ANM Leadership Skills & Staff Supervision 5 — Questions and Answers
Question 1: An ANM observes a nurse who is highly skilled clinically but dismissive of unlicensed assistive personnel (UAP). The BEST intervention is to:
- Overlook the behavior given the nurse's clinical value
- Address the behavior privately and explain the impact on team function and patient care (Correct answer)
- Reassign the UAP to work with different nurses
- Document one instance and wait for a pattern before acting
Correct answer: Address the behavior privately and explain the impact on team function and patient care
Disrespectful behavior toward any team member harms collaboration and patient safety and must be addressed directly and promptly.
Question 2: Which scheduling model has been associated with improved nurse satisfaction and reduced burnout in the literature?
- Rotating shifts with mandatory overtime
- Self-scheduling within defined unit parameters (Correct answer)
- Fixed assignment with no schedule flexibility
- Cyclical scheduling determined exclusively by seniority
Correct answer: Self-scheduling within defined unit parameters
Self-scheduling gives nurses control over their work-life balance, which is consistently linked to higher job satisfaction and retention.
Question 3: A staff nurse approaches the ANM claiming a peer is taking credit for her ideas in team meetings. This BEST exemplifies which type of workplace conflict?
- Role conflict
- Interpersonal conflict (Correct answer)
- Structural conflict
- Intergroup conflict
Correct answer: Interpersonal conflict
Interpersonal conflict involves tension between two individuals, often around issues of fairness, respect, or communication.
Question 4: When using the SBAR communication framework, what is the purpose of the 'Background' component?
- State the immediate concern or problem
- Provide relevant patient history and context (Correct answer)
- Offer the communicator's clinical assessment
- Request a specific action or response
Correct answer: Provide relevant patient history and context
Background provides the receiver with relevant clinical history so they can understand the full context of the situation.
Question 5: An ANM wants to evaluate the effectiveness of a new onboarding program. Which outcome measure is MOST appropriate?
- Number of staff who attended orientation sessions
- New hire turnover rate at 90 days and one year (Correct answer)
- Cost per hire for the new cohort
- Score on onboarding satisfaction surveys alone
Correct answer: New hire turnover rate at 90 days and one year
Retention data at 90 days and one year directly measures whether the onboarding program leads to sustained employment, the ultimate program goal.
Question 6: During a difficult staffing shortage, an ANM asks a nurse to take a fifth consecutive shift. The nurse refuses. The MOST appropriate ANM response is to:
- Document the refusal and begin disciplinary steps
- Acknowledge the refusal, explore the nurse's concerns, and seek alternative solutions (Correct answer)
- Mandate the shift under the hospital's emergency staffing policy without discussion
- Offer the shift to per diem staff before escalating
Correct answer: Acknowledge the refusal, explore the nurse's concerns, and seek alternative solutions
Acknowledging the refusal and exploring alternatives respects nurse wellbeing while still working toward a staffing solution.
Question 7: An ANM is facilitating a quality improvement (QI) project to reduce catheter-associated urinary tract infections (CAUTIs). Which framework is MOST commonly used to structure this improvement effort?
- PDCA (Plan-Do-Check-Act) (Correct answer)
- SWOT analysis
- Root cause analysis (RCA)
- Fishbone (Ishikawa) diagram alone
Correct answer: PDCA (Plan-Do-Check-Act)
The PDCA cycle is the standard QI framework used in healthcare to test, implement, and sustain process improvements.
ANM Leadership Skills & Staff Supervision 5
An ANM observes a nurse who is highly skilled clinically but dismissive of unlicensed assistive personnel (UAP).
The BEST intervention is to: