1. As a nurse manager, you observe a staff nurse who over the past few weeks has become withdrawn and has had several absences due to minor ailments. Your best action would be to
a. ask the nurse if she is okay during report.
b. refer the nurse to the employee assistance program.
c. ask the nurse to meet with you for a few minutes before she leaves for the day.
d. write a note to the nurse advising her that her work attendance must improve.
2. The nurse manager of a unit has lost many staff members, and the unit is now staffed with a large number of agency and traveling nurses. She knows that the agency and traveling nurses are all contracted to stay on the unit for the next 3 months. One way to improve morale and decrease stress in the unit would be to:
a. plan a social event and include the agency and traveling nurse staff members.
b. plan unit-based social events for your remaining permanent staff members.
c. request hospital-based “floating” nurses to substitute for the temporary staff.
d. implement team nursing
3. As a nurse manager, the one activity you should not overlook is:
a. posting the yearly rotation schedule.
b. reviewing vacation requests.
c. scheduling staffing for holidays 6 months in advance.
d. anticipating staff sick days.
4. A nurse manager has decided that she must institute some personal time-management steps to survive work and home life. Her first step should be to:
a. determine what takes up so much of her time and energy.
b. organize her personal and work spaces.
c. purchase a handheld personal digital assistant to help remind her of important meetings.
d. determine her personal and professional goals.
5. A hospice nurse has been feeling very stressed at work because of both the physical strain and the emotional drain of working with clients with AIDS. She tries to walk 1 to 2 miles three times a week and to talk regularly with her husband about her work-related feelings. One reasonable stress-management strategy would be to:
6. The nurse manager is implementing a shared governance model to help with communication and decision making. Although staff members like the concept, change is difficult. Staff nurses feel:
a. more empowered.
b. more communicative.
c. less stressed.
d. more powerless and devalued.
7. The chief nursing officer listens to nurse managers verbalize their feelings of internal stress. One common source of internal stress seems to be:
a. the death of a loved one.
b. perfectionism.
c. getting married.
d. losing a job.
8. The staff development educator presents a series of programs on stress management to the nurse managers. Research has indicated that an individual’s ability to deal with stress is moderated by psychological hardiness. Psychological hardiness is a composite of:
a. commitment, control, and challenge.
b. commitment, powerlessness, and passivity.
c. commitment, control, and passivity.
d. decreased isolation, challenge, and passivity.
9. The chief nursing officer understands that a nurse manager can exhibit stress that is related to trying to keep up with the number of electronic messages that arrive, as well as trying to remain accessible to staff. What is a strategy that would assist the manager to manage the information overload effectively?
a. Ignore messages unless they are labeled as important.
b. Determine who is most likely to send useful or important information or requests.
c. Check e-mail messages once a day.
d. Encourage face-to-face meetings rather than e-mail.
10. In helping nurse managers to manage their time, the chief nursing officer suggests that they:
a. maintain a perfectionistic attitude.
b. set up a complaint list.
c. have good negotiation skills.
d. have good information literacy skills.
11. Which of the following statements would best define stress? Stress is:
a. the comfortable gap between how we like our life to be and how it actually is.
b. everyday life, both the highs and the lows.
c. a consequence or response to an event or stimulus that can be positive or negative.
d. identical to distress.
12. In a job interview for a nursing position, Marley can be assured that which of the following will occur?
a. Both eustress and distress
b. Only eustress
c. Only distress
d. Neither eustress nor distress
13. Which one of the following statements has been proven to be true?
a. Recent research has found that women do not have a unique physiologic response to stress.
b. Both men and women interpret the same stressor in the same manner without regard to past experiences.
c. Stress influences the immune system in one complex manner.
d. Stressors that are identical do not necessarily have similar effects on each individual.
14. An example of role stress occurs when:
a. the director of the ICU and the manager of the surgical unit wish to hire the same new employee.
b. two part-time staff members are hired to work in a unit, but the job expectations for them are not clear, and the head nurse expresses disappointment in their performance.
c. the nurse manager for the ICU wants to advocate for more staff and finds it difficult to find data to substantiate his proposal.
d. line managers believe that support staff use their technical knowledge to intrude on their authority.
15. A staff nurse approaches the unit manager and indicates to her that because of her father’s death in the previous month, she is now finding it very difficult to do her work effectively. This would be considered a(n) ________ stress.
a. internal source
b. familial
c. burnout
d. external
16. Sources of occupational stress in nursing include all except which of the following?
a. Authoritarian leadership
b. Concern about moral wrongdoing by colleagues
c. Multiple changes in a short time
d. Rotating shifts
17. Mr. T. Jones and Mr. R. Smith are both going to become residents in Sunny Haven Lodge. Mr. Jones views it as an opportunity to socialize and meet new friends. Mr. Smith views this as abandonment by his family and is worried that the care will be inadequate. Each senior perceives the situation differently. This is a good example of stress that is:
a. both a positive stressor and a negative stressor.
b. occurring only because of age.
c. positive in both cases.
d. harmful in both cases.
18. Jeff, an RN in his 30s, has lost a parent, just purchased a new home, and is laid off with 6 months’ severance pay. At the same time, Jerry, an RN in his 50s, is financially secure and is asked to take early retirement with a buyout. How will the two men react to the emotional and physical influences and the sequence of stress?
a. The younger man will feel more stress.
b. The two men may or may not feel the same amount of stress.
c. The older man will feel more stress.
d. Neither man will experience any stress.
19. Social stressors are considered a major factor in the stress nurses experience in the healthcare system. Which of the following is not considered to be a social stressor?
a. High amounts of stress in the nursing home environment
b. Changes in the current healthcare system such as nursing strategies
c. Disruptive behavior coming from physicians and other healthcare workers
d. Stress triggers such as self-criticism and overanalyzing
20. After several months of heavy patient loads in the Emergency Department and inability to secure sufficient and experienced staff, the department is especially taxed by a train accident that brings in many seriously injured individuals. You observe that Rama ignores the requests of several of the injured, even when time is available to care for them and is rude to two older adult patients. You are concerned that Rama is evidencing which state?
a. Hardiness
b. Depression
c. Role ambiguity
d. Depersonalization
21. “Stress-buffering” behaviors can be elicited to reduce stress. All of the following behavioral coping responses can be used by nurse managers to reduce and manage stress except:
a. distancing oneself from work.
b. using cognitive reframing to change irrational thoughts.
c. refusing a request to sit on a committee to evaluate scheduling software.
d. exercising regularly.
22. The education consultant at St. Joseph Hospital is giving a workshop on cognitive reframing. The consultant explains that cognitive reframing reduces stress by:
a. aiding individuals in identifying positive stressors.
b. helping people realize that negative thinking causes emotional distress.
c. eliminating negative stressors.
d. replacing positive self-statements with negative irrational beliefs.
23. Time management is very essential for the nurse manager. Which of the following is not a good time-management technique?
a. Decide what not to do.
b. Learn to say “No.”
c. Learn to delegate.
d. Break down your workload into smaller, manageable tasks.
24. As a unit manager, you chair the unit meetings. For each meeting, you consider and establish the purpose of the meeting. Second, you prepare an agenda. Arrange the following steps in an order that would make the meetings productive and successful. 1. Distribute an agenda. 2. Distribute minutes. 3. Select team members. 4. Start on time. 5. Keep the meeting focused and directed toward accomplishing the set objectives. Select the correct order from the following options:
a. 1, 2, 4, 5, 3
b. 4, 1, 2, 5, 3
c. 3, 1, 4, 5, 2
d. 3, 4, 2, 1, 5
1. High levels of work-related stress affect all but which of the following? (Select all that apply.)
a. Job satisfaction
b. Absenteeism and turnover
c. Nurses’ health
d. Client welfare
