Grohar-Murray
Chapter 11: Monitoring and Improving Performance
Learning Objective 1
Describe the appraisal system.
1. The nurse manager is conducting a performance appraisal interview with the nurse.
Which of the following questions posed by the nurse manager yields the most
information about the strength of their health care organization?
1. “Where do you see yourself in five years?”
2. “How does the work of our department contribute to the organization’s mission?”
3. “Do you have any ideas about some possible research that our unit could perform?”
4. “How are you getting along with the other members of this department?
2. The nurse and the nurse manager are discussing Sigma Theta Tau’s “8 Skills for a
Healthy Career.” Which of the following statements by the nurse indicates the nurse is
implementing or intends to implement one of these skills? Select all that apply.
1. “I enrolled in a new class about personal finances.”
2. “I made an appointment to talk to the education department about these new cardiac
monitors. I’m tired of new things being forced down our throats every time we turn
around.”
3. “After I retire, I’m going to take a Spanish class.”
4. “Have you read about the new research about pain control for surgical patients? We
should see if we could try some of the principles here.”
5. “I volunteer as a parish nurse at our church.”
3. The hospitalized client is having a discussion with the physician. Which of the following
client issues will the physician typically focus on?
1. The client’s lack of compliance with coughing and deep-breathing exercises after
major abdominal surgery.
2. The client’s estrangement from her daughter.
3. The client’s perceived issues with financial insecurity.
4. Pathophysiological principles, treatment, and diagnostic testing related to the client’s
new diagnosis of colon cancer.
4. The nurse manager is conducting a performance appraisal interview with the nurse.
Which of the following statements or questions indicate that the nurse might be receiving
a “one-way” evaluation?
1. The nurse manager states, “Here is your performance evaluation. You can read
it when you get a chance, sign it, and put it back on my desk.”
2. The nurse states, “What do you think I need to improve upon?”
3. The nurse manager states, “I think you’re becoming more assertive.”
4. The nurse states, “I’ve got to work on becoming more flexible.”
Learning Objective 3
Describe the process of an objective evaluation.
5. A nurse manager has discussed the nurse’s unprofessional behaviors with the nurse
during the performance appraisal interview. Which of the following is the nurse
manager’s best next course of action?
1. Encourage the nurse to change a behavior prior to the next annual evaluation.
2. Schedule a follow-up interim evaluation with the nurse to monitor the nurse’s
progress.
3. Speak to the nurse’s peers about the nurse’s negative evaluation and request
that they monitor the nurse for progress.
4. Terminate the nurse from the organization.
6. The nurse manager is conducting a performance appraisal interview with a nurse.
Which of the following might occur during this process? Select all that apply.
1. The nurse learns that their position has been terminated due to budgeting
constraints.
2. The nurse is in charge of conducting the meeting with the nurse manager.
3. The nurse manager learns that the nurse speaks fluent Spanish.
4. The nurse manager dictates specific goals for the nurse.
5. The nurse manager learns that the nurse does not feel comfortable using the new
patient controlled analgesic pumps.
7. The nurse has been selected to act as a member of an interdisciplinary care team.
Which of the following statements by the nurse is most reflective of this nurse’s role
on the team?
1. “It is important to remember that I’m a member of a team. We have to put our
professional values aside.”
2. “As always, the bottom line is fiscal responsibility.”
3. “I just need to ensure that the other team members understand nursing’s view
surrounding these issues”
4. “Client safety is the number one concern.”
8. The nurse manager is interviewing a nurse candidate for a staff position on the unit.
Which of the following questions should be included in this interview?
1. “What year were you born?”
2. “What church do you attend?”
3. “Where were your parents born?”
4. “What kinds of skills were needed for your last position?”
9. Place the following activities in order according to the performance appraisal process.
_____ The nurse manager shares the results of the evaluation process with the nurse’s
immediate supervisor, per the organization’s policies.
_____ The nurse manager includes specific ways for the nurse to achieve more success.
_____ The staff nurse creates a summary of goals that the nurse has achieved since the last
evaluation.
_____ The nurse manager praises the nurse for successes that have occurred since the last
evaluation.
Answer:
10. The nurse manager discovers that the nurse has been arriving late to work frequently.
This practice has been disruptive to the other staff members. Which of the following is
the nursing manager’s best course of action?
1. The nurse manager meets with the nurse and praises the nurse’s desirable behavior.
2. The nurse manager meets with the nurse and provides information about the
organization’s termination process.
3. The nurse manager meets with the nurse and provides constructive criticism about
how to avoid future late arrivals.
4. The nurse manager meets with the unit’s immediate supervisor to brainstorm about
methods to prevent the nurse from filing a grievance against the nurse manager.
11. The nurse manager is apprehensive about conducting a performance appraisal interview
with a nurse. The nurse manager feels the nurse’s care is substandard, and seeks to
discuss specific ways to improve the nurse’s ability to provide care. How should the
nurse manager conduct this interview?
1. Place the evaluation in an envelope with specific information about ways to correct
the nurse’s behavior in the nurse’s mailbox on the unit.
2. The nurse manager should schedule private time with the nurse to discuss the
performance appraisal.
3. The nurse manager should allow the human resources department personnel to
conduct the interview.
4. The nurse manager should allow one of the nurse’s peers to review the evaluation for
accuracy prior to the interview.
12. The nurse manager is discussing ways to motivate the nursing staff with the nurse
manager’s immediate supervisor. Which of the following is the best example of a reward
for the staff nurse working on this unit?
1. All nurses on this unit work 8 hours per shift, five times each week.
2. Tuition reimbursement benefits are extended to those moving from a licensed
practical nurse to a registered nurse.
3. The organization adopts a clinical ladder system.
4. All full-time nurses are provided with health care insurance.
13. The nurse manager is preparing to perform a performance appraisal interview with a
nurse. Which of the following scenarios may indicate the nurse manager is conducting a
distortion error known as the recency effect?
1. Three clients assigned to the nurse have fallen during the last month. The nursing
manager remembers this information, but does not examine any other information
acquired during the year about the nurse’s performance.
2. The nurse manager has been unable to adequately monitor or evaluate the
performance of a nurse due to an increased number of meetings during the time this
nurse usually works. However, all information that the nurse manager knows about
the nurse has been positive.
3. The nurse manager has had very little contact with the new nurse, but remembers an
incident 6 months ago with a client’s family where the nurse was thought to be loud
and offensive.
4. The new nurse manager feels very strongly that the most important quality in a nurse
is lack of absenteeism. The previous nurse manager felt that the most important
quality was client safety.
14. A nurse manager gives every staff nurse on the unit the same positive performance appraisal.
The nurse manager’s supervisor questions the results. The nurse manager states, “I was unable to
watch all of them perform, but as a whole, the unit is performing well on our leading indicators.”
Which of the following errors as occurred?
1. Halo effect error
2. Recency effect error
3. Sunflower effect
4. Rater temperament effect
15. The nurse manager is preparing to conduct performance appraisal interviews with the
nurses on the unit. The nurse manager ensures that the recency effect error does not occur
by doing which of the following things?
1. The nurse manager is careful to evaluate only information that is personally known
about the nurse’s skills and attributes.
2. The nurse manager ensures that the evaluation tool guidelines are defined.
3. The nurse manager evaluates each nurse every 3 to 6 months.
4. The nurse manager is careful to review each nurse’s file to acquire information about
events that have occurred over the last year