Nursing Elites

1. A ___________ manager supervises a number of first-level managers, usually within related specialties.

• A. self-directed
• B. first-level
• C. middle-level
• D. self-motivated

Correct answer: C

Rationale: A middle-level manager is responsible for overseeing a group of first-level managers who handle day-to-day operations within their respective specialties. Middle-level managers play a crucial role in coordinating and aligning the efforts of multiple first-level managers to achieve organizational goals. They act as a bridge between top management and frontline employees, ensuring that strategies are effectively implemented at the operational level. Choice A, 'self-directed,' refers to an individual's ability to manage their own work without direct supervision and does not specifically relate to supervising other managers. Choice B, 'first-level,' describes the managers being supervised, not the position responsible for overseeing them. Choice D, 'self-motivated,' pertains to an individual's drive and determination, which is not directly related to the hierarchical level of management being discussed.

2. During a performance appraisal, how should the manager best provide constructive feedback to an employee?

• A. Focus only on the negative aspects of performance
• B. Provide general comments without specifics
• C. Discuss specific examples of strengths and areas for improvement
• D. Delay feedback until the next appraisal period

Correct answer: C

Rationale: During a performance appraisal, the best approach to provide constructive feedback is by discussing specific examples of strengths and areas for improvement. This method allows the employee to understand what they are excelling at and where they need to focus on development. By highlighting both aspects, the employee can work on enhancing their performance effectively. Option A is incorrect because solely focusing on the negative aspects can demotivate the employee and hinder their growth. Option B is incorrect as providing general comments without specifics does not offer clear guidance for improvement. Option D is also incorrect as delaying feedback can prevent timely corrective actions and hinder performance progress.

3. A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

• A. Satisficing
• B. Routine
• C. Adaptive
• D. Rationalizing

Correct answer: A

Rationale: The correct answer is A: Satisficing. Satisficing is a decision-making strategy where the person chooses an alternative that is good enough given the circumstances. In this scenario, the nurse manager is making a satisfactory decision by managing the unit with the three remaining nurses to meet minimal staffing standards despite the reduced availability of staff. Choice B, Routine, does not apply as the decision made in the scenario is not part of a regular or standard procedure. Choice C, Adaptive, is not the best fit as the decision is more about making do with the available resources rather than adapting to a new situation. Choice D, Rationalizing, does not align with the scenario as it refers to justifying decisions rather than making a practical choice under constraints.

4. A client who is nonambulatory notifies the nurse that their trash can is on fire. After the nurse confirms the presence of the fire, which of the following actions should the nurse take next?

• A. Activate the emergency fire alarm.
• B. Extinguish the fire.
• C. Evacuate the client.
• D. Confine the fire.

Correct answer: D

Rationale: In this situation, the nurse's priority should be to confine the fire. By confining the fire, the nurse can prevent it from spreading further and causing more harm. Activating the emergency fire alarm (choice A) is important but should come after confining the fire. Extinguishing the fire (choice B) might not be safe for the nurse to do without proper equipment and training. Evacuating the client (choice C) can be considered once the fire is confined to ensure the client's safety.

5. The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problems?

• A. Downward communication
• B. Lateral communication
• C. Distorted communication
• D. Upward communication

Correct answer: B

Rationale: The correct answer is B: Lateral communication. Lateral communication occurs between individuals or departments of the same hierarchical level, making it suitable for addressing conflicts between the staff on a medical-surgical unit and the occupational therapy department. Upward communication involves communication from staff to management or from lower management to middle or upper management. Downward communication is typically directive communication from an authority figure or manager to staff. Distorted communication is not a recognized type of communication and does not apply to this scenario.

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