Chapter 05: Managing Time and Stress
Huber: Leadership & Nursing Care Management, 6th Edition
MULTIPLE CHOICE1. _____ is defined as the accomplishment of specified activities during the time available.
a. Stress
b. Mismanagement of resources
c. Time management
d. Self-management
ANS: CTime management is defined as the accomplishment of specified activities during the time
available. It is the process of managing the things an individual does with his or her available
time. At its core, time management is self-management.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
2. Nurses who are successful at time management:
a. display an ability to set measurable goals and objectives.
b. frequently volunteer for new and creative projects.
c. hesitate to delegate because of perfectionist characteristics.
d. tend to accomplish specific activities within a time frame.
ANS: DTime management is accomplishing specific activities during the time available. It is a
process of managing the things an individual does with his or her available time.
DIF: Cognitive Level: Understand (Comprehension) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. Jay, a nurse in the intensive care unit, has been caring for a patient with end-stage renal
disease, congestive heart failure, and a stroke. The client has had four cardiac arrests in 4
days. Despite the grave prognosis, the client’s family continues to want resuscitation at all
cost. Jay knows that further medical care is futile. Jay is at risk for:
a. confrontational conflict.
b. resilience.
c. burnout.
d. moral distress.
ANS: DMoral distress is linked to issues related to patient care, including ethical dilemmas that can
put professionals in difficulty and give rise to feelings of unease. It occurs when an individual
knows what ethical action should occur but is prevented from doing so by either internal or
external barriers (Rushton, 2006).
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Evaluation MSC: Client Needs: Physiological Integrity: Physiological Adaptation
4. Nurses who must manage unplanned and regular responsibilities simultaneously may
experience:
a. complexity compression.
b. resilience.
c. moral distress.
d. empowerment.
ANS: AWhen unexpected conditions are added to regular responsibilities, nurses may experience
what experts call complexity compression , which has been linked to burnout, turnover, and
other types of work-related stress (Krichbaum et al., 2007). Nurses experience this when they
must manage unplanned (complexity) and regular responsibilities simultaneously
(compression).
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. Creating a safe, empowering, and satisfying work environment can be accomplished through
implementation of:
a. Institute of Medicine Coalitions.
b. health care reform.
c. the Troubled Asset Relief Program.
d. Healthy Work Environment (HWE) standards.
ANS: DA Healthy Work Environment (HWE) is one that is safe, empowering, and satisfying. The
American Association of Critical-Care Nurses (AACN) has established six standards that
support Healthy Work Environments (AACN, 2005). Although developed for nurses, they are
applicable for all types of employees.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. A staff nurse has a concern about a co-worker who may be diverting medications. The staff
nurse would like to report the concern to a supervisor, but she is fearful of retaliation from her
colleagues. The staff nurse knows that the ethical thing to do is report the concern for the sake
of patient safety. This nurse is experiencing:
a. stress.
b. procrastination.
c. moral distress.
d. burnout.
ANS: CMoral distress occurs when clinicians know what is the ethical action to take, yet are
prevented by either external or internal obstacles. Moral distress will contribute to stress and
eventual burnout if the staff nurse does not take action.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity: Reduction of Risk Potential
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
10. Nurse managers are in a position of impacting the stress levels of employees through
improving work environments and creating a culture of enhanced staff satisfaction. Having
structures and processes in place to prevent work-related stress from happening in the first
place requires:
a. genuine intention and corresponding action.
b. additional evidence about the human and financial costs of work-related stress.
c. more stability in the health care industry.
d. decreased demands from payers, consumers, and regulators.
ANS: AIt has always been challenging to secure the necessary resources for prevention, even for
patient care. However, failure to do so puts employees at risk, which in turn can jeopardize the
lives of patients. It is no longer possible to wait for more evidence about the human and
financial costs of work-related stress. Waiting for more stability in the industry, which may
never come, wastes precious time. Once that is embraced and there is genuine intention, then
design and creation can begin in earnest.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
11. There is evidence of a link between _____ employees with higher productivity and more
satisfied customers.
a. stressed
b. empowered
c. financially focused
d. creative
ANS: BEmployees who are empowered in their jobs are also more engaged and satisfied. Research
indicates that structural empowerment leads to higher productivity and satisfaction for the
employee, which translates to more satisfied customers.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
12. Nurses on the midnight shift are experiencing difficulty with receiving materials from the
central supply department. Last night a patient was admitted to the unit from the emergency
department with a heart dysrhythmia. The nurse requested that a temporary pacemaker kit be
placed in the unit as a standby in case the patient required its use. The central supply unit did
not comply until the patient required its emergent use. The nurse was stressed. This is an
example of which type of stress?
a. Job stress
b. Overload of role
c. Moral distress
d. Role conflict
ANS: AJob stress is a tension that arises related to the person-in-environment demands of a person’s
role or job. Job stress, or “disquieting influences,” can accumulate into levels that are too
high, reach the point of burnout, and manifest as emotional and/or physical exhaustion and
lowered job productivity.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
13. When a nurse leader is able to fully embrace the American Association of Critical-Care
Nurses’ (AACN’s) Healthy Work Environment and engage others in its achievement, what is
the leader demonstrating?
a. Authentic leadership
b. Meaningful recognition
c. True collaboration
d. Skilled communication
ANS: AThe nurse leader is demonstrating authentic leadership when he or she is able to embrace and
model the AACN’s Healthy Work Environment.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
14. A new nursing manager is falling behind on the staffing schedule, the monthly budget, and
employee evaluations. She says to her director, “I’m working 60 hours per week and I still
don’t have enough time to do it all.” The nursing director suggests which of the following to
her?
a. Setting priorities
b. Obtaining additional preceptoring.
c. Scheduling blocks of time for each activity to be accomplished.
d. Giving up management and returning as a regular staff nurse.
ANS: CTime management involves a deliberative process of identifying, focusing, and completing
activities needed to accomplish specific tasks and achieve goals. Blocking time to get tasks
done is a strategy that can be used to for time management at work.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Nursing Diagnosis MSC: Client Needs: Safe and Effective Care Environment: Management of Care
15. In setting boundaries it is important to do which of the following?
a. Set rigid boundaries.
b. Set boundaries based on individual needs.
c. Consider where one is in the lifespan when setting boundaries.
d. Set boundaries even if it produces more stress than not having boundaries at all.
ANS: BStress has a variety of induced changes, including increases in heart rate and blood glucose
levels, emotional changes, and burnout, and it can lead to acute and chronic health problems.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. Which of the following statements are true regarding job stress? ( Select all that apply .)
a. Job stress is related more to external demands that are brought into the workplace.
b. Job stress can lead to burnout.
c. Job stress is manifested as emotional and/or physical exhaustion.
d. Job stress increases productivity.
e. Levels of job stress that are too low or too high decrease individual productivity.
ANS: B, C, EJob stress is a tension that arises related to the environmental demands of a person’s role or
job. Job stress can accumulate to levels that are too high, reach the point of burnout, and
manifest as emotional and/or physical exhaustion. Levels of job stress that are too low or too
high decrease individual productivity.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care
4. What are some methods that nursing staff can use to manage personal stress levels? ( Select all
that apply .)
a. Take personal time each day.
b. Take on extra shifts to keep the mind occupied.
c. Get enough sleep.
d. Pay attention to diet and exercise.
e. Have a strong support network of friends and family.
ANS: A, C, D, EWhile stress management is unique to each person, some of the tools that may be effective
include taking personal downtime each day, getting enough sleep, eating right, exercising, and
having a strong network of friends and family for support.
DIF: Cognitive Level: Remember (Knowledge) TOP: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. What are some potential reasons that nurses experience higher levels of stress? ( Select all that
apply .)
a. Nurses are skilled at setting boundaries.
b. Nurses often put others’ needs ahead of their own.
c. Staff nurses are under pressure to do more with less.
d. There are support staff cuts.
e. There are fluctuations in staffing levels.
ANS: B, C, D, EStaff nurses are under constant pressure to do more with less, and this can cause professional
and personal stress for staff as well as managers. Support staff have been cut, jobs are fewer,
and staffing levels fluctuate. Nurses may have a difficult time dealing with stress, because
they often put others’ needs ahead of their own and need to be able to create healthy
boundaries.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Nursing Diagnosis MSC: Client Needs: Safe and Effective Care Environment: Management of Care
6. Managers have a key role in mitigating stress in the workplace. Which strategies will assist
the manager in creating a more healthy work environment? ( Select all that apply .)
a. Recognize nurses for the value they bring to the organization.
b. Partner with the nursing staff to make policies and lead organizational operations.
c. Keep information confidential regarding safety concerns or initiatives.
d. Ensure staffing is an effective match between patient needs and nurse
competencies.
e. Ensure that the manager maintains responsibility for all aspects of unit functioning.
ANS: A, B, DA healthy work environment (HWE) is one that is safe, empowering, and satisfying. Nurse
managers can foster an HWE by recognizing nurses for the value they bring to the
organization, partnering with the nursing staff to make policies and lead organizational
operations, and ensuring that staffing is an effective match between patient needs and nurse
competencies.
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Implementation MSC: Client Needs: Safe and Effective Care Environment: Management of Care
7. Conflict and stress in the workplace can be managed through building relationships.
Organizations can foster the building of relationships through: ( Select all that apply .)
a. social media.
b. informal social gatherings.
c. mentoring.
d. confidential meetings.
ANS: A, B, CBuilding relationships can be fostered in organizations by formal and informal social
gatherings, mentoring, social media, and deliberate culture creation (Moreland & Apker,
2016). Perceived supportive work environments are characterized by perceptions that
supervisors are supportive, there is fairness, and there is open communication. Stress is
reduced when nurses feel that win-win solutions occur in the work environment.
DIF: Cognitive Level: Analyze (Analysis) TOP: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment: Management of Care
8. Job stress can accumulate into: ( Select all that apply.)
a. better time management skills.
b. feelings of elation.
c. burnout.
High stress is experienced by nurse leaders and stems from the challenges of a multifaceted
job with myriad sources of stress. Having support from others (e., supervisors, comanagers,
and coworkers) is a factor that decreases stress (Kath et al., 2012; Shirey et al., 2010). The
amount of autonomy and predictability in the job mitigates the negative effects of stress as
well (Kath et al., 2012).
DIF: Cognitive Level: Apply (Application) TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment: Management of Care