Question 1

Clinical incompetence is one of the more serious problems facing a nurse manager.Joyce,the nurse manager,is not aware of the problems of Sarah,a novice nurse.After she investigates,it is obvious that Sarah's peers are covering for her.Which of the following might Joyce include in her meeting with the nurses? (Select all that apply.)

Accepted Answer

A)  "It is a nurse's professional responsibility to maintain quality control."
B)  "All instances of clinical incompetence are to be reported."
C)  "It is not considered being disloyal when one nurse reports another for poor care."
D)  "Patient care is the number one concern. Meeting standards is mandatory and necessary."
E)  None of the above A,B,C,D

Question 2

Incivility is a disruptive behavior or communication that creates a negative environment and interferes with quality patient care and safety.The manager can implement steps that help to alleviate uncivil behavior on a unit.Which of the following would not be an appropriate first step?

Accepted Answer

A)  Suspending the staff member from work
B)  Providing written admonishment that is discussed and placed in the employee's file
C)  Providing verbal admonishment
D)  Terminating the staff member D

Question 3

Nathan has been on the cardiac unit for 6 months and has found it difficult to adjust to the expectations of his team.Which of the following behaviors would most likely signal that Nathan is intending to resign from his position on the unit?

Accepted Answer

A)  Increased absenteeism over the past month
B)  Increased attempts to discuss his concerns with his colleagues
C)  Testing of workplace guidelines
D)  Frequent defensiveness A

Question 4

When progressive discipline is used,the steps are followed progressively only for repeated infractions of the same rule.On some occasions,rules that are broken are so serious that the employee is:

Accepted Answer

A)  Transferred to another unit.
B)  Suspended indefinitely.
C)  Asked to attend a union grievance meeting.
D)  Terminated after the first infraction.

Question 5

Nurses generally experience difficulty in identifying behaviors and actions that could signal chemical dependency in a co-worker.Which of the following is not a behavioral change that occurs with chemical dependency?

Accepted Answer

A)  Personality and behavioral changes
B)  Job performance changes
C)  Changes in educational involvement and pursuit
D)  Absenteeism

Question 6

The unit manager on 4E is concerned about the performance of Jean,a staff nurse.She is not involved directly with Jean,so she has not been able to determine whether the problem is one of motivation,ability,or both.If Jean lacks ability,which of the following strategies might the head nurse use?

Accepted Answer

A)  Dismiss or transfer Jean.
B)  Document all problem areas and then discuss them with Jean.
C)  Develop appropriate solutions and make recommendations to Human Resources.
D)  Smooth over the problems if they are minor in nature.

Question 7

The education consultant for the hospital is presenting a workshop titled "Documentation: A Manager's Responsibility." Which of the following points would she not include in her PowerPoint presentation? Documentation:

Accepted Answer

A)  Cannot be left to memory. A notation must be placed in the personnel file.
B)  Should avoid discussion of the problem.
C)  Should include what was done about the problem when it occurred.
D)  Needs to include date, time, and place.

Question 8

The chief nursing officer reviews the policy about "progressive discipline process." The progressive discipline process includes which of the following? The manager:

Accepted Answer

A)  Is a counselor and friend to the employee.
B)  Should reprimand and suspend the employee as a last resort.
C)  Should rehire the employee after a reasonable length of time.
D)  Should terminate the employee if the problem persists.

Question 9

The nurse manager places a staff member on probation because of reports of chemical dependency.The nurse manager should be aware that which of the following statements is true regarding chemical dependency?

Accepted Answer

A)  The chemically dependent employee usually hides any changes in behavior.
B)  When confronted with the issue, the affected employee is usually relieved to have someone to talk to about the problem.
C)  The chemically impaired nurse affects the entire healthcare organization.
D)  Hospital policy, state laws, and nurse practice acts address procedures for the chemically dependent employee in the most general terms.

Question 10

The nursing director calls a meeting with one of the new unit managers.She is very concerned about a report of substance abuse on the manager's unit,and she reviews the procedures involved in dealing with chemically dependent staff.Which of the following statements would NOT be included in the discussion? "As a manager,you:

Accepted Answer

A)  Need to be aware of ADA issues."
B)  Should check with Human Resources regarding chemically dependent employees and employment practices."
C)  Check the nurse practice acts for the state in which the nurse resides."
D)  Should realize that the nurse is a professional embarrassment and should be kept out of sight of other staff."

Question 11

The unit manager discusses absenteeism with the unit clerk.She indicates that it is a serious problem on the unit.Which of the following points would they have likely discussed? (Select all that apply.)

Accepted Answer

A)  Employee morale is at a high level.
B)  Care will suffer and standards will be lowered.
C)  Existing staff have experienced little effect from the absenteeism.
D)  Replacement staff usually needs little supervision.
E)  Unit costs have increased because of staff replacements and overtime.

Question 12

Before terminating an employee,a nurse manager must:

Accepted Answer

A)  Be an expert in all legal aspects of termination and discipline practices.
B)  Follow the organization's specific policies for addressing disciplinary problems and termination.
C)  Function as a counselor for problem employees.
D)  Do everything to assist and protect the employee by adjusting standards and policies.

Question 13

Incivility is a disruptive behavior or communication that creates a negative environment and interferes with quality patient care and safety.The manager can implement the following steps that help to alleviate uncivil behavior on a unit.A)Suspending the staff member from work,B)Providing written admonishment that is discussed and placed in the employee's file,C)Providing verbal admonishment,D)Terminating the staff member

Accepted Answer

A)  A, B, C, D
B)  B, A, C, D
C)  C, B, A, D
D)  C, A, B, D

Question 14

The nurse manager knows that the most serious effect that absenteeism has on the nursing unit is that:

Accepted Answer

A)  Using replacement personnel with new ideas may be beneficial.
B)  Salary costs are lower because personnel are fewer, and outcome is favorable.
C)  Absence on the part of the rest of the staff is decreased.
D)  Unacceptable patient care may result.

Question 15

The most important approach that a nurse manager can take with an emotionally troubled employee is to:

Accepted Answer

A)  Act as a therapist for the employee.
B)  Adjust the standard of care to assist the employee.
C)  Assist the employee in obtaining professional help.
D)  Adjust the employee's work schedule to decrease stress.

Question 16

During unit staff meetings,you observe that Marg rolls her eyes and snorts whenever Julia makes a comment.Your first response as a unit manager is to:

Accepted Answer

A)  Discuss what you have observed with Marg.
B)  File immediate documentation in Marg's personnel file.
C)  Ask Julie to monitor Marg's behavior during meetings.
D)  Ignore the behavior, as Marg is one of your strongest nurses.

Question 17

A nurse manager understands that the typical first step in handling an employee with a disciplinary problem is a:

Accepted Answer

A)  Verbal reprimand.
B)  Written reprimand.
C)  Reminder of employment standards.
D)  Day off without pay.

Question 18

The chief nursing officer understands that clinical incompetence is best prevented by a(n):

Accepted Answer

A)  Flexible protocol for evaluating competency skills.
B)  Standardized clinical skills checklist.
C)  Administration of personality tests and competency assessments at point of hire.
D)  Formalized competency program with established standards for practice.

Question 19

Ellen is a novice nurse on your unit.Even though she has come to you highly recommended,as her supervisor,you have noticed some knowledge and skill deficiencies.These deficiencies have been noticed by her peers as well,who cover for her because she is new and they like her.Which of the following is likely to be the greatest asset to Ellen in improving her performance?

Accepted Answer

A)  Ignore Ellen's errors until she has more experience.
B)  Instruct staff to avoid working with Ellen until she learns to how do things herself.
C)  Ask Ellen to complete a self-assessment, using a standard skills checklist.
D)  Encourage staff to report every behavior of Ellen's that is different from theirs.

Question 20

In keeping with guidelines of the organization,the nurse manager documents staff problems.Documentation of disciplinary problems should:

Accepted Answer

A)  Include a plan to correct them and to prevent future occurrences.
B)  State a detailed history of past problems that are related to the current one.
C)  Be written at the convenience of the manager.
D)  Not be discussed until the formal performance evaluation.

Exam 24: Managing Personal/Personnel Problems