chapter 26 Flashcards
Your health care organization places a high value on workplace safety and integrates this
into all aspects of administrative and patient care processes. As a unit manager, you
thoroughly endorse this direction, and during the selection and hiring of new staff, you
consistently:
a. Refuse to hire applicants who are pushy during interviews.
b. Thoroughly follow up with all references before offering a position.
c. Ask applicants during the interview whether drug or alcohol abuse is a problem.
d. Refuse to interview applicants with sporadic work histories.
B
Jay, a newly graduated registered nurse (RN), has just begun work on an acute care nursing
unit. As a nurse manager, you know that new graduates are most likely to experience:
a. Aggression.
b. Horizontal violence.
c. Physical violence.
d. Vertical violence.
B
In which of the following situations would you, as the head nurse, be concerned about
potential safety issues?
a. Jordan comes to your office to complain about inadequate staffing on the unit. He
says that he is concerned because he attributes a recent incident to the staffing
levels.
b. Heinrich, a long-standing RN on the unit, has begun to miss work regularly. He
calls in but is vague about his reasons for the absences.
c. Carla, RN, has just ended a relationship with Jake, RN, and he will not leave her
alone. You are meeting with Jake today because colleagues on night shifts have
reported that Jake seems to have been intoxicated last night and the previous night.
d. Sarah is very quiet and says almost nothing in team meetings. Lately, she has been
much more animated since becoming friendly with a couple of other RNs on the unit
C
Delaney, one of your staff nurses, confides that Marjorie, another nurse, has been actively
telling others that you are incompetent, you do not know what you are doing in relation to
patient care, and that you lie to the staff about attempts to get more staffing. Through
telephone calls and conversations during breaks, she is recruiting other staff to her position.
Delaney confides that most staff members find you fair, honest, and knowledgeable.
Marjorie’s behaviour can best be characterized as:
a. Political action.
b. Bullying.
c. Building alliances.
d. Disgruntlement.
B
During coffee and other breaks, Rosalie, the new RN, is excluded from conversations with
the other staff. When she approaches other staff on the unit to ask questions, they turn and
walk off in the other direction. The behaviour of the staff is characteristic of:
a. Dislike.
b. Lack of trust in Rosalie’s abilities.
c. Horizontal violence.
d. Cultural incompetence.
C
Sabotage is an example of which type of violence?
a. Threatening behaviour.
b. Written threat.
c. Harassment.
d. Verbal abuse.
C
Caroline asks family members to leave while she cares for the 16-year-old victim of a recent
car accident. The father screams at her and tells her that she has no right to ask his family to
leave, and that if she continues to do so, he will “throw her out of the room.” Caroline is
shaken and tells her head nurse, who tells her that this kind of thing is just part of the job.
The guidance of the head nurse:
a. Is reasonable. No physical violence was involved.
b. Is related to why incidents of violence in health care are probably underreported.
c. Acknowledges the deep distress and fear of the family.
d. Acknowledges the concern of the nurse.
B
You are part of a multidisciplinary team that is charged with designing a workplace safety
plan for your health care organization. This team has been established in response to
increases in reports of violence and aggression. You begin designing the safety plan by:
a. Surveying staff about levels of satisfaction with the workplace and management,
collegial, and patient relations.
b. Offering training sessions in self-defence.
c. Developing a policy that outlines zero tolerance for bullying.
d. Offering education sessions on recognizing behaviours with potential for violence.
A
At 3 a.m., a man walks into your emergency department. He paces back and forth in the
waiting area before he approaches staff to ask if he can see his wife, who is a patient on
another floor. He speaks rapidly, his face is flushed, he glances around often, and he keeps
his hand in his jacket pocket. A best initial response would be to:
a. Assess your situation and your surroundings.
b. Ask two or three staff to assist in confronting the individual.
c. Ask what floor his wife is on and remind him that visiting hours are over.
d. Remain calm as there is no potential for violence here.
A
In the emergency department waiting room, you notice a patient sitting, with his head in his
hands, who has been waiting for about 5 hours for relief of his headache. When you
approach him to ask him how he is doing, he says, “I can’t believe that I have to wait this
long for help! Do you know what it is like to be in pain for 10 hours?” Your response to him
would be:
a. “It is frustrating to wait when you are in pain and when you are expecting toreceive relief right away.”
b. “Don’t talk to me. If you are going to be rude, then you will not receive treatment
here.”
c. “We are very busy and don’t have enough staff to deal with problems such as
yours.”
d. “Perhaps you should go elsewhere. We do not have time for you here, as many
more sick patients are waiting.”
A
The Canadian Nurses Association (CNA) cites studies that suggest that intimidating and
disruptive behaviours in the nursing profession contribute to:
a. Low morale.
b. Preventable adverse outcomes.
c. An increase in power for leaders.
d. Citations of leaders for not addressing workplace violence.
B
Residents in a new long-term care facility attend meals in a large dining hall. In reviewing
reports of aggression and violence, you note that behaviours such as hitting or attempts to
hit staff are increasing. Further investigation suggests that this behaviour occurs most often
at mealtimes. A possible intervention would be to:
a. Seat residents with the highest potential for violence next to those with the lowest
potential for aggression.
b. Feed residents earlier in the day.
c. Restrain residents who are violent or aggressive during meal times.
d. Establish a smaller dining area that is away from the main area that is for residents
who have potential for aggression/violence.
D
Many inaccurately believe workplace violence to be related specifically to:
a. Verbal abuse.
b. Physical injury.
c. Incivility.
d. Harassment.
B
As indicated by Shield and Wilkins for Statistics Canada (2014), abuse in the health care
setting is most often perpetrated by someone who:
a. Is male.
b. Has more experience.
c. Consistently works day shifts.
d. Has high coworker support.
A
In addressing a high staff turnover rate that results from violence on a nursing unit, you are:
a. Confirming the high correlation between managerial incompetence and violence.
b. Demonstrating awareness that workplace violence, if present, has significant costs.
c. Aware that staff and manager experiences contribute to high turnover.
d. Aware that violence is a rare but present factor in the workplace.
B
