Deck 9: Personnel Policies and Programs in the Workplace

Question 1

Which of the following is a risk factor for hospital workplace violence?

A)Unlimited security coverage
B)Public availability 24 hours a day
C)Insecure medication access
D)Semiprivate rooms

Answer 1

Public availability 24 hours a day

Question 2

In the workplace, violence may escalate as a result of many factors.Which of the following should the nurse be alert for in the escalation to violence?

A)Crying
B)Isolation
C)Asking for help
D)Pacing and using profanity

Answer 2

Pacing and using profanity

Question 3

Family members who have access to hospitals may present risks to the staff when which of the following is most likely present?

A)Family members are not doing well.
B)Family members are in the intensive care unit.
C)Family members are under the influence of drugs or alcohol.
D)Family members are unable to visit regularly.

Answer 3

Family members are under the influence of drugs or alcohol.

Question 4

When analyzing the sources for conflict, the nurse manager may identify which of the following as one of the most likely sources?

A)Different attitudes
B)Different facts or perception of the event
C)Different incomes
D)Different ages

Question 5

What is a recommendation from the Occupational Health and Safety Administration for prevention of violence in the workplace?

A)Assign different shifts.
B)Provide training and education.
C)Point out the issues to the people involved.
D)Arrange for the people involved to meet and discuss the issues.

Question 6

Workplace violence can be initiated by an employee in the workplace as well as by patients or family members.Which of the following would be cause for concern when observed in an employee?

A)Divorce
B)Personality changes
C)Death in the family
D)Miscarriage

Question 7

Horizontal conflict in the workplace is observed with which of the following situations?

A)Discussion with the manager before escalation occurs
B)Refusing to work on day off
C)Sharing views on patient care
D)Withholding information that will undermine the ability to perform his job

Question 8

Universal strategies to use in the presence of escalation of a potential violent situation include which of the following?

A)Demand that the potentially person back off.
B)Remain close to the patient to protect her.
C)Remain calm with a caring attitude.
D)Speak loudly with authority.

Question 9

The AACN has addressed the issue of horizontal violence in the workplace and made recommendations for actions by the nurse manager.Which of the following are recommendations for action by the AACN against workplace horizontal violence?

A)Develop a culture that does not tolerate violence.
B)Report all incidences to upper management.
C)Separate the two people by not assigning them to work on the same shifts.
D)Ask the two people to sit down and work it out.

Question 10

There are three steps to conflict management: determining the basis, analyzing the source, and conflict resolution.Which of the following may be the most likely source for conflict between a patient and the health care provider in the workplace?

A)Food served
B)Medication effects
C)Ethical dilemmas
D)Smoking withdrawal

Question 11

The nurse working the night shift has concerns about the safety of the unit.What would cause security concerns for this nurse?

A)A visitor is sleeping in the recliner in the room with their family member.
B)A parent stays overnight with their teenage child.
C)No unit secretary is assigned for the night shift.
D)She is working with only one other employee.

Question 12

Most organizations provide assistance to employees with problems that can affect their work performance.They provide assistance with issues ranging from financial issues to personal relationship issues.Which of the following best describes these programs?

A)Faith-based initiatives
B)Free confidential employee assistance programs (EAPs)
C)Fee-for-service private counseling
D)The nurse manager fills this role in most institutions.

Question 13

The nurse manager works regularly with a nurse who has recently gone through a custody battle with her ex-husband.The nurse manager has become concerned about some of the changes in appearance of the nurse.One evening the nurse comes to work and seems "giddy" and is acting inappropriately.The nurse manager understands that she must take which of the following actions?

A)Counsel the nurse on these observations.
B)Report this behavior to human resources and the state board of nursing.
C)Give her the evening off.
D)Work closely with her to prevent unsafe care to the patients.

Question 14

Human resources is required to provide education on violence prevention and management, which is tracked by the state board of health and The Joint Commission.Which of the following would the nurse expect to find in an education program required by state and federal health care regulatory agencies about violence prevention in the workplace?

A)Location of all monitoring equipment
B)Schedule of security officers rounds
C)Early recognition and response plan
D)Identification of people most at risk for causing harm

Question 15

A nurse is confronted by a visitor and is threatened to be hurt when she gets to her car.What action is best for the nurse to take to protect herself?

A)Call security and notify them of the threat.
B)Ask security to escort you to your car.
C)Explain to the visitor that you carry a gun.
D)Assume that this was a joke.

Question 16

What methods can administration use for the prevention of workplace violence?

A)Separate staff entrance
B)Staff ID badges
C)Separate parking for staff
D)Visual presence of security at all times

Question 17

Employees who are dependent on drugs or alcohol will exhibit signs that should not be ignored by the nurse manager and colleagues.Which of the following signs would alert the nurse manager that the employee may have a dependency problem?

A)Changes in behavior or appearance
B)Requesting time off to be with a family member
C)Scheduled overtime
D)Dieting

Question 18

A nurse is working the night shift with another RN who keeps disappearing without explanation.The nurse is caught napping in a patient's room.What is the best action by the discovery nurse to take?

A)Confront the nurse and ask what is wrong.
B)Report the behavior to the vice president of nursing.
C)Ask to not be scheduled on the same nights again.
D)Report the behavior to the nurse manager.

Question 19

When determining the basis for conflict, interpersonal sources as the basis would include which of the following?

A)Personality differences
B)Shift preferences
C)Staffing inconsistency
D)Assignments

Question 20

After reporting a nurse with a substance abuse problem to the State Board of Nursing (SBON), the next step that will most likely occur is

A)surrender of license if complaint is found to be valid.
B)counseling and then the nurse can return to work.
C)the nurse is fired.
D)the nurse is prevented from ever working as a nurse again.

Question 21

A male nurse is working with female nurses on a unit.One of the female nurses is overheard talking about how cute the male nurse is.The nurse overhearing this comment should be expected to do which of the following?

A)Notify the nurse manager.
B)Tell the male nurse that the female nurse was making inappropriate comments.
C)Nothing, this is not harassment.
D)Warn the nurse that the conversation was overheard.

Question 22

Upper-level managers are responsible for the management of the nursing organization of the institution.What activity would the nurse expect to see only from an upper-level manager?

A)Supervising patient care delivery
B)Establishing strategic goals for nursing
C)Maintaining currency in profession
D)Being responsible for activities on the unit 24/7

Question 23

A patient admitted with an elevated ST-segment myocardial infarction on oxygen per nasal cannula for his diagnosed influenza is complaining of shortness of breath with an oxygen saturation of 88%.The albuterol treatment provides no relief.What is the next best action by the RN?

A)Increase the oxygen concentration and recheck the saturation after 10 minutes.
B)Obtain a 12-lead ECG.
C)Notify the health care provider.
D)Call the patient's wife to have her sit with him to calm him.

Question 24

There are three levels of management in nursing.Which action by the nurse would indicate the nurse is a first-line nurse manager?

A)Responding to a patient complaint
B)Deciding to incorporate walking rounds shift report hospitalwide
C)Reevaluating the nursing policy permitting IV push of certain medications by RNs
D)Designating assignment of new admissions

Question 25

Which patient should be considered the highest priority by the charge nurse?

A)A patient who is complaining that no one answers his call light
B)A patient who is threatening to leave AMA with tubes and drains in place from a surgical procedure
C)A confused patient who is attempting to get out of bed
D)A patient who is asking for help to the bathroom

Question 26

A patient admitted with an elevated ST-segment myocardial infarction (MI) on oxygen per nasal cannula for his diagnosed influenza is complaining of shortness of breath with an oxygen saturation of 88%.Respiratory therapy administers an albuterol treatment that provides no change in the oxygen saturation.What is the next best action by the RN is best?

A)Obtain a 12-lead ECG.
B)Notify the health care provider.
C)Call the patient's wife to have her sit with him to calm him.
D)Ask the UAP to obtain a blood glucose level.

Question 27

A student nurse is working with a preceptor who appears abrupt and disinterested in precepting students.What action by the student is most appropriate?

A)Notify the instructor.
B)Talk with the nurse to see what is wrong.
C)Identify this as lateral violence.
D)Nothing, he was having a bad day.

Question 28

The nurses are complaining about how busy they are this shift.The charge nurse must do which of the following to ensure the safety of the patients and staff for this and future shifts?

A)Take responsibility for a team of patients.
B)Delegate care to the UAPs.
C)Assist the RNs to prioritize their patients and their responsibilities.
D)Call the supervisor for more staff.

Question 29

A patient admitted with an elevated ST-segment myocardial infarction on oxygen per nasal cannula for his diagnosed influenza continues to experience shortness of breath and has no ECG changes.What is the next best action by the RN is best?

A)Call the patient's wife to have her sit with him to calm him.
B)Ask the UAP to obtain a blood glucose level.
C)Call the Rapid Response Team.
D)Ask the charge nurse to check on the other patients.

Question 30

The nurse manager receives a telephone call from an RN saying she will be late because of traffic due to an accident.The charge nurse needs to make arrangements for the care of that nurse's team of patients until her arrival.What is the best action to take to ensure the management of those patients until the RN arrives?

A)Distribute the patients evenly to each of the other nurses.
B)The charge nurse will take the assignment until the RN's arrival.
C)Ask the nurse manager to assume care temporarily.
D)Ask the night nurse to stay until the RN's arrival.

Question 31

The management process consists of six functions: planning, staffing, organizing, directing, controlling, and decision making.What might be seen in the decision-making process?

A)Organizing a meeting to address the problem
B)Establishing an alternate site within the hospital for these patients
C)Assigning experienced staff to implement care of these patients
D)Establishing the new area as a step-down unit

Question 32

Which patient should be considered the highest priority by the new RN?

A)A patient who is requesting his pain medication
B)A patient who is reported by the UAP to be choking
C)A patient who is requiring suctioning per tracheostomy
D)A patient who is requiring discharge instructions who is waiting at the desk with her family

Question 33

Middle-level managers are responsible for planning for changes of the unit.What activity would the nurse expect to see only from a middle-level manager?

A)Maintaining currency in profession
B)Planning for changes within the service line in the organization
C)Being responsible for activities on the unit 24/7
D)Supervising patient care delivery

Question 34

Arrange in order of priority the nurse's actions when a patient admitted with an elevated ST-segment myocardial infarction on droplet precautions and oxygen per nasal cannula for his diagnosed influenza is complaining of shortness of breath with an oxygen saturation of 88%.
1)Call the rapid response team (RRT).
2)Obtain a chest radiograph.
3)Obtain a 12-lead ECG.
4)Initiate a bronchodilator nebulizer treatment.
5)Increase the oxygen concentration 2 L.
6)Repeat the oxygen saturation in 10 minutes.

A)5, 3, 2, 4, 6, 1
B)1, 4, 2, 5, 6, 3
C)4, 5, 6, 3, 1, 2
D)5, 4, 3, 6, 2, 1

Question 35

A patient admitted with an elevated ST-segment myocardial infarction on oxygen per nasal cannula for his diagnosed influenza is complaining of shortness of breath with an oxygen saturation of 88%.Which action by the RN is best?

A)Increase the oxygen concentration.
B)Ask respiratory therapy to administer an albuterol treatment.
C)Notify the health care provider.
D)Determine if anxiety could be causing the shortness of breath.

Question 36

Which of the following patients should the charge nurse admit to a room with a patient who is confused and incontinent of stool?

A)A postoperative patient
B)A patient with diabetes
C)A patient who is going to surgery later today
D)A patient from the cardiac catheterization lab who is going home in the morning

Question 37

Which activity should be considered the highest priority by the RN?

A)Assessment of a stable patient ready for discharge
B)Administration of daily medications
C)Administration of STAT medications
D)Discharge teaching for a patient with heart failure

Question 38

The management process consists of six functions: planning, staffing, organizing, directing, controlling, and decision making.What might be seen in the planning step of the process?

A)Identifying the problem of the lack of ICU beds
B)Organizing a meeting to address the problem
C)Establishing an alternate site within the hospital for these patients
D)Assigning experienced staff to implement care of these patients

Question 39

Which patient should be considered the highest priority by the nurse manager?

A)A patient who attempts suicide
B)A patient who attempts to escape from the hospital
C)A patient who refuses to eat
D)A patient who refuses her medications

Question 40

First-level managers are responsible for the day-to-day activities of the unit.Which activity would the nurse expect to see only from a first-level manager?

A)Making daily staffing assignments
B)Managing the unit's budget
C)Maintaining currency in profession
D)Making daily patient rounds

Question 41

What step in the employment process may have been omitted when the staff appears to be nervous and overly cautious around a new nurse manager?

A)Involvement of human resources in the interview process
B)Involvement of the upper-level manager in the interview process
C)Involvement of the staff in the interview process
D)Involvement of the middle-level manager in the interview process

Question 42

What are some tools available for the nurse manager to use for conflict resolution? (Select all that apply.)

A)Prevention
B)Negotiation
C)Cooperation
D)Resentment
E)Rejection

Question 43

Personal and financial issues, as well as drugs or alcohol, can impair employees and can precipitate violence.The nurse manager and all staff must be aware of the signs of drug or alcohol use.Which of the following indicators should concern the nurse manager in an employee when addressing violence in the workplace? (Select all that apply.)

A)Recent divorce
B)Troubled adolescent
C)Tremors of the hands
D)House foreclosure
E)Religious counseling

Question 44

The role of the charge nurse is a relatively new role in nursing.What responsibilities would the nurse expect to see from the charge nurse? (Select all that apply.)

A)Making daily patient care assignments
B)Troubleshooting problems occurring during shift
C)Providing coverage for breaks
D)Taking turns floating to another unit
E)Assisting staff as needed

Question 45

What methods can the nurse manager use to address horizontal violence in the workplace? (Select all that apply.)

A)Provide training to staff.
B)Pick a side so that the assaults do not include you.
C)Name the problem "horizontal violence."
D)Observe and analyze the culture of the workplace.
E)Have the victim file a grievance.

Question 46

In an escalating situation, the nurse should observe certain rules to protect herself from violence.Which of the following are good rules to keep in mind if one is ever in a violent situation? (Select all that apply.)

A)Remove yourself from the situation.
B)Speak loudly with authority.
C)Call for help.
D)Do not allow the person to stand between you and the door.
E)Stand in a corner against a wall.

Question 47

In what ways is the environment controlled by the hospital safety committee to prevent workplace violence? (Select all that apply.)

A)Emergency alarms
B)Cameras and videos
C)Assigned patrol for each unit
D)Security provided for visitors in parking lots, etc.
E)Respond only when called