Exam 3: Chapter 21

Question 1

The nurse manager schedules evaluations of staff members using a newly developed performance appraisal tool. The development
of a performance appraisal tool should include:
a. organizational mission, philosophy, and position requirements.
b. a generalized overview of the duties of a position.
c. a skills checklist and accreditation requirements.
d. an ordinal scale that ranks all employees.

Answer 1

ANS: A
Performance appraisal tools and processes should reflect the organizational mission and philosophy, as well as position
requirements.

Question 2

John, a new graduate, reviews the employee evaluation for his new position. The first section requires that he list his own specific objectives to be accomplished. This is an example of:

a. the traditional rating scale.
b. learning goals, or management by objectives.
c. a forced distribution scale.
d. a behavior-anchored rating scale.

Answer 2

ANS: B
In management by objectives, the employer and the employee jointly establish clear and measurable objectives for the next
performance period.

Question 3

John notes that the next section is specific to the organizational philosophy and has a 4-point ordinal scale that describes
performance from “always meets expectations” to “does not meet expectations.” This type of evaluation is most commonly known
as:
a. a behavior-anchored rating scale.
b. management by objectives/learning goals.
c. the forced distribution scale.
d. a graphic rating scale.

Answer 3

ANS: D

Graphic rating scales are commonly used in evaluation and reflect generalizations rather than specific behaviors.

Question 4

On your unit, despite efforts to build a strong sense of team, conflict between some of the staff is ongoing. Nonetheless, you want
to proceed with developing a systematic and effective performance appraisal system. Which of the following approaches would be most appropriate for you to implement?
a. Peer review
b. A combination of tools
c. Anecdotal notes
d. Rating scale

Answer 4

ANS: B

A combination of tools is likely superior to any one method in any situation.

Question 5

As part of orientation to your unit, you decide to administer Kolb Learning Style Inventory (LSI) to new staff. The most likely
reason for your decision is that the use of Kolb LSI:
a. reduces the cost of orientation.
b. determines if there is fit between learner and organizational values.
c. develops the strengths of the new staff member.
d. enables individualization of learning to the learner’s needs.

Answer 5

ANS: D
Administration of Kolb LSI enables identification of the learning styles of new employees, which assists in focusing the
implementation of orientation goals and in individualizing learning to the needs and learning style of the employee.

Question 6

Which of the following might best conclude an interview?
a. “Thank you for your interest. Someone will be in touch with you soon.”
b. “Before you go, we will make sure that we have your contact information. Thank you for coming.”
c. “I will be in contact with all candidates by telephone by next Friday. It has been a
pleasure to meet you.”
d. “We have several excellent candidates so I am not sure about the outcome of the
interview, but I will let you know. Thank you for coming.”

Answer 6

ANS: C
An employment interview should always conclude with information as to how and when follow-up to the interview will occur.

Question 7

In determining the fit of a candidate with the culture on your unit, which of the following interview questions might be asked?
a. “Could you review your résumé for us, highlighting your certifications and
experience?”
b. “If we were to ask your references, what would they list as your strengths?
Weaknesses?”
c. “We have a number of older adult patients on this unit. If you noticed another
staff member addressing one of these patients impatiently, how would you
respond?”
d. “Tell us about your work and academic experiences and qualifications.”

Answer 7

ANS: C
The nurse manager wants the most qualified individual for the position who also fits the culture of the organization. Asking behavioral questions in the interview allows you to assess how a candidate may function in real-life situations and to assess if this
behavior is compatible with the culture on the unit.

Question 8

The biggest challenge in the recruitment of staff is:
a. finding well-qualified candidates who can function well within your particular
work culture.
b. recruiting individuals with the appropriate qualifications and experience.
c. screening out candidates who are unable to function well within a team.
d. determining if candidates have had previous negative experiences in a work
environment.

Answer 8

ANS: A
Choosing the right individual is the challenge for managers and involves finding qualified candidates who will work well within your culture.

Question 9

Anecdotal notes:

a. should be completed only when there are performance concerns.
b. can be used to support and justify fairness in termination discussions.
c. are unnecessary if the evaluation instrument is thorough.
d. need to be completed at the end of a performance period.

Answer 9

B
Anecdotal notes should be kept consistently throughout the evaluation period and should reflect both negative and positive
behaviors if they are to provide an accurate assessment of performance. Anecdotal notes provide documentation to support rating
scales and narrative evaluation summaries.

Question 10

An outpatient clinic advertised for RN positions. Before authorizing an open position, the nurse manager should:

a. review the position description and performance expectations for the opening.
b. place an ad in the local newspaper and on the telephone job line.
c. review all current applications on file.
d. look for employees within the system who might best fill the position.

Answer 10

ANS: A
The position description provides the basis for this position within the organization and communicates expectations for the role.
When applying for a position, researching the facility and position description will help an applicant gain insight into the organization; therefore, the position description should be current and communicate expectations.

Question 11

The turnover rate for RNs in the ICU is high. You discuss this situation with existing staff and you find out that because of the
rapid turnover, new staff are frequently required to assume full responsibilities soon into the position and before training is
completed. In considering approaches that will reduce turnover rates, the staff and you decide to implement:
a. an employee recognition program.
b. coaching for new staff.
c. a new performance appraisal system.
d. a committed orientation and training program.

Answer 11

ANS: D
Retention of new nursing personnel begins on the day of their hire. This includes an effective, appropriate orientation and training
program, which has a measurable impact on reducing turnover.

Question 12

The validity of comments and ratings related to performance is enhanced by:

a. maintenance of anecdotal notes over the entire evaluation period.
b. quantity of information gathered for appraisal purposes.
c. agreement of the employee with the ratings and comments.
d. whether or not other individuals have contributed to the observations.

Answer 12

ANS: A
Anecdotal notes compiled consistently over the entire rating period are a much more equitable method of providing an accurate summary of the employee’s performance.

Question 13

A nurse manager in the ICU works with his staff to develop an appraisal instrument that includes quantitative data and respects standards for an RN working on that unit. This type of appraisal is a:

a. rating scale.
b. collaboratively based appraisal system.
c. narrative instrument.
d. behaviorally anchored rating scale.

Answer 13

ANS: D

Behaviorally anchored rating scales (BARSs) describe performance quantitatively and qualitatively.

Question 14

You have hired a new RN to replace a well-respected and experienced nurse in your outpatient department. The new RN recently
graduated and is nervous about stepping into a role that was previously filled by someone who was so competent. You recognize
anxiety and set up regular, frequent meetings during which you explore how she is dealing with her anxiety, provide feedback, and
discuss strategies/ideas that will enhance her performance. What development approach are you using?
a. Performance appraisal
b. Counseling
c. Empowerment
d. Coaching

Answer 14

ANS: D
The overall evaluative process can be enhanced if the manager employs the technique of coaching. Coaching is a process that
involves the development of individuals within an organization. This coaching process is a personal approach in which the manager and the employee interact on a frequent and regular basis with the ultimate outcome that the employee performs at an optimal level.

Question 15

Sue, a nurse manager, discusses her concerns about the hospital’s employee appraisal system with her work group, noting that it includes only one rating scale and that it means nothing unless the manager has effective relationship skills. Sue’s concerns reflect
which best practices associated with performance appraisal?
a. Rating scales are too generalized to be considered valid or reliable.
b. The effectiveness of appraisal is enhanced by a combination of methods and
effective communication skills.
c. BARS is considered superior to simple rating scales in terms of performance
appraisal.
d. Rating scales need to be designed by users to be well accepted.

Answer 15

ANS: B
A combination of several methods is probably superior to any one method. The primary success of any performance appraisal lies
in the skills and communication abilities of the manager.

Question 16

During a performance appraisal, Joanne, the nurse manager, indicates that Alysha has difficulty mentoring students on the unit. Alysha responds that this is not her responsibility. In responding to Alysha, Joanne needs to consider:

a. Alysha’s level of confidence.
b. whether mentoring is included in the position description.
c. whether mentoring is an essential component of the position description.
d. whether mentoring can be accurately observed and measured.

Answer 16

ANS: B
Employees must have clear role expectations, clearly understand what is expected of their performance, and understand the
ramifications of not meeting those expectations. Position descriptions provide written guidelines detailing the roles and responsibilities of a specific position within the organizational context.

Question 17

The final section of a performance appraisal is a rating scale. This scale is very detailed and relates to competency standards
specific to surgical clients. The scale is a summary of performance directly observed or documentation reviewed and is specific to
client care situations in which the employee has been involved. This type of evaluation is most commonly known as:
a. a traditional rating scale.
b. management by objectives/learning goals.
c. a forced distribution scale.
d. a behaviorally anchored rating scale.

Answer 17

ANS: D

BARS contain both quantitative (rating scales) and qualitative data. They are specific to situations and positions.

Question 18

John’s performance was satisfactory during the first month, but after that time, he was found to be very inconsistent in the
provision of nursing care. One month before the end of the rating period, he cared for a very wealthy and influential client, who is
best friends with the clinical manager. This client donated new furniture for the staff lounge in John’s name to show appreciation
for his care. John’s subsequent performance appraisal resulted in outstanding ratings in all areas. This is an example of:
a. a performance rating based on justifiable evidence.
b. a bias related to recent events.
c. the impact of personality on the appraisal of performance.
d. the effective use of a behaviorally anchored rating scale.

Answer 18

ANS: B
To gain and to provide an accurate evaluation of performance over time, anecdotal notes need to be maintained throughout the
evaluation period. This process assists in avoiding bias related to recent or sensational events that make a particularly strong
impression.

Question 19

As a manager, you are interested in developing behavioral questions for an interview. Knowing that there is team conflict at times on your unit, which of the following questions would satisfy your interest in behavioral questions?
a. “Tell me about a time you were involved in a conflict related to a project. What
was your role in the conflict? In the resolution of the conflict?”
b. “If you were to employ one strategy for managing conflict, what would it be?”
c. “What is your preferred style of conflict resolution?”
d. “How effective are you in working in a group? In dealing with conflict?”

Answer 19

ANS: A
Behavioral questions seek demonstrated examples of behavior from the candidate’s past experiences; behavioral-based interviewing can be a strong predictor of a future employee.

Question 20

Which of the following strategies might be effective in empowering staff?
a. Communication book in which new information on policies and processes is
communicated and mistakes are highlighted.
b. Monthly staff meetings during which a portion of the agenda is devoted to sharing
ideas and presentations on best practices for implementation on the unit.
c. Once-yearly summative evaluations based on what the manager best likes about
the individual.
d. Focus on discussion of errors in care with direction as to how errors are to be
prevented in the future.

Answer 20

ANS: B
Empowerment is a process that acknowledges the values and judgments of others and trusts their decisions. It allows freedom for making decisions while retaining accountability and provides an environment that is safe in which to explore.

Question 21

The chief nursing officer establishes a shared governance model to help empower the nursing staff, thus empowering the
organization. Common characteristics of empowered organizations are:
a. shared values, high salaries, and a human focus.
b. shared values, flexibility, and a human-capital focus.
c. commitment to communication, high salaries, and flexibility for evaluations.
d. creation of community and of effective stress management in the midst of
divergent goals.

Answer 21

ANS: B
Shared governance involves valuing the contributions of each member of the team, releasing the need to control, and understanding
that accountability rests with members of the team.

Question 22

Joanne, a new nurse manager, writes certain assumptions regarding the organization’s objectives into her budget. Her supervisor
tells her that the objectives implied in her assumptions are not entirely consistent with the organization, and that she needs to clarify
these objectives with her supervisor. Joanne apologizes and says she had more latitude with the budget where she previously
worked. This is an example of:
a. role complexity.
b. role ambiguity.
c. role conflict.
d. time-dependent roles.

Answer 22

ANS: B
Role ambiguity in the workplace creates an environment for misunderstanding and hinders effective communication. Without clear
expectations of performance, missteps in performance can occur.

Question 23

A survey of staff satisfaction is conducted. The survey indicates that staff members are satisfied, are loyal to the organization, and
feel that they have reasonable control in their individual responsibilities. The findings best exemplify:
a. clarity in roles and valuing of contributions.
b. satisfaction but not empowerment.
c. effective coaching of new staff.
d. role attachment.

Answer 23

ANS: A
Commitment, a sense of control, and satisfaction are linked to clear role expectations and a feeling that contributions are valued.

Question 24

You have hired Chelsea as a new staff member on your unit. Although she is an experienced ICU nurse, this is her first educator
role. A month into her new position, she confides that she feels really incompetent in her new position and bursts into tears. Your
response is based on application of your understanding of:
a. role acquisition.
b. role conflict.
c. role complexity.
d. performance appraisal.

Answer 24

ANS: A
Acquisition of a role is time dependent and involves application of life experiences to each role and interpretation of the role within
one’s own value system. As roles become more complex, an individual may take longer to assimilate the components of each role.

Question 25

During the performance appraisal session, the manager should: (Select all that apply.)

a. maintain a relaxed and professional manner.
b. inquire about the employee’s personal life and how it is affecting performance.
c. allow the employee to express opinions orally and in writing.
d. plan to give specific examples only for poor performance.

Answer 25

ANS: A, C
During a performance appraisal, it is important to provide examples of both strong and problematic performance and to provide
opportunities to express opinions. The supervisor needs to maintain a relaxed professional manner.