Nursing Elites

1. How will working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims affect staff?

• A. Feelings of extreme overload.
• B. Fear of failure.
• C. A pessimistic sense about the world.
• D. Inability to separate intense work situations from personal situations.

Correct answer: B

Rationale: Working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims can lead to feelings of extreme overload, a pessimistic sense about the world, and an inability to separate intense work situations from personal situations. Fear of failure is not specifically mentioned in the context of the question, so it is the correct answer. The constant noises and intense emotional situations can create tension, stress, and negative reactions among staff. Managers can help by assessing the environment, labeling situations, and debriefing with staff to make them more aware of how stressors impact their behaviors.

2. Which patient action indicates a good understanding of the nurse�s teaching about the use of an insulin pump?

• A. The patient programs the pump for an insulin bolus after eating
• B. The patient changes the location of the insertion site every week
• C. The patient takes the pump off at bedtime and starts it again each morning.
• D. The patient plans for a diet that is less flexible when using the insulin pump.

Correct answer: A

Rationale:

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: Satisficing is the correct decision-making strategy in this scenario. The nurse manager is not aiming for the best solution but rather choosing an alternative that is good enough given the circumstances of staff shortage. Choice B, Routine, does not apply here as the situation is not part of the manager's regular tasks. Choice C, Adaptive, involves adjusting to new conditions, which is not the primary focus in this scenario. Choice D, Rationalizing, does not fit as the decision made is more about finding an acceptable solution rather than justifying it.

4. The nurse manager is talking with the CNA about her time management. Which of the following is an example of a nurse manager as a coach?

• A. Your timely response to patients' call lights is exemplary.
• B. Your appearance is seldom professional.
• C. You must get the vital signs taken on time or you will be disciplined.
• D. You never report AM blood sugar levels on time.

Correct answer: A

Rationale: The correct answer is A: 'Your timely response to patients' call lights is exemplary.' This choice reflects a positive reinforcement approach, providing feedback that praises and encourages good behavior. A coach in a professional setting aims to motivate, guide, and support staff rather than focusing on negative aspects or threats of discipline. Effective coaching involves recognizing and acknowledging employees' strengths and achievements to inspire continuous improvement and development. Choices B, C, and D are not examples of coaching as they either focus on criticism regarding appearance, use threatening language, or highlight a negative behavior without offering guidance or support.

5. Which of the following is used as an indirect estimate of voluntary absenteeism?

• A. Involuntary absenteeism
• B. Voluntary absenteeism
• C. Total time lost
• D. Absence frequency

Correct answer: D

Rationale: The correct answer is 'Absence frequency.' Absence frequency is the total number of distinct absence periods, regardless of duration. It is used as an indirect estimate of voluntary absenteeism because it provides insights into the frequency of absences. Voluntary absenteeism refers to absences that are under the employee's control, while involuntary absenteeism is not under their control. Total time lost, on the other hand, represents the number of scheduled days that employees miss, which is different from absence frequency.

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