ECPI University NUR 475/NUR475: Exam 2 Study Guide | answered and explained | updated 100% fall 2025/26.

NUR 475 Exam 2 Study Guide Unions - From the nurse’s perspective o Can be helpful in collective bargaining o Can show united front to fight for better working conditions, pay, and benefits - From the manager’s perspective o Can be disruptive to the normal flow of how decisions are made o It is in the best interest of management for unions NOT to exist o Ways to prevent union formation  Pay attention to staff needs, implement shared decisionmaking models, keep up with competitive wages and benefits A nurse executive wants to decrease the chances of unionization of the nursing service department. To accomplish this goal, where should financial and energy resources best be directed? a. Publicizing the potential cost and harm of unionization b. Increasing the quality and amount of equipment available to nurses c. Implementing a shared decision-making model in the department d. Emphasizing the identity of nursing as a “helping” profession that prioritizes others’ needs One of the nurses comes to the manager and reports, “I didn’t receive overtime pay when I acted as ambulance support last week. Our union contract says that we’re supposed to. Will you please follow up and see that I get the overtime on my next check?” What is this an example of? a. An issue around the implementation of a contract b. An employee contributing to a toxic workplace setting c. A formal grievance about a contract d. A problem that needs to be reported to the director of nursing immediately What event tends to be the primary reason for an increase in the numbers of unions being formed? a. Salaries are not keeping pace with the economy. b. Organizations are insensitive to employees’ needs. c. There is an economic downturn. d. Jobs are scarce. EHR - When implementing new EHRs, there should be adequate training for staff and the appropriate budget to accommodate for the new technology A large health-care organization has struggled to meet mandated electronic health record (EHR) standards. What actions address the likely challenge that this organization is facing? Select all that apply. a. Improving communication between managers at the organization’s various sites b. Increasing the organization’s budget for technology c. Investing more in employee training d. Engaging clients and families with the process e. Increasing the use of evidence-based practice Effective Communication Strategies - Keep a calm demeanor - Have inviting body language - Make eye contact - Allow for privacy - Be respectful of physical boundaries Group Roles - Initiator: starts the group, initiates tasks and projects - Information seeker: gathers info, research - Information giver: disseminates new information to the group - Opinion seeker: does surveys, gathers group opinions - Elaborator: makes ideas come to life - Coordinator: coordinates group activities - Orienteer: teaches new members how to be a part of the group - Evaluator: evaluates group success - Energizer/encourager keeps the group motivated - Procedural technician: takes care of technical tasks (cleaning, rearranging, photocopying) - Recorder: keeps a record of what goes on in the group, keeps documents or meeting minutes - Harmonizer/compromiser keeps the peace, resolves conflict - Gatekeeper: ensures everyone is a part of decision making, keeps people from going on tangents The nurse-manager is sitting on a practice committee and has adopted the role of gatekeeper. What action should the manager perform in this role? a. Acknowledge and praise each member’s contributions. b. Mediate, harmonize, and resolve conflict when it arises. c. Facilitate and promote participation by all group members. d. Record the group’s process and provide feedback to the group. - Standard setter: sets a standard for how the group should behave and conduct themselves - Group commentator has commentary about how the group is functioning, can be positive or negative - Follower: does not take initiative, just does what they’re told - Aggressor: aggressive communication style, may be argumentative - Blocker: stops group progress, always has something negative to say - Recognition seeker: needs constant praise for their work - Self-confessor: uses the group to explore or talk about non-group related, personal things - Playboy: does not care about the group and is very vocal about it. Can be cynical and overly playful/nonchalant A member of a work group that the nurse-manager leads is aloof and dismissive of the group’s role. The member has occasionally made jokes during serious discussions and seems skeptical that the group will meet its goals. What role is this member playing? a. Blocker b. Playboy c. Dominator d. Recognition seeker - Dominator: tries to control the group - Help seeker tries to get sympathy from the group by stressing how much help they need - Special interest pleader: always has a secondary agenda and pleads on the behalf of a special interest group (race, gender, sexual orientation, etc...) Grapevine communication - Informal, haphazard, and random communication that does not follow chain of command - To combat this, try to understand why chain of command is not being followed and re-educate team members Distance with communication - Social exchange: a few feet away, for people that you do not know A nurse sits at the foot of a patient’s bed during an admission interview. This positioning supports the proxemics concept of which psychological comfort zone? a. Intimate relationships b. Personal interactions c. Social exchange d. Public distance - Intimate distance: face to face, very close to each other, reserved for loved ones - Public distance: 6 feet, far away from people, how far you would be from someone walking down the street Assertive communication - To be direct, open and honest when speaking but NOT aggressive or rude A nurse-manager has a reputation as being an assertive communicator. How does this manager most likely communicate? a. Through confrontation and intimidation b. In an unfeminine way that is clear and direct c. Directly and honestly, while respecting the rights of others d. In a clear, but occasionally offensive, manner Group Formation - Forming – team gets to know each other - Storming – interpersonal conflict arises as people’s true nature comes out and boundaries are pushed A nurse-manager has recently established a “best practice committee” at the clinic. Which behavior by the committee members suggests that it is in the “storming” stage? a. Members attempt to impress each other with their credentials. b. The short- and long-term goals for the group are agreed upon. c. Group members achieve their stated goals. d. The members receive their instructions and mandate from the manager. - Norming – differences are resolved, people start to agree and recognize each other’s strengths - Performing – team is in sync and performs to full potential Barriers to effective communication - Internal o Personal characteristics like stubbornness, aggressive communication styles, lack of respect, poor listening ability, facial expression, body language, incongruence between verbal and nonverbal communication Which principle should guide the nurse-manager’s use of nonverbal communication? a. It is generally consistent across cultures, unlike verbal communication. b. It supersedes verbal communication when the two are incongruent. c. Nonverbal communication should be minimized because it confuses the receiver regarding the true intent of the message. d. Nonverbal communication is a significant part of the communication exchange only when it is not congruent with the verbal exchange. Feedback from a nurse-manager’s peers suggests that the manager’s faceto-face communication is often ineffective. The manager should consider what potential cause of this problem? a. Incongruence between the manager’s verbal and nonverbal messages b. Ineffective listening skills on the part of subordinates and colleagues c. Inadequate formal training on communication skills d. Career stagnation by the nurse-manager - External o Changes in the environment, location, culture of the organization, chains of command, etc... A nurse-manager is communicating with a subordinate. What component of this communication would be considered as part of the external climate? a. The clarity of the message b. The subordinate’s personality c. The culture of the organization d. The manager’s stress level Grievances: complaints filed by employees - Should be handled by HR or a third party that is NOT involved in the conflict. Should not be handled directly by a manger, especially if the manager is involved in the issue A nurse filed a grievance against the employer and the matter has proceeded to arbitration. What is true about this employee’s grievance? a. Arbitration is likely the initial step in resolving the grievance. b. A neutral third party will impose a solution to the grievance. c. The grievance took place at a public health-care organization. d. The employer is likely trying to avert a strike. Age Discrimination in Employment Act - Individuals cannot be discriminated against by their age as long as they are able to perform the job up to the appropriate standards Which statement concerning the 1967 and 1987 Age Discrimination and Employment Acts is true? a. Maximum age restrictions were lifted for almost all job categories. b. Employees can be forced to retire at age 70 years if their health is poor. c. Underage minors can be employed up to 20 hours per week. d. Individuals seeking retirement before the age of 60 years may be exempt from company pension plans. A nurse has over four decades of work experience and is weighing the benefits of retiring versus continuing to work. How will the Age Discrimination in Employment Act affect this nurse? a. The nurse may continue to work but must forfeit job security. b. The nurse will be required to retire once he or she turns 70 years. c. The nurse will be required to retire once he or she turns 65 years. d. The nurse may retire, or continue to work, as long as he or she is capable of performing the job. Equal Pay Act of 1963: made it so men and women should be paid the exact same as long as they are: - Performing the same amount of responsibility, performing the same skills, use the same amount of effort, and work under the same working conditions A senior manager is ensuring that organizational policies for compensation align with the Equal Pay Act of 1963. What domains of work should the manager examine? Select all that apply. a. The potential for promotion or advancement in the job b. The working conditions associated with the job c. The amount of responsibility that the job carries d. The effort that is required to perform the job e. The level of job satisfaction associated with the job f. The skill that is needed to perform the job Charge nurse vs. Supervisor - There has been debate on whether charge nurses can be considered supervisors. This classification is based on how often the nurse in question spends time as regular staff versus actually being a charge nurse. A situation has occurred in a health-care organization where it is important to determine whether a particular nurse is categorized as a “staff nurse” or as a supervisor. What criterion should be used to make this differentiation? a. The nurse’s position in the hierarchy of the unit based on years of experienced b. The nurse position on the organization’s salary scale c. The nurse’s level of influence on his or her peers and colleagues d. The percentage of time that the nurse spends as charge nurse versus giving direct client care Affirmative action - Program used to extend jobs to underemployed groups based on race or gender An affirmative action plan has been established in the jurisdiction where a nurse works. The nurse should understand what characteristic of this program? a. The terms of the plan are laid out in United States Equal Employment Opportunity legislation. b. It aims to prevent workplace discrimination on the basis of age or sexual orientation. c. It actively seeks members of underemployed groups to fill job vacancies. d. Few affirmative action programs still exist because they encourage reverse discrimination. ANS: C Labor Standards: ensures that working conditions are up to code and safe for employees - Includes things like safety standards, certain number of hours the employee should work and when it is considered overtime or unsafe, and the way pay is determined/sent out During orientation to a new job, a nurse is reviewing the relevance of labor standards to the new position. What aspects of the job will these standards affect? Select all that apply. a. The number of hours that the nurse will work b. The nurse’s right to a safe workplace c. The way the nurse’s salary is determined and paid d. The nurse’s continuing education requirements e. The nurse’s accountability to his or her supervisor - Labor laws also prevent employers from retaliating against employees who are a part of a union or strike The managers of a clinic have been accused of creating an unpleasant work schedule and increased workload for a nurse who helped lead an unsuccessful union drive. How should the managers’ actions be best interpreted? a. Creating schedules and work assignment are valid management roles. b. These actions are violations of labor relations law. c. Management is within its rights but in violation of ethics standards. d. These actions are criminal offenses.