Nursing Elites

1. A client complains every morning that the night shift nursing staff does not answer his call light promptly to assist his elimination needs. His concerns are not shared with the Nurse Manager, and he falls while trying to walk to the bathroom. This fall could be attributed to which of the following?

• A. Breakdown in communication
• B. Lack of staff
• C. Lack of concern
• D. Breakdown in management

Correct answer: A

Rationale: The correct answer is A: Breakdown in communication. In this scenario, the client's complaints about the night shift nursing staff not responding promptly to his call light indicate a lack of effective communication. If the client's concerns were properly communicated to the Nurse Manager, steps could have been taken to address the issue and prevent the fall. Choice B, Lack of staff, is incorrect as the issue here is not related to staffing levels but rather to communication breakdown. Choice C, Lack of concern, is not the primary cause of the fall; the root cause lies in communication failure. Choice D, Breakdown in management, while related, is not as direct a cause as the breakdown in communication which led to the fall.

2. A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?

• A. Wear an N95 respirator when giving direct care to the client.
• B. Place the client in a private room with negative-pressure airflow.
• C. Ensure the client's room has at least six air exchanges per hour.
• D. Ensure the client wears a mask when outside their room if there is construction in the area.

Correct answer: A

Rationale: In a protective environment for a client with an allogeneic stem cell transplant, the nurse needs to wear an N95 respirator when providing direct care to the client. This precaution is essential to protect the client, whose immune system is compromised after the transplant, from exposure to potential pathogens. Placing the client in a private room with negative-pressure airflow (choice B) is more appropriate for clients with airborne infections. Ensuring the client's room has sufficient air exchanges (choice C) is important for maintaining air quality but is not the primary precaution for protecting an immunocompromised client. Making the client wear a mask when outside the room due to construction (choice D) focuses on external factors and does not directly address the risk of infection during direct care.

3. Which of the following is a skill emotionally intelligent leaders must develop?

• A. Encourage constructive criticism.
• B. Work to complete all assigned tasks on his or her own.
• C.
• D. Encourage others to work efficiently and independently.

Correct answer: A

Rationale: Encourage constructive criticism.

4. A nurse is caring for a client who is postoperative and is exhibiting signs of hemorrhagic shock. The nurse notifies the surgeon, who tells the nurse to continue to measure the client's vital signs every 15 min and to report back in 1 hour. Which of the following actions should the nurse take next?

• A. Document the surgeon's instructions in the client's medical record.
• B. Complete an incident report.
• C. Consult the charge nurse.
• D. Notify the nursing manager.

Correct answer: D

Rationale: In this scenario, the nurse should notify the nursing manager next. The surgeon's instructions are related to the client's condition, and it is crucial to inform the nursing manager about the situation. Option A is incorrect because documenting the surgeon's instructions in the medical record is not the immediate next step. Option B is also incorrect as completing an incident report is not warranted in this situation. Option C is not the best choice as consulting the charge nurse may cause a delay in escalating the situation to higher management, which is necessary in cases of emergency like hemorrhagic shock.

5. In dealing with a conflict on a unit, the nurse manager decides to ask one of the staff nurses, who is not moving towards resolution, to transfer to another unit. What tactic has the manager implemented?

• A. Avoidance
• B. Withdrawal
• C. Suppression
• D. Competition

Correct answer: C

Rationale: The correct answer is C: Suppression. In this scenario, the nurse manager has implemented a suppression tactic by asking the staff nurse to transfer to another unit, which eliminates one of the conflicting parties from the current unit. This technique aims to resolve the conflict by physically separating the individuals involved. Choices A, B, and D are incorrect: Avoidance involves ignoring the conflict, withdrawal is the act of pulling out or retreating, and competition refers to a situation where one party's gain is at the expense of the other.

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