Chapter 21

Question 1

Which action is an accepted tactic when engaged in a negotiation?
A) Being willing to win at any cost
B) Communicating only when asked direct questions
C) Compromising only as a last resort
D) Beginning with a high but realistic expectation

Answer 1

D) Beginning with a high but realistic expectation

The selected starting point in negotiations should be at the upper limits of the
negotiator’s expectations, within reason. However, negotiators must realize they may
have to come down to a lesser goal. The other options are not reflective of accepted
tactics used in successful negotiations.

Question 2

A charge nurse assists a group of personnel to resolve their conflict, with the outcome
being that the two opposing goals were discarded and new goals were adopted. What is
this an example of?
A) Smoothing of conflict by the leader
B) Facilitating collaboration among personnel
C) A majority rule approach
D) A good lesson in compromising

Answer 2

B) Facilitating collaboration among personnel

In collaboration, all parties set aside their original goals and work together to establish a
common goal. None of the other options are examples of the described outcome.

Question 3

Which is a true statement about negotiation tactics?
A) Ridicule often takes the form of ambiguous or inappropriate questioning and is a
diversionary tactic
B) Most managers successfully resist the illness/wellness tactic because of their
nursing preparation.
C) Negotiation tactics can be manipulative; thus, managers should know how to
identify and counter destructive tactics
D) The tactic of paternalism allows both parties in the negotiation to reach a
consensus of opinion

Answer 3

C) Negotiation tactics can be manipulative; thus, managers should know how to
identify and counter destructive tactics

Destructive negotiation tactics are never a part of a successful collaborative conflict
resolution. A good manager will be alert for such tactics. None of the other options are
true statements regarding negotiation tactics.

Question 4

What did the interactionist theorists of the 1970s believe about organizational conflict?
A) It should be dealt with immediately
B) It should be encouraged
C) It was an indication of poor management
D) It should be avoided

Answer 4

B) It should be encouraged

The interactionist movement encouraged organizations to promote conflict as a means
of producing growth. The remaining options were not necessarily supported by the
interactionist theorists.

Question 5

Which statement reflects the contemporary thinking about conflict?
A) It can lead to new ideas
B) It leads to decreased motivation
C) It should be avoided whenever possible
D) It is neither qualitative nor quantitative

Answer 5

A) It can lead to new ideas

Some level of conflict in an organization appears to be desirable since it appears to
prevent organizational stagnation. None of the other options reflect contemporary
thinking about conflict.

Question 6

What term is used when two or more people have conflict about values or goals?
A) Intergroup conflict
B) Common control
C) Intrapersonal conflict
D) Interpersonal conflict

Answer 6

D) Interpersonal conflict

Interpersonal conflict happens between two or more people with differing values, goals,
and beliefs. No other option is used to describe this situation.

Question 7

Which statement is true concerning perceived conflict?
A) It develops during the first stage of the conflict process
B) It is sometimes referred to as antecedent conflict
C) It occurs if the conflict is intellectualized
D) It occurs when the conflict is emotionalized

Answer 7

C) It occurs if the conflict is intellectualized

Perceived or substantive conflict is intellectualized and often involves issues and roles.
The person recognizes it logically and impersonally as occurring. None of the other
options are true statements concerning perceived conflict.

Question 8

When is the competing approach to resolving conflict used?
A) When fair play is important to all involved parties
B) When one party wins at the expense of the others
C) When managers need to control a volatile situation
D) When an appropriate political strategy is necessary

Answer 8

B) When one party wins at the expense of the others

The competing approach is used when one party pursues what it wants at the expense of
the others. Because only one party typically wins, the competing party seeks to win
regardless of the cost to others. Neither manager control nor political strategy is
necessarily associated with the competing approach to resolving conflict.

Question 9

What is the most important criterion for success for health-care providers collaborate on
patient care?
A) Having mutual respect for one another’s knowledge and expertise
B) Having the skills to negotiate successfully
C) Liking each other enough to want to collaborate
D) Being willing to cooperate with each other

Answer 9

A) Having mutual respect for one another’s knowledge and expertise

In collaboration, problem solving is a joint effort with no superior/subordinate
relationships. Mutual respect is required for its success. While the other options identify
factors that add to the collaborative process, its foundation is mutual respect.

Question 10

A registered nurse reports to the nurse-manager that the team’s nursing assistant
regularly fails to complete assigned tasks. The nurse-manager responds that it is the
nurse’s responsibility to talk with the nursing assistant about this problem. The manager
is engaged in what aspect of conflict?
A) Conflict avoidance
B) Conflict smoothing
C) Encouraging competitive conflict
D) Facilitating conflict resolution

Answer 10

D) Facilitating conflict resolution

Managers should not intervene in every conflict, but should urge subordinates to handle
their own problems. This is an example of supporting conflict resolution. The action of
the manager is not reflective of any of the other options.

Question 11

Which statement best defines conflict?
A) It involves an internal struggle resulting from value-related discord
B) Its basis is the violation of personal rights or values
C) It centers on either internal or external discord between individuals
D) It is the outcome of a visible struggle between individuals

Answer 11

C) It centers on either internal or external discord between individuals

Conflict is generally defined as the internal or external discord that results from
differences in ideas, values, or feelings between two or more people. The remaining
options describe only limited aspects of conflict.

Question 12

What is a critical goal in negotiation?
A) That gains for each party are different but equal
B) That the hidden agendas of all parties be exposed
C) That each party willingly reveals their negotiated limits
D) That both parties perceive that they have won something they value

Answer 12

D) That both parties perceive that they have won something they value

A successful negotiation leaves both parties feeling like they have gained something
they want and/or value. None of the other options are considered a goal of negotiation.

Question 13

What is ìConsensusî in negotiation referring to?
A) One party wins at the expense of another
B) The willingness by all parties to accept agreed-on conditions
C) The most rapid conflict resolution strategies
D) An unanimous decision has been reached

Answer 13

B) The willingness by all parties to accept agreed-on conditions

In a consensus, an agreement is found that all parties can support, or at least not oppose.
The term is not used to describe any of the other options.

Question 14

The nurse-manager is negotiating for the funds necessary to purchase several new
isolettes for the facility’s newborn nursery. The Chief Financial Officer (CFO) states,
ìI’ve always been curious about that piece of equipment; how does it actually work?î
What negotiation action has the CFO engaged in?
A) Collaborating
B) Smoothing
C) A diversionary tactic
D) Appropriate fact finding

Answer 14

C) A diversionary tactic

The CFO was consciously or unconsciously using a diversionary tactic. The action
described is not accurately associated with any of the other options.

Question 15

Several RNs on the unit want to address the possibility of initiating flextime on the unit.
What is the manager’s initial response?
A) Assuring the RNs that their suggestion will be taking under consideration
B) Asking the RNs to circulate a partition to be signed by employees who support the
change
C) Arranging for the RNs to air their views at the next staff meeting.
D) Sharing with the RNs that they need to address the issue with upper management

Answer 15

C) Arranging for the RNs to air their views at the next staff meeting.

This manager should plan to let employees air their views at the next staff meeting.
Nursing managers can no longer afford to respond to conflict traditionally (to avoid or
suppress conflict), because this is nonproductive. In an era of shrinking health-care
dollars, it has become increasingly important for managers to confront and manage
conflict appropriately. The ability to understand and deal with conflict appropriately is a
critical leadership skill.

Question 16

The nurse-manager facilitates a conflict that involves the delineation of staff job
descriptions. What is this an example of?
A) Responsibility charting
B) Smoothing conflict
C) Alternate dispute resolution
D) Mediation counseling

Answer 16

A) Responsibility charting

When a supervisor delineates job duties to persons in conflict, it is called responsibility
charting. The other options are not related to job description conflict.

Question 17

What are the least common sources of organizational conflict?
A) Communication problems
B) Organizational structure
C) Individual behavior within the organization
D) Self-scheduling

Answer 17

A) Communication problems

Self-scheduling is not generally associated with common causes of organizational
conflict. The most common sources of organizational conflict are communication
problems, organizational structure, and individual behavior within the organization.

Question 18

What occurs when there is very little conflict in an organization?
A) Stasis
B) Increased productivity
C) Decreased effectiveness
D) Employee immobilization

Answer 18

A) Stasis

Too little conflict results in organizational stasis and decreased productivity, whereas
too much conflict reduces the organization’s effectiveness and eventually immobilizes
its employees.

Question 19

What is the name given to the first stage in the conflict process?
A) Latent
B) Perceived
C) Felt
D) Manifest

Answer 19

A) Latent

The first stage in the conflict process is called latent conflict, which implies the
existence of antecedent conditions. Latent conflict may proceed to perceived conflict or
to felt conflict. Manifest conflict may also ensue. The last stage in the process is conflict
aftermath.

Question 20

Considering dispute resolution, which statement is true regarding what occurs during
mediation?
A) It uses a neutral third party; is a confidential, legally nonbinding process designed
to help bring the parties together to devise a solution to the conflict
B) It asks questions to clarify the issues
C) It makes a final decision for the parties in conflict
D) It involves presentation of evidence including that of expert witnesses

Answer 20

A) It uses a neutral third party; is a confidential, legally nonbinding process designed
to help bring the parties together to devise a solution to the conflict

Mediation uses a neutral third party; is a confidential, legally nonbinding process
designed to help bring the parties together to devise a solution to the conflict. None of
the other options accurately describes the process of mediation.

Question 21

What is the result of arriving at a consensus?
A) All involved parties agree to support the way a conflict has been resolved
B) A conflict is resolved by meeting the goals of all involved parties
C) It resolves a conflict by an initial unanimous decision
D) Conflict is resolved through the mediation process

Answer 21

A) All involved parties agree to support the way a conflict has been resolved

Consensus means that negotiating parties reach an agreement that all parties can
support, even if it does not represent everyone’s first priorities. Consensus decision
making does not provide complete satisfaction for everyone involved in the negotiation
as an initially unanimous decision would, but it does indicate willingness by all parties
to accept the agreed-upon conditions. Mediation is not a required factor in arriving at a
consensus.

Question 22

What is the function of an ombudsperson?
A) Providing expert testimony in conflict cases
B) Mediating disputes between an organization and its employees
C) Educating individuals involved in a grievance situation of their rights
D) Monitoring the implementation of the terms of a conflict’s compromise

Answer 22

C) Educating individuals involved in a grievance situation of their rights

A function of an ombudsperson is to assure that those involved in a conflict understand
their rights as well as the process that should be used to report and resolve the conflict.
This role is not appropriately described by any of the other options.

Question 23

After a compromise has been made, what is the manager’s initial action?
A) Clearly restating the compromise’s specific outcomes to all involved
B) Thanking all involved for their cooperation on reaching the compromise
C) Evaluating the compromise’s outcomes for fairness to all involved parties
D) Assuring all involved that the compromise will not cause a change in goals

Answer 23

A) Clearly restating the compromise’s specific outcomes to all involved

Once a compromise has been reached, restate it so that everyone is clear about what has
been agreed upon. A compromise by its natural requires a change in original goals. The
evaluation for fairness needs to have been done prior to the compromise being agreed
upon. Thanking all involved is appropriate but would not be the initial action.

Question 24

A nurse-manager is engaged in a negotiation with staff representatives when the
discussion becomes controlled by a particularly aggressive member. Which action will
the nurse-manager take to assure that the process is successful?
A) Asks that the aggressive individual recognize the rights of all the other members
B) States, ìI need to have time to think over all that we have discussed.î
C) Halts any discussion until new representatives can be appointed
D) Shares with the members that aggressiveness negatively impacts the negotiations

Answer 24

B) States, ìI need to have time to think over all that we have discussed.î

Some people win in negotiation simply by rapidly and aggressively taking over and
controlling the negotiation before other members realize what is happening. If managers
believe that this may be happening, they should call a halt to the negotiations before
decisions are made. Saying simply, ìI need to have time to think this overî is a good
method of stopping an aggressive takeover. The other options are much less effective
and may even lead to increased aggressiveness among team members.

Question 25

Which personal characteristics will best help meet the psychological needs of conflict
negotiation?
A) Perseverance and assertiveness
B) Calmness and self-assuredness
C) Compassion and reflectiveness
D) Organization and preparedness

Answer 25

B) Calmness and self-assuredness

Negotiation is psychological and verbal. The effective negotiator always appears calm
and self-assured. The other options are not as impactful when considering the
psychological aspects of the negotiation process.

Question 26

The nurse manager is completing employee evaluations. Which practices should the manager use when doing these appraisals?
Select all that apply.
1. Appraising staff nurses every 18 to 24 months
2. Sharing the appraisal with staff nurses verbally and in writing
3. Requiring the staff nurse to sign the appraisal
4. Allowing the nurse to make written comments on the appraisal
5. Advising the nurse of the right to appeal the appraisal

Answer 26

2. Sharing the appraisal with staff nurses verbally and in writing
3. Requiring the staff nurse to sign the appraisal
4. Allowing the nurse to make written comments on the appraisal
5. Advising the nurse of the right to appeal the appraisal

Rationale 2: The appraisal should be shared with the staff nurses both in writing and face-to-face discussion.
Rationale 3: The nurse should sign the appraisal to indicate that it has been received.
Rationale 4: The nurse should be allowed to make written comments on the appraisal.
Rationale 5: The nurse does have the right to appeal the findings of the appraisal and should be advised of this right.

Question 27

Which statement would be inappropriate for a manager to write on an employee’s performance appraisal?

1. “The nurse’s attitude positively affects coworkers.”
2. “The nurse seeks learning experiences.”
3. “The nurse is frequently tardy.”
4. “The nurse is shy and quiet.”

Answer 27

4. “The nurse is shy and quiet.”

Rationale 4: A performance appraisal must focus on an individual’s job performance and not personal characteristics. Shy and quiet are personal characteristics. If the nurse has impaired communication skills because of being too shy and quiet, then that is related to job performance.

Question 28

An ICU nurse manager prefers to use a “results-oriented system” when evaluating employees. Why would the manager prefer this system?

1. It allows for comparison between employees.
2. The employee knows in advance what is expected.
3. It is apparent when an employee stands out against peers.
4. It eliminates the category of “excellence” from the system.

Answer 28

2. The employee knows in advance what is expected.

A results-oriented system evaluates the employee based upon outcomes and the employee knows what is expected. This appraisal system is quantifiable, objective, and easily measured.

Question 29

A nurse manager is discussing the hospital’s changes to peer evaluation with nursing staff. Which comment by a staff nurse would the manager interpret as evidence of understanding this process?

1. “Our evaluations will be more objective.”
2. “This must be a less expensive method of evaluation.”
3. “This should be quicker than our existing method.”
4. “This would be a good way to get back at the nurses who don’t work as hard.”

Answer 29

1. “Our evaluations will be more objective.”

A benefit of peer evaluations is that more than one person writes the evaluation. This increases objectivity.

Question 30

An organization has changed its performance appraisal process and is conducting training for managers. What topics should the trainer include in the agenda for this session?

Select all that apply.

1. What a reasonable job performance should look like
2. How to conduct a disciplinary meeting
3. How to complete the evaluation form
4. How to give the employee feedback on evaluation
5. Use of anecdotal notes

Answer 30

1. What a reasonable job performance should look like
2. How to complete the evaluation form
3. How to give the employee feedback on evaluation
4. Use of anecdotal notes

Rationale 1: The manager must be able to differentiate reasonable job performance from unreasonable job performance.
Rationale 3: The evaluation form becomes a part of the employee’s permanent file and is legally discoverable. It must be completed accurately and completely.
Rationale 4: Feedback is important and must be offered and documented.
Rationale 5: Anecdotal notes or critical incident notes are a vital part of the evaluation process.

Question 31

A nurse manager has been terminated for failing to follow institutional policy and procedures. Upon reviewing the manager’s files, the supervisor discovers multiple unfinished employee evaluations from the last two years. The supervisor is faced with which concerns?

Select all that apply.

1. Finding someone with enough knowledge of the employee’s work to complete the evaluation processes
2. How to share evaluation information with employees
3. The legal steps necessary to invalidate the in-process evaluations and begin new evaluations
4. Whether the care provided on the unit has been safe and effective
5. How long it has been since employees have had a valid evaluation

Answer 31

1. Finding someone with enough knowledge of the employee’s work to complete the evaluation processes
2. How to share evaluation information with employees
3. Whether the care provided on the unit has been safe and effective
4. How long it has been since employees have had a valid evaluation

Rationale 1: The evaluator must have direct knowledge of the employee’s work. The supervisor must find people who have that knowledge who are qualified to evaluate the work, whether the current evaluations are finished or new ones are started.
Rationale 2: Evaluations must be shared with the employee. If these evaluations were not finished, it is likely they were not shared.
Rationale 4: Without a valid evaluation process, the care on the unit has not been assessed.
Rationale 5: Employees should be evaluated at least once a year.

Question 32

Adopting which strategy would be helpful in reducing recency error in staff appraisals?

1. Being careful not to overrate employees
2. Evaluating each behavior separately and fairly
3. Carefully defining performance standards
4. Recording critical incidents as they occur

Answer 32

4. Recording critical incidents as they occur

Recency error is the tendency of a manager to remember only what has occurred with an employee recently. To combat recency error, the manager should keep notes on critical incidents in the employee’s work as they occur.

Question 33

A nurse manager looks through a file that contains information regarding critical incident reports filed within the past year. For which reasons does the manager review and use this information?

Select all that apply.

1. To increase leniency
2. To decrease the possibility of lawsuits by the employee being evaluated
3. To increase manager-employee communication
4. To decrease recency error
5. To increase the accuracy of the evaluation

Answer 33

2. To decrease the possibility of lawsuits by the employee being evaluated
3. To increase manager-employee communication
4. To decrease recency error
5. To increase the accuracy of the evaluation

Rationale 2: The reason the manager doing evaluations reviews the critical incident file is to collect information to help the manager do the best evaluation appraisal possible. This helps to decrease the possibility of a lawsuit being filed against the manager for inaccurate evaluation.
Rationale 3: Reviewing the critical incident file prior to the evaluation will refresh the manager’s memory of the employee’s overall performance and will increase and improve manager-employee communication.
Rationale 4: Looking back at the employee’s record for the evaluation period will help to decrease recency error.
Rationale 5: Reviewing the employee’s records over the evaluation period will help the manager write a more accurate evaluation.

Question 34

The registered nurse has had recent difficulty finishing and documenting client care during the assigned shift. The nurse has historically had very good appraisals, and the climate of the unit has not changed. Which would be the best approach to correct recent behaviors?

1. Provide education
2. Simplify tasks
3. Clarify expectations
4. Reassign the nurse to another unit.

Answer 34

3. Clarify expectations

The nurse may lack the motivation to do the job on time. The manager should first clarify the expectation that the nurse will have work completed by the end of the shift. If the problem continues, additional intervention may be necessary.

Question 35

A nurse manager and an employee meet to discuss the employee’s appraisal. They disagree on the content of the employee evaluation. The disagreement turns into an argument. Which is the best managerial strategy in this situation?

1. Postpone the interview.
2. Agree on arbitration.
3. Seek input from employee peers.
4. Report the employee to the human resources manager.

Answer 35

1. Postpone the interview.

Postponing the interview allows both manager and employee to calm down and reflect on the disagreement.

Question 36

A nurse manager gives a staff nurse an exceptional appraisal. The other nurses learn of the appraisal and are upset because this nurse has had numerous complaints from peers regarding laziness. The manager informs a colleague the nurse obtained an exceptional appraisal because the nurse “will always work for me when I need extra help to come in.” This is an example of which problem in evaluating?

1. Recency error
2. Leniency error
3. Ambiguity error
4. Halo error

Answer 36

2. Leniency error

Leniency error indicates the manager is allowing tolerance, which may not provide an accurate account of the nurse’s performance. In this case, the manager is lenient with the nurse who is always eager to work extra if needed.

Question 37

The manager overhears a nurse say to a client, “I am having trouble getting your IV started because you are so fat.” The manager determines that a critical incident form should be completed. Which entry is appropriate to document on the form?

1. The nurse was rude to the client.
2. The nurse was rude and incompetent when caring for the client.
3. The client is obese, and intravenous catheter placement was attempted but unsuccessful due to the client’s size.
4. Nurse _____ attempted to start an IV on this client and stated, “I’m having trouble getting your IV started because you are so fat.”

Answer 37

4. Nurse _____ attempted to start an IV on this client and stated, “I’m having trouble getting your IV started because you are so fat.”

The critical incident form must contain the event with accuracy and without judgment. Documentation should include the facts and the sequence of events.

Question 38

An experienced ICU nurse manager is orienting a newly hired nurse manager to the organization. The ICU manager makes occasional notes in a small notebook. The new manager asks why the ICU manager is taking notes. What are the most likely rationales for this behavior?

Select all that apply.

1. “It saves me time in the long run,”
2. “Taking notes helps me to address issues immediately so they do not escalate.”
3. “Although this looks time consuming, it is just how I learned to manage.”
4. “It helps me to remember what to address in staff meetings.”
5. “Having notes helps protect me when evaluations are written.”

Answer 38

1. “It saves me time in the long run,”
2. “Taking notes helps me to address issues immediately so they do not escalate.”
3. “It helps me to remember what to address in staff meetings.”
4. “Having notes helps protect me when evaluations are written.”

Rationale 1: Taking notes does save time for the manager when evaluations are written or if other issues come up on the unit.
Rationale 2: On a busy unit, the manager must rely on written notes as a reminder of issues that should be discussed with staff.
Rationale 4: Notes will help the manager remember what should be addressed in staff meetings.
Rationale 5: Having notes about the incidents cited in evaluations helps to protect the manager in case a staff member disputes the situation

Question 39

During appraisal interviews, the nurse manager defends the choice of rating by emphasizing the negative aspects of the nurse’s performance. What is the likely outcome of this strategy?

1. The nurse will clearly see the impact of attitude on performance.
2. The nurse will identify ways that performance can be improved.
3. The nurse will pay less attention to maintaining what is done well.
4. The nurse will ignore the negative statements and focus only on the positive.

Answer 39

3. The nurse will pay less attention to maintaining what is done well.

Focusing only on the negative aspects of a nurse’s performance can result in the nurse discounting the importance of the things the nurse does well. If this is the case, the nurse may pay less attention to those areas in the future and may not do them as well.

Question 40

A nurse manager believes that a staff nurse is rude to clients. In the past year, other nurses and staff from other departments have reported that the nurse has treated them rudely. The manager reviews the staff nurse’s employee file and finds last year’s appraisal as exceptional. What is the manager’s best course of action during this year’s evaluation?

1. Tell the nurse that complaints about rudeness have been received and that additional complaints will result in termination.
2. Notify nursing administration of the issues and complaints.
3. Tell the nurse that other staff nurses have complained about rudeness and have been instructed to keep a log of incidents.
4. Include documentation of these issues in the evaluation that is discussed with the nurse and provide a plan of action.

Answer 40

4. Include documentation of these issues in the evaluation that is discussed with the nurse and provide a plan of action.

Documenting the issues, a one-on-one conference with the nurse, and providing a specific plan of action with a specific time frame is the best course of action.

Question 41

An emergency department nurse manager is preparing for a night-shift nurse’s annual appraisal. The manager is apprehensive because there are issues to address regarding rudeness and unprofessional behavior. How should the manager prepare for conducting this appraisal?

1. Place the evaluation in an envelope with specific details addressing the nurse’s behavior and allow the nurse to review it during his or her next shift.
2. The manager should complete the evaluation and ask a peer to review it and provide feedback.
3. The manager should arrange a 20–30 minute meeting with the nurse to discuss the evaluation privately.
4. The manager should allow the human resources manager to conduct the appraisal.

Answer 41

3. The manager should arrange a 20–30 minute meeting with the nurse to discuss the evaluation privately.

The manager should control the environment in which the appraisal meeting is conducted. The meeting should be private and the manager should allow at least 20–30 minutes for the interview.

Question 42

A nurse manager has discussed behavioral and unprofessional behaviors with a nurse. During the performance appraisal the manager addressed these issues and the two nurses have developed a specific plan to address the performance areas that can be strengthened. What should the manager’s next course of action be?

1. Take notes of the nurse’s behavior during the appraisal.
2. Inquire as to the nurse’s perception of the appraisal.
3. Schedule a follow-up session to determine if the nurse has made progress in the areas specified.
4. Schedule the next annual appraisal

Answer 42

3. Schedule a follow-up session to determine if the nurse has made progress in the areas specified.

At this point of the interview, the manager should schedule a follow-up session to determine if the nurse has made progress.

Question 43

A director has performed an annual appraisal of the ICU manager, which reflects several issues in regard to the manager’s attitude. At the end of the interview the manager expresses disagreement with the appraisal. The director instructs the manager to sign the appraisal and ends the interview. The manager reports this situation to the human resources director for which reason?

1. The interview was conducted in an unprofessional manner.
2. The appraisal could be interpreted as discriminatory.
3. The appraisal was not a fair evaluation of the manager’s work.
4. The director appraised the manager’s attitude which is unprofessional.

Answer 43

2. The appraisal could be interpreted as discriminatory.

The appraisal could be discriminatory because the manager should be offered the time to add written comments to the appraisal form. The director failed to allow this time.

Question 44

A manager has conducted a nurse’s evaluation, focusing a large portion of the appraisal on the nurse’s personality. The nurse does not agree with the appraisal and contacts the human resources director. What is the soundest basis on which to dispute the appraisal?

1. The appraisal is incomplete.
2. The appraisal is unfair.
3. The appraisal is not valid.
4. The nurse’s perception of the appraisal is unjustified.

Answer 44

3. The appraisal is not valid.

Because the majority of the appraisal focused on the nurse’s personality, the appraisal is not valid. The focus of the appraisal should be how the nurse’s actions affect the work of the unit.

Question 45

During the review of an organization’s appraisal policies, a nurse consultant finds that the facility uses a traditional rating scale based on general performance. What would be the consultant’s greatest concern with this choice of appraisal style?

1. It is time consuming for the manager to write the evaluation essay required by this method.
2. Ratings are based on the supervisor’s idea of satisfactory performance.
3. The standards used are so specific that they do not allow for individual variation.
4. Since this style involves input from peers, there is room for problems with confidentiality.

Answer 45

2. Ratings are based on the supervisor’s idea of satisfactory performance.

One of the problems with this style of appraisal is that the ratings are based on the supervisor’s idea of satisfactory performance rather than specific employee behaviors.

Question 46

A hospital uses a results-oriented evaluation system. During a nurse’s hiring process, the manager states, “Once you have been officially hired, I want to meet with you regarding evaluation.” What will be the focus of this meeting?

1. The manager will give the nurse a set of work objectives for the next year.
2. The manager will explain how poor evaluations can lead to termination.
3. The nurse and the manager will work together to write work objectives for the nurse.
4. The manager will review the nurse’s previous job experiences.

Answer 46

3. The nurse and the manager will work together to write work objectives for the nurse.

The nurse and the manager should work together to write these work objectives.

Question 47

An organization has adopted the peer review process of evaluation. The manager shares which information with staff?

Select all that apply.

1. “Begin to work on a portfolio that shows how you have met your work goals for this year.”
2. “All of you will be called on to review each of the other nurses working on the unit.”
3. “If you are a member of a peer review committee, you will submit a written evaluation to me.”
4. “The evaluation will be based solely on the input of the peer committee.”
5. “This change has occurred as a result of our move to self-governance.”

Answer 47

1. “Begin to work on a portfolio that shows how you have met your work goals for this year.”
2. “If you are a member of a peer review committee, you will submit a written evaluation to me.”
3. “This change has occurred as a result of our move to self-governance.”

Rationale 1: The portfolio is a part of the peer review system of evaluation.
Rationale 3: The members of the peer review committee submit a written evaluation to the manager.
Rationale 5: Peer review is often used in self-governance models.

Question 48

The standard method of appraisal used by the facility rates a nurse’s performance as satisfactory, but the nurse manager feels the nurse has room for improvement in many areas. What action should be taken by the manager?

1. Ask another staff nurse’s opinion of the situation.
2. Address the situation with the chief nursing officer.
3. Submit the appraisal as computed by the standard form.
4. Focus on developing a plan to improve the areas concerned.

Answer 48

4. Focus on developing a plan to improve the areas concerned.

In this situation, the nurse does not “match” the method of appraisal used by the facility. The nurse manager should “go beyond the form” and strive to help this nurse improve his or her practice.

Question 49

The staff nurse has challenged the appraisal rating given by a new nurse manager. What should the nurse manager do?

1. Do not change the rating as that will undermine the manager’s authority.
2. Change the rating immediately as the staff nurse has more experience than the manager.
3. Investigate the staff nurse’s challenge and change the rating if it is justified.
4. Ask another staff nurse to act as a mediator in the challenge.

Answer 49

3. Investigate the staff nurse’s challenge and change the rating if it is justified.

The manager should investigate the challenge and if there is merit should change the appraisal. Staff members respect a manager who admits a mistake and corrects it.

Question 50

A nurse manager overhears a conversation in which staff nurses complain about the evaluation process. One nurse says, “It really is just a waste of time. I get the same raise no matter what I’m rated.” Which is the best way for the manager to address this concern?

1. Lobby administration to implement raises based on merit.
2. Call the nurse aside and state agreement with the complaint.
3. Report the episode to the chief nursing officer.
4. Emphasize the practice development aspects of evaluation.

Answer 50

4. Emphasize the practice development aspects of evaluation.

All of these options are possible strategies for dealing with this complaint, but the best one is to emphasize the practice development aspects of evaluation.

Question 51

An organization has elected to use a behavior-oriented self-evaluation system for nurses. Which statement would be included on the evaluation form?

Select all that apply.

1. Becomes BLS (basic life support) instructor within 1 year of employment
2. Maintains confidentiality of information
3. Achieves certification in specialty
4. Demonstrates care, respect, and compassion in all interactions
5. Works well on multidisciplinary teams

Answer 51

2. Maintains confidentiality of information
3. Demonstrates care, respect, and compassion in all interactions
4. Works well on multidisciplinary teams

This is a behavior-based statement.

Question 52

An organization has begun using critical incidents as part of the evaluation process. The supervisor is meeting with a manager to review the manager’s use of critical incidents since training last week. Which finding would concern the supervisor?

Select all that apply.

1. Each nurse has one critical incident recorded and it is positive.
2. The manager is writing these notes in a handheld electronic device.
3. The manager’s notes are all written at the same time on the same day.
4. There is no indication that the critical incidents recorded have been shared with staff.
5. One note states, “This nurse has an abrasive personality.”

Answer 52

3. The manager’s notes are all written at the same time on the same day.
4. There is no indication that the critical incidents recorded have been shared with staff.
5. One note states, “This nurse has an abrasive personality.”

Rationale 3: It is best that the note be recorded at the time of the occurrence.
Rationale 4: The reason for critical incident recording is to improve practice. If the note is not shared with the employee, this improvement is less likely to occur.
Rationale 5: Notes should focus specifically on what occurred, not on personal traits.

Question 53

The supervisor is teaching managers about the use of critical incidents as part of the evaluation process. What information should the supervisor share?

Select all that apply.

1. “Our primary focus for using these notes is to find out who is doing a poor job.”
2. “Using these notes will help you identify little problems before they become big problems.”
3. “You can expect some negative reactions from staff.”
4. “It is okay to tell your staff that you cannot remember all the details of each encounter for evaluation and the notes will help.”
5. “Having these notes will help you feel more confident in your evaluation of staff.”

Answer 53

2. “Using these notes will help you identify little problems before they become big problems.”
3. “You can expect some negative reactions from staff.”
4. “It is okay to tell your staff that you cannot remember all the details of each encounter for evaluation and the notes will help.”
5. “Having these notes will help you feel more confident in your evaluation of staff.”

Rationale 2: Using notes forces the manager to deal with problems when they begin, rather after they have caused additional issues to arise.
Rationale 3: When note taking is introduced, people tend to be suspicious and to react negatively.
Rationale 4: Managers should be encouraged to be honest with staff about the note-taking strategy.
Rationale 5: Having performance notes written across the evaluation period will help the manager have greater confidence in the evaluation process.

Question 54

A nurse manager elects to ignore a nurse’s performance problem, hoping it will go away. What does this strategy indicate about the nurse’s management ability?

1. The nurse is a lazy manager.
2. The nurse is gullible.
3. The nurse is using a valid strategy.
4. The nurse needs an update on management strategy.

Answer 54

3. The nurse is using a valid strategy.

Ignoring a performance problem may be a valid strategy—for instance, if a new nurse is late for report and a seasoned nurse tells the new nurse not to be late again.

Question 55

The manager senses that a nurse is very anxious at the beginning of the performance interview. How should the manager proceed?

1. “I have looked back over all of my notes and interactions with you to prepare for our interview.”
2. “I sense that you are very tense. Is there a reason you feel this way?”
3. “You are so tense! How about a cup of coffee to relax.”
4. “How are your children? Are you planning anything fun this summer with them?”

Answer 55

1. “I have looked back over all of my notes and interactions with you to prepare for our interview.”

The manager should calmly start the interview, ignoring the nurse’s tension, which will likely pass as the interview continues.