropriate staffing

2. Involvement in organizational decision making

3. Ability to work overtime

4. Being recognized for a job well done

5. Good relationships among staff

Correct Answer: 1,2,4,5

Rationale 1: Nurse retention may be a result of enhancing the work environment. Appropriate staffing is a positive indicator of a healthy work environment.

Rationale 2: Involvement in organizational decision making improves the overall work environment for nurses.

Rationale 3: Being able to work overtime is not universally important.

Rationale 4: Recognition for doing ones job well is an important component of job satisfaction.

Rationale 5: Good staff relationships improve the work environment.

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: 20-5: Discuss what organizations can do to improve retention of nurses.

Question 20

Type: MCSA

An ICU manager is discussing a nurses frequent absences and tardiness, which the nurse explains results from unreliable child care. The nurse states, None of the other nurses mind if I am late or have to miss a shift. My kids are important to me. Id do the same for any of them. This is an example of which situation?

1. Enriched job environment

2. Organizational practices

3. Absence culture

4. Generational differences

Correct Answer: 3

Rationale 1: Enrichment of the job environment makes the job challenging and rewarding, which encourages employee attendance and participation.

Rationale 2: Organizational practices are such things as on-site child care that can influence an employees motivation to work.

Rationale 3: Absence culture on this unit is tolerant of absences.

Rationale 4: While there may be some differences in how generations view punctuality and attendance, it is not clear that is an issue in this 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: 20-2: Discuss ways to manage absenteeism.

Question 21

Type: MCMA

A nurse manager has recently been transferred from obstetrics to pediatrics. The manager consistently stays in the office, does not relieve staff for lunches, and rarely assists staff when the unit is busy. Lately, the manager has noticed an increase in staff absences. Which options may contribute to the situation on this unit?

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

Standard Text: Select all that apply.

1. The manager has a lack of confidence in personal ability to provide care to pediatric clients.

2. The manager is unable to confront staff regarding absences.

3. The manger is not supervising the work of the unit.

4. The staff is consciously taking advantage of the manager.

5. The manager has a lax attitude toward absenteeism.

Correct Answer: 1,2,3,5

Rationale 1: The manager just transferred from a different unit and may be uncomfortable with skills needed to care for pediatric clients.

Rationale 2: Confronting the staff about absences may be difficult for a new manager.

Rationale 3: If the manager consistently stays in the office, supervision is minimal.

Rationale 4: It is difficult to say that the staff is consciously taking advantage of the manager, but this may be occurring on a subconscious level.

Rationale 5: The managers own absence culture may be very tolerant.

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: 20-1: Explain absenteeism.

Question 22

Type: MCSA

An organization has not updated its sick day policy in the last 5 years and has experienced an increase in employee days off for illness over the last year. Which change to the sick leave policy might have a positive effect on the organizations absenteeism?

1. Change the policy to award personal use days rather than sick days.

2. Place stricter limits on the number of sick days that can be accrued.

3. Limit the amount of sick time an employee can use each year regardless of the amount accrued.

4. Allow employees to trade sick time for money no matter how many hours are accrued.

Correct Answer: 1

Rationale 1: Personal use days are days that the employee can schedule for any use or can use in time of sickness. When the days are designated as personal use days, the employee does not have to be deceitful when using a day for personal time rather than when sick.

Rationale 2: When the number of sick days is limited, employees tend to use days to avoid losing the benefit.

Rationale 3: Limiting the amount of sick time an employee can use would work as a disadvantage to loyal employees who happen to have an extended illness.

Rationale 4: Allowing employees to trade sick time for money would be an unmanageable strain on the budget. Employees might trade in all sick time and then become ill and not have a sick time bank.

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: 20-2: Discuss ways to manage absenteeism.

Question 23

Type: MCSA

The director of two nursing units is off on medical leave. The morale on these units has decreased over the past year. During the directors absence the chief nurse officer (CNO) notices a marked increase in the staffs morale. This causes the CNO to be concerned about which factor on these two units?

1. Lack of appropriate staffing when the manager is present

2. Recognition of the nurses performance may be lacking

3. A lack of authentic leadership

4. The manager may have unrealistic attitudes about staff work levels.

Correct Answer: 3

Rationale 1: Lack of appropriate staffing is not the overriding concern.

Rationale 2: While this may be a part of the problem, it is not the major concern.

Rationale 3: Authentic leadership is required for a healthy work environment. Since the morale on these units has increased in the directors absence, the CNO would be concerned about the managers leadership style.

Rationale 4: This is not the primary concern.

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: 20-5: Discuss what organizations can do to improve retention of nurses.

Question 24

Type: MCSA

A newly hired nurse has incurred two absences within two pay periods. The nurse manager has scheduled a meeting with the nurse. What other action should the manager plan in addressing this issue?

1. Have a person from human resources (HR) present when confronting the nurse.

2. Discuss the absenteeism with the nurse and then forget the issue.

3. Discuss the issue of absenteeism and other nurses who have had similar experiences when first hired.

4. Document the absences, review the attendance policy with the nurse, and provide a copy of the policy.

Correct Answer: 4

Rationale 1: It is not necessary to have HR present at this meeting since this is the nurses first occurrence with absenteeism.

Rationale 2: The absenteeism needs to be addressed and monitored in the future to determine the nurses progress.

Rationale 3: It is not appropriate to discuss the absence experiences of other nurses.

Rationale 4: The manger should document the absences so they can be monitored and discussed. The manager should discuss and present the attendance policy to clarify possible misconceptions by the nurse and to be clear about the consequences of future issues relating to absenteeism.

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: 20-2: Discuss ways to manage absenteeism.

Question 25

Type: MCSA

A nursing unit is extremely short staffed. The manager calls a nurse who is on Family and Medical leave (FMLA) to ask the nurse to return to work 2 days prior to schedule. When the nurse declines, the manager becomes insistent. What should be the nurses first action?

1. Contact a lawyer.

2. Agree to return 2 days early.

3. Contact the human resources director.

4. Contact nursing administration.

Correct Answer: 3

Rationale 1: The employee should contact a lawyer only after all attempts to rectify the situation with the organization have been exhausted.

Rationale 2: The nurse is assured the time off through FMLA and should not return to work early.

Rationale 3: The nurses first action should be to contact the human resources (HR) director.

Rationale 4: If the nurse contacts nursing administration, he or she is likely to be referred to the human resources department.

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: 20-2: Discuss ways to manage absenteeism.

Question 26

Type: MCMA

Which personal characteristics would increase a nurses potential for voluntary turnover?

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 holds an associates degree in nursing.

2. The nurse walks to work each day.

3. Through task force meetings, the nurse has become friends with several nurses who work in different organizations in town.

4. The nurse has few personal ties to the city of current employment.

5. The nurse has worked at several job-fairs in the area as a hospital representative.

Correct Answer: 3,4,5

Rationale 1: A nurse who holds a higher degree is likely to be more mobile.

Rationale 2: If the nurse lives within walking distance to the hospital he or she is less likely to voluntarily resign.

Rationale 3: Having contacts in other health care organizations increases the nurses likelihood of changing work sites.

Rationale 4: If the nurse is geographically mobile, leaving for a change of scenery is attractive.

Rationale 5: Attending job fairs, even as a hospital representative, opens up new contacts and possibilities of new jobs.

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: 20-4: Explain voluntary turnover.

Question 27

Type: MCSA

A valued longtime nursing employee says to the manager, Im so tired of all the politics on this unit. Im thinking about retiring. What should be the mangers response?

1. Ive just got 3 more years and I can retire. I cant wait.

2. I know, but I cant do anything to change the situation.

3. Id hate to lose you, but have you thought about transferring to a different unit?

4. Will you stay if I can get you a raise?

Correct Answer: 3

Rationale 1: If the manager wishes to retain this employee, a statement about wanting to retire is not prudent.

Rationale 2: The manager is not offering this nurse any alternative except that the politics will continue.

Rationale 3: The manager has offered the possibility of lateral transfer to this employee. It will not keep the employee on the managers unit, but will keep the employee in the organization.

Rationale 4: Money might be enough to entice the employee to stay, but it is not the best option offered.

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: 20-4: Explain voluntary turnover.

Question 28

Type: MCMA

The nurse manager charged with hiring staff for a new nursing unit explains the units rigid structure and scheduling policies to all potential applicants. The manager is most likely to lose the interest of applicants of which generations?

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

Standard Text: Select all that apply.

1. Traditionals

2. Baby boomers

3. Generation X

4. Generation Y

5. Nurses in general do not like structure and rigidity in scheduling.

Correct Answer: 3,4

Rationale 1: Traditionals in general like structure and are more likely to work well with inflexible schedules.

Rationale 2: Baby boomers in general do fairly well with structure and rigid scheduling.

Rationale 3: Generations X in general does not like structure and is interested in flexible scheduling.

Rationale 4: Generation Y in general does not like structure and is interested in flexible scheduling.

Rationale 5: Some nurses thrive in an environment with lots of structure and a predictable, somewhat rigid schedule.

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: 20-6: Discuss what managers can do to help retain nurses.

Question 29

Type: MCSA

An employee has called in to report being unable to come to work due to car trouble. This is the third time this has happened in the last 2 weeks. The manager should question which variable in this employees attendance?

1. Ability

2. Motivation

3. Need

4. Supervision

Correct Answer: 2

Rationale 1: Ability to attend is generally linked to such obstacles as car trouble, but since this has happened frequently the manager should look to another issue.

Rationale 2: Since this car trouble is frequent, the manager must look to the employees motivation to attend. Why has the employee not arranged better or different transportation?

Rationale 3: Need to attend can be linked to motivation, but motivation is a better descriptor in this situation. The employee might need to attend for the salary, but is not motivated to do so.

Rationale 4: Supervision has little to do with this scenario.

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: 20-1: Explain absenteeism.

Question 30

Type: MCMA

A nurse manager strongly believes that nurses should seek advanced educational degrees. The manager encourages this attitude in staff nurses. What are the dangers of this practice?

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

Standard Text: Select all that apply.

1. Nurses who achieve an advanced degree are more mobile.

2. Staff nurses may have a higher degree than the manager.

3. Staff members may need time off to attend school.

4. Staff members may resign to attend school full time.

5. Salaries are higher for nurses with advanced degrees.

Correct Answer: 1,3,4

Rationale 1: The nurse with an advanced degree has greater job opportunity and is more mobile.

Rationale 2: This may be the case, but should not be a problem.

Rationale 3: Scheduling around several nurses who have school schedules can be difficult.

Rationale 4: There is a chance that nurses may resign in order to attend school on a full-time basis.

Rationale 5: While salaries are higher for nurses with advanced degrees, the manager should know well in advance that a staff member is in school and should have opportunity to budget for those salaries.

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: 20-6: Discuss what managers can do to help retain nurses.

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

Copyright 2013 by Pearson Education, Inc.

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