1.
The nurse manager is coaching an employee who has been late for work three mornings this week. What statements and questions should the manager include in this coaching session?
Correct Answer(s)
A. “What is causing you to be late?”
B. “When you are late it throws the pace of the entire unit off and client care suffers.”
D. “You have been late three times this week and that is not acceptable.”
E. “What are you going to do to avoid being tardy again?”
Explanation
The correct answer includes statements and questions that address the employee's lateness, its impact on the unit and client care, and the need for improvement. By asking about the cause of lateness, the manager can understand the underlying issue. Highlighting the negative consequences of lateness emphasizes its impact on the unit and client care. Stating that being late three times is unacceptable sets clear expectations. Finally, asking about the employee's plan to avoid future tardiness encourages personal responsibility and problem-solving.
2.
What is the primary reason a nurse manager would confront a nurse who has been reported for violating infection control policy?
Correct Answer
D. To encourage the correct behavior
Explanation
A nurse manager would confront a nurse who has been reported for violating infection control policy to encourage the correct behavior. By addressing the issue directly with the nurse, the manager can provide guidance and education on proper infection control practices, emphasizing the importance of following the policy. This approach aims to promote a safe and healthy environment for both patients and staff, ultimately improving compliance with infection control protocols.
3.
An employee has consistently violated policy and has not responded to coaching. The manager has decided that discipline is required. What should the manager do first?
Correct Answer
C. Make certain that the information regarding policy violations is correct.
Explanation
Before taking any disciplinary action, it is crucial for the manager to ensure that the information regarding policy violations is accurate. This step is important to avoid any potential misunderstandings or wrongful accusations. By confirming the validity of the policy violations, the manager can proceed with confidence in addressing the employee's misconduct. It also demonstrates fairness and professionalism in handling the situation.
4.
Which statement by the nurse manager is the best example of day-to-day coaching?
Correct Answer
D. “Let me show you a method I have found to be effective in making patient assignments.”
Explanation
The answer "Let me show you a method I have found to be effective in making patient assignments" is the best example of day-to-day coaching because it demonstrates a proactive approach to improving the nurse's skills and knowledge. By offering to show a method that has been successful, the nurse manager is providing guidance and support to help the nurse improve their patient assignment skills. This approach focuses on skill development and continuous improvement, which are key aspects of day-to-day coaching.
5.
A certified nurse’s aide (CNA) has been reported to the nurse manager for refusing to perform hand hygiene between clients when providing morning care. Which statement by the nurse manager would be the most effective?
Correct Answer
B. “Forgetting to perform hand hygiene between clients can spread infection.”
Explanation
The nurse manager should choose the statement "Forgetting to perform hand hygiene between clients can spread infection" as the most effective response. This statement highlights the importance of hand hygiene and the potential consequences of not following proper protocols. It educates the CNA about the potential risks associated with their behavior and encourages them to prioritize patient safety by practicing proper hand hygiene.
6.
Coaching and discipline have failed and the nurse manager is faced with no alternative but to terminate an employee. Which aspect of this situation requires the most careful planning?
Correct Answer
C. Accurately documenting all stages of the situation
Explanation
In this situation, the aspect that requires the most careful planning is accurately documenting all stages of the situation. This is important because having proper documentation ensures that there is a clear record of the employee's performance issues, the coaching and discipline measures taken, and the reasons for the termination. Accurate documentation is crucial for legal and HR purposes, as it provides evidence and protection in case of any disputes or legal actions that may arise from the termination. It also helps in maintaining transparency and consistency in the organization's processes.
7.
A terminated employee files a grievance against the nurse manager. Which situations would benefit the employee’s claim?
Correct Answer(s)
B. The terminated employee’s last evaluation discusses problems with performance, but no coaching is described.
E. In one note, the manager describes the employee as “petulant, immature, and uncaring.”
Explanation
The terminated employee's last evaluation discussing problems with performance, but no coaching being described, would benefit the employee's claim because it suggests that the employee was not given the opportunity to improve or receive guidance on how to address the performance issues. Additionally, the manager describing the employee as "petulant, immature, and uncaring" in one note could support the claim of unfair treatment or bias on the part of the manager.
8.
It has been reported to the nurse manager that an employee is repeatedly parking in the patient/visitor parking area. What action should the manager take?
Correct Answer
A. Confront the employee.
Explanation
The correct action for the nurse manager in this situation is to confront the employee. Confronting the employee directly allows the manager to address the issue and communicate the importance of following parking policies. It also gives the employee an opportunity to explain their actions and understand the impact it has on patients and visitors. By directly addressing the problem, the manager can work towards finding a solution and preventing further violations of the parking policy.
9.
A nursing assistant has taken long lunch breaks for the last 2 days and today is 15 minutes late returning from the cafeteria. What should the manager do?
Correct Answer(s)
D. Meet with the assistant and calmly say, “You have been late back from lunch for 3 days this week.”
E. Anticipate that the assistant will give an explanation for the lateness.
Explanation
The manager should meet with the assistant and calmly address the issue of being late back from lunch for 3 days in a row. By having a conversation with the assistant, the manager can express their concern and give the assistant an opportunity to explain the reasons for their lateness. This approach allows for open communication and understanding between the manager and the assistant, which can help in resolving the issue and finding a solution moving forward.
10.
A newly hired certified nurse’s aide (CNA) has been 15 minutes late returning from mealtime 4 days this week. The nurse manager coaches the employee and finds the CNA thought meal breaks were 45 minutes. What is the most appropriate response from the nurse manager?
Correct Answer
B. Show the CNA the break hours in the employee handbook.
Explanation
The most appropriate response from the nurse manager would be to show the CNA the break hours in the employee handbook. This response addresses the issue by providing the CNA with the correct information about meal breaks, allowing them to understand the expectations and avoid future tardiness. It also promotes open communication and education, helping the CNA to improve their performance without immediately resorting to disciplinary measures.
11.
A manager has been informed by a reliable registered nurse that an assistant lied about bathing a client. The manager calls the assistant into the office with a written warning. Why is this action inappropriate?
Correct Answer
C. The assistant should be allowed to discuss the matter.
Explanation
The action of calling the assistant into the office with a written warning without allowing them to discuss the matter is inappropriate because it denies the assistant an opportunity to provide their side of the story or explain their actions. It is important to give the assistant a chance to explain themselves and provide any necessary context before issuing a written warning. This allows for a fair and objective assessment of the situation and ensures that all parties involved have been heard.
12.
A charge nurse on the night shift did not notify the anesthesiologist regarding an emergency case. The manager investigated the matter and learned the charge nurse thought the primary care nurse would call the anesthesiologist. Which response by the manager would be most appropriate?
Correct Answer
B. “It is your responsibility. In the future, call anesthesia and transfer the call to the primary nurse.”
Explanation
The correct answer is appropriate because it acknowledges the charge nurse's responsibility to notify the anesthesiologist and provides a solution for future cases. It addresses the issue directly and provides clear instructions on how to handle similar situations in the future.
13.
The nurse manager identifies a minor problem with the way a staff nurse documents client care. The manager meets with the nurse and discusses the issue, but does not issue a warning. What is the manager’s next action?
Correct Answer
C. Record the specific behavioral steps discussed for future reference.
Explanation
The nurse manager's next action would be to record the specific behavioral steps discussed for future reference. This allows the manager to have a documented record of the discussion and the agreed-upon steps to address the issue with the nurse's documentation. It also serves as a reference point for any future discussions or evaluations regarding the nurse's performance.
14.
The staff has complained that a nurse receives frequent personal phone calls, which is a violation of policy. In what manner should the manager address this nurse?
Correct Answer
A. Meet with the nurse privately and inquire as to the necessity of personal pHone calls.
Explanation
The correct answer is to meet with the nurse privately and inquire as to the necessity of personal phone calls. This approach allows the manager to address the issue directly with the nurse and understand the reasons behind the frequent personal phone calls. It also provides an opportunity for the nurse to explain their situation and for the manager to discuss the policy violation and potential consequences. This approach promotes open communication and allows for a fair resolution to the issue.
15.
A nurse who receives frequent phone calls informs the manager the phone calls are related to a health crisis concerning a family member. Other nurses also receive personal calls, but not as many as the first nurse. Which action by the manager is appropriate?
Correct Answer
B. Discuss with the nurse how personal pHone calls may affect client care and should be limited.
Explanation
The appropriate action for the manager is to discuss with the nurse how personal phone calls may affect client care and should be limited. This option addresses the issue of personal phone calls without completely restricting the nurse's ability to receive important calls related to a health crisis. By having a conversation with the nurse, the manager can communicate the importance of limiting personal calls and ensure that client care is not compromised.
16.
A nurse has frequent visitors while working. The manager has discussed with the nurse the negative effect of these visits on client care. What should the manager do next?
Correct Answer
B. Arrange a follow-up meeting with the nurse.
Explanation
The manager should arrange a follow-up meeting with the nurse because it is important to address the issue directly with the nurse and discuss the negative effect of frequent visitors on client care. This meeting will provide an opportunity to have a detailed conversation about the concerns and find a solution together. It allows the manager to provide guidance, support, and further discuss any necessary actions or changes that need to be made.
17.
A nurse has been pulled from the surgical unit to the ICU unit and is asked by an ICU nurse to administer a medication that requires monitoring the cardiac rhythm. When asked about the client’s cardiac rhythm after the medication was administered, the surgical nurse states, “I don’t know.” What actions should be taken by the unit’s nurse manager?
Correct Answer(s)
A. Meet with the ICU nurse to discuss the situation.
B. Meet with the surgical nurse to discuss the situation.
Explanation
The correct answer is to meet with both the ICU nurse and the surgical nurse to discuss the situation. This is the appropriate action for the unit's nurse manager to take because it allows for open communication and clarification of expectations. Meeting with both nurses together and issuing an informal verbal warning allows for a collaborative approach to addressing the issue and ensures that both nurses understand the importance of monitoring the cardiac rhythm after administering medication. Giving a written warning to either nurse or giving a written warning to the surgical nurse for not following policy would not address the underlying communication issue between the two nurses.
18.
An ICU nurse does not follow policy when administering a medication intravenously. Which would be the most appropriate action by the manager to assist the employee?
Correct Answer
C. Provide a copy of the policy and discuss the rationale for the policy as it relates to client care.
Explanation
The most appropriate action by the manager would be to provide a copy of the policy and discuss the rationale for the policy as it relates to client care. This action allows the manager to address the nurse's non-compliance with the policy in a constructive manner. By providing a copy of the policy, the manager ensures that the nurse has access to the correct information and guidelines for administering the medication. Additionally, discussing the rationale for the policy helps the nurse understand the importance of following it for the well-being and safety of the patients.
19.
An OB nurse has violated a unit policy. The OB manager is discussing the incident with the nurse. During the discussion the nurse informs the OB manager of the actions of other staff and the physician’s attitude leading up to the event. How should the manager address these issues?
Correct Answer
D. Redirect the nurse to focus on the issue.
Explanation
The manager should redirect the nurse to focus on the issue because discussing the actions of other staff and the physician's attitude is not relevant to addressing the policy violation. By redirecting the nurse's attention to the issue at hand, the manager can ensure that the incident is properly addressed and resolved.
20.
The nurse was reported for not following unit policy in relaying a client’s complaint regarding another staff member. During a meeting, the nurse insists he managed the situation appropriately. How should the manager respond?
Correct Answer
B. “Let’s explore some alternative solutions to what happened.”
Explanation
The manager should respond by suggesting to explore alternative solutions to what happened. This response indicates that the manager is open to finding a resolution and is willing to consider different approaches to address the issue. It promotes a collaborative and problem-solving approach rather than placing blame or criticizing the nurse.
21.
An ICU nurse manager has been struggling to correct client care issues on the unit and has asked the unit director for assistance. The director says, “Training and discipline on your unit is your responsibility. I have other things to do.” Now, the manager is faced with disciplining a nurse regarding another client care issue. What is the most significant reason this manager is hesitant to administer this discipline?
Correct Answer
D. The manager does not feel supported by the director.
Explanation
The manager is hesitant to administer discipline because they do not feel supported by the director. This lack of support suggests that the director may not back up the manager's decisions or provide assistance when needed. Without the director's support, the manager may fear facing pushback or resistance from the nurse or the nursing staff. This lack of support can undermine the manager's authority and ability to effectively address client care issues on the unit.
22.
An emergency department (ED) manager is disciplining a nurse with a history of multiple client and staff complaints. The last disciplinary action was a verbal warning. If the institution follows the progressive method of addressing disciplinary issues, the manager would prepare for which action?
Correct Answer
A. A written warning
Explanation
In the given scenario, the nurse has already received a verbal warning as the last disciplinary action. According to the progressive method of addressing disciplinary issues, the next step would be to escalate the disciplinary action to a written warning. This is a more formal and documented form of disciplinary action, indicating that the nurse's behavior or performance issues have not been adequately addressed or improved.
23.
A nurse has complained to the human resources (HR) director regarding unfair treatment by the nurse’s manager. The nurse describes receiving a written warning, unlike other nursing staff who exhibit similar behaviors but are not reprimanded. Which concerns would the HR director discuss with the hospital chief nursing officer?
Correct Answer(s)
C. The apparent inconsistencies in discipline within the unit
D. The potential for litigation that arises from this complaint
Explanation
The HR director would discuss the apparent inconsistencies in discipline within the unit with the hospital chief nursing officer. This is because the nurse has complained about unfair treatment by their manager, specifically mentioning that they received a written warning while other nursing staff who exhibit similar behaviors were not reprimanded. This indicates a lack of consistency in disciplinary actions within the unit, which could be a concern for the hospital. Additionally, the potential for litigation arising from this complaint would also be a topic of discussion as it could have legal implications for the hospital.
24.
A director must discipline an ICU manager. The director and manager have become friends. When disciplining the manager, what is the best approach by the director?
Correct Answer
D. Discuss the issue, concentrate on the issue, and do not make it personal.
Explanation
The best approach for the director when disciplining the ICU manager is to discuss the issue, concentrate on the issue, and not make it personal. This approach allows for a professional and objective discussion about the problem at hand, without damaging the personal relationship between the director and the manager. It ensures that the focus remains on addressing the issue and finding a solution, rather than getting caught up in personal emotions or conflicts.
25.
An OB manager discusses a nurse’s performance with the chief nurse officer (CNO). The CNO learns the nurse has had multiple client and physician complaints that the manager investigated and for which counseling was provided. The behavior continues even though the nurse has received verbal and written warnings. Which course of action would be most appropriate at this time?
Correct Answer
C. Terminate the nurse.
Explanation
Based on the given information, the nurse has had multiple client and physician complaints, and despite receiving verbal and written warnings, the behavior continues. This suggests that the nurse has not responded to previous interventions and is not likely to change their behavior. Therefore, terminating the nurse would be the most appropriate course of action to address the ongoing issue and protect the interests of the clients and physicians.
26.
The hospital’s new management company has assigned a “leadership coach” to groups of current nurse managers. Which statements made by a manager would the coach interpret as indicating the manager does not value this opportunity?
Correct Answer(s)
B. “I’ve been a manager longer than our coach has been a nurse.”
D. “Another new program to waste our time.”
Explanation
The coach would interpret the statement "I've been a manager longer than our coach has been a nurse" as indicating that the manager does not value the opportunity because it suggests that the manager believes they have more experience and knowledge than the coach, therefore implying that they do not need the coach's guidance. The statement "Another new program to waste our time" also indicates a lack of value for the opportunity, as it suggests that the manager sees the coaching program as a waste of time rather than a valuable learning experience.
27.
The manager is contemplating terminating a nurse. What should the manager consider regarding the expectations of the job prior to proceeding with termination?
Correct Answer(s)
A. Did the nurse receive and sign for a copy of the appropriate job description when hired?
B. Was the nurse apprised of the criteria on which evaluation would be based?
C. Have any changes to policy and procedure been discussed with the nurse and made available in writing?
Explanation
The manager should consider whether the nurse received and signed for a copy of the appropriate job description when hired, as this ensures that the nurse is aware of the expectations of the job. The manager should also consider whether the nurse was apprised of the criteria on which evaluation would be based, as this establishes clear performance expectations. Additionally, the manager should consider whether any changes to policy and procedure have been discussed with the nurse and made available in writing, as this ensures that the nurse is aware of any updates or changes that may affect their performance.
28.
The manager has disciplined a nurse with a written warning. At the end of the session, the manager asks the nurse to sign the warning and the nurse refuses. What should the manager do?
Correct Answer
B. Indicate on the form that the nurse declined to sign.
Explanation
The manager should indicate on the form that the nurse declined to sign. This is the appropriate action because it accurately reflects the nurse's refusal to sign the warning. Signing the nurse's name without consent or completing a second warning would be unethical and dishonest.
29.
The manager has just terminated a nurse. What statement by the manager is appropriate?
Correct Answer(s)
C. “I have notified security to escort you as you leave the building.”
D. “As of this time, you are no longer an employee of this institution.”
Explanation
The correct answer is appropriate because it ensures the safety and security of the terminated nurse by notifying security to escort them out of the building. Additionally, it clearly communicates that the nurse is no longer an employee of the institution. This statement provides a sense of finality and clarity to the termination process.
30.
A nurse is being terminated due to continued violation of hospital policy. What statements by the manager are appropriate?
Correct Answer(s)
B. “You may wish to resign rather than being terminated.”
C. “Human resources will answer any questions you may have about benefits.”
E. “You are being terminated for the policy violations I have just outlined.”
Explanation
The manager's statements are appropriate because they provide options and information to the nurse who is being terminated. The statement "You may wish to resign rather than being terminated" gives the nurse the opportunity to leave on their own terms. The statement "Human resources will answer any questions you may have about benefits" shows that the nurse will be provided with support and assistance during the termination process. Lastly, the statement "You are being terminated for the policy violations I have just outlined" clearly communicates the reason for the termination, ensuring transparency and clarity.