Chapter 24 My Nursing Test Banks

Sullivan, Effective Leadership and Management, 8/e
Chapter 24

Question 1

Type: MCSA

The nurse manager is educating staff about the collective bargaining process. Who should this nurse say controls collective bargaining in health care?

1. The judicial system

2. Individual hospitals

3. Nurses unions

4. Federal laws

Correct Answer: 4

Rationale 1: The judicial system has ruled on some collective bargaining laws but does not write the law.

Rationale 2: Individual hospitals are participants in collective bargaining but do not govern it.

Rationale 3: Nurses unions are participants in collective bargaining but do not govern it.

Rationale 4: Laws have been enacted by Congress to guide and control labor relations between employees and employers.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 2

Type: MCMA

The nurses of a hospital have given notice of their desire to unionize. The nurse executive is meeting with all nurse managers to discuss their role. Which information should the executive provide for these managers?

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

Standard Text: Select all that apply.

1. We need to stop this if at all possible. I am counting on you to discourage nurses from joining the union.

2. If the nurses on your unit want to organize, do not interfere.

3. You cannot say anything about the union, but your actions can speak for you.

4. We are not going to participate in this.

5. I will keep you posted as we move through this process.

Correct Answer: 2,5

Rationale 1: Encouraging or discouraging union membership by a manager is an unfair labor practice.

Rationale 2: Interference with the right to organize is an unfair labor practice.

Rationale 3: Any act of domination or indication of preference regarding the union is an unfair labor practice.

Rationale 4: Refusal to bargain collectively is an unfair labor practice.

Rationale 5: The managers must be kept apprised of the 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: 24-2: Describe the nurse managers role in collective bargaining.

Question 3

Type: MCSA

Nurses in a hospital are working to establish a union. Which finding will these nurses be interested in seeing?

1. Thirty percent of eligible hospital nurses have signed a card indicating interest.

2. Seventy percent of hospital employees have said they are interested.

3. Fifty percent of staff nurses and management nurses must vote.

4. Thirty percent of all nurses working for the agency must vote.

Correct Answer: 1

Rationale 1: Before an election can be held, the union must demonstrate interest by 30 percent of eligible hospital nurses signing an authorization card.

Rationale 2: Interest in establishing a union must be demonstrated by those who will be establishing the unionin this case, nurses.

Rationale 3: Management nurses are not considered eligible employees when interest in a union is measured.

Rationale 4: Eligible employees include staff nurses but not managers and supervisors.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 4

Type: MCSA

The nurses in an organization are in the process of selecting a bargaining agent. Which action by the nurse executive is considered a fair labor practice?

1. Promising wage increases if the desired agent is chosen

2. Questioning staff nurses regarding their vote

3. Threatening demotions if the desired agent is not chosen

4. Disallowing collective bargaining organizational meetings at the hospital

Correct Answer: 4

Rationale 1: Administrators are not allowed to promise incentives in return for a favorable selection.

Rationale 2: Nursing management is not allowed to question nurses regarding their feelings about the union activity.

Rationale 3: Nursing administrators are not allowed to threaten punishment for undesirable choices.

Rationale 4: Nursing administrators are not required to allow union activities on hospital property or during working hours.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 5

Type: MCSA

A housekeeping employee is questioning the employees agent regarding the role of administering the ratified contract. The agent should explain to the employee that this role belongs to which person?

1. Union president

2. Hospital administrator

3. Designated union representative

4. Bargaining agent

Correct Answer: 3

Rationale 1: The union president is most active during the collective bargaining phase or when negotiating the contract and does not administer the contract.

Rationale 2: The hospital administrator is responsible for adhering to the negotiated contract but does not administer it.

Rationale 3: A designated hospital staff nurse may serve as the union representative. It is the duty of this nurse to provide fair and equal representation to all members of the unit.

Rationale 4: The bargaining agent is most active during the collective bargaining phase or when negotiating the contract but does not administer the contract.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 6

Type: MCSA

The housekeeping employee asks the employees agent what role the union representative plays. What answer should the agent provide?

1. They will set wages for union members.

2. They are responsible for writing floating policy for administration.

3. They oversee the retirement funds.

4. They are responsible for administering the contract.

Correct Answer: 4

Rationale 1: Wages are set in the contract.

Rationale 2: Policies are negotiated in the contract.

Rationale 3: Retirement funds are negotiated in the contract.

Rationale 4: The role of administering the contract falls to an individual designated as the union representative.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 7

Type: MCSA

Approximately half of an organizations employees decide they are not happy with their current contract, which will expire in 4 months. The union representative informs the group that they can work to change the contract. What is the next step in this process?

1. Giving the union notice of desire to change the contract at least 90 days before it expires

2. Ratification of the current contract

3. Vote for cessation

4. Appointment of a mediator

Correct Answer: 1

Rationale 1: Before changing or terminating a contract, one party must notify the other of its intent to do so 90 days prior to the contract expiration date.

Rationale 2: Ratification is the process by which employees approve a contract.

Rationale 3: Cessation is not related to union membership.

Rationale 4: A mediator is appointed if the two sides of the contract cannot agree on changes.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 8

Type: MCSA

As a cost-saving initiative, the hospital administration has asked the night staff nurses to refill drug supplies at night while the pharmacist is not present. The nurses file a grievance and nurse managers become involved. How would this grievance be classified?

1. Violation of agency rules

2. Contract violation

3. Failure of management to meet its responsibilities

4. Violation of federal and state laws

Correct Answer: 4

Rationale 1: The agency could make a new rule that allows this practice.

Rationale 2: It is unlikely that this scenario would be covered in the contract.

Rationale 3: This is the second best answer to this question.

Rationale 4: Nurses cannot act as substitute pharmacists.

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: 24-2: Describe the nurse managers role in collective bargaining.

Question 9

Type: MCMA

A nurse has been hired as a new nurse manager at a hospital that has union representation. Which union-related activities should this manager expect will be included in the role?

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

Standard Text: Select all that apply.

1. Actively helping to administer any grievance procedures

2. Participating in issues related to disciplining employees

3. Encouraging union membership

4. Being certain that all disputes within management are public

5. Avoiding collective bargaining

Correct Answer: 1,2

Rationale 1: The nurse manager should help to administer grievance procedures and should participate in issues about disciplining employees.

Rationale 2: The nurse manager should help to administer grievance procedures and should participate in issues about disciplining employees.

Rationale 3: The nurse manager should not encourage or discourage union membership.

Rationale 4: Disputes within management should be confidential.

Rationale 5: The nurse manager must participate in the activities of collective bargaining.

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: 24-2. Describe the nurse managers role in collective bargaining.

Question 10

Type: MCSA

A union has won a representative election. What right does that union now hold?

1. The right to represent all employees of the hospital

2. The right to forbid management from unilaterally changing employment conditions for employees outside the bargaining unit

3. The right to jointly negotiate expanded bargaining units with the employer after the election

4. The right to be the bargaining agent for a group of employees

Correct Answer: 4

Rationale 1: The union has the right to represent the group of employees covered by the election. For example, a nurses union may or may not include health care workers in the laboratory or radiology departments.

Rationale 2: The union cannot effect change for employees outside of the bargaining unit.

Rationale 3: The union cannot expand to another unit without an election.

Rationale 4: The union that wins the election then has the right to enter into contract negotiations with the organization on behalf of the employees.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 11

Type: MCSA

A nurse manager enters the staff break room. The manager overhears the nursing staff discussing wages and paid time off as issues to consider during the bargaining process. Which action by the manager would be appropriate?

1. Leave the break room and not discuss with others what was heard.

2. Inform staff they are not to talk about their bargaining issues during work time or at the work site.

3. Issue a written warning regarding discussion of wages while on the job.

4. Tell nursing administration that a strike is likely.

Correct Answer: 2

Rationale 1: The manager may leave the break room but should address the issue of employees not discussing collective bargaining while at work or on the work site.

Rationale 2: The manager should address the issue of employees not discussing collective bargaining while at work or on the work site.

Rationale 3: It is not necessary to issue a written warning for discussion of wages.

Rationale 4: Simple discussion of wages and benefits does not herald a strike.

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: 24-2: Describe the nurse managers role in collective bargaining.

Question 12

Type: MCMA

A nurse who works in a hospital with a collective bargaining unit requires disciplining. Which actions by the nurse manager are critical?

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

Standard Text: Select all that apply.

1. Coaching the nurse as appropriate

2. Letting the collective bargaining unit handle any disciplinary needs

3. Reviewing policy and procedures with the nurse

4. Discussing expectations that were not met

5. Directing any questions the nurse has to the union representative

Correct Answer: 1,3,4

Rationale 1: The manager is responsible for many of the same activities as in any situation. Coaching is included in these responsibilities.

Rationale 2: The manager is responsible for discipline in the unit just as in any other situation.

Rationale 3: A review of policy and procedures is part of all disciplinary issues.

Rationale 4: Discussing unmet expectations is a part of all disciplinary issues.

Rationale 5: The manager should answer questions that pertain to the actions for which the nurse is being disciplined.

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: 24-2: Describe the nurse managers role in collective bargaining.

Question 13

Type: MCSA

An ICU nurse manager states, The hospital has a union but I wouldnt advise joining, to a newly hired nurse. The human resources (HR) director is informed of this comment. How should the HR director respond?

1. Call the new nurse and explain that joining the union is encouraged by the hospital.

2. Remind the manager that there is to be no interference with an employees decision to join the union.

3. File a grievance against the manager.

4. Terminate the manager.

Correct Answer: 2

Rationale 1: The hospital should neither encourage nor discourage employees from joining the union.

Rationale 2: The managers role is not to interfere with the employees right to organize. The manager should not dominate; encourage or discourage union membership; terminate an employee for filing a charge with the NLRB; or refuse to bargain collectively. The HR director should clarify this role with the manager.

Rationale 3: There is no reason to file a grievance.

Rationale 4: Unless this manager makes it a practice to tell employees to avoid the union and has continued to do so after being apprised of the regulations, there is no reason for termination.

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: 24-2: Describe the nurse managers role in collective bargaining.

Question 14

Type: MCSA

A grievance has been filed against a hospital whose nursing staff has just established a union. What is the nurse executives first step?

1. Call the union representative for a meeting to discuss the grievance.

2. Call managers together to discuss the grievance.

3. Notify staff nurses that the grievance has been received.

4. Review the agreement for information about grievances.

Correct Answer: 4

Rationale 1: This may be a wise idea, but it is not the first step.

Rationale 2: This may be a wise idea, but it is not the first step.

Rationale 3: This is not the first step.

Rationale 4: The nurse executives first step should be to review the agreement with the union. This agreement will describe the steps and progression of a grievance.

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: 24-3: Explain what is involved in the grievance process.

Question 15

Type: MCMA

A grievance has been filed against a hospital. Which statement by the nurse executive reflects common reasons for grievances?

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

Standard Text: Select all that apply.

1. The nurses want more benefits than specified in the contract we just signed.

2. I think there is a misunderstanding of one of the terms of the contract.

3. I think this grievance is based on a term in the old contract that is not included in the new contract.

4. The nurses want higher wages because the other hospital in town just raised their pay scale.

5. This contract just is not going to work. We need to renegotiate.

Correct Answer: 2,3,5

Rationale 1: If the benefits provided are those specified in the contract, there are no grounds for grievance.

Rationale 2: Misunderstandings are common causes of grievances.

Rationale 3: Lack of familiarity with the contract is a common reason for a grievance.

Rationale 4: It the nurses want higher wages, the contract should be renegotiated. A grievance is not indicated.

Rationale 5: An inadequate agreement is a common reason for a grievance.

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: 24-3: Explain what is involved in the grievance process.

Question 16

Type: FIB

To balance the rights of employees and the public, Congress passed a special set of procedures for settling labor disputes in the health care industry. These include a specification that one party must notify the other of intent to change or terminate a contract ______ days before the contract expires.

Standard Text: 

Correct Answer: 90

Rationale : The time period for this notification in the health care industry is 90 days.

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: 24-3: Explain what is involved in the grievance process.

Question 17

Type: MCSA

A nurse assistant states, I dont understand why they would select a nurse to be the union representative. Which response by a coworker is appropriate?

1. Administration chose a nurse for this role.

2. Why do you care who is the representative?

3. The representative must be an employee of the union or a member of the nursing staff.

4. The representative must be a nurse if the unionized organization is a hospital or health care organization.

Correct Answer: 3

Rationale 1: This person is not chosen by administration.

Rationale 2: It is important that all staff know who the representative is.

Rationale 3: The union representative may be an employee of the union or a member of the nursing staff.

Rationale 4: The union representative may be an employee of the union or a member of the nursing staff.

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: 24-3: Explain what is involved in the grievance process.

Question 18

Type: MCSA

A union representative tells the nurses of a hospital that they should review the Kentucky River trilogy as part of their education regarding unionization. What will the nurses learn from this review?

1. A summary of the benefits of collective bargaining in the health care industry

2. The history of unionization in the United States

3. What the nurse can expect to pay as a member of the collective bargaining unit

4. Which nurses are considered to have supervisory status

Correct Answer: 4

Rationale 1: This is not the focus of this work.

Rationale 2: This is not the focus of this work.

Rationale 3: This is not the focus of this work.

Rationale 4: These three landmark decisions outline which nurses have supervisory status.

Global Rationale: 

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 24-4: Describe the legal issues involved for nurses.

Question 19

Type: MCSA

A nurse is discussing the intent of the nurses collective bargaining representation to strike. The nurses spouse is concerned about the length of time the nurse may lose as a result of a strike. Which statement by the nurse is correct?

1. Nurses cant strike; its just a term on paper.

2. The hospital isnt allowed to replace my position because of a strike.

3. The hospital has a 10-day notice before we go on strike.

4. Not all staff nurses are included in the strike.

Correct Answer: 3

Rationale 1: Nurses do strike.

Rationale 2: The hospital has the right and obligation to provide continuity of care.

Rationale 3: By law, a 10-day notice must be given to allow hospitals the opportunity to prepare for striking nurses absences.

Rationale 4: All staff nurses employed by the facility are included in the strike.

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: 24-3: Explain what is involved in the grievance process.

Question 20

Type: MCSA

The nursing staff at a hospital is upset regarding nurseclient ratios. One of the nurses says, Our contract is not being honored. I think we need to tear it up and strike, starting tomorrow. Which response by the union representative is most appropriate?

1. We cant strike until we have given administration 10 days notice of our desire to change the contract.

2. The FMCS (Federal Mediation and Conciliation Service) has to have 30 days notice of our intent to strike.

3. I have to let the medical chief of staff know we are going to strike at least 30 days before it happens.

4. I have to meet with the Board of Directors and tell them 24 hours in advance.

Correct Answer: 2

Rationale 1: Notice to change the contract must be given 90 days in advance.

Rationale 2: The FMCS is notified if agreement has not occurred within 30 days of the notification to terminate the contract.

Rationale 3: The notification of intent to strike goes to the management, not the chief of staff. The notice is 10 days.

Rationale 4: Notice of intent to strike is given farther in advance than 24 hours and must be in writing.

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: 24-3: Explain what is involved in the grievance process.

Question 21

Type: MCSA

The manager tells a potential nurse hire that the organization is a closed shop organization. The nurse asks for clarification. Which response by the manager is most accurate?

1. A closed shop is an organization in which union representation and collective bargaining practices are not discussed.

2. It is a term used to describe the collective bargaining practices in this state.

3. It means you are required to join the union if you accept this position.

4. You are required to sign a statement stating you received information regarding union membership.

Correct Answer: 3

Rationale 1: Closed shop does not refer to where union activities can be discussed.

Rationale 2: While the term closed shop is used to describe collective bargaining practices in the hospital, it does not necessarily pertain to the whole state.

Rationale 3: A closed shop is a business in which union membership is a precondition of employment.

Rationale 4: The requirement extends further than just signing a statement that information was received.

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: 24-1: Discuss the laws that govern collective bargaining.

Question 22

Type: MCMA

A nurse manager is conversing with a colleague at a national meeting. The colleague states, Ive just never understood why a nurse would want to join a union. What responses by the manager would explain the attraction of unionization?

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

Standard Text: Select all that apply.

1. Its usually a combination of factors such as low wages and high nurse-to-client ratios.

2. Low wages cause so much job dissatisfaction that the nurses unionize.

3. Having to work with supervisors as staff when nurses call in is one reason.

4. Many nurses have supervisors who think they understand what its like to work on the unit every day.

5. Many nurses are frustrated because communication between nurses and administration is so poor.

Correct Answer: 1,4,5

Rationale 1: Unionization becomes an attractive option when a combination of factors causes dissatisfaction. Low wages alone are not usually the cause, but low wages associated with other factors such as high client acuity and ratios may cause nurses to seek unionization.

Rationale 2: Unionization is an attractive option when a combination of factors causes dissatisfaction. Low wages alone are not usually the cause.

Rationale 3: Supervisors and managers working and assisting as staff would improve nurse/management relations and assist with communication.

Rationale 4: Supervisors who assume they know what issues are concerning to the staff do not help create trust in the work environment.

Rationale 5: Ineffective communication is often the reason for job dissatisfaction, which can make unionization an attractive option.

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: 24-5: Discuss the future of nursing unions.

Question 23

Type: MCMA

Which job responsibilities indicate that a nurse has supervisory capacity?

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 makes clinical judgments about client care.

2. The nurse assigns a nurse assistant to care for a team of clients.

3. The nurse discusses client care with the supervising physician.

4. The nurse hires staff to manage units.

5. The nurse retains responsibility for the actions of nurses assigned to provide client care.

Correct Answer: 2,4,5

Rationale 1: Both staff nurses and supervisory nurses make clinical judgments about client care.

Rationale 2: If the nurse makes assignments to a nurse assistant, the nurse has supervisory capacity.

Rationale 3: Both staff nurses and supervisors discuss client care with supervising physicians and other physicians.

Rationale 4: Hiring staff to manage a unit is a type of assignment that indicates supervisory capacity.

Rationale 5: If the nurse has responsibility for the actions of those to whom client care has been assigned, the nurse has supervisory capacity.

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: 24-4: Describe the legal issues involved for nurses.

Question 24

Type: MCSA

A nurse who has accepted a position as an assistant ICU manager is discussing unionization with the human resources (HR) director. The HR director says the nurse cannot join the union. What rationale should the HR director offer for this statement?

1. The nurse has never been in a union in the past.

2. The nurse must first complete orientation before being eligible to join the union.

3. The nurse must have worked in a hospital environment for at least 5 years.

4. Registered nurses hired as management are not eligible for collective bargaining.

Correct Answer: 4

Rationale 1: Not being in a union in the past is not a valid rationale.

Rationale 2: Completing orientation is not pertinent in this situation.

Rationale 3: Length of employment is not pertinent to this situation.

Rationale 4: Registered nurses employed as staff nurses are eligible for collective bargaining, but nurses who are employed as managers are not.

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: 24-4: Describe the legal issues involved for nurses.

Question 25

Type: MCSA

The National Labor Relations Board (NLRB) has certified a union to be the bargaining agent for a hospital. A nurse working in the hospital has a grievance and says to the nurse manager, Wait until the union gets involved. Which response by the manager is appropriate?

1. NLRB certification does not mean a union will develop.

2. A union will not get involved in this situation.

3. The NLRB is not concerned with your grievance.

4. The grievance will be resolved with or without the NLRB.

Correct Answer: 1

Rationale 1: Certification by the NLRB of a union to be the bargaining agent does not automatically mean employees have a contract.

Rationale 2: The manager has no way of knowing if this grievance will be settled by the time the union is in place.

Rationale 3: Unions do get involved in grievances.

Rationale 4: There is no guarantee that this grievance will be resolved.

Global Rationale: 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 24-1: Discuss the laws that govern collective bargaining.

Question 26

Type: MCMA

One of the areas of supervision defined by the National Labor Relations Board (NLRB) is independent judgment. Which nurses fall into this category?

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

Standard Text: Select all that apply.

1. A nurse who routinely reviews lab work and makes a clinical judgment of when to notify the physician

2. A nurse who works twice a month as charge nurse on an acute care unit

3. A nurse who makes team assignments as part of the charge nurse role

4. A nurse whose job includes choosing which assistants to place with which clients

5. A nurse who applies assessment findings when altering the plan of care for a client

Correct Answer: 2,3,4

Rationale 1: Routine clinical judgment in care of clients is not included in independent judgment.

Rationale 2: If the nurse is regularly scheduled as charge nurse, the nurse is considered to be using independent judgment to match staff skills to client needs.

Rationale 3: If the nurse is matching staff skills to client needs, independent judgment is being used.

Rationale 4: If the nurse is matching employee skills with client needs, independent judgment is being used.

Rationale 5: Using assessment findings to alter the plan of care is clinical judgment, not independent judgment in the context of collective bargaining.

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: 24-4: Describe the legal issues involved for nurses.

Question 27

Type: MCMA

Which statements by a nurse manager would the supervisor interpret as indicating an understanding of why collective bargaining is complicated for nurses?

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

Standard Text: Select all that apply.

1. There just are not many union options for nurses.

2. None of the unions available for nurses were developed specifically for nurses.

3. The determination of who is eligible to join a union is complicated.

4. In some institutions, nurses have formed their own unions.

5. No nursing unions have the backing of national organizations like the AFL/CIO.

Correct Answer: 3,4

Rationale 1: Several organizations offer union options for nurses.

Rationale 2: National Nurses United and United American Nurses are organizations specifically for nurses.

Rationale 3: The determination of who is a supervisor is complicated in nursing.

Rationale 4: Nurses in some institutions have formed their own unions.

Rationale 5: Untied American Nurses is an AFL/CIO affiliate.

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: 24-4: Describe the legal issues involved for nurses.

Question 28

Type: MCSA

The nurse executive is addressing a conference on collective bargaining and nurses. Which statement should the executive include in this address?

1. It is clear that collective bargaining is the way of the future for nursing.

2. Collective bargaining does not help nurses influence the practice environment.

3. Your concerns that collective bargaining may separate staff nurses and managerial nurses are well founded.

4. The future of collective bargaining in nursing will begin to stabilize along with the health care environment.

Correct Answer: 3

Rationale 1: The future of collective bargaining in nursing is uncertain and unknown.

Rationale 2: The primary reason nurses participate in collective bargaining is to influence the practice environment.

Rationale 3: One of the major concerns regarding collective bargaining in nursing is the fear that this separation will occur.

Rationale 4: There is no indication that this is going to occur in the near future.

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: 24-5: Discuss the future of nursing unions.

Question 29

Type: MCMA

A nurse is interested in the possibility of collective bargaining in the workplace. What will the nurse find when researching this possibility?

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

Standard Text: Select all that apply.

1. Most nurses do not work under collective bargaining agreements.

2. As the nurse is a manager, collective bargaining would be of no interest.

3. The National Labor Relations Board (NLRB) has addressed collective bargaining in nursing.

4. The nurse works in a state hospital, where collective bargaining is not possible.

5. The cost of the dues or fees associated with collective bargaining is more than could be gained from joining.

Correct Answer: 1,3

Rationale 1: This is a true statement.

Rationale 2: The nurse manager may not be included in the collective bargaining agreement but certainly would have an interest in the process.

Rationale 3: The NLRB has addressed many issues that directly impact collective bargaining and nursing.

Rationale 4: Whether or not collective bargaining is used depends on the state in which the nurse works.

Rationale 5: The fee schedule is set by the union, and the value of unions differs.

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: 24-5: Discuss the future of nursing unions.

Question 30

Type: MCSA

The nurse works in a federal hospital that is beginning the collective bargaining process with nurses. The nurse is disappointed to discover that which concern cannot be addressed in negotiations?

1. Work hours

2. Job responsibilities

3. Wages

4. Conditions of client care

Correct Answer: 3

Rationale 1: Conditions of work, such as work hours, can be negotiated.

Rationale 2: Job responsibilities can be negotiated.

Rationale 3: Wages cannot be negotiated in federal institutions.

Rationale 4: Conditions of client care can be negotiated.

Global Rationale: 

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 24-1: Discuss the laws that govern collective bargaining.

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

Copyright 2013 by Pearson Education, Inc.

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