RN Registered Nurse: Management Care 2 — Questions and Answers
Question 1: A charge nurse notices two staff members have a recurring interpersonal conflict that is affecting unit morale. What is the most appropriate initial action?
- Reassign one staff member to a different unit permanently
- Meet privately with each staff member to hear their perspectives (Correct answer)
- Ignore the conflict unless patient care is directly impacted
- Issue formal disciplinary warnings to both staff members
Correct answer: Meet privately with each staff member to hear their perspectives
Meeting individually with each party allows the charge nurse to gather unbiased perspectives before facilitating resolution.
Question 2: Which staffing model distributes care based on patient acuity and nurse competency rather than a fixed nurse-to-patient ratio?
- Functional nursing
- Team nursing
- Primary nursing
- Acuity-based staffing (Correct answer)
Correct answer: Acuity-based staffing
Acuity-based staffing dynamically assigns nurses based on individual patient complexity and nurse skill sets.
Question 3: A nurse manager identifies that incident report filings have dropped significantly over the past month. This most likely indicates:
- Improved patient safety outcomes
- Under-reporting of adverse events (Correct answer)
- Fewer patient admissions
- Better staff competency
Correct answer: Under-reporting of adverse events
A sudden drop in incident reports typically signals a culture of fear or under-reporting, not a genuine safety improvement.
Question 4: When implementing a new evidence-based protocol, which change theory focuses on unfreezing old behaviors, moving to new ones, and refreezing the change?
- Rogers' Diffusion of Innovation
- Lewin's Force Field Analysis (Correct answer)
- Kotter's 8-Step Model
- Lippitt's Phases of Change
Correct answer: Lewin's Force Field Analysis
Lewin's three-step model (unfreeze, change, refreeze) is the foundational theory for planned organizational change.
Question 5: A nurse delegates wound care to an unlicensed assistive personnel (UAP). Later, the UAP performs the task incorrectly. Who bears ultimate accountability?
- The UAP who performed the task
- The charge nurse on duty
- The delegating registered nurse (Correct answer)
- The hospital risk management team
Correct answer: The delegating registered nurse
The delegating RN retains accountability for the outcome of any task delegated to UAP under the five rights of delegation.
Question 6: A unit's medication error rate has increased over three consecutive months. Using the Plan-Do-Study-Act (PDSA) cycle, what is the FIRST step the nurse manager should take?
- Implement a mandatory double-check policy immediately
- Analyze root causes and plan a targeted intervention (Correct answer)
- Report the trend to the Joint Commission
- Suspend staff pending investigation
Correct answer: Analyze root causes and plan a targeted intervention
The 'Plan' phase of PDSA begins with identifying root causes and designing a specific, testable intervention before acting.
Question 7: Which leadership style is most effective when managing a highly experienced team during a routine, stable workload?
- Autocratic leadership
- Laissez-faire leadership (Correct answer)
- Transactional leadership
- Transformational leadership
Correct answer: Laissez-faire leadership
Laissez-faire leadership is appropriate when staff are highly skilled and self-directed and the situation is stable and low-risk.
RN Registered Nurse: Management Care 2
A charge nurse notices two staff members have a recurring interpersonal conflict that is affecting unit morale.
What is the most appropriate initial action?