Question 1

The nurse manager of a rehab unit wants to purchase a new anti-embolic stocking.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.

Accepted Answer

In a shared decision model,the decisions are made through an interactive,deliberate process and the staff may express and discuss options and preferences.The shared decision model has been shown to increase work performance and productivity,decrease employee turnover,and enhance employee satisfaction.

Question 2

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.

Accepted Answer

It is generally accepted by many authors and researchers that this statement best defines critical thinking.

Question 3

Sue,a nurse manager,has a staff nurse that has been absent a great deal for the past three 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.

Accepted Answer

Doing nothing is often warranted because of lack of energy,time,or resources to solve the real problem adequately,and because the benefits are not seen as sufficiently compelling to commit to an action.

Question 4

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

Accepted Answer

The unit manager did not begin with an accurate identification of the problem.Problem solving needs to begin with "why?"

Question 5

After the nurses who work on an adolescent psychiatric unit have had a brainstorming session,they are ready to resolve the problem of teenagers who are unmanageable.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.

Accepted Answer

Groups are more likely to be effective if members are involved,the group is cohesive,communication is encouraged,and members demonstrate some understanding of the group process.The nurse leader or manager should provide a nonthreatening and positive environment in which group members are encouraged to participate actively.

Question 6

The risk manager informs the nurse manager of an orthopedic unit that her unit has had an increase in incident reports about 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.

Accepted Answer

Identification of a problem is the first step in problem solving and occurs before any other step.The most common cause for failure to resolve problems is the improper identification of the problem/issue; therefore,problem recognition and identification are considered the most vital steps.

Question 7

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)Consider all the options listed.

Accepted Answer

Decision making involves a goal-oriented consideration of many options that are objectively weighed according to their possible risks,consequences,and positive outcomes.The options should be ranked in the order in which they are likely to result in the desired goals or objectives.The solution selected should be the one that is most feasible and satisfactory and has the fewest undesirable consequences.In this instance,all of the options listed might be considered and weighed.

Question 8

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.

Accepted Answer

An autocratic style is appropriate when rapid decision making is required,such as in a crisis situation.

Question 9

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.

Accepted Answer

The decision model that a nurse uses depends on specific circumstances.Is the situation routine and predictable or complex and uncertain? Is the goal to make a decision that is "just good enough" (conservative)or one that is optimal?

Question 10

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.

Accepted Answer

A fishbone diagram,also known as a cause-and-effect diagram,is useful for determining the reasons (causes)for an effect (falls).

Question 11

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.

Accepted Answer

The hallmark of decision making is choosing among options.Generating options is one phase of decision making,and solving a problem refers to problem solving,which is problem centered.Decision making does not always begin with problems,but rather is defined as a purposeful,goal-directed effort that uses a systematic process to choose among options.

Question 12

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

Accepted Answer

Optimizing is a decision style in which the decision maker selects the option that is best,based on an analysis of the pros and cons associated with each option.A better decision is more likely when using this approach,although it takes longer to arrive at a decision.

Question 13

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

Accepted Answer

In this particular model (a model similar to the nursing model),data collection is the first step toward identifying important alternatives or determining if there is a problem or problems.

Question 14

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.

Accepted Answer

To proceed effectively,it is important to determine if a problem exists and to accurately identify a problem.Failure to resolve problems is most often linked to improper identification of the problem.

Question 15

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.

Accepted Answer

Problem solving is focused on solving immediate problems,whereas decision making is a goal-directed process that is aimed at selecting appropriate actions from among options.Not all decisions begin with a problem.

Question 16

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 unregulated assistant is also available.You must decide which patient situation you will take and where the 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.

Accepted Answer

With this approach,the decision maker selects an acceptable solution,one that may minimally meet the objective or standard for a decision.This approach allows for quick decisions and may be the most appropriate when lack of time is an issue.

Question 17

An outpatient surgery manager is evaluating infusion pumps for 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.

Accepted Answer

Decision-making tools such as decision grids and SWOT analyses are most appropriate when information is available and options are known.

Question 18

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.

Accepted Answer

If the situation is subjective,non-routine,and unstructured or if outcomes are unknown or unpredictable,the nurse leader and manager may need to take a descriptive or behavioral approach.More information (such as degree of risk to the client and to the agency)needs to be gathered to address this situation effectively.

Question 19

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.

Accepted Answer

Two primary criteria make for effective decisions.First,the decision must be of a high quality; that is,it achieves the predefined goals,objectives,and outcomes.Second,those who are responsible for its implementation must accept the decision.Higher-quality decisions are more likely to result if groups are involved in the decision-making and problem-solving process.Taking ownership of the process and outcome provides a smoother transition in changes.

Question 20

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.

Accepted Answer

Brainstorming encourages creativity when one is beginning to problem-solve and avoids premature shutting down of ideas through early evaluation.The goal is to generate ideas,no matter how seemingly unrealistic or absurd.

Quiz 6: Making Decisions and Solving Problems

The nurse manager of a rehab unit wants to purchase a new anti-embolic stocking.To make a high-quality decision,the nurse manager would:

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

Sue,a nurse manager,has a staff nurse that has been absent a great deal for the past three 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?

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

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

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 good nursing decision maker is one who:

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:

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

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

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

An outpatient surgery manager is evaluating infusion pumps for the operating room.The manager should:

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:

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: