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. A technique used to eliminate negative behavior by ignoring the behavior is known as __________.

• A. Punishment
• B. Extinction
• C. Shaping
• D. Equity

Correct answer: B

Rationale: The correct answer is B, 'Extinction.' Extinction is a behavioral psychology technique where undesirable behavior is ignored, leading to its eventual decrease or elimination. This process involves withholding reinforcement that was previously maintaining the behavior. Choice A, 'Punishment,' involves applying negative consequences to reduce unwanted behavior, which is different from extinction. Choice C, 'Shaping,' is a method of gradually molding or reinforcing behaviors to reach a desired behavior, not ignoring negative behavior. Choice D, 'Equity,' refers to fairness and equal treatment, which is unrelated to eliminating negative behavior through ignoring it.

3. A client who had a stroke resulting in aphasia and dysphagia needs assistance. Which of the following tasks should the nurse assign to an assistive personnel (AP)?

• A. Assist the client with a partial bed bath.
• B. Measure the client's BP after the nurse administers an antihypertensive medication.
• C. Test the client's swallowing ability by providing thickened liquids.
• D. Use a communication board to ask what the client wants for lunch.

Correct answer: A

Rationale: The correct answer is A because assisting the client with a partial bed bath is within the scope of practice for an assistive personnel and does not require specialized medical knowledge. Choice B involves measuring BP, which requires specific training and assessment skills that an assistive personnel may not have. Choice C involves testing swallowing ability, which should be done by a healthcare provider due to the risks involved in dysphagia. Choice D involves communication, which is crucial but should be done by someone with training in managing aphasia to ensure effective communication with the client.

4. Which of the following statements about time management is true?

• A. Time management is not important in nursing
• B. Writing goals will increase stress
• C. Effective time management reduces stress
• D. Setting goals is a time waster

Correct answer: C

Rationale: The correct answer is C: Effective time management reduces stress. Proper time management allows nurses to prioritize tasks, allocate sufficient time for each activity, and reduce the feeling of being overwhelmed. This, in turn, helps in reducing stress levels and increasing productivity. Choices A, B, and D are incorrect. Time management is crucial in nursing to ensure efficient patient care and task completion. Writing goals helps in providing direction and motivation, reducing stress rather than increasing it. Setting goals is not a time waster; it is a fundamental aspect of effective time management.

5. A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

• A. Have the client wear a mask when receiving visitors.
• B. Limit the client's time with visitors to no more than 30 minutes per day.
• C. Assign the client to a room with negative-pressure airflow exchange.
• D. Wear a gown when caring for the client.

Correct answer: B

Rationale: The correct answer is B because limiting the client's time with visitors helps prevent the spread of shigella infection to others. Shigella is transmitted through the fecal-oral route, so minimizing contact time reduces the risk of transmission. Choice A is incorrect as there is no need for the client to wear a mask in this situation. Choice C is also incorrect as negative-pressure airflow exchange rooms are typically used for clients with airborne infections. Choice D is incorrect as wearing a gown is not the primary precaution needed for shigella infection.

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