Chapter 5

Question 1

What defines the legal boundaries of nursing at the state level?
A) The state's Attorney General
B) The Nurse Practice Act
C) The ANA standards of practice
D) The ANA Code for Nurses

Answer 1

B) The Nurse Practice Act

The 51 Nurse Practice Acts representing the 50 states and the District of Columbia are
examples of statutes. These Nurse Practice Acts define and limit the practice of nursing,
stating what constitutes authorized practice as well as what exceeds the scope of
authority. Although Nurse Practice Acts may vary among states, all must be consistent
with provisions or statutes established at the federal level. The other options lack the
comprehensiveness and focus of a state’s Nurse Practice Act.

Question 2

How is the question of whether a nurse acted with reasonable care generally proven?
A) The expert testimony of nursing witnesses
B) The defendant’s explanation of what the nurse did
C) The trial judge, after checking the outcome of prior similar court cases
D) The testimony of expert medical witnesses

Answer 2

A) The expert testimony of nursing witnesses

The testimony of other nurses in the same specialty as the defendant may be used to
prove breach of duty. The other options are not considered qualified to testify to this
matter.

Question 3

A doctor orders a medical procedure that the staff nurse has reason to believe will harm
the patient. Which statement accurately states the legal consequences of carrying out, or
refusing to carry out, the procedure?
A) The staff nurse cannot be held legally liable for any harm to the patient if the
procedure is carried out with due care
B) The nurse may lose his or her license by refusing to carry out the procedure
C) The nurse can be held legally liable for any harm if the procedure is carried out
without question
D) The nurse can be held accountable for practicing medicine without a license

Answer 3

C) The nurse can be held legally liable for any harm if the procedure is carried out
without question

All nurses have personal liability, which means that every person is liable for his or her
own conduct. None of the remaining options describes that liability or its outcomes
accurately.

Question 4

The nurse witnesses a patient sign an operative permit form. Legally, what does the
nurse’s signature imply?
A) Observed the client sign the consent form
B) Is certain the client understands the proposed procedure
C) Believe the client is capable of understanding the proposed procedure
D) Assumes the client has had an adequate evaluation to agree to the procedure

Answer 4

A) Observed the client sign the consent form

Informed consent is obtained by a physician; therefore, a nurse is not legally responsible
for informed consent but is confirming that the client signed the consent form. The other
options are the responsibilities of the professional performing the procedure.

Question 5

How is the legal expansion of nursing roles accomplished?
A) The expansion of job descriptions in an agency
B) Written contracts between the nurse and the client
C) A written agreement between the nurse and the physician
D) Revision of the Nurse Practice Act

Answer 5

D) Revision of the Nurse Practice Act

RN scope of practice is always determined by the Nurse Practice Act and any expansion
of roles must occur through legislated changes in that statute. None of the remaining
options are sufficient to expand nursing roles legally.

Question 6

What is the responsibility of a charge nurse who discovers that a medication error was
made on the previous shift?
A) Share that information with the charge nurse on the previous shift
B) Document the incident as per hospital policy
C) Write a memo to the nurse who made the error requesting incident report be
written
D) Write a note in the client’s chart that an incident report will be completed

Answer 6

B) Document the incident as per hospital policy

It is the responsibility as manager to immediately document the error according to
hospital policy. Since policies concerning such situations vary, it is vital to know and
follow established policies. It is not generally appropriate to make such a note on the
client’s chart.

Question 7

What is the best reason that nurse-managers have an ongoing responsibility to be aware
of legislation affecting nursing practice?
A) This will prevent them from getting sued
B) Laws are fluid and subject to change
C) It will protect the agency from a lawsuit
D) It will ensure that correct procedure is carried out

Answer 7

B) Laws are fluid and subject to change

When using doctrines as a guide for nursing practice, the nurse must remember that all
laws are fluid and subject to change. Laws are not static. It is the responsibility of each
manager to keep abreast of legislation and laws affecting both nursing practice and
management practice. While the other options are correct, they do not describe the most
encompassing reason that nurse-managers need to keep aware of current legislature
affecting nursing practice.

Question 8

Which characteristics are required of a reasonable and prudent nurse?
A) Years of clinically focused nursing experience
B) Specialized nursing skills
C) Average nursing judgment and skills
D) Earned advanced nursing degree

Answer 8

C) Average nursing judgment and skills

Reasonable and prudent generally means the average judgment, foresight, intelligence,
and skill that would be expected of a person with similar training and experience. The
other options describe qualifications not required of a reasonable and prudent nurse.

Question 9

A state Nurse Practice Act is an example of which source of law?
A) Statutes
B) Constitution
C) Administrative
D) Judicial

Answer 9

A) Statutes

Statutes are the only laws made by official enactment by the legislative body.

Question 10

A verdict of suspension or loss of licensure represents what type of law?
A) Criminal
B) Civil
C) Administrative
D) Judicial

Answer 10

C) Administrative

A verdict of suspension or loss of licensure represents administrative law. This type of
law is not based on any of the other options.

Question 11

A lawsuit pertaining to professional negligence must include duty, breach of duty,
injury, and a causal relationship between breach of duty and injury. What else must be
included? Which element is necessary to prove professional negligence? Select all that
apply.
A) Breach of duty
B) Presence of injury
C) Ability to foresee harm
D) Causal relationship

Answer 11

A) Breach of duty
B) Presence of injury
C) Ability to foresee harm
D) Causal relationship

A lawsuit pertaining to professional negligence must include duty, breach of duty,
injury, a causal relationship between breach of duty and injury, and the ability to foresee
harm. Intent to cause injury is not a requirement.

Question 12

What component of professional negligence is represented when a patient experiences a
seizure resulting from a medication error?
A) Duty to use due care
B) Failure to meet standard of care
C) Foreseeability of harm
D) A causal relationship

Answer 12

D) A causal relationship

A direct causal relationship between failure to meet the standard of care (breach) and
injury can be proved when a patient is harmed because proper care is not given. None of
the remaining options are relevant to this criterion.

Question 13

What component of professional negligence is represented when a nurse fails to look up
an unfamiliar medication before administering it?
A) Duty to use due care
B) Failure to meet standard of care
C) Foreseeability of harm
D) A direct relationship between failure to meet the standard of care (breach) and
injury can be proved

Answer 13

C) Foreseeability of harm

The nurse must have reasonable access to information about whether the possibility of
harm exists not fulfilling this responsibility may result in a foreseeable harm to the
client. None of the remaining options are relevant to this criterion.

Question 14

What element must be included in the process of securing informed consent?
A) A timeline of when the treatment is expected to occur
B) Written information on what the post procedure outcomes will be
C) Information regarding the risks involved in the proposed procedure
D) An explanation of the nature of all associated treatment provided by the nurse

Answer 14

C) Information regarding the risks involved in the proposed procedure

Informed consent can be given only after the patient has received a complete
explanation of the surgery, procedure, or treatment and indicates that he or she
understands the risks and benefits related to it. Timeline and nursing responsibilities are
not components that are included. Outcomes are identified as expected or desired; no
guarantees are given.

Question 15

Which situations is a nurse-manager illegally responsible for reporting? Select all that
apply.
A) Suspected incidents of elder abuse
B) Examples of substandard medical care
C) Client-reported incidents of child abuse
D) Confirmed case of a communicable disease

Answer 15

A) Suspected incidents of elder abuse
B) Examples of substandard medical care
C) Client-reported incidents of child abuse
D) Confirmed case of a communicable disease

In addition, the manager, like all professional nurses, is responsible for reporting
improper or substandard medical care, child and elder abuse, and communicable
diseases, as specified by the Centers for Disease Control and Prevention. Disagreements
are not mandated reportable situations.

Question 16

What is one way to promote open communication between patients and practitioners?
A) Involving health-care consumers as active members of the health-care team
B) Promoting the creation of cultures of patient safety in health-care organizations
C) Establishing a federal leadership locus for advocacy of patient safety and healthcare
quality
D) Building an evidence-based information and technology system that impacts
patient safety and pursue proposals to offset implementation costs

Answer 16

A) Involving health-care consumers as active members of the health-care team

One way to promote open communication between patients and practitioners is
involving health-care consumers as active members of the health-care team. Pursing
patient safety initiatives prevent medical injury by promoting the creation of cultures of
patient safety in health-care organizations; establishing a federal leadership locus for
advocacy of patient safety and health-care quality; and building an evidence-based
information and technology system that impacts patient safety and pursue proposals to
offset implementation costs.

Question 17

What document permits a registered nurse to offer special skills and knowledge to the
public in a particular jurisdiction when such practice would otherwise be unlawful?
A) A state nursing license
B) Institutional licensure
C) ANA certificate
D) ANA practice standards

Answer 17

A) A state nursing license

In general, a license is a legal document that permits a person to offer special skills and
knowledge to the public in a particular jurisdiction when such practice would otherwise
be unlawful. A state nursing license allows for the practice of nursing in a specific state.
Some professionals have advocated shifting the burden of licensure, and thus
accountability, from individual practitioners to an institution or agency. Proponents for
this move believe that institutional licensure would provide more effective use of
personnel and greater flexibility. The ANA is not capable of permitting a person to
practice nursing.

Question 18

Professional organizations generally espouse standards of care that have what
relationship to those required by law? Select all that apply.
A) Higher than those required by law
B) The same as those required by law
C) Are established after those required by law
D) Are established prior to those required by law

Answer 18

A) Higher than those required by law
D) Are established prior to those required by law

Professional organizations generally espouse standards of care that are higher than those
required by law. These voluntary controls often are forerunners of legal controls. The
standards are written by health-care professionals while laws are written by legislatures.

Question 19

What is an example of an unintentional tort?
A) Professional negligence
B) Assault
C) Battery
D) False imprisonment

Answer 19

A) Professional negligence

While professional negligence is considered to be an unintentional tort, assault, battery,
false imprisonment, invasion of privacy, defamation, and slander are intentional torts.

Question 20

Malpractice or professional negligence is the failure of a person with professional
training to act in a reasonable and prudent manner. How many components must be
present for an individual to be found guilty of malpractice?
A) Three
B) Four
C) Five
D) Six

Answer 20

C) Five

Five components must be present for a professional to be held liable for malpractice:
duty to use care, failure to meet standard of care, foreseeability of harm, direct
relationship between failure to meet the standard of care and injury can be proved, and
injury.

Question 21

Which statement is true regarding criminal law cases? Select all that apply.
A) Incarceration is a likely consequence of being found guilty of a criminal offense
B) Intentionally giving an overdose of a potent narcotic is a criminal offense
C) A guilty verdict requires evidence beyond a reasonable doubt
D) Most malpractice cases are tried in criminal court

Answer 21

A) Incarceration is a likely consequence of being found guilty of a criminal offense
B) Intentionally giving an overdose of a potent narcotic is a criminal offense
C) A guilty verdict requires evidence beyond a reasonable doubt

In criminal cases, the individual faces charges generally filed by the state or federal
attorney general for crimes committed against an individual or society. In criminal
cases, the individual is always presumed to be innocent unless the state can prove his or
her guilt beyond a reasonable doubt. Incarceration and even death are possible
consequences for being found guilty in criminal matters. Nurses found guilty of
intentionally administering fatal doses of drugs to patients would be charged in a
criminal court. Most malpractice cases are tried in civil court.

Question 22

Which behavior will best minimize a nurse’s risk for a malpractice claim?
A) Always carry a personal liability insurance policy
B) Always function with the state’s nursing practice act
C) Ask for assistance when engaged in complicated procedures
D) Devote time to establishing an effective nurseñpatient relationship

Answer 22

B) Always function with the state’s nursing practice act

Nurses can reduce the risk of malpractice claims by practicing within the scope of the
Nurse Practice Act. Nurses should purchase their own liability insurance and understand
the limits of their policies. Although this will not prevent a malpractice suit, it should
help to protect a nurse from financial ruin should there be a malpractice claim. While
the other options present reasonable advice, they will not necessarily help in the
avoidance of a malpractice claim.

Question 23

Which statement is true regarding the implications of a Good Samaritan law for a
registered nurse? Select all that apply.
A) A nurse has a legal responsibility to provide emergency services
B) Such laws are universally worded so as to minimize state-to-state differences
C) In order for protection to apply, the nursing care cannot be considered negligent
D) A nurse who provided out-of-scope care is not protected by the Good Samaritan

Answer 23

C) In order for protection to apply, the nursing care cannot be considered negligent
D) A nurse who provided out-of-scope care is not protected by the Good Samaritan

Nurses are not required to stop and provide emergency services as a matter of law,
although most health-care workers feel ethically compelled to stop if they believe they
can help. Good Samaritan laws suggest that health-care providers are typically protected
from potential liability if they volunteer their nursing skills away from the workplace
(generally limited to emergencies), provided that actions taken are not grossly negligent
and if the health-care worker does not exceed his or her training or scope of practice in
performing the emergency services. However, not being paid for your services alone
will not provide Good Samaritan law protection. Good Samaritan laws apply only if the
health-care worker does not exceed his or her training or scope of practice in performing
the emergency services. Protection under Good Samaritan laws varies tremendously
from state to state. In some states, the law grants immunity to RNs but does not protect
LVNs or LPNs. Other states offer protection to anyone who offers assistance, even if
they do not have a health-care background. Nurses should be familiar with the Good
Samaritan laws in their state.

Question 24

Which action demonstrates appropriate management regarding legal issues? Select all
that apply.
A) Remains current on all institutional policies and procedures
B) Delegates with consideration to appropriate scopes of practice
C) Requires physical proof of appropriate professional licensure each year
D) Provides yearly in-services on the operation of newly acquired equipment

Answer 24

A) Remains current on all institutional policies and procedures
B) Delegates with consideration to appropriate scopes of practice
C) Requires physical proof of appropriate professional licensure each year

Sound management functions regarding legal issues include understanding and adhering
to institutional policies and procedures delegating to subordinates wisely, looking at the
manager’s scope of practice and that of the individuals he or she supervises, and
monitoring subordinates to ensure they have a valid, current, and appropriate license to
practice nursing. In-services should be held frequently especially when related to issues
that affect care delivery. The reliance on peers for advice in such matters is not prudent;
the institution’s legal advisor is much better prepared for this task.

Question 25

Which statement best describes the impact that the concept of respondeat superior has
on the issue of nursing liability?
A) It allows for joint liability among physicians, nurses, and health-care
organizations
B) It supports the sharing of blame among all involved sources of health-care
services
C) It encourages legal intervention when health care is thought to be substandard
D) It implies that the institution is responsible for the acts of its employees

Answer 25

B) It supports the sharing of blame among all involved sources of health-care
services

Nurses must remember that the purpose of respondeat superior is not to shift the burden
of blame from the employee to the organization but rather to share the blame, increasing
the possibility of larger financial compensation to the injured party. While the other
options may be true statements, the correct option describes the more nurse-related
implication of the concept.

Question 26

The nurse manager is facilitating the work of a collaborative team whose mission is to negotiate employment contracts with physicians. The nurse manager does not want to compromise the nurses’ concerns in favor of the doctors’ concerns. Which strategies would facilitate this outcome?
Select all that apply.
1. Accommodating
2. Compromising
3. Smoothing
4. Collaborating
5. Competing

Answer 26

4. Collaborating
5. Competing

Collaborating focuses on solving the problem and satisfying both parties’ concerns. Competing is a victory for one side and a loss for the other.

Question 27

The nurse manager asks the staff nurse to work a double shift because the census is high. Although the nurse realizes the staffing for the night shift is low, the nurse has already made a family commitment for the same night. This is an example of which concept?

1. Intrapersonal conflict
2. Interpersonal conflict
3. Intragroup conflict
4. Intergroup conflict

Answer 27

1. Intrapersonal conflict

Intrapersonal conflict occurs when the consequence of real or perceived differences in mutually exclusive goals, values, attitudes, beliefs, feelings, or actions occurs within one individual. In this case, the nurse’s conflict is between personal plans and the need to help alleviate the low staffing issue.

Question 28

The nurse manager presents an issue to the nursing staff for a decision. The group assesses the problem, and a decision is made meeting the needs of both the nurse manager and the nursing staff. This is an example of which conflict management strategy?

1. Integrative decision making
2. Win-lose strategy
3. Accommodation
4. Consensus

Answer 28

4. Consensus

Consensus occurs when the problem is fully explored, the needs and goals of both parties are addressed, and a mutual decision is made.

Question 29

The nurse manager meets with the staff nurses to discuss ways to improve communication among the shifts. Which statement by the nurse manager best exemplifies the final stage of conflict management?

1. “We need to clearly define the nature of the conflict.”
2. “I will evaluate the outcomes of our strategies on a monthly basis.”
3. “Let’s create a time line for the implementation of our strategies.”
4. “Hopefully, each group can understand each other’s perceptions of the issue.”

Answer 29

2. “I will evaluate the outcomes of our strategies on a monthly basis.”

In any situation, the nurse manager should use the nursing process to intervene. The final step of the nursing process is evaluation, which is reflected in the statement, “I will evaluate the outcomes….”

Question 30

The staff nurses and nursing administration are attempting to construct a method of scheduling that meets the needs of both the clients and the nursing personnel. Because nurses and nursing administration have experienced conflict about the issue, their intent is to arrive at an agreeable solution between both parties. Which option does this process best exemplify?

1. Negotiation
2. Accommodation
3. Forcing
4. Consensus

Answer 30

1. Negotiation

Negotiation involves a reciprocal “give and take” on issues among the parties. The desired outcome is to achieve agreement even though consensus will never be reached.

Question 31

A staff nurse has experienced disagreements with one of the medical residents about several issues. The resident reacts to this conflict by belittling the nurse in front of colleagues. This behavior is most characteristic of which type of conflict?

1. Competitive
2. Role
3. Perceived
4. Disruptive

Answer 31

4. Disruptive

Both parties are engaged in activities to reduce, defeat, or eliminate the opponent, which result in irrational, unproductive behavior. This is disruptive conflict.

Question 32

The day shift nurses and night shift nurses are in clear opposition regarding the responsibilities that each shift should be assigned. This opposition has created a “we-they” distinction on the unit. This is an example of which phenomenon?

1. Distancing
2. Suppression
3. Group withdrawal
4. Unification

Answer 32

1. Distancing

Distancing mechanisms or differentiation serve to divide group members into small, distinct groups, which increases the risk for conflict.

Question 33

A conflict has arisen between two staff nurses who work on the same unit. Which strategy is most important for the nurse manager to consider?

1. Address the conflict in the break room.
2. Make a timely decision regarding if and when to intervene.
3. Accept full responsibility for developing a solution.
4. Redirect expressions of disagreement between the participants.

Answer 33

2. Make a timely decision regarding if and when to intervene.

Conflict management begins with a decision regarding if and when to intervene. Failure to intervene can allow the conflict to escalate, whereas premature intervention can cause individuals to lose self-confidence and avoid risk taking.

Question 34

A difference in opinion has arisen regarding methods to care for clients who are on mechanical ventilators. The nurse manager asks a group of nurses to meet and review evidence-based practice related to this client care situation. Each nurse volunteers to gather data prior to the next meeting. This is an example of which type of problem solving?

1. Negotiation
2. Collaboration
3. Compromise
4. Forcing

Answer 34

2. Collaboration

Collaboration occurs when all parties use their expertise to problem solve. The group focuses on problem solving as opposed to competition.

Question 35

The nurse manager assesses that there is conflict between two of the charge nurses. The decision is made to postpone an intervention and allow the conflict to escalate. Why might the nurse manager make this decision?

1. Allow sufficient time for the problem to spontaneously resolve.
2. Motivate the participants to seek resolution.
3. Give the nurse manager time to identify problem-solving strategies.
4. Relieve the nurse manager of the time commitment necessary to intervene.

Answer 35

2. Motivate the participants to seek resolution.

The nurse manager may delay intervention to allow the conflict to escalate because increased intensity can motivate participants to seek resolution. The nurses would still actively work to resolve the issue.

Question 36

The nurse manager assesses that two staff nurses are engaged in a conflict that is having a negative impact on client care. The manager meets with the nurses involved and identifies the conflict. An attempt is made to resolve the conflict through knowledge and reason. What strategy is this manager using?

1. Confrontation
2. Resolution
3. Negotiation
4. Forcing

Answer 36

1. Confrontation

Confrontation is the most effective means of resolving conflict, in which the conflict is brought out in the open and deliberate attempts are made to resolve it through knowledge and reason.

Question 37

A nurse manager states, “I cannot stand all these conflicts in my department. Nothing good can come out of it.” Which indicates the best reason the manager’s statement is untrue?

1. Conflict can stimulate more people to become involved in a situation, thus creating more innovative solutions to the issue.
2. When people are in conflict, they tend to work harder just to avoid the conflicting situation.
3. Groups in conflict spur competition, which is always beneficial to the units from which the groups emerged.
4. When there is conflict in an organization, people are more open to discussion, thus conflict can open the lines of communication.

Answer 37

1. Conflict can stimulate more people to become involved in a situation, thus creating more innovative solutions to the issue.

Conflict can be positive because as a conflict arises, individuals may become involved that might not have otherwise. Getting more people involved usually results in more creative solutions.

Question 38

A nurse has a longstanding conflict with another nurse working the same shift. Over the last few days the first nurse has made an effort to smooth over the conflict. Which statement would the nurse manager evaluate as an example of a “smoothing” comment?

1. “We are never going to agree because I am from Generation X and you are a baby boomer.”
2. “I’m tired of this fight and I’m not going to argue with you anymore.”
3. “Even though we don’t agree on much, I do think you are correct about enforcing the length of lunch breaks.”
4. “I think everything is fine and that we can get along.”

Answer 38

3. “Even though we don’t agree on much, I do think you are correct about enforcing the length of lunch breaks.”

Smoothing includes statements or actions such as complementing one’s opponent, downplaying differences, and focusing on minor areas of agreement. Agreeing about the length of lunch break is one such minor area.

Question 39

The hospital has an annual campaign in which the staff is divided into two teams to raise money for hospital special events. The team raising the most money gets possession of a “trophy” designed by the administrative staff. This is an example of which type of conflict?

1. A conflict that is disruptive to the work of the hospital
2. A competitive conflict that is positive to the work environment
3. An intragroup conflict that is not appropriate in health care
4. A felt conflict that will result in unresolved feelings of frustration

Answer 39

2. A competitive conflict that is positive to the work environment

This is an example of a competitive conflict and is an example of how conflict can be positive in an organization.

Question 40

Why does conflict help generate change?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Conflict assists change to occur more rapidly than it would otherwise.
2. It brings more attention to an issue in need of change.
3. People get involved because conflict breeds curiosity.
4. If there is an existing conflict, a change must occur to stop the conflict.
5. Change is inevitable, and some people refuse to change, which causes conflict.

Answer 40

2. It brings more attention to an issue in need of change.
3. People get involved because conflict breeds curiosity.

Rationale 2: When conflict around a change occurs, more people become aware of the issue, and because of curiosity or interest, more people become involved in the process.
Rationale 3: When conflict around a change occurs, more people become aware of the issue, and because of curiosity or interest, more people become involved in the process.

Question 41

A new triage area has been built in the emergency department causing conflict between the nurse manager and the nurses who think the design is not “user friendly.” After repeated complaints the nurse manager asks maintenance to change the arrangement of the room. What is the most important reason this change occurred?

1. The complaints motivated the nurse manager to make the change to increase unit effectiveness.
2. The room design was uncomfortable for the nurses, which convinced the nurse manager to change the design.
3. The nurse manager was afraid the nurses would refuse to work in the room so the room had to be changed.
4. The nurses would keep complaining so the nurse manager changed the room to stop the griping.

Answer 41

1. The complaints motivated the nurse manager to make the change to increase unit effectiveness.

As the nurse manager, unit effectiveness is paramount. If the nurses are complaining, it is probably a legitimate problem in need of change.

Question 42

The medical residents on a particular unit do not answer pages very quickly, and sometimes do not answer them at all. The nursing staff complains to the nursing supervisor. After several weeks, this conflict has spiraled into a heated disagreement. Which is the most important reason to make the necessary changes to settle this conflict?

1. Client care and satisfaction will suffer should it be allowed to continue.
2. The residents cannot be allowed to continue such unprofessional behavior.
3. Residents who do not answer pages do not get the most out of the experience.
4. Physicians do not know what is going on with clients if the residents do not tell them

Answer 42

1. Client care and satisfaction will suffer should it be allowed to continue.

Client care and satisfaction must take precedence over other reasons for settling the conflict.

Question 43

The nurse and a client are discussing instructions for self-care after discharge. The client’s husband says, “I can’t take care of her by myself. We need home health like we had before she came to the hospital.” This statement reflects which antecedent condition?

1. Task interdependence
2. Resource competition
3. Structural conflict
4. Differences in values and beliefs

Answer 43

4. Differences in values and beliefs

This situation is a potential conflict between the health care workers who believe that the husband can take care of the wife and the husband who believes that he cannot.

Question 44

The nursing staff is continually upset about inability to provide clients with supplies needed because third-party payers will not reimburse for those items. This is an example of which conflict antecedent?

1. Task interdependencies
2. Distancing
3. Role
4. Incompatible goals

Answer 44

4. Incompatible goals

The nurses in this situation have the goal to provide the best possible care to clients. The third-party payers have the goal of providing care at the least cost. These two sets of goals are often incompatible and result in conflict.

Question 45

Which is the most important factor in whether a conflict will be perceived or felt between two nurses?

1. How well the nurses know and trust each other
2. If the nurses are on the same job level
3. The congruence of the nurse’s values and beliefs
4. Whether or not the nurses perform the same roles

Answer 45

1. How well the nurses know and trust each other

Perceived versus felt conflict depends on whether or not the involved parties know and trust each other. If past problems have been handled calmly and rationally, and each knows what to expect from the other, it is considered a perceived conflict.

Question 46

Which statements would alert a nurse manager that a unit conflict has become disruptive?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. “I won’t stop until I have gotten her fired.”
2. “He doesn’t fight fairly.”
3. “I’ve almost forgotten what started this, I just focused on beating her.”
4. “I am going to win this argument.”
5. “He is so wrong, he just has to go.”

Answer 46

1. “I won’t stop until I have gotten her fired.”
2. “He doesn’t fight fairly.”
3. “I’ve almost forgotten what started this, I just focused on beating her.”
4. “He is so wrong, he just has to go.”

An urge to eliminate the competitor is reflective of the competition becoming disruptive.

Question 47

A nurse and a physician are in conflict over the treatment of a client. Which statements by the nurse reflect the best way to handle interprofessional conflict?

Select all that apply.

1. “I think it would be better for the client to stay another day.”
2. “This client needs an additional day to learn how to care for a complex wound.”
3. “It will help this client manage her diabetes more effectively if she is assigned a diabetic educator.”
4. “Research has shown that early ambulation helps to reduce the likelihood of pulmonary embolism.”
5. “Do you not remember what happened when you sent that other client home too early?”

Answer 47

2. “This client needs an additional day to learn how to care for a complex wound.”
3. “It will help this client manage her diabetes more effectively if she is assigned a diabetic educator.”
4. “Research has shown that early ambulation helps to reduce the likelihood of pulmonary embolism.”

Rationale 2: Speaking from the vantage point of the client helps to support the nurse’s position in this conflict.
Rationale 3: Explaining what will best help the client helps to support the nurse’s position in this conflict.
Rationale 4: Using facts to support the nurse’s point in the conflict is an important strategy.

Question 48

A physician criticizes the care provided by a nurse in an area where others are present. Which actions by the nurse would the manager interpret as a covert conflict behavior resulting from this situation?
Select all that apply.
1. The nurse says, “You can’t talk to me like that.”
2. The nurse avoids the physician in the hallway.
3. The nurse refuses to care for the physician’s clients.
4. The nurse is no longer as careful in caring for this physician’s clients.
5. The nurse is apathetic about the care of clients.

Answer 48

2. The nurse avoids the physician in the hallway.
3. The nurse is no longer as careful in caring for this physician’s clients.
4. The nurse is apathetic about the care of clients.

Rationale 2: Avoidance is a covert behavior.
Rationale 4: Not being as careful is a covert action.
Rationale 5: Apathy is a covert conflict behavior.

Question 49

Two staff nurses are in conflict about the summer vacation schedule. The nurse manager is contemplating assigning both nurses to a task that will require frequent contact with each other, hoping that they will resolve the issue themselves. What should the manager consider before making this assignment?

Select all that apply.

1. What is the anxiety level of the nurses in regard to the vacation schedule?
2. Have the nurses ever worked together before on a project?
3. Will the conflict decrease the efficiency of the unit while the nurses are self-solving the issue?
4. How intense is the conflict about vacation scheduling?
5. Are the nurses talking to the rest of the staff about the conflict?

Answer 49

1. What is the anxiety level of the nurses in regard to the vacation schedule?
2. Will the conflict decrease the efficiency of the unit while the nurses are self-solving the issue?
3. How intense is the conflict about vacation scheduling?

Rationale 1: If there is high anxiety about the issue, assigning the nurses to a task together is likely not a good idea.
Rationale 3: If the efficiency of the unit is in jeopardy, the manager should intervene.
Rationale 4: If the conflict regarding vacation scheduling is intense, the nurse manager should abandon this plan.

Question 50

A nurse manager and a staff nurse are in conflict. The nursing supervisor has decided to use mediation to arrive at a solution. The supervisor should be most concerned about which person’s level of comfort when choosing a place for the mediation meeting?

1. The manager
2. The staff nurse
3. The supervisor
4. There should be equal concern for all participants.

Answer 50

2. The staff nurse

The staff nurse has the lowest ranking of all involved in this mediation. The most concern should be with the staff nurse’s level of comfort.

Question 51

A serious conflict between a nurse and a nursing assistant erupted into a shouting match in the hallway. The nurse attempted to slap the nursing assistant. What conflict responses are appropriate for the assistant?

Select all that apply.

1. Accommodating
2. Withdrawal
3. Avoiding
4. Smoothing
5. Negotiation

Answer 51

2. Withdrawal
3. Avoiding

Rationale 2: When safety is at risk, withdrawal is a valid response.
Rationale 3: When safety is at risk, avoiding is a valid response.

Question 52

Conflict has arisen within the hospital regarding who will staff a proposed high-acuity unit. The nurse executive and other administrators have purposefully not intervened in this conflict. Why is that strategy appropriate?

Select all that apply.

1. Conflict draws attention to an issue.
2. The administrators do not like conflict management.
3. Conflict can stimulate new ideas about how to manage the high-acuity unit.
4. Conflict about the unit will help to identify the compromises necessary to make it a viable part of the hospital system.
5. Conflicts about staffing may make current staff members reexamine their own performance.

Answer 52

1. Conflict draws attention to an issue.
2. Conflict can stimulate new ideas about how to manage the high-acuity unit.
3. Conflict about the unit will help to identify the compromises necessary to make it a viable part of the hospital system.
4. Conflicts about staffing may make current staff members reexamine their own performance.

Rationale 1: There may be a reason that administration would desire that attention be brought to the new unit. Conflict will bring that attention.
Rationale 3: Conflict can stimulate thought and new ideas.
Rationale 4: Any new program or unit comes at a cost and the cost-benefit ratio must be explored. Conflict can help others identify the compromises and costs associated with starting this unit.
Rationale 5: Staff members who wish to be considered for staffing the new unit may improve their own performance and effectiveness.

Question 53

A nurse manager is trying to manage a conflict between a staff nurse and a medical student. Which statement by the manager would the nursing supervisor interpret as following the rules of basic mediation?

1. “Both parties need to grow up. They are so immature.”
2. “The problem is partially the fault of both parties.”
3. “I stopped the conversation frequently to have the parties summarize what was being said.”
4. “They just went on and on. I had to stop the discussion because I was out of time.”

Answer 53

3. “I stopped the conversation frequently to have the parties summarize what was being said.”

Rationale 3: Having the parties summarize the discussion helps to ensure active listening

Question 54

Which statement by the nurse managing a unit conflict indicates that the integrative decision-making strategy is being used?

1. “I’ve heard all I need to hear. I’ll have a decision tomorrow.”
2. “Once you have signed this informed consent, the issue will go to mediation.”
3. “This will all blow over if everyone just tries to get along better.”
4. “Both parties should come up with as many alternative solutions as possible before our next meeting.”

Answer 54

4. “Both parties should come up with as many alternative solutions as possible before our next meeting.”

Rationale 4: In integrative decision-making, both parties conduct an exhaustive search for acceptable alternatives.

Question 55

In order to come to a solution for an ongoing conflict among several nursing units, the nursing supervisor says, “Your managers will meet to create a voting form representing both sides of this issue. Each of you will vote and the majority will rule.” What kind of a solution is the supervisor seeking?

1. Consensus
2. Win-win
3. Forcing
4. Win-lose

Answer 55

4. Win-lose

Rationale 4: Someone will win in this case and someone will lose.