A new nurse manager has observed several instances of horizontal violence between staff members on her unit, primarily verbal abuse and malicious gossip.
What should she do?

Confront the bullying behavior and discuss strategies for responding to it.

Model this bullying behavior so that staff can see how it affects people.

Ignore it because it is not physical violence and will not hurt anyone.

Keep a log of observed bullying behavior to discuss during the employees' annual evaluation.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Confronting bullying behavior directly establishes clear professional boundaries and expectations within the unit. This approach fosters a psychologically safe environment, which is crucial for team cohesion and optimal patient care. Addressing the issue promptly prevents escalation and demonstrates leadership commitment to a respectful workplace, promoting accountability and encouraging healthier communication patterns among staff.

Choice B rationale

Modeling bullying behavior is counterproductive and unethical, as it normalizes and perpetuates harmful actions within the workplace. Such actions undermine trust, decrease morale, and can lead to increased stress, burnout, and higher staff turnover rates. A nurse manager's role is to promote a positive and supportive work environment, not to emulate detrimental behaviors.

Choice C rationale

Ignoring horizontal violence, even if not physical, can have significant negative psychological and professional consequences for staff members and the unit. Verbal abuse and gossip erode trust, create a toxic work environment, and can lead to increased anxiety, depression, and decreased job satisfaction, ultimately impacting patient care quality.

Choice D rationale

While logging observed behavior is a useful documentation tool, waiting for an annual evaluation to address horizontal violence delays necessary intervention. Prompt and direct confrontation is essential to mitigate immediate harm and prevent further escalation. Addressing the issue in a timely manner demonstrates a commitment to a safe workplace and supports a healthy team dynamic.

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Correct Answer is ["A","C"]

Explanation

Choice A rationale

Atraumatic care focuses on minimizing physical and psychological distress for both the client and their caregivers. By employing strategies such as therapeutic play, age-appropriate explanations, and parental involvement, it reduces fear, anxiety, and stress responses, which can negatively impact physiological outcomes and coping mechanisms. This approach promotes a sense of security and control.

Choice B rationale

Atraumatic care aims to *enhance* client and caregiver control, not remove it. Empowering clients and families by providing information, involving them in decision-making, and respecting their preferences is a core principle. This approach fosters a sense of partnership and autonomy, which inherently reduces feelings of helplessness and stress, improving overall well-being.

Choice C rationale

By minimizing emotional and physical distress, atraumatic care helps to reduce the physiological stress response, including the release of cortisol and catecholamines. This reduction in stress mediators can improve immune function and reduce inflammation, thereby promoting a more conducive environment for healing and recovery, leading to potentially faster resolution of illness or injury.

Choice D rationale

Atraumatic care often requires *more* time initially from nurses to establish rapport, provide thorough explanations, engage in therapeutic play, and involve families in care. While it can lead to improved long-term outcomes and potentially fewer complications, its immediate implementation involves an investment of time to ensure comfort and understanding, not a reduction.

Correct Answer is ["9"]

Explanation

Step 1 is: Heart rate 120 BPM = 2 points (HR > 100 BPM).

Step 2 is: Strong cry = 2 points (Strong cry/cough).

Step 3 is: Well-flexed = 2 points (Well flexed).

Step 4 is: Reflex-crying = 2 points (Cry/sneeze).

Step 5 is: Body pink; acrocyanosis present in hands and feet = 1 point (Body pink, extremities blue).

Step 6 is: Add up all the points: 2 + 2 + 2 + 2 + 1 = 9.

Answer: 9.

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A new nurse manager has observed several instances of horizontal violence between staff members on her unit, primarily verbal abuse and malicious gossip. What should she do?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newly licensed nurse about the benefits of atraumatic care. Which of the following statements by the newly licensed nurse indicates that the teaching was effective?

Correct Answer is ["A","C"]

Explanation

When calculating a 1-minute APGAR, the nurse evaluates the following assessment data: Heart rate 120 BPM; strong cry; well-flexed; reflex-crying: body pink; acrocyanosis present in hands and feet. In view of these findings, the nurse should assign an APGAR score of:

Correct Answer is ["9"]

Explanation

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A new nurse manager has observed several instances of horizontal violence between staff members on her unit, primarily verbal abuse and malicious gossip.
What should she do?