Question 1

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?

Accepted Answer

The manager should remind the charge nurse that it is ultimately their responsibility to notify the anesthesiologist in emergency cases and provide specific guidance on how to do so. Option A may seem confrontational and option C is incorrect as it is the responsibility of the surgery nurse to call anesthesia. Option D is not relevant to the situation at hand.

Question 2

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?

Accepted Answer

This statement clearly identifies the importance of hand hygiene and its relationship to preventing the spread of infection. It does not use accusatory language or threats, but rather provides education and reinforces the importance of the CNA's role in infection control. The other options either use accusatory language (Option A and D) or are not open-ended enough to promote discussion and education (Option C).

Question 3

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?

Accepted Answer

This response offers a constructive approach to addressing the issue by working together to find alternative solutions. It also encourages open communication and collaboration between the nurse and the manager. It is important to address the issue, but it should be done in a respectful and productive manner. Option A may not address the issue directly and option D may be too confrontational. Option C may be necessary in extreme situations, but it should be a last resort.

Question 4

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?

Accepted Answer

The manager should directly address the issue with the employee to ensure they understand and comply with the parking policy.

Question 5

What is the primary reason a nurse manager would confront a nurse who has been reported for violating infection control policy?

Accepted Answer

The primary reason a nurse manager would confront a nurse who has been reported for violating infection control policy is to encourage the correct behavior. The purpose is to educate the nurse on proper infection control measures and ensure that they understand the potential consequences of not following these policies in order to prevent the spread of infections. While protecting the institution from liability and setting an example for other employees are important factors, the primary goal is to encourage proper behavior and prevent future violations. Punishing the guilty may be a secondary action if necessary, but it is not the primary reason for the confrontation.

Question 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?

Accepted Answer

Accurately documenting all stages of the situation is crucial in case there are legal repercussions or if the terminated employee decides to challenge the decision. It is important to have clear documentation of the disciplinary actions taken before termination and the reason for termination. This can protect the organization from potential lawsuits and provide evidence of professional conduct. While the other aspects mentioned are also important, documenting the situation is the priority.

Question 7

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?

Accepted Answer

The assistant should be allowed to discuss the matter before receiving a written warning.

Question 8

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?

Accepted Answer

Before taking any disciplinary action, the manager should make sure that the information regarding policy violations is correct. It is important to gather evidence, review company policies and procedures, and seek guidance from HR as necessary. This will help ensure that the disciplinary action is fair, consistent, and appropriate for the situation.

Question 9

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?

Accepted Answer

Providing a copy of the policy and discussing the rationale for the policy as it relates to client care would be the best course of action to assist the employee. This will not only improve the nurse's understanding of the policy but also promote quality patient care. Providing written instructions would not address any underlying issues that may have led to the deviation from policy. Remediation may be necessary, but it is not the best first course of action. Reprimanding the nurse would not promote a positive workplace culture and may not address the underlying issue.

Question 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?

Accepted Answer

The most appropriate response would be to show the CNA the break hours in the employee handbook. This will clear up any confusion and prevent future tardiness. It is not necessary to document the behavior or issue a warning at this point. It is also not necessary to implement monitoring of future meal breaks as the issue has been addressed and resolved.

Question 11

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?

Accepted Answer

The appropriate action would be to discuss with the nurse how personal phone calls may affect client care and should be limited. This allows the manager to address the issue without completely prohibiting personal phone use and also addresses the potential impact on client care. Option A is not appropriate as it would not help the nurse in the case of a personal emergency. Option C is not appropriate as it is not clear that the phone calls are causing morale issues. Option D is not appropriate as it would be a violation of policy and set a precedent for other staff members to carry personal cell phones.

Question 12

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?

Accepted Answer

The nurse manager should meet with both the surgical nurse and the ICU nurse to discuss the situation. The surgical nurse needs to be educated on the importance of monitoring the cardiac rhythm after administering the medication, and the ICU nurse needs to be reminded of the importance of providing clear instructions to the surgical nurse.

Question 13

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?

Accepted Answer

1. The physician's attitude is not the issue the manager is addressing at this moment.
2. The nurse is already aware of the policy violation because it has been discussed.
3. The physician's attitude and the staff's actions are not the issue the manager is addressing at this moment.
4. The nurse may be attempting to divert the manager's focus from the nurse to others. The focus of this discussion is the nurse's violation of policy.

Question 14

The nurse manager is coaching an employee who has been late for work three mornings this week. What statements and

Accepted Answer

A) Identifies the cause of the problem.  B) Explains the impact of the behavior on the team and patient care.  D) Clearly states the behavior is unacceptable.  E) Encourages the employee to take responsibility and find a solution.

Question 15

A terminated employee files a grievance against the nurse manager. Which situations would benefit the employee's claim?

Accepted Answer

B) The lack of documented coaching or attempts to improve performance could support the employee's claim of unfair termination. E) Using subjective and potentially biased language like "petulant, immature, and uncaring" could be seen as unprofessional and may support claims of unfair treatment.

Question 16

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?

Accepted Answer

The best course of action would be for the manager to meet with the nurse privately and inquire as to the need for personal phone calls. This approach allows for the manager to gather information about the situation in a non-confrontational manner and discuss any concerns regarding policy violations. It also affords the nurse the opportunity to provide any necessary explanations or seek clarification on the policy. This approach promotes a constructive and proactive approach to the situation.

Question 17

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?

Accepted Answer

Recording the specific behavioral steps discussed will serve as a reference for future follow-up and evaluation of the staff nurse's progress in addressing the issue. It is not necessary to involve human resources or issue a warning at this stage, especially if it was a minor problem that could be resolved through coaching and feedback. Enlisting the aid of a more experienced nurse may also be helpful, but it is not specified in the scenario if this is necessary or feasible.

Question 18

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?

Accepted Answer

The answer of A nursing assistant has taken long lunch...

Question 19

Which statement by the nurse manager is the best example of day-to-day coaching?

Accepted Answer

Day-to-day coaching involves giving specific, constructive feedback and providing guidance on how to improve. Option D is the best example of day-to-day coaching because the nurse manager is offering a practical solution to improve patient assignments. The other options are either too vague or too directive, which doesn't encourage the employee to take ownership of the problem or find their own solutions.

Question 20

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?

Accepted Answer

The next step should be to arrange a follow-up meeting with the nurse to discuss further the issue and explore possible solutions. This allows the manager to work collaboratively with the nurse to address the problem and find a solution that works for everyone involved. Asking staff if the visits have decreased (A) may not provide accurate information as the nurse might not have changed their behavior. Counseling all nursing staff regarding the limitations of personal visitors (C) is not necessary if this is an isolated incident with one nurse. Arranging to be visible on the nursing unit when this nurse is working (D) may not address the root cause of the problem and might not be feasible for the manager to do consistently.

Quiz 19: Coaching, Disciplining, and Terminating Staff