Deck 15: Making Decisions and Solving Problems

Question 1

During a fire drill,several psychiatric patients become agitated.The nurse manager quickly assigns a staff member to each patient.This autocratic decision style is most appropriate for:

A) routine problems.
B) crisis situations.
C) managers who prefer a "telling" style.
D) followers who cannot agree on a solution.

Answer 1

crisis situations.

Question 2

A clinic nurse has observed another nurse deviating from agency policy in performing wound care.The best approach for the clinic nurse to take is to:

A) stay out of it.
B) inform the nursing supervisor.
C) fill out a notification form (incident report).
D) assess the risk to the client and the agency before proceeding.

Answer 2

assess the risk to the client and the agency before proceeding.

Question 3

Sue,a nurse manager,has a staff nurse that has been absent a great deal for the past 3 months.A whistleblower gives some information to Sue indicating that the staff nurse will be resigning and returning to school.Because of this,Sue decides to do which of the following?

A) Immediately fire the staff nurse.
B) Speak to the whistleblower and elicit more information.
C) Speak to the staff nurse and ask her to resign.
D) Do nothing.

Answer 3

Do nothing.

Question 4

The nurse manager of a rehab unit wants to purchase a new antiembolic stocking for use with patients.To make a high-quality decision,the nurse manager would:

A) involve the rehab staff in the decision.
B) involve the sales representative.
C) make the decision alone.
D) involve administration in the decision.

Question 5

Select the statement that best defines the difference between problem solving and decision making:

A) decision-making skills require critical thinking; problem-solving skills do not.
B) problem-solving skills require critical thinking; decision-making skills do not.
C) decision making is a goal-directed effort; problem solving is focused on solving an immediate problem.
D) problem solving is a goal-directed effort; decision making is focused on solving an immediate problem.

Question 6

Decision making is described by the nursing educator as the process one uses to:

A) solve a problem.
B) choose between alternatives.
C) reflect on a certain situation.
D) generate ideas.

Question 7

After the nurses who work on an adolescent psychiatric unit have had a brainstorming session,they are ready to resolve the problem of unmanageable teenage patients.To maximize group effectiveness in decision making and problem solving,the nurse manager has:

A) prevented conflict.
B) formed highly cohesive groups.
C) used majority rule to arrive at decisions.
D) encouraged equal participation among members.

Question 8

An outpatient surgery manager is evaluating new infusion pumps for purchase to use in the operating room.The manager should:

A) select the least expensive brand.
B) use a decision-making tool to evaluate brands.
C) ask the nursing staff which brand they prefer.
D) select the vendor the institution usually buys from.

Question 9

When confronted with the controversy and the apparent poor morale of the evening staff,the unit manager decided the staff needed to take some time off.He scheduled holidays for the staff without consulting them.A couple of the staff nurses approached the manager and indicated that the problem was not scheduling,but rather the team leader and her patient assignments.What was the unit manager's first missed step in problem solving?

A) Not using a problem-solving model
B) Not considering a number of alternatives
C) Poor evaluation of outcomes
D) Incorrect problem identification

Question 10

John Smith,one of three managers at BSG Labs,drafted a policy that would allow his department to do more testing in his lab.This policy included the times for regular collection as well as a new process for emergency laboratory testing.The policy and procedures were never followed.The reason was that:

A) the policy was too lengthy and inundated readers with too much detail.
B) the policy made decisions for other departments in the company.
C) the staff did not believe that the new policy would be effective.
D) testing should not be done in the lab.

Question 11

From the information supplied in this chapter,which statement best defines critical thinking? Critical thinking is a:

A) high-level cognitive process.
B) process that helps to develop reflective criticism for the purpose of reaching a conclusion.
C) high-level cognitive process that includes creativity, problem solving, and decision making.
D) discussion that guides the nursing process.

Question 12

In a rural hospital,the unit for which you are charge nurse has a particularly busy morning.A 52-year-old patient is complaining of left-sided chest pain and a multiparous patient is about to deliver.A child with asthma is experiencing early signs of an attack.The other RN on the unit is a recent graduate who has not yet been orientated to the labor room and has limited cardiac nursing experience.An unlicensed assistant is available to assist.You must decide which patient situation you will take and where the new graduate RN's skills can best be used.Given the limitations in skills and experience,number of staff available,and time constraints,you must make a decision that involves:

A) a higher order thinking process.
B) selecting the best option for reaching a predefined goal.
C) optimizing.
D) satisficing.

Question 13

The risk manager wants to evaluate the reasons for an increased number of falls on the rehab unit.The risk manager devises a fishbone diagram.A fishbone diagram is a useful tool to:

A) identify the root causes of problems.
B) list possible solutions to problems.
C) help leaders select the best options.
D) evaluate the outcomes of decisions made.

Question 14

A good nursing decision maker is one who:

A) uses various models to guide the process based on the circumstances of the situation.
B) adopts one model and uses it to guide all decision making.
C) decides not to use any models because they are all useless.
D) develops a new model each time a decision has to be made.

Question 15

Justin is a nurse manager in a rehabilitation unit in a small urban center.There is a high turnover rate among rehab-assistants because of the heavy work assignments.Despite his need for staff,Justin decides to review each application thoroughly and interview candidates carefully because he recognizes that it is important to hire staff who can best provide high-quality care and who will fit well with the team.Which of the following decision-making models did Justin use in making his decision?

A) Subjective model
B) Objective model
C) Optimizing model
D) Satisficing model

Question 16

The maintenance department wishes to have the nursing lounge renovated,so the lounge will be more "user-friendly." The department asks the nursing staff to make a wish list of everything that they would like to see in the new lounge.This process is an example of which part of the decision-making process?

A) Assessment/Data collection
B) Planning
C) Data interpretation
D) Generating hypotheses

Question 17

Several nurses on an adolescent psychiatric unit complain that the teens are becoming unmanageable on the 0700-1900 shift.To resolve this problem,the nurse manager decides that the staff should have a brainstorming session.The goal of brainstorming is to:

A) evaluate problem solutions.
B) critique the ideas of others.
C) generate as many solutions as possible.
D) identify only practical and realistic ideas.

Question 18

The risk manager informs the nurse manager of an orthopedic unit that her unit has had an increase in incident reports related to patients falling during the 11-7 shift.The nurse manager knows that the best way to resolve the problem is to:

A) use creativity.
B) obtain support from the 7-3 shift.
C) use institutional research.
D) identify the problem.

Question 19

To solve a problem,the nurse manager understands that the most important problem-solving step is:

A) the implementation phase.
B) identification of numerous solutions.
C) accurate identification of the problem.
D) evaluation of the effectiveness of problem resolution.

Question 20

Justin is a nurse manager in a rehabilitation unit in a small urban center.There is a high turnover rate among rehab-assistants because of the heavy work assignments.Despite his need for staff,Justin decides to review each application thoroughly and interview candidates carefully because he recognizes that it is important to hire staff who can best provide high-quality care and who will fit well with the team.Which of the following decision-making solutions should Justin consider to have a more efficient department?

A) Replace staff only with qualified applicants.
B) Determine what the problem or problems are before hiring new staff.
C) Consult with the human resources department and develop a plan for hiring new staff.
D) All listed are appropriate to consider.

Question 21

Knowing when to have the entire team participate in the decision-making process or when to have only the team leader make the decisions depends on the situation and the desired outcomes.The autocratic process is used in which of the following situations?

A) The task and the outcome are relatively simple and defined.
B) It is unlikely that the group will reach a consensus.
C) A decision has to be discussed thoroughly.
D) A number of options need to be considered.

Question 22

Jane,an experienced head nurse,is given the task of completing the summer vacation schedule for the pediatric unit.She is fully aware of the hospital's restrictions on time off and the number of staff on vacation at any given time,as well as its issues regarding seniority.She weighs the options of allowing staff choice,such as it takes more time but gives employees options.However,if choice is allowed,this could cause arguments.Which of the following is the best alternative?

A) Ask for requests for vacation time in advance, and post the times.
B) Post the completed vacation schedule.
C) Post a tentative schedule, and request feedback.
D) Post a blank schedule, and ask staff members to fill in their times by a given date.

Question 23

In a busy rehabilitation unit,the team manager decided that the best way to reward the staff was to give them a monetary bonus rather than time off.The staff was very concerned about the decision and went to the administration with a number of complaints.Critical thinking is a process that entails a number of steps.What steps did the manager omit? She should have:

A) identified what assumptions were underpinning the issues.
B) considered why it was important to make this change or the context for the change.
C) considered how this change might affect staff relationships.
D) attained a majority consensus of all staff.

Question 24

High-quality decisions are most likely to be made in nursing situations when:

A) team leaders make the crucial decisions.
B) individuals are advised of the problems.
C) group size is neither too small nor too large.
D) members are passively involved.

Question 25

The agency in which you are a nursing leader makes a decision to reduce the number of RN positions in favor of PN positions because agency data suggest that the clients in the agency can receive appropriate care from PN staff.Furthermore,the agency is facing a decline in funding and without restructuring,some clients might not receive services at all.You provide this information on this decision to the staff and ask them to advise you if they have any feedback,concerns,or alternative solutions.This decision-making style is known as:

A) paternalistic.
B) shared.
C) reasoned
D) informative.