RN 402 Exam 4 Questions With
Answers 100% Verified
A nurse manager of a 20-bed medical unit finds that 80% of the patients are
older adults. She is asked to assess and adapt the unit to better meet the unique
needs of the older adult patient. Using complexity principles, what would be the
best approach to take for implementation of this change?
a. Leverage the hierarchical management position to get unit staff involved in
assessment and planning.
b. Engage involved staff at all levels in the decision-making process.
c. Focus the assessment on the unit and omit the hospital and community
environment.
d. Hire a geriatric specialist to oversee and control the project. - ANSWER b.
Engage involved staff at all levels in the decision-making process.
*****A unit manager of a 25-bed medical/surgical area receives a phone call
from a nurse who has
called in sick five times in the past month. He tells the manager that he very
much wants to
come to work when scheduled but must often care for his wife, who is
undergoing treatment for breast cancer. According to Maslow's need hierarchy
theory, what would be the best approach to satisfying the needs of this nurse,
other staff, and patients?
a. Line up agency nurses who can be called in to work on short notice.
b. Place the nurse on unpaid leave for the remainder of his wife's treatment.
c. Sympathize with the nurse's dilemma and let the charge nurse know that this
nurse may be calling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his
scheduled days off around his wife's treatments. - ANSWER d. Work with the
nurse, staffing office, and other nurses to arrange his scheduled days off around
his wife's treatments.
A grievance brought by a staff nurse against the unit manager requires
mediation. At the first mediation session, the staff nurse repeatedly calls the unit
manager's actions unfair, and the unit manager continues to reiterate the
reasons for the actions. What would be the best course of action at this time?
a. Send the two disputants away to reach their own resolution.
,b. Involve another staff nurse in the discussion for clarity issues.
c. Ask each party to examine their own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the
conflict. - ANSWER c. Ask each party to examine their own motives and issues in
the conflict.
At a second negotiation session, the unit manager and staff nurse are unable to
reach a resolution. What is the appropriate next step?
a. Arrange another meeting in a week's time so as to allow a cooling-off period.
b. Elevate the next negation session to the next manager, one level above.
c. Insist that participants continue to talk until a resolution has been reached.
d. Back the unit manager's actions and end the dispute. - ANSWER b. Elevate
the next negation session to the next manager, one level above.
The manager of a surgical area has a vision for the future that requires the
addition of RN assistants or unlicensed persons to feed, bathe, and ambulate
patients. The RNs on the staff have always practiced in a primary nursing-
delivery system and are very resistant to this idea. What would be the best initial
strategy for implementation of this change?
a. Exploring the values and feelings of the RN group in relationship to this
change
b. Leaving the RNs alone for a time so they can think about the change before it
is implemented
c. Dropping the idea and trying for the change in a year or so when some of the
present RNs have retired
d. Hiring the assistants and allowing the RNs to see what good additions they
are - ANSWER a. Exploring the values and feelings of the RN group in
relationship to this change
****As the RN charge nurse on the night shift in a small long-term care facility,
you've found that there is little turnover among your LPN and nursing assistant
(NA) staff members, but they are not very motivated to go beyond their job
descriptions in their work. Which of the following strategies might motivate the
staff and lead to greater job satisfaction?
a. Ask the director of nursing to offer higher wages and bonuses for extra work
for the night LPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the scope of
their positions in the institution.
c. Hire additional staff so that there are more staff available for enhanced care,
and individual workloads are lessened.
d. Ask the director of nursing to increase job security for night staff by having
them sign contracts that guarantee work. - ANSWER b. Allow the LPNs and NAs
greater decision-making power within the scope of their positions in the
institution.
,A new graduate nurse wonders about the directions that her preceptor has
given her regarding management of incontinent, confused patients. The new
nurse brings the preceptor evidence-based information she located regarding
incontinence interventions for confused patients and asks to talk about the
guidance that given after the preceptor reviews the information in the article.
What is the new nurse demonstrating in this situation? (Select all that apply.)
a. Assertiveness
b. Followership
c. Management
d. Insubordination - ANSWER a. Assertiveness
b. Followership
The nurse manager wants to increase motivation by providing motivating factors
for the nurse on the unit. What action would be appropriate to motivate the staff?
a. Collaborate with the human resource/personnel department to develop on-
site daycare services.
b. Provide a hierarchical organizational structure
c. Implement a model of shared governance - ANSWER c. Implement a model of
shared governance
The unit is shifting from primary nursing to a team model in an effort to contain
costs. Staff members are upset about the change and ask for a meeting to
discuss the new model. After hearing their concerns related to reduction in
professional autonomy, what is the initial response by the manager to address
the concerns?
a. Acknowledge the loss.
b. Explain the reasons for change, emphasizing the need to reduce costs.
c. Repeat the information several times, giving detailed budget overviews.
d. Adjourn the meeting and provide explanation through e-mail. - ANSWER a.
Acknowledge the loss.
****A charge nurse on a busy 40-bed medical/surgical unit is approached by a
family member who begins to complain loudly about the quality of care his
mother is receiving. His behavior is so disruptive that it is overheard by staff,
physicians, and other visitors. The family member leaves the unit abruptly, and
the nurse is left feeling frustrated. Which behavior by the charge nurse best
illustrates refined leadership skills in an emotionally intelligent practitioner?
a. Reflect to gain insight into how the situation could be handled differently in
the future.
b. Try to catch up with the angry family member to resolve the concern.
c. Discuss the concern with the patient after the family member has left.
d. Notify nursing administration of the situation. - ANSWER a. Reflect to gain
insight into how the situation could be handled differently in the future.
During a staff meeting held to discuss developing a mission statement for the
unit, the idea of placing patient needs first is discussed. What is considered
, when the suggestion by the manager is for the unit mission to be derived from
the organization mission?
a. Empowering
b. A leadership tag
c. A symbol
d. A management task - ANSWER b. A leadership tag
The chief nursing officer has asked the staff development coordinator to
facilitate the development of a clinical competency program for the facility.
While making rounds on the units, the staff development coordinator overhears
RN staff complaining that they feel it is insulting to be required to participate in a
competency program. What behavior by the staff development coordinator is
most appropriate in this situation?
a. Disregard staff concerns and continue with development of the program.
b. Inform the nurses that this program is a requirement for JCAHO
accreditation.
c. Schedule a meeting with the chief nurse executive to apprise her of the
situation.
d. Facilitate a meeting so nurses can articulate their values and concerns about
a competency program. - ANSWER d. Facilitate a meeting so nurses can
articulate their values and concerns about a competency program.
A dispute arises between an RN and an LPN over a patient issue. The tension
continues between the two and begins to affect other staff members, who are
drawn into the conflict. Over time, the team becomes polarized toward either the
RN or the LPN. How might this situation be prevented?
a. Expediency in responding to the initial dispute, once it became apparent that
it could not be resolved by the two parties themselves
b. Asking other staff members what the real issues were in the dispute between
the RN and the LPN
c. Reassigning one of the parties to another unit when it became apparent that
the two individuals could not resolve the dispute themselves
d. Calling a staff meeting at the onset of the dispute to allow the team and the RN
and LPN to discuss the initial dispute - ANSWER a. Expediency in responding to
the initial dispute, once it became apparent that it could not be resolved by the
two parties themselves
The nurse manager has been asked to implement an evidence-based approach
to teach ostomy patients self-management skills postoperatively. The program
is to be implemented across the entire facility. What illustrates effective
leadership in this situation?
a. The training modules are left in the staff room for times when staff are
available.
b. The current approach is continued because it is also evidence-based and is
more familiar to staff.
Answers 100% Verified
A nurse manager of a 20-bed medical unit finds that 80% of the patients are
older adults. She is asked to assess and adapt the unit to better meet the unique
needs of the older adult patient. Using complexity principles, what would be the
best approach to take for implementation of this change?
a. Leverage the hierarchical management position to get unit staff involved in
assessment and planning.
b. Engage involved staff at all levels in the decision-making process.
c. Focus the assessment on the unit and omit the hospital and community
environment.
d. Hire a geriatric specialist to oversee and control the project. - ANSWER b.
Engage involved staff at all levels in the decision-making process.
*****A unit manager of a 25-bed medical/surgical area receives a phone call
from a nurse who has
called in sick five times in the past month. He tells the manager that he very
much wants to
come to work when scheduled but must often care for his wife, who is
undergoing treatment for breast cancer. According to Maslow's need hierarchy
theory, what would be the best approach to satisfying the needs of this nurse,
other staff, and patients?
a. Line up agency nurses who can be called in to work on short notice.
b. Place the nurse on unpaid leave for the remainder of his wife's treatment.
c. Sympathize with the nurse's dilemma and let the charge nurse know that this
nurse may be calling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his
scheduled days off around his wife's treatments. - ANSWER d. Work with the
nurse, staffing office, and other nurses to arrange his scheduled days off around
his wife's treatments.
A grievance brought by a staff nurse against the unit manager requires
mediation. At the first mediation session, the staff nurse repeatedly calls the unit
manager's actions unfair, and the unit manager continues to reiterate the
reasons for the actions. What would be the best course of action at this time?
a. Send the two disputants away to reach their own resolution.
,b. Involve another staff nurse in the discussion for clarity issues.
c. Ask each party to examine their own motives and issues in the conflict.
d. Continue to listen as the parties repeat their thoughts and feelings about the
conflict. - ANSWER c. Ask each party to examine their own motives and issues in
the conflict.
At a second negotiation session, the unit manager and staff nurse are unable to
reach a resolution. What is the appropriate next step?
a. Arrange another meeting in a week's time so as to allow a cooling-off period.
b. Elevate the next negation session to the next manager, one level above.
c. Insist that participants continue to talk until a resolution has been reached.
d. Back the unit manager's actions and end the dispute. - ANSWER b. Elevate
the next negation session to the next manager, one level above.
The manager of a surgical area has a vision for the future that requires the
addition of RN assistants or unlicensed persons to feed, bathe, and ambulate
patients. The RNs on the staff have always practiced in a primary nursing-
delivery system and are very resistant to this idea. What would be the best initial
strategy for implementation of this change?
a. Exploring the values and feelings of the RN group in relationship to this
change
b. Leaving the RNs alone for a time so they can think about the change before it
is implemented
c. Dropping the idea and trying for the change in a year or so when some of the
present RNs have retired
d. Hiring the assistants and allowing the RNs to see what good additions they
are - ANSWER a. Exploring the values and feelings of the RN group in
relationship to this change
****As the RN charge nurse on the night shift in a small long-term care facility,
you've found that there is little turnover among your LPN and nursing assistant
(NA) staff members, but they are not very motivated to go beyond their job
descriptions in their work. Which of the following strategies might motivate the
staff and lead to greater job satisfaction?
a. Ask the director of nursing to offer higher wages and bonuses for extra work
for the night LPNs and NAs.
b. Allow the LPNs and NAs greater decision-making power within the scope of
their positions in the institution.
c. Hire additional staff so that there are more staff available for enhanced care,
and individual workloads are lessened.
d. Ask the director of nursing to increase job security for night staff by having
them sign contracts that guarantee work. - ANSWER b. Allow the LPNs and NAs
greater decision-making power within the scope of their positions in the
institution.
,A new graduate nurse wonders about the directions that her preceptor has
given her regarding management of incontinent, confused patients. The new
nurse brings the preceptor evidence-based information she located regarding
incontinence interventions for confused patients and asks to talk about the
guidance that given after the preceptor reviews the information in the article.
What is the new nurse demonstrating in this situation? (Select all that apply.)
a. Assertiveness
b. Followership
c. Management
d. Insubordination - ANSWER a. Assertiveness
b. Followership
The nurse manager wants to increase motivation by providing motivating factors
for the nurse on the unit. What action would be appropriate to motivate the staff?
a. Collaborate with the human resource/personnel department to develop on-
site daycare services.
b. Provide a hierarchical organizational structure
c. Implement a model of shared governance - ANSWER c. Implement a model of
shared governance
The unit is shifting from primary nursing to a team model in an effort to contain
costs. Staff members are upset about the change and ask for a meeting to
discuss the new model. After hearing their concerns related to reduction in
professional autonomy, what is the initial response by the manager to address
the concerns?
a. Acknowledge the loss.
b. Explain the reasons for change, emphasizing the need to reduce costs.
c. Repeat the information several times, giving detailed budget overviews.
d. Adjourn the meeting and provide explanation through e-mail. - ANSWER a.
Acknowledge the loss.
****A charge nurse on a busy 40-bed medical/surgical unit is approached by a
family member who begins to complain loudly about the quality of care his
mother is receiving. His behavior is so disruptive that it is overheard by staff,
physicians, and other visitors. The family member leaves the unit abruptly, and
the nurse is left feeling frustrated. Which behavior by the charge nurse best
illustrates refined leadership skills in an emotionally intelligent practitioner?
a. Reflect to gain insight into how the situation could be handled differently in
the future.
b. Try to catch up with the angry family member to resolve the concern.
c. Discuss the concern with the patient after the family member has left.
d. Notify nursing administration of the situation. - ANSWER a. Reflect to gain
insight into how the situation could be handled differently in the future.
During a staff meeting held to discuss developing a mission statement for the
unit, the idea of placing patient needs first is discussed. What is considered
, when the suggestion by the manager is for the unit mission to be derived from
the organization mission?
a. Empowering
b. A leadership tag
c. A symbol
d. A management task - ANSWER b. A leadership tag
The chief nursing officer has asked the staff development coordinator to
facilitate the development of a clinical competency program for the facility.
While making rounds on the units, the staff development coordinator overhears
RN staff complaining that they feel it is insulting to be required to participate in a
competency program. What behavior by the staff development coordinator is
most appropriate in this situation?
a. Disregard staff concerns and continue with development of the program.
b. Inform the nurses that this program is a requirement for JCAHO
accreditation.
c. Schedule a meeting with the chief nurse executive to apprise her of the
situation.
d. Facilitate a meeting so nurses can articulate their values and concerns about
a competency program. - ANSWER d. Facilitate a meeting so nurses can
articulate their values and concerns about a competency program.
A dispute arises between an RN and an LPN over a patient issue. The tension
continues between the two and begins to affect other staff members, who are
drawn into the conflict. Over time, the team becomes polarized toward either the
RN or the LPN. How might this situation be prevented?
a. Expediency in responding to the initial dispute, once it became apparent that
it could not be resolved by the two parties themselves
b. Asking other staff members what the real issues were in the dispute between
the RN and the LPN
c. Reassigning one of the parties to another unit when it became apparent that
the two individuals could not resolve the dispute themselves
d. Calling a staff meeting at the onset of the dispute to allow the team and the RN
and LPN to discuss the initial dispute - ANSWER a. Expediency in responding to
the initial dispute, once it became apparent that it could not be resolved by the
two parties themselves
The nurse manager has been asked to implement an evidence-based approach
to teach ostomy patients self-management skills postoperatively. The program
is to be implemented across the entire facility. What illustrates effective
leadership in this situation?
a. The training modules are left in the staff room for times when staff are
available.
b. The current approach is continued because it is also evidence-based and is
more familiar to staff.
