Rationale 3: The manager must remain professional at all times. In this case, when the manager was not
professional, an apology is in order.
Rationale 4: The manager has made a tactical error and should not send this employee back to work.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 21-4: Discuss how to handle marginal and disgruntled employees.
Question 23
Type: MCSA
A nurse comes to a mandatory education session wearing a shirt with a picture and slogan that is degrading to
nursing. What should the manager do first?
1. Tell the employee to go home and change.
2. Check the human resources policies regarding appropriate dress.
3. Ask the employee why the shirt was worn to this event.
4. Bring the employee a scrub shirt from surgery to change into.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 21-3: Explain how to manage staff with problem behaviors.
Question 24
Sullivan, Effective Leadership and Management, 8/e Test Bank
Type: MCSA
A nurse who is a chronic complainer comes back from lunch 20 minutes late. When confronted by the manager
the nurse says, “The nurses who smoke always take longer lunches. No one says anything to them.” What is the
manager’s major consideration before replying to this statement?
1. Policies must be consistently applied to all employees.
2. Since the hospital is smoke free, those nurses who wish to smoke must leave campus for lunch.
3. This nurse complains about everything.
4. The human resources policy is that nurses get 60 minutes for lunch.
Rationale 1: Discussing the issue of morale and monitoring staff regarding civility will not address the issues
regarding the marginal employee.
Rationale 2: Using progressive discipline to manage the employee allows for communication regarding poor
performance and allows the employee the opportunity to improve their performance.
Rationale 3: Discussing the issue of morale and monitoring staff regarding civility will not address the issues
regarding the marginal employee.
Rationale 4: Terminating the employee does not provide the employee with an opportunity to improve their
performance.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 21-4: Discuss how to handle marginal and disgruntled employees.
Question 26
Type: MCMA
Pharmacy reports that the medication records of a unit have begun to show frequent corrections. What other signs
of diversion would the manager look for on the unit?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Chart review on effectiveness of pain control
2. Increase in clients with conditions requiring pain medications
3. Increase in use of doses of as-needed narcotics that results in wastage
4. Chart review that reveals that clients require much more narcotic pain medication on one shift than on others
5. Narcotic containers that look as if they have been altered
Rationale 3: If the nurse has a choice of doses and is trying to divert medications, a smaller dose might be given
resulting in a larger wastage that is then diverted.
Rationale 4: If one shift is giving much more pain medication that the other, it may be because someone is
diverting drugs on that shift. It may also mean that inadequate pain control is being given on the other shift
because someone is diverting drugs.
Rationale 5: Altering the container is a method of diversion.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 21-5: Explain how to handle staff with a substance abuse problem.
Question 27
Type: MCSA
A nurse admits to diverting narcotic drugs while working. The manager says, “All nurses who admit diverting
narcotics have to be reported to the state board of nursing.” How should the nurse interpret this statement?
1. As true, because any nurse who admits diversion must be reported to the state’s board of nursing
2. As false, because in some states reporting depends on other factors
3. As beneficial, because the state board of nursing will help the nurse find a substance abuse program
4. As career ending, because the state board of nursing is required to suspend the license of any nurse who admits
to diverting drugs
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 21-5: Explain how to handle staff with a substance abuse problem.
Question 28
Type: MCSA
A nurse is suspected of abusing narcotics. A thorough investigation has been performed, and the nurse will now be
notified of the suspicion and investigation. How should this notification be handled?
1. A certified letter outlining the accusation and investigation should be sent to the nurse’s home.
2. A certified letter outlining the accusation and investigation should be sent to the nurse at work.
3. The nurse should be contacted and asked to make an appointment with the nurse executive without giving
cause.
4. The nurse should be approached at work with no prior notice and asked to come to the nurse executive’s office.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 21-5: Explain how to handle staff with a substance abuse problem.
Question 29
Type: MCSA
A nurse who has been abusing narcotics is in the nurse executive’s office discussing the charges. The nurse
executive is trying to convince the nurse to seek treatment for the abuse. Which statement should the nurse
executive make?
Sullivan, Effective Leadership and Management, 8/e Test Bank
1. “Health insurances generally pay 100 percent of treatment charges for medical professionals who are seeking
help.”
2. “If you go to treatment, the state board will never know you were abusing.”
3. “Treatment is your best chance at returning to practice.”
4. “We will be able to follow your progress through reports from your treatment team.”
Rationale 2: If the nurse agrees to treatment, help is forthcoming.
Rationale 3: In this case the nurse is supervised and a treatment plan is forthcoming.
Rationale 4: If the nurse is terminated, employment at another facility may occur and the cycle may continue.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 21-5: Explain how to handle staff with a substance abuse problem.
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.