Deck 26: Managing Stress

Question 1

Which factors increase the stress associated with interpersonal relationships in healthcare? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Longer length of stay for clients
B) Few assistive personnel
C) Job redesign
D) New technology
E) Unrealistic expectations of other disciplines

Answer 1

Job redesign
New technology
Unrealistic expectations of other disciplines

Question 2

The manager is watchful of compassion fatigue among the nursing staff of the emergency department. What is the best indicator to the manager that this disorder is occurring?

A) Nurses complain of being too tired to work.
B) Clients complain that nurses are not compassionate.
C) Physicians complain that the nurses are not taking good care of clients.
D) Symptoms much like severe burnout occur in the staff.

Answer 2

Symptoms much like severe burnout occur in the staff.

Question 3

A nurse who has just returned from two weeks of time off following minor surgery says, "I'm so glad to be back to work. I'm sick of watching television. I can't believe I missed the stress here." What are possible explanations for this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Lack of stress can cause boredom.
B) Stress can be motivational.
C) Apathy can occur if stress is absent.
D) Eustress occurs when stress is decreased too much.
E) A balance between stress and coping is essential.

Answer 3

Lack of stress can cause boredom.
Stress can be motivational.
Apathy can occur if stress is absent.
A balance between stress and coping is essential.

Question 4

A nurse manager praises a staff nurse by saying, "You are such a perfectionist, and it clearly shows in your work." The supervisor who hears this praise is concerned for which reason?

A) Giving such high praise to a staff nurse may result in the nurse asking for a raise.
B) The manager should not praise a staff nurse so highly in front of other nurses.
C) The manager may be promoting a trait that often leads to constant stress.
D) This type of praise often leads to the nurse behaving in a superior manner when around the other nurses.

Question 5

A staff nurse finds a newly licensed, newly hired staff nurse crying in the break room halfway through a shift. The new nurse says, "I am just not getting this. I had no idea nursing would be this hard." The experienced nurse says, "Reality shock is terrible, but you will get through it." What does the nurse mean by reality shock?

A) A period when it becomes clear the new nurse is not able to function as a registered nurse
B) A period of surprise and disequilibrium about the nursing role
C) A period when expectations of the role are unclear
D) A period when managers determine if the new nurse is a good fit for the profession of nursing

Question 6

The unit nurses take turns filling the charge nurse role. Which statement reveals risk for development of role conflict in these nurses?

A) "I think I do a better job as charge nurse than the other nurses."
B) "I like being charge nurse better than being a staff nurse."
C) "Sometimes it is just faster to do things myself."
D) "I have difficulty with understanding the report from the previous shift."

Question 7

An ICU nurse manager noticed a competent nurse has become forgetful and has made medication errors in the past few months. This type of behavior is unusual for this nurse. What action should the manager take?

A) Issue a written warning to the nurse.
B) Meet individually with the nurse to discuss the behavior.
C) Ask other staff members if they have noticed the behavior.
D) Report the nurse to the human resources department.

Question 8

A nurse who had advanced to assistant nurse manager was demoted back to staff nurse last month. The manager gives the nurse low-acuity client assignments. The nurse is efficient, unhappy, and bored. The nurse's response is most likely related to which phenomena?

A) Low self-esteem
B) Low morale
C) Mismanagement
D) Underutilization

Question 9

A staff nurse on a busy outpatient surgery unit comes to the manager and says, "I don't know what is going on. I just feel unsettled and anxious." How should the manager interpret this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The nurse is trying to establish a problem for which days off will be necessary.
B) The nurse may be suffering from free-floating anxiety.
C) The nurse may be overstressed.
D) The nurse has compassion fatigue.
E) The nurse is about to experience posttraumatic stress disorder.

Question 10

An assistant nurse manager has relieved a staff nurse for lunch. After the nurse leaves, the assistant manager realizes there is a nursing administration meeting at noon. Which stress-producing event does this exemplify?

A) Poor leadership
B) Mismanagement of the unit
C) Role conflict
D) Miscommunication

Question 11

The nurse manager asks a nurse to become a charge nurse, but then frequently questions the nurse's daily decisions. This situation reflects which problem that will increase the nurse's stress?

A) Reality shock
B) Role ambiguity
C) Role conflict
D) Burnout

Question 12

The chief nursing officer (CNO) recognizes a large increase in turnover on a given unit. The nurse manager of the unit says that this is just a coincidence and that the unit is "fine." What action by the CNO is appropriate?

A) Talk to current nursing staff and review the exit interviews of those who have left.
B) Call the unit supervisor and inquire as to why the turnover rate is high.
C) Discuss the matter with other nurse managers.
D) Discuss the matter with the hospital chief administrator.

Question 13

A medical-surgical nurse manager has received a complaint by a client regarding the noise level on the unit. The manager reviews the schedule and harshly reprimands the nursing staff who cared for the client. What is the evaluation of this manager's action?

A) It is appropriate and timely.
B) The action is inappropriate and increases the nursing staff's level of stress.
C) The action is inappropriate and should be reported.
D) It is appropriate and should be a model for future disciplinary actions.

Question 14

The hospital has elected to initiate a rotating 8-hour shift schedule. Which strategy, taken by the nurse manager, will help staff cope with the stress associated with this staffing pattern?

A) Rotate the shifts several times each month so no one is on one shift very long.
B) Rotate the nurses among all shifts so that they know the concerns of each shift.
C) Be certain that nurses are taking their meal and work breaks during each shift to increase rest.
D) Schedule a "double back" at the end of each rotation to allow new rotations to start uniformly.

Question 15

A newly hired registered nurse is having difficulty focusing and performing nursing tasks. The nurse manager has noted a decrease in the nurse's performance. When meeting with the nurse, the manager learns the nurse has recently gotten married and moved into a new home. The client load in the unit has returned to normal levels from very high levels and the employment of another newly hired nurse was terminated for disruptive behavior. The nurse reports that "everyone has been so nice and they try to help me." Which situations are most likely causing this nurse's stress? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Marriage
B) Purchasing a new home
C) Decreased workload
D) Assistance from other nursing staff
E) The coworker whose employment was terminated

Question 16

A staff nurse tells the nurse manager, "I don't know how you do it. You manage the unit, work extra shifts, and have so many people depending on you and yet you seem so calm and in control." What explains this nurse's perception?

A) Nurse managers don't do much direct client care, so their work is predicable.
B) The staff nurse is trying to manipulate the manager.
C) The manager has excellent coping skills and high stress tolerance.
D) Some people do a very good job of hiding their stress.

Question 17

A rural hospital has been at capacity for the past 3 months. The chief nursing officer (CNO) has heard numerous complaints from the nursing staff. Most of the complaints are issues related to other nursing departments and are minor. How should the CNO interpret these complaints?

A) The nursing staff members are inefficient in managing the client load.
B) This is a typical reaction among nursing departments.
C) The nursing staff are stressed due to a sustained increased workload.
D) The nurses are ready to unionize.

Question 18

The nurse manager holds a staff meeting and announces, "I want to aggressively manage the stress on this unit." Why would the manager have this goal?

A) Stress has a negative impact on the functioning of the unit.
B) If the stress level is too low, people become apathetic and bored.
C) Low stress levels will reduce turnover on the unit.
D) Coping mechanisms only work when stress is high.

Question 19

A staff nurse is late for work for the second time this week. When the manager mentions the tardiness, the nurse says, "I'm so sorry. I've just got so much going on with my impending wedding. I am so stressed." Which responses by the manager would help this nurse cope? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "Good stress can be just as bad as negative stress."
B) "We need to get you back in balance."
C) "Your personal issues should not interfere with work."
D) "Weddings are fun, but they can be stressful as well."
E) "If you are late again, I am going to write you up."

Question 20

A busy ICU unit has a high noise level. This frustrates the charge nurse in part because it is difficult to focus when entering physician's orders into the electronic medical record. Which would be the most appropriate action by the ICU nurse manager?

A) Decrease the noise level on the unit.
B) Tell the staff members that they need to be quiet when sitting at the nurse's station.
C) Close the doors to the client's rooms.
D) Rearrange the space so that a quieter area is available for order entry.

Question 21

A nurse manager notes that staff members are struggling with caring for an increased client load while a new management system is being implemented. What managerial action would help reduce this stress?

A) Asking a nursing faculty friend to use the unit for a student clinical
B) Hiring two newly licensed nurses for each shift
C) Asking for nurse input into decisions that directly affect care
D) Instituting a method of shift rotation that increases staff on each shift

Question 22

What are the warning signs of too much stress?

A) Physical illness
B) Prolonged anxiety
C) Clarification of roles
D) Abrupt changes in mood
E) Feeling of helplessness

Question 23

An experienced nurse manager is serving as mentor to a newly appointed manager. The experienced manager says, "Always try to keep your staff as well informed as possible about what is going on at the administrative level." What rationale should the manager offer for this advice?

A) Nursing involvement at the administrative level is required by accrediting agencies.
B) Involvement of all departments in the agency supports the organizations' management style.
C) Staff members who are kept informed are less likely to be suspicious and spread rumors.
D) Sharing both the positive and negative information from administration helps to reduce the manager's stress.

Question 24

During an annual performance review, the staff nurse admits to being very stressed by the demands of the job, marriage, and four teenage children. Which comment by the nurse manager is indicated?

A) "We need to figure out what you can give up in your personal life to help decrease your stress."
B) "You need to be more flexible with the hours you work."
C) "You should not let your personal problems affect your work."
D) "Let's talk about how we can help you develop some resiliency."

Question 25

________ is the result of incompatibility between the individual's perception of the role and its actual ________.

Question 26

A charge nurse has been trying to please all the nurses, physicians, clients, and staff of the unit. This has caused considerable stress for this nurse. After a few days off, the nurse decides to manage the role differently. What has occurred to the nurse over these days off?

A) Role conflict
B) Role definition
C) Role redefinition
D) Interrelated conflict

Question 27

A hospital has been acquired by a new management company. As part of this acquisition, several different types of equipment have been introduced into the client care area. How can the manager best plan to reduce the stress of using this equipment?

A) Have all the equipment put into service at one time so learning will be compressed.
B) Teach the nurses with the most seniority to use the equipment and let them teach the other nurses.
C) Be certain that all nurses attend training sessions on the use of all equipment.
D) Post written instructions in the break room on how to use the equipment.

Question 28

The supervisor of critical care services tells the unit manager, "We must cut costs, so I am asking you to arrange your day so that you provide care to two or three clients and cover for lunch and rest breaks. Also don't forget that your budget estimates are due next week, as are your preliminary schedules for the winter holidays." Two days later, the nurse manager is stressed and exhausted. What should the manager do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Think through the roles being required.
B) Confront the supervisor and ask for clarification of status.
C) Try to improve work organization.
D) Tell the supervisor, "I can't work this hard. Get someone else to be manager."
E) Call in sick for a day to rest.

Question 29

A nurse who transferred from the medical-surgical unit completed orientation to the ICU 6 weeks ago, but is stressed and unsure of personal skill competency. The nurse manager learns of this lack of confidence. Which action by the manager would best benefit this nurse and the unit?

A) Reduce the nurse's client assignment.
B) Transfer the nurse back to the medical-surgical unit.
C) Provide written instruction regarding the desired unit specific skills.
D) Provide additional weeks to orientation with a focus on skill development.

Question 30

A nurse supervisor is aware that nurses in the facility have been under a great deal of stress while working through a major change in the ownership of the hospital. Which nurses would the supervisor be most concerned might develop compassion fatigue? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Emergency department nurses
B) Outpatient diagnostic procedure nurses
C) Nurses working in the trauma surgery unit
D) Nurses working in geriatrics
E) Nurses working in obstetrics

Question 31

The nursing unit has experienced high stress and a higher than normal turnover rate. The manager asks a longtime member of the nursing staff to analyze the manager's job performance. What is most likely the reason for this request?

A) The manager is questioning his or her leadership style and its effectiveness.
B) The manager is required to ask for input on his or her personal job evaluation.
C) The manager is attempting to show concern about unit conditions.
D) The manager is inquiring about other leadership styles the nurse has encountered.

Question 32

A nurse manager is considering referring a nurse who is very stressed to the employee assistance program (EAP) offered by the institution. What does this consideration indicate?

A) The manager believes this service would promote the nurse's health and well-being.
B) The manager thinks the nurse is abusing alcohol to cope with the stress.
C) The manager thinks that this referral will help the nurse avoid sanction by the state board of nursing.
D) The manager believes the nurse is abusing controlled medications to cope with stress.