Sullivan, Effective Leadership and Management, 8/e
Chapter 23
Question 1
Type: MCSA
A nurse manager is investigating a report made by a staff nurse. The nurses states that a visitor backed the nurse
up against a wall and was verbally abusive but did not touch the nurse. How should the manager describe this
incident to the human resources (HR) director?
1. As an encounter with a disgruntled family member
2. As violence against the nurse
3. As an incident with a family member
4. As a physical attack against an employee
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Diagnosis
Learning Outcome: 23-2: Identify threats and threatening behaviors.
Question 2
Type: MCSA
A chief nurse officer (CNO) is contacted by the organization’s supervisor on a Saturday night regarding a problem
in the hospital’s emergency department. The supervisor describes an incident in which an orderly was assaulted.
Why is the CNO not surprised about this report?
1. This is a typical occurrence in the emergency department.
2. Health care violence is more likely to occur in emergency departments.
Sullivan, Effective Leadership and Management, 8/e Test Bank
3. Health care violence generally occurs on the weekend.
4. Health care violence is likely to occur on the night shift.
Rationale 3: The hostile work environment may cause a decline in morale or staff may be frightened to come to
work.
Rationale 4: Management miscommunication with administration is not uncommon in health care and would not
result in an increase in absenteeism.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 23-1: Discuss what health care organizations can do to prevent violence.
Question 4
Type: MCSA
An ICU unit has experienced an influx of aggressive behaviors by visitors against nurses The ICU manager has
instituted a policy to limit visiting hours. An employee asks the manager why the change in visiting hours has
been implemented. Which response is likely the most accurate?
1. “The unit has been so busy, I must allow for the nurses to have time to provide client care.”
2. “The visitor hours have not been adjusted in years. It was time to change them.”
3. “The physicians have requested limited visiting hours.”
4. “The visiting hours allowed for added stress and commotion to the nursing staff.”
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Learning Outcome: 23-1: Discuss what health care organizations can do to prevent violence.
Question 5
Type: MCSA
An ICU nurse has just assisted the physician in placing a central line in a client. Over the past few days the
client’s son has been increasingly verbally abusive to the nursing staff. The unit secretary tells the nurse that the
son is at the nurse’s station demanding to see the client. Which action by the nurse is most important?
1. Remove the central line tray from the room.
2. Inform the son regarding the client’s condition.
3. Ignore the son as he enters the client’s room.
4. Limit the son’s visitation.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23-1: Discuss what health care organizations can do to prevent violence.
Question 6
Type: MCSA
The hospital operator announced over the paging system, “Dr. Strong, fourth floor, A-wing, Dr. Strong, fourth
floor, A-wing.” A newly hired nurse asks another nurse, “Who is Dr. Strong?” The nurse replies, “This is the
announcement that alerts security there is violent behavior on that unit.” Which statement would be an appropriate
report to this unit’s manager?
1. “Our new nurse does not know what ‘Dr. Strong’ means.”
Sullivan, Effective Leadership and Management, 8/e Test Bank
2. “There was an incident in which a staff person did not know what ‘Dr. Strong’ meant. Could we have an in-
service on this policy?”
3. “The operator paged a ‘Dr. Strong’ and we didn’t know what to do.”
4. “Why do they use ‘Dr. Strong’ when there is trouble? They should just call for help.”
5. Requiring all personnel to take physical self-defense training
Rationale 2: Verbal aggression often precedes physical violence; if the situation can be defused at the verbal
stage, physical violence may not occur.
Rationale 3: Staff members cannot be expected to handle everything, but they should be prepared to handle
common incidents.
Rationale 4: The manager should have a more concrete and personally relevant rationale for this action.
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: 23-1: Discuss what health care organizations can do to prevent violence.
Question 9
Type: MCSA
An emergency department (ED) client is demanding pain medication and threatening to harm staff if they do not
provide it. The ED physician calmly continues to ask the client about the level and location of pain as the nurse
steps away and notifies security. What is the physician attempting to do by asking these questions?
1. Distract the client.
2. De-escalate the situation.
3. Determine the client’s real reason for seeking treatment.
4. Assess the client’s level of pain.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Learning Outcome: 23-4: Discuss how to respond to a violent incident.
Question 10
Type: MCSA
The emergency department (ED) staff has been caring for a client who exhibited violent behavior when pain
medication was denied. Once the situation was resolved, which action by the ED manager would be appropriate?
1. Arrange an agreement with law enforcement for rapid response on these incidents.
2. Post a sign stating that pain management medications are not given unless the client is admitted to the hospital.
3. Develop a team of staff who would be on call for these types of situations.
4. Organize a training program to educate staff on how to manage these types of situations.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23-1: Discuss what health care organizations can do to prevent violence.
Question 11
Type: MCMA
A newly formed task force is addressing the prevention of violence in the health care organization. Which group
of employees is most likely to experience violence?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
Sullivan, Effective Leadership and Management, 8/e Test Bank
1. Private practice physicians
2. Nurses working in a geriatric unit
3. Nurses working in a pediatric clinic
4. Nurses whose work space includes large waiting rooms
5. Technicians working in the medical laboratory
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.