Nursing Leadership and Management Canadian Edition by Alice Gaudine – Test Bank

Nursing Leadership and Management Canadian Edition by Alice Gaudine – Test Bank

Multiple Choice Questions

1) Bonnie has been a nurse on a medical-surgical unit for 6 months. Recently, there has been mention of cutbacks in the hospital and she is sure she will be one of the nurses who will be let go. She has been finding it increasingly difficult to find motivation to go to work. This is an example of which theory of motivation?

1. social cognitive theory
2. Maslow’s hierarchy of needs
3. Herzberg’s motivation-hygiene theory
4. McClelland’s theory

Answer: b

Rationale for correct answer:

1. Incorrect: Incorrect: In social cognitive theory, self-efficacy is an important component, and is defined as the degree of confidence an individual has that he or she can do a particular task. Job security is not a motivating factor in this theory.
2. Correct: Maslow’s hierarchy of needs includes physiological, safety, belonging (love), self-esteem, and self-actualization needs. According to the safety tier of this theory, a person cannot feel motivated in their job if they feel it is not secure.
3. Incorrect: In Hertzberg’s theory, the motivation factors are personal achievement, status, recognition, challenging work, responsibility, and advancement opportunities. Job security is not a motivating factor in this theory.
4. Incorrect: Incorrect: McClelland’s theory deals with the need for achievement, affiliation, and power, and motivation is tied to whether or not a nurse is able to influence others, work on a team where he or she is liked and feels part of the group, and where success is achieved through recognition of achievement. Job security is not a motivating factor in this theory.

Client need per NCLEX: safe and effective care environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 1—Analyze how different theories of work motivation can be applied to the motivation of nurses in the workplace

2) Personal achievement, status, policies and administration, work/life balance, and interpersonal relationships are all aspects of which motivation theory?

1. social cognitive theory
2. Maslow’s hierarchy of needs
3. Herzberg’s motivation-hygiene theory
4. McClelland’s theory

Answer: c

Rationale for correct answer:

1. Incorrect: The motivating needs that must be met according to social cognitive theory are self-efficacy, cognitive factors, and behavioural factors.
2. Incorrect: Maslow’s eight-stage needs hierarchy does not include these categories.
3. Correct: Personal achievement, status, policies and administration, work/life balance, and interpersonal relationships are all needs that need to met within Herzberg’s motivation-hygiene theory.
4. Incorrect: McClelland’s theory deals with the need for achievement, affiliation, and power.

Client need per NCLEX: safe and effective care environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 1—Analyze how different theories of work motivation can be applied to the motivation of nurses in the workplace

3) Which of the following is true of the clinical ladders used by health care organizations to motivate and reward the performance of nurses?

1. They are based on salary alone.
2. They vary among organizations in terms of the number and type of steps included.
3. They are professional purpose statements.
4. They are not supported by the International Council of Nurses (ICN).

Answer: b

Rationale for correct answer:

1. Incorrect: Clinical ladders include various components, such as job title and nursing role, and may or may not include a salary scale range.
2. Correct: Clinical ladders enable nurses to progress in their career while remaining in direct patient care positions. New nurses start at the first step on the ladder and are promoted to subsequent steps as they gain expertise. However, there is variation among health care organizations in the number of steps on the ladder, the position titles for each step, and whether there is a different salary scale for each step.
3. Incorrect: Clinical ladders do not include professional purpose statements.
4. Incorrect: The ICN has supported the use of clinical ladders to promote nurses who work in direct care.

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 2—Discuss how career development plans can facilitate nurses’ motivation and performance

4) Professional purpose is __________.

1. outlined by each regulatory body
2. included in the mission statement of many organizations
3. unique to each individual nurse
4. for unregulated health care providers

Answer: c

Rationale for correct answer:

1. Incorrect: Professional purpose is unique to each individual nurse. Professional purpose is not outlined by a regulatory body.
2. Incorrect: Professional purpose is unique to each individual nurse. It is not included in an organization’s mission statement.
3. Correct: Professional purpose is each individual nurse’s unique reason for why he or she practises nursing, and is intertwined with each nurse’s unique capabilities and values.
4. Incorrect: Professional purpose is unique to each individual nurse. It includes unregulated health care providers, but is not specific to only this group.

Client need per NCLEX: safe and effective care environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 2—Discuss how career development plans can facilitate nurses’ motivation and performance

5) Reductions in productivity, fostering fear and a lack of trust, and damaging morale and motivation, are all said to be the _____________ of performance appraisals.

1. soft costs
2. hard costs
3. simple costs
4. complex costs

Answer: a

Rationale for correct answer:

1. Correct: The benefits of performance appraisals are receiving feedback about job performance, goal-setting, career management, objective assessment, and legal protection. However, according to Nickols (2007), the cost of performance appraisals outweighs these benefits and can be divided into soft costs and hard costs. The soft costs identified include reductions in productivity, erosion of performance, creation of emotional anguish, damage to morale and motivation, emphasis on the individual versus team and task versus process, fostering a short-term view, fostering fear and lack of trust, and political gains.
2. Incorrect: The hard costs of performance appraisals have been identified as direct financial expenses and indirect financial expenses.
3. Incorrect: Simple costs were not identified by Nickols (2007) as costs of the performance appraisal process.
4. Incorrect: Complex costs were not identified by Nickols (2007) as costs of the performance appraisal process.

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 3—Debate the pros and cons of performance appraisals

6) Performance appraisals are considered to have the following positive impacts on employees:

1. goal setting, career management, and reductions in productivity.
2. legal protection, objective assessment, and feedback.
3. rewarding the team, career management, and feedback.
4. a long-term goal, career management, and goal setting.

Answer: b

Rationale for correct answer:

1. Incorrect: Reduction in productivity is considered to be a negative impact of performance appraisals, not a positive one.
2. Correct: The benefits of performance appraisals are receiving feedback about job performance, goal-setting, career management, objective assessment, and legal protection.
3. Incorrect: One of the negative impacts of performance appraisals is that they reward the individual rather than rewarding the team.
4. Incorrect: One of the negative impacts of performance appraisals is that they foster short-term goals rather than long-term goals.

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 3—Debate the pros and cons of performance appraisals

7) Consider each of the following situations. In which one would the use of progressive discipline not be appropriate?

1. when a nurse assaults a patient
2. when a medication error is made
3. when a second medication error is made
4. when a patient makes a complaint about a nurse’s behaviour

Answer: a

Rationale for correct answer:

1. Correct: Progressive discipline is a contracture approach to discipline that is based on the belief that employees should receive several warnings regarding their performance or behaviour if it is problematic. It is based on a manager’s belief that employees can learn, develop, and change. However, in cases where the nurse’s action is extreme, such as stealing narcotics or intentionally harming a patient, progressive discipline would not be used, and instead the nurse might be terminated or put on paid leave until an investigation is completed.
2. Incorrect: Medication errors are a situation where progressive discipline would be appropriate.
3. Incorrect: A second occurrence of a medication error is a situation where progressive discipline would be appropriate.
4. Incorrect: A patient complaining about a nurse’s behaviour is a situation where progressive discipline would be appropriate.

Client need per NCLEX: safe and effective care environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 4—Suggest situations when disciplinary procedures may help or hurt nurses’ motivation and performance in the workplace

8) Honest mistakes should be reviewed in order to __________.

1. build a case for disciplinary action against a nurse
2. look for the root cause and analyze work processes
3. penalize nurses who are forgetful
4. discipline nurses who do not perform according to unit policy

Answer: b

Rationale for correct answer:

1. Incorrect: The disciplinary process should not be used for nurses who make an honest mistake. Using discipline in cases where nurses make honest mistakes may reduce the reporting of errors, as well as demotivate the nurse and cause all nurses who are aware of the nurse’s treatment to experience anger.
2. Correct: The disciplinary process should not be used for nurses who make an honest mistake. Honest mistakes should instead be reviewed to look for root causes and analyze work processes to see how they can be improved to reduce errors.
3. Incorrect: The disciplinary process should not be used for nurses who make an honest mistake. Using discipline in cases where nurses make honest mistakes may reduce the reporting of errors, as well as demotivate the nurse and cause all nurses who are aware of the nurse’s treatment to experience anger.
4. Incorrect: The disciplinary process should not be used for nurses who make an honest mistake. Using discipline in cases where nurses make honest mistakes may reduce the reporting of errors, as well as demotivate the nurse and cause all nurses who are aware of the nurse’s treatment to experience anger.

Client need per NCLEX: safe and effective care environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 4—Suggest situations when disciplinary procedures may help or hurt nurses’ motivation and performance in the workplace

9) While nexters and baby boomers differ in many ways, there are some similarities in what motivates both groups in the workplace. These similarities include __________.

1. desire to help, caring, and salary
2. desire to help, caring, and scheduled time off
3. desire to help, caring, and sense of achievement
4. salary, caring, and self-validation

Answer: c

1. Incorrect: Salary was not a factor that was motivating to nurses across different age groups.
2. Incorrect: Scheduled time off was not identified as a factor that was motivating across different age groups in the workplace. Time off was has been identified as a motivating factor specifically for Generation X employees.
3. Correct: Similarities in what motivates both nexters and baby boomers in the workplace include the desire to help, caring, a sense of achievement, and self-validation.
4. Incorrect: Salary and self-validation are not factors that were identified as motivating to nurses across different age groups.

Rationale for correct answer:

Client need per NCLEX: safe and effective care environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 5—Identify how nexters, members of Generation X, and nurses nearing retirement (baby boomers) may differ in what motivates them in the workplace

10) It has been a busy night in the emergency room and there is now a trauma patient coming in. Given what you know about the differences among generations of nurses, which of the following would you expect to volunteer to participate in the care of the trauma patient?

1. Marnie, aged 55
2. John, aged 28
3. Elizabeth, aged 42
4. Marilyn, aged 36

Answer: b

1. Incorrect: Research by Newton et al (2009) found that nurses 30 years of age or younger were more motivated by exciting and challenging work situations than nurses aged 40 to 50 years.
2. Correct: Research by Newton et al (2009) found that nurses 30 years of age or younger were more motivated by exciting and challenging work situations than nurses aged 40 to 50 years.
3. Incorrect: Research by Newton et al (2009) found that nurses 30 years of age or younger were more motivated by exciting and challenging work situations than nurses aged 40 to 50 years.
4. Incorrect: Research by Newton et al (2009) found that nurses 30 years of age or younger were more motivated by exciting and challenging work situations than nurses aged 40 to 50 years.

Rationale for correct answer:

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 5—Identify how nexters, members of Generation X, and nurses nearing retirement (baby boomers) may differ in what motivates them in the workplace

11) In which type of workplace would a nurse be more motivated to practice?

1. where there is a high level of autonomy
2. where there is no apparent collaboration among team members
3. where there are few opportunities to learn
4. where there are definite hierarchical relationships among the team

Answer: a

Rationale for correct answer:

1. Correct: A review by Toode et al (2011) identified studies that showed nurses were more motivated by good collaboration with other members of the health care team, social support within the team, positive team spirit, being an equally valued member of the team, high autonomy, a variety of different work-related activities, manual work, opportunities to learn, opportunities to share their knowledge with physicians, and receiving supervision.
2. Incorrect: Nurses are motivated by collaboration with other team members. A lack of collaboration would be demotivating.
3. Incorrect: Nurses are motivated by having opportunities to learn. A lack of opportunities would be demotivating.
4. Incorrect: Nurses are motivated by being an equally valued member of the team and having a high degree of autonomy. Working within a definite hierarchical relationship would be demotivating.

Client need per NCLEX: safe and effective work environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 6—Relate issues related to motivation and performance to your practice setting(s)

12) How will performance be affected by setting objectives that can be easily achieved?

1. It will be eroded.
2. It will improve.
3. It will lead to increased motivation.
4. It will eliminate the need for performance appraisals.

Answer: a

Rationale for correct answer:

1. Correct: Erosion of performance might occur if employees are given objectives that they can easily achieve.
2. Incorrect: If objectives are too easy to achieve, performance will be eroded, not improved.
3. Incorrect: If objectives are too easy to achieve, motivation will decrease, not increase.
4. Incorrect: Performance appraisals are required, regardless of performance erosion/motivation.

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 6—Relate issues related to motivation and performance to your practice setting(s)

Short Answer Questions

13) Name three motivation factors and three hygiene factors in Herzberg’s motivation-hygiene theory.

Answer: Correct answers should include three points from each of the following categories:

• Motivation factors: personal achievement, status, recognition, challenging work, responsibility, advancement opportunities
• Hygiene factors: salaries and benefits, employer policies and administration, interpersonal relationships, supervision, job security, working conditions, work/life balance

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 1—Analyze how different theories of work motivation can be applied to the motivation of nurses in the workplace

14) Discuss how a professional purpose statement can facilitate a nurse’s motivation and performance.

Answer: Correct answers should include some of the following points.

• Professional purpose statements involve nurses in writing their view of their own professional purpose and values.
• Through reflection and articulating their purpose and values, nurses can increase their motivation to fulfill their desired purposes and act in accordance with their professional values
• Professional purpose is each individual nurse’s unique reason for practising nursing and is intertwined with each nurse’s unique capabilities and values. The nurse’s reason for choosing to become a nurse and to continue to practise are articulated, and help motivate the nurse to direct his or her practice and self-development in congruence with his or her professional purpose.
• In challenging clinical or workplace situations, reflecting on your professional purpose statements can help guide your decisions and behaviours, enabling you to be the type of nurse you want to be.

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 2—Discuss how career development plans can facilitate nurses’ motivation and performance

15) Discuss four pros and four cons of performance appraisals

Answer: Correct answers will include four points from each of the following categories.

• Pros:
  • use of self-reflection may be mandated by regulatory body
  • feedback
  • goal setting
  • career management
  • objective assessment
  • legal protection
  • facilitates communication between nurse manager and health care worker
• Cons:
  • time-consuming
  • may focus on brief encounters
  • reductions in productivity
  • rewards the individual, not the team
  • fosters a short-term view
  • may foster fear and lack of trust in management
  • cost

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 3—Debate the pros and cons of performance appraisals

16) When might discipline procedures hinder or hurt a nurse’s performance and motivation?

Answer: Correct answers will include at least one of the following points.

• When discipline is not progressive (e.g., it is not constructive or based on the belief that employees should receive several warnings regarding problematic performance or behaviour)
• When discipline is used to punish an honest mistake made by the nurse. Honest mistakes should be reviewed to look for root causes and analyze work process; the disciplinary process should not be used in such instances because it may reduce the reporting of errors, demotivate the nurse, and cause other nurses who are aware of the disciplined nurse’s treatment to experience anger.
• When a nurse manager and organization does not practice according to the philosophy they are asking the nurse being disciplined to practice within

Client need per NCLEX: safe and effective care environment, psychological integrity

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 4—Suggest situations when disciplinary procedures may help or hurt nurses’ motivation and performance in the workplace

17) What are four motivators that are common to nurses in all age groups?

Answer: Correct answers should include the following four points.

• desire to help
• caring
• sense of achievement
• self-validation

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 5—Identify how nexters, members of Generation X, and nurses nearing retirement (baby boomers) may differ in what motivates them in the workplace

18) Select three motivators from the following list that you have witnessed in your workplace. Describe their effect on your own motivation and/or performance.

1. good collaboration with other members of the health care team
2. social support within the team
3. positive team spirit
4. being an equally valued member of the team
5. high autonomy
6. variety of different work-related activities
7. manual work
8. opportunities to learn
9. opportunities to share knowledge with physicians

Answer: Responses will vary according to personal experience.

Client need per NCLEX: safe and effective care environment

Integrated Nursing Process: Assessment, Diagnosis, Planning, Implementation, Evaluation

Objective: 6—Relate issues related to motivation and performance to your practice setting(s)