Question 1

Which job behaviors would the nurse executive consider troublesome no matter which unit employed the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) The nurse made two medication errors today that resulted in poor client outcomes.
B) A nurse was tardy twice last month due to car trouble.
C) A manager reports that a nurse used a piece of equipment that had been taken out of service for malfunction.
D) A nurse did not report to work for 2 days and did not call in the absence.
E) A physician calls to complain that a nurse was rude.

Accepted Answer

1. Medication errors are serious no matter where they occur.
2. This might or might not be a problem, depending on the unit.
3. Using malfunctioning equipment is a serious problem, no matter where it occurs.
4. Not calling to report intended absence is a serious problem.
5. This might or might not be a problem, depending on the situation.

Question 2

A nurse manager is investigating the application of the principles of equity theory to rewarding staff. Which options are rewards that the manager could influence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) Job satisfaction
B) Prestige
C) Pay
D) Ability
E) Effort

Accepted Answer

1. Job satisfaction is a reward that the manager could influence.
2. The prestige associated with a job is a reward the manager could influence.
3. Pay is a reward the manager could influence.
4. Ability is typically seen as a contribution to the job by the employee.
5. Effort is a job contribution by the employee.

Question 3

The newly licensed nurse is delighted to have been hired at a Magnet hospital and says, "They even assigned me a mentor." What is erroneous about this statement?
A) Magnet hospitals do not hire new graduates.
B) Magnet hospitals do not use mentor programs.
C) Mentors are only assigned to experienced nurses.
D) Preceptors are assigned; mentors choose protégés.

Accepted Answer

1. Magnet hospitals do hire new graduates.
2. Magnet hospitals do use mentor programs.
3. The mentor-protégé relationship is typically between an experienced nurse and a younger, inexperienced nurse. They are not assigned.
4. The nurse is mistakenly describing a preceptor as a mentor. Preceptors are assigned, whereas mentors choose protégés.

Question 4

A nurse manager wishes to use a model of job performance to help match employees and tasks to achieve the greatest effectiveness. What should the manager do first?
A) Evaluate each employee's educational and experiential background.
B) Establish the expectations of each task in writing.
C) Consider how much variation from standard is acceptable.
D) Review unit statistics for incidents, errors, and accidents.

Accepted Answer

1. This evaluation is not the first step of this process.
2. In order to know which employee can do the task, a description of how the task looks when it is done correctly must be established.
3. Variation from standard cannot be assessed until the acceptable standard is established.
4. Using a job performance model focuses on specific individuals, not unit-wide statistics.

Question 5

The staff development nurse has elected to use coaching as a staff development technique. Which situation is an example of this technique?
A) Pairing a newly licensed nurse with a nurse who has worked on the unit for 5 years
B) Matching a newly hired male nurse with a newly hired female nurse
C) Pairing a nurse with conflict management experience with an employee who has expressed dissatisfaction with the job
D) Matching nurses who have similar educational and cultural backgrounds when selecting participants for an educational offering

Accepted Answer

1. Pairing a newly licensed nurse with a nurse who has worked on the unit for 5 years more closely describes preceptorship.
2. Matching a new male nurse and a new female nurse does not describe coaching.
3. Coaching is a strategy suggested to address a nurse's job dissatisfaction.
4. Assigning educational offerings on the basis of similar educational and cultural backgrounds does not represent coaching.

Question 6

After the second week of orientation the new nurse witnesses the death of a child in the ED. Which role should this nurse's preceptor focus on at this time?
A) Orientation of the nurse to protocols associated with this death
B) Socialization of the nurse to the staff
C) Counseling the new nurse
D) Serving as a role model

Accepted Answer

1. The new nurse should be oriented to protocols, but this is not the most important role at this time.
2. The new nurse should be socialized to the staff, but this is not the most important role at this time.
3. In this situation, the most important role is counseling.
4. The preceptor should always act as a role model for the new nurse, but this is not the most important role at this time.

Question 7

The hospital has initiated a new fall risk assessment tool. The nurse manager would like to reward those staff members who use the tool regularly. Which method of reinforcement would be most successful in getting long-term compliance?
A) A coupon for free lunch for staff members each time they use the tool
B) A counseling session with the nurse manager when the assessment tool has not been used
C) A coupon for a free lunch for staff members who, according to a medical record review of nursing documentation, consistently use the tool correctly
D) A pizza party for the staff when there is 100% compliance

Accepted Answer

1. A reward on each instance of a behavior will change behavior but is not as effective for a lasting behavior change. Behaviors learned under a continuous schedule extinguish very quickly once the reinforcement stops.
2. Positive reinforcement is a better way to change behavior than punishment.
3. When giving reinforcement for desired behaviors, the reward should be seen as positive for the employee and based on continued performance.
4. To be most effective the staff member should have as much control as possible over the reward. This is not possible with a pizza party.

Question 8

An experienced nurse often answers less experienced nurses' questions about client care and teaches hemodynamics during orientation to the unit. The nurse has also participated in research into hemodynamic monitoring of ICU clients. Which clinical ladder designation does this nurse best exemplify?
A) Clinical colleague
B) Clinical mentor
C) Clinical leader
D) Clinical expert

Accepted Answer

1. Clinical colleagues are full partners in care, but do not teach or do research.
2. A clinical mentor demonstrates preceptor abilities.
3. A clinical leader demonstrates leadership in practice.
4. The clinical expert combines teaching and research with practice.

Question 9

A registered nurse is dissatisfied with the wages and health benefits available in his current position and decides to seek other employment. This employee's frustration is most linked to which motivational theory?
A) Reinforcement theory
B) Process theory
C) Content theory
D) Equity theory

Accepted Answer

1. Reinforcement theory deals with behavioral modification and the individual's response to positive or negative reinforcement.
2. Process theories emphasize how the motivation process works to direct an individual's effort into performance.
3. Content theories explain why an individual behaves in a particular manner, emphasizing the individual's needs or the rewards that satisfy those needs-in this case, wages and health benefits.
4. Equity theory suggests that effort and job satisfaction depend on the degree of equity, or perceived fairness, in the work situation.

Question 10

The nursing administration has instituted a "horizontal promotion" system within the nursing department. What benefit is this program to the staff nurse?
A) The most competent nurses will rise to managerial positions.
B) It rewards the nurse's clinical excellence.
C) Over time the nurse will move steadily upward through the levels.
D) The process is practice based rather than research based.

Accepted Answer

1. In horizontal promotion, the system rewards clinical excellence by moving clinically superb nurses upward on a clinical ladder, but they remain at the bedside.
2. Horizontal promotion is a reward for clinical excellence.
3. This promotion process is based upon the nurse's clinical excellence, not longevity.
4. The process is based on Patricia Benner's novice-to-expert concepts.

Question 11

A unit secretary is chronically late returning from breaks. The rest of the secretary's work is excellent and he is always helpful and supportive of nurses and client families. The nurse manager has discussed the lateness with him, but it has not stopped. Thinking this might be an attention-seeking behavior, the manager decides to use extinction as a strategy. What should the manager do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) Offer the secretary a free lunch if he can go 1 week without being late.
B) Ignore the behavior.
C) Place a large alarm clock in the break room and set it each time the secretary takes a break.
D) Plan to be away from the secretary's area during his break times.
E) Tell the secretary that one more late return will result in a written critical incident report.

Accepted Answer

1. This is a reward, not extinction.
2. Extinction occurs when the stimulus to continue the behavior is removed. In this case, the secretary will no longer get the manager's attention.
3. This is not the way an adult should be disciplined.
4. If the manager is not there to see the lateness and "reward" the employee with attention, perhaps the behavior will stop.
5. If the manager is correct and this is an attention-seeking behavior, a written critical incident is reinforcing the behavior.

Question 12

In an attempt to decrease tardiness, a hospital gives employees an extra hour's pay for each wage period that the employee has not been late for work. This incentive program is an example of which theory?
A) Expectancy
B) Shaping
C) Equity
D) Goal-setting

Accepted Answer

1. Expectancy theory emphasizes the role of rewards to the employee in order to increase a desired behavior.
2. Shaping is a procedure that involves selectively reinforcing behaviors that are successively closer approximations to the desired behavior.
3. Equity theory is concerned with the conditions under which employees perceive their contribution to the job and the rewards obtained as fair and equitable.
4. Goal-setting theory suggests that it is not the reward or outcomes of task performance per se that causes an individual to expend effort, but rather the goal itself.

Question 13

The nurse manager is concerned about the apparent lack of staff motivation to improve client care on a unit. How should this manager use motivational theories to help improve this situation?
A) Choose one theory that the manager thinks best suits the situation.
B) Review several theories but use no more than two.
C) Combine theories to develop a plan for this specific unit.
D) Review the motivational theories, but don't depend on any of them to work in "the real world."

Accepted Answer

1. Limiting motivation to one theory will narrow the manager's influence. Different workers are motivated in different ways.
2. It is important for the manager to be aware of many theories. Using only two theories narrows the managers' ability to be influential.
3. The manager will encounter workers who are motivated in a variety of ways. The manager should learn about as many theories as possible and combine them to suit the specific population of the unit.
4. There is a significant amount of research that supports the use of these theories in "the real world."

Question 14

There is substantial unrest among the staff of an intensive care unit that has resulted in negative client outcomes. Which employee factors should the manager assess first?
A) Motivation and ability to be effective in the job
B) The age of employees and their social background
C) Gender and educational preparation of staff
D) Experience base of employees and their attitude toward the job

Accepted Answer

1. Research has found an employee's ability and motivation to be the two major dimensions that most affect the employee's effectiveness.
2. The age of employees and their social background may influence job performance but are not as significant as other factors.
3. Educational preparation and gender may influence job performance but are not as significant as other factors.
4. The experience base of employees and their attitude toward the job may influence job performance but are not as significant as other factors.

Question 15

The nurse manager is reviewing the current staff to determine who should precept a newly licensed nurse. Which nurse is the most logical choice?
A) A nurse who needs the temporary pay increase that accompanies precepting
B) A nurse who is clinically competent and has the desire to assume the responsibility to train new staff
C) A nurse who has expressed the desire for additional training and unit responsibilities
D) The nurse who needs to work an 8-hour schedule for a few weeks while recovering from a work-related incident

Accepted Answer

1. The preceptor role may offer a financial incentive, but this is not sufficient reason to choose this nurse.
2. Clinical competence and concern for effective orientation of new nurses are critical attributes for the preceptor.
3. While precepting will be an additional unit responsibility, the focus is on orienting the new nurse, not on increasing a staff nurse's skills.
4. Preceptorship may or may not be based on an 8-hour schedule. Also, a nurse recovering from a work-related incident may not have the focus and energy necessary for precepting.

Question 16

The nurse has expressed job dissatisfaction to the unit manager. The manager assigns another staff member as a coach for this nurse. What is the most important aspect of the coach's job?
A) Get the nurse to explain the cause of the dissatisfaction.
B) Conduct the relationship in a confidential manner.
C) Encourage the nurse to stay in the organization.
D) Help the nurse increase bedside skill competency.

Accepted Answer

1. This is an important strategy, but is not the most important aspect of the relationship.
2. The relationship and the information divulged must be treated in a confidential manner.
3. While it is important to try to get the nurse to stay if possible, this is not the most important aspect of this relationship.
4. There may be nothing wrong with bedside skills. Even if that is the case, this is not the most important aspect.

Question 17

The nurse manager has identified physical assessment skills lacking in a new RN. Using goal-setting theory, which statement by the manager would be the most effective in enhancing the RN's assessment skills?
A) "You need to work on your health assessment skills before your next employee evaluation."
B) "Get someone to help you with your health assessment skills by the end of the month."
C) "Read a health assessment book and practice your skills."
D) "Plan to study one body system a week and demonstrate your assessment skills to me every week."

Accepted Answer

1. Telling the nurse to develop skills without offering a plan will not motivate the nurse.
2. Saying "Get someone to help you" is not managing the process of development.
3. Reading and practicing skills is a good plan, but there is no component of review by the manager to motivate the nurse.
4. A measurable, realistic, and obtainable goal with a component of follow-up will be more motivating to the nurse.

Question 18

A nurse manager has planned orientation activities for a new registered nurse. The new nurse is required to observe shift report and UAP delegation for a week. Then the new nurse is required to take shift report and delegate UAP assignments for a week. What is the rationale for making this orientation assignment?
A) Delegation is not taught at all nursing schools.
B) Shift report differs in all hospitals.
C) Shift report and UAP delegation are minimal tasks and good for novice nurses.
D) The manager should focus on those skills specific to the new nurse's role.

Accepted Answer

1. Delegation is taught in nursing schools, but must be practiced.
2. The fact that shift report may differ in all hospitals is not relevant to this situation.
3. Shift report and UAP delegation are not minimal assignments.
4. Successful orientation requires that the nurse understand job responsibilities. The manager should focus on those items unique to the employee's specific job. Learning how to delegate staff will take time, and orientation is a good opportunity to allow the employee to learn this role.

Question 19

The nurse manager tells a newly licensed nurse that having a mentor is a benefit to career development. What should the new nurse expect from a mentor-protégé relationship?
A) The protégé will select the mentor.
B) Once established, this relationship lasts forever.
C) The relationship will develop through stages.
D) Mentors are generally of the opposite gender as the protégé.

Accepted Answer

1. The mentor typically selects the protégé.
2. These relationships change and often end as the protégé develops.
3. These relationships move through a definable series of stages, just like most relationships.
4. The mentor and protégé are typically the same gender.

Question 20

Which findings associated with an employee are likely to be considered when discussing performance? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) The employee states, "I have to work so that we can have insurance coverage for our disabled child."
B) The employee has been tardy on one occasion when an unexpected snow fell just before shift change.
C) The employee was involved in a motor vehicle crash last fall.
D) The employee found a purse containing $200 in the cafeteria and turned it in to security.
E) The employee made two work errors requiring incident reports in the last year.

Accepted Answer

1. This statement relates more to motivation rather than to performance.
2. Punctuality is a performance measure.
3. Personal accidents that occur when the employee is not on shift are not considered as part of performance.
4. Honesty and trustworthiness are considered performance measures.
5. Work errors are considered performance measures.

Quiz 18: Motivating and Developing Staff

Which job behaviors would the nurse executive consider troublesome no matter which unit employed the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A nurse manager is investigating the application of the principles of equity theory to rewarding staff. Which options are rewards that the manager could influence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

The newly licensed nurse is delighted to have been hired at a Magnet hospital and says, "They even assigned me a mentor." What is erroneous about this statement?

A nurse manager wishes to use a model of job performance to help match employees and tasks to achieve the greatest effectiveness. What should the manager do first?

The staff development nurse has elected to use coaching as a staff development technique. Which situation is an example of this technique?

After the second week of orientation the new nurse witnesses the death of a child in the ED. Which role should this nurse's preceptor focus on at this time?

The hospital has initiated a new fall risk assessment tool. The nurse manager would like to reward those staff members who use the tool regularly. Which method of reinforcement would be most successful in getting long-term compliance?

An experienced nurse often answers less experienced nurses' questions about client care and teaches hemodynamics during orientation to the unit. The nurse has also participated in research into hemodynamic monitoring of ICU clients. Which clinical ladder designation does this nurse best exemplify?

A registered nurse is dissatisfied with the wages and health benefits available in his current position and decides to seek other employment. This employee's frustration is most linked to which motivational theory?

The nursing administration has instituted a "horizontal promotion" system within the nursing department. What benefit is this program to the staff nurse?

In an attempt to decrease tardiness, a hospital gives employees an extra hour's pay for each wage period that the employee has not been late for work. This incentive program is an example of which theory?

The nurse manager is concerned about the apparent lack of staff motivation to improve client care on a unit. How should this manager use motivational theories to help improve this situation?

There is substantial unrest among the staff of an intensive care unit that has resulted in negative client outcomes. Which employee factors should the manager assess first?

The nurse manager is reviewing the current staff to determine who should precept a newly licensed nurse. Which nurse is the most logical choice?

The nurse has expressed job dissatisfaction to the unit manager. The manager assigns another staff member as a coach for this nurse. What is the most important aspect of the coach's job?

The nurse manager has identified physical assessment skills lacking in a new RN. Using goal-setting theory, which statement by the manager would be the most effective in enhancing the RN's assessment skills?

The nurse manager tells a newly licensed nurse that having a mentor is a benefit to career development. What should the new nurse expect from a mentor-protégé relationship?

Which findings associated with an employee are likely to be considered when discussing performance? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.