Question 1

________, is the harassment between employees of equal rank.

Accepted Answer

The answer of ________, is the harassment between employees of...

Question 2

A nurse has been discovered using drugs on the unit. Investigation reveals the nurse has likely been diverting and abusing narcotics for some time. What is the likely the worst outcome for this nurse?
A) Administration reports the nurse to the state board of nursing.
B) The nurse is counseled and asked to participate in a treatment center plan.
C) The nurse is allowed to continue supervised practice while a treatment plan is being devised.
D) The nurse's employment is terminated with no report made.

Accepted Answer

1. If this occurs, the nurse is likely to be offered some kind of assistance back into health and the profession.
2. If the nurse agrees to treatment, help is forthcoming.
3. In this case, the nurse is supervised, and a treatment plan is forthcoming.
4. If the nurse's employment is terminated, employment at another facility may occur and the cycle may continue.

Question 3

A nurse manager has been working with a disgruntled employee for several weeks. Today the employee comes to the manager's office with yet another complaint about a new hospital policy. The manager says, "I am sick of your complaining. Leave me alone so I can get some work done." What should the manager do now?
A) Firmly shut the office door.
B) Tell the employee to go to human resources with complaints about the policy change.
C) Apologize to the employee for being unprofessional and ask what the issue with the policy is.
D) Tell the employee to go back to work.

Accepted Answer

1. The manager has made a tactical error and should not just shut the door.
2. There is no reason to send the employee to HR.
3. The manager must remain professional at all times. In this case, when the manager was not professional, an apology is in order.
4. The manager has made a tactical error and should not send this employee back to work.

Question 4

Lack of civility includes behaviors that are what?
A) Ill-mannered
B) Rude
C) Violent
D) Impolite
E) Disrespectful

Accepted Answer

1. Behaviors that indicate lack of civility include those that are ill-mannered, rude, impolite, and disrespectful.
2. Behaviors that indicate lack of civility include those that are ill-mannered, rude, impolite, and disrespectful.
3. Behaviors that indicate lack of civility include those that are ill-mannered, rude, impolite, and disrespectful.
4. Behaviors that indicate lack of civility include those that are ill-mannered, rude, impolite, and disrespectful.
5. Behaviors that indicate lack of civility include those that are ill-mannered, rude, impolite, and disrespectful.

Question 5

Pharmacy reports that the medication records of a unit have begun to show frequent corrections. What other signs of diversion would the manager look for on the unit? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) Chart review on effectiveness of pain control.
B) Increase in clients with conditions requiring pain medications.
C) Increase in use of doses of as-needed narcotics that results in wastage.
D) Chart review that reveals that clients require much more narcotic pain medication on one shift than on others.
E) Narcotic containers that look as if they have been altered.

Accepted Answer

1. If many clients report their pain is not controlled, diversion may be occurring.
2. An increase in clients requiring pain medications is likely census related.
3. If the nurse has a choice of doses and is trying to divert medications, a smaller dose might be given resulting in a larger wastage that is then diverted.
4. If one shift is giving much more pain medication that the other, it may be because someone is diverting drugs on that shift. It may also mean that inadequate pain control is being given on the other shift because someone is diverting drugs.
5. Altering the container is a method of diversion.

Question 6

A nurse manager has had issues with a marginal employee. Staff members have complained several times to the manager regarding this employee's competence. Which action by the manager would be appropriate?
A) Discuss the issues at a staff meeting and elicit methods to improve morale.
B) Use progressive discipline to manage the employee.
C) Monitor the staff's performance to determine the lack of civility.
D) Terminate the employee's employment.

Accepted Answer

1. Discussing the issue of morale and monitoring staff regarding civility will not address the issues regarding the marginal employee.
2. Using progressive discipline to manage the employee allows for communication regarding poor performance and allows the employee the opportunity to improve his or her performance.
3. Discussing the issue of morale and monitoring staff regarding civility will not address the issues regarding the marginal employee.
4. Terminating employment does not provide the employee with an opportunity to improve his or her performance.

Question 7

A nurse is suspected of abusing narcotics. A thorough investigation has been performed, and the nurse will now be notified of the suspicion and investigation. How should this notification be handled?
A) A certified letter outlining the accusation and investigation should be sent to the nurse's home.
B) A certified letter outlining the accusation and investigation should be sent to the nurse at work.
C) The nurse should be contacted and asked to make an appointment with the nurse executive without giving cause.
D) The nurse should be approached at work with no prior notice and asked to come to the nurse executive's office.

Accepted Answer

1. Sending a letter to the nurse's home will give the nurse opportunity to rationalize the abuse, to create a "story," or to develop denial.
2. Sending a letter to the nurse at work will give the nurse opportunity to rationalize the abuse, to create a "story," or to develop denial.
3. If a request to make an appointment with the nurse executive is made, a nurse who is abusing narcotics would likely be suspicious that administration had found out about the abuse.
4. This surprise approach minimizes the amount of time the nurse has to create a story or to rationalize the abuse of narcotics.

Question 8

A nurse comes to a mandatory education session wearing a shirt with a picture and slogan that is degrading to nursing. What should the manager do first?
A) Tell the employee to go home and change.
B) Check the human resources policies regarding appropriate dress.
C) Ask the employee why the shirt was worn to this event.
D) Bring the employee a scrub shirt from surgery to change into.

Accepted Answer

1. This is not the first step of this process.
2. Before the manager does anything else, he or she must be certain that policy backs up the planned actions.
3. This is not the first action the manager should take.
4. This is not the first action the manager should take.

Question 9

A nurse constantly complains about employee policies and procedures and frequently mentions how "they" are "out to get us." The nurse is surprised when referred to by the manager as "disgruntled" during a discussion of this behavior. What information should the manager provide this nurse?
A) "People who are constantly complaining decrease the morale of the rest of the unit."
B) "You have complained so long, it will be impossible to change your behavior."
C) "Being a complainer is a character trait."
D) "Your attitude problem makes everyone else in the unit miserable."

Accepted Answer

1. Disgruntled, complaining employees adversely affect everyone else's morale.
2. Complaining is a behavior, and it can be changed with time, work, and coaching.
3. Complaining is a learned behavior and can be unlearned.
4. Complaining is not an attitude problem as much as a learned behavior.

Question 10

A nurse who has been abusing narcotics is in the nurse executive's office discussing the charges. The nurse executive is trying to convince the nurse to seek treatment for the abuse. Which statement should the nurse executive make?
A) "Health insurances generally pay 100% of treatment charges for medical professionals who are seeking help."
B) "If you go to treatment, the state board will never know you were abusing."
C) "Treatment is your best chance at returning to practice."
D) "We will be able to follow your progress through reports from your treatment team."

Accepted Answer

1. Unfortunately, this is not a true statement.
2. Just going to treatment is not sufficient; the nurse must successfully complete treatment. In some states, the state board must be notified regardless of the decision to seek treatment.
3. The nurse who successfully completes treatment stands the best chance at successfully reentering practice.
4. Unless the nurse gives consent to release information to the nurse executive, this is not possible.

Question 11

A nurse admits to diverting narcotic drugs while working. The manager says, "All nurses who admit diverting narcotics have to be reported to the state board of nursing." How should the nurse interpret this statement?
A) As true, because any nurse who admits diversion must be reported to the state's board of nursing
B) As false, because in some states reporting depends on other factors
C) As beneficial, because the state board of nursing will help the nurse find a substance abuse program
D) As career ending, because the state board of nursing is required to suspend the license of any nurse who admits to diverting drugs

Accepted Answer

1. This is not universally true.
2. In some states, if the nurse completes a substance abuse program, reporting is not done.
3. This is true in some but not all states.
4. This is not a true statement.

Question 12

A nurse who is a chronic complainer comes back from lunch 20 minutes late. When confronted by the manager, the nurse says, "The nurses who smoke always take longer lunches. No one says anything to them." What is the manager's major consideration before replying to this statement?
A) Policies must be consistently applied to all employees.
B) Because the hospital is smoke free, those nurses who wish to smoke must leave campus for lunch.
C) This nurse complains about everything.
D) The human resources policy is that nurses get 60 minutes for lunch.

Accepted Answer

1. No matter the situation, policies must be consistently applied.
2. This may be a fact, but it is not relevant to this discussion.
3. The fact that this nurse is a known complainer is not relevant to the issue.
4. The length of the lunch break is not the most important aspect of this discussion.

Quiz 22: Dealing With Disruptive Staff Problems

________, is the harassment between employees of equal rank.

A nurse has been discovered using drugs on the unit. Investigation reveals the nurse has likely been diverting and abusing narcotics for some time. What is the likely the worst outcome for this nurse?

Lack of civility includes behaviors that are what?

Pharmacy reports that the medication records of a unit have begun to show frequent corrections. What other signs of diversion would the manager look for on the unit? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A nurse manager has had issues with a marginal employee. Staff members have complained several times to the manager regarding this employee's competence. Which action by the manager would be appropriate?

A nurse is suspected of abusing narcotics. A thorough investigation has been performed, and the nurse will now be notified of the suspicion and investigation. How should this notification be handled?

A nurse comes to a mandatory education session wearing a shirt with a picture and slogan that is degrading to nursing. What should the manager do first?

A nurse constantly complains about employee policies and procedures and frequently mentions how "they" are "out to get us." The nurse is surprised when referred to by the manager as "disgruntled" during a discussion of this behavior. What information should the manager provide this nurse?

A nurse who has been abusing narcotics is in the nurse executive's office discussing the charges. The nurse executive is trying to convince the nurse to seek treatment for the abuse. Which statement should the nurse executive make?

A nurse admits to diverting narcotic drugs while working. The manager says, "All nurses who admit diverting narcotics have to be reported to the state board of nursing." How should the nurse interpret this statement?

A nurse who is a chronic complainer comes back from lunch 20 minutes late. When confronted by the manager, the nurse says, "The nurses who smoke always take longer lunches. No one says anything to them." What is the manager's major consideration before replying to this statement?