Nursing Elites

1. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

2. How has advanced technology in health care, such as integrated health records, benefited nurses?

• A. Skip the assessment step of the nursing process
• B. Order medications
• C. Take blood samples
• D. Track patients' vital signs

Correct answer: D

Rationale: Advanced technology in health care, like integrated health records, has enabled nurses to efficiently track patients' vital signs. This capability helps nurses monitor patients' health status closely and make informed decisions regarding their care. Choices A, B, and C are incorrect because technology does not replace the vital role of nurses in conducting assessments, ordering medications (typically done by prescribers), or collecting blood samples.

3. When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model?

• A. Moving the system to a new level
• B. Unfreezing the system
• C. Refreezing the system
• D. Institutionalization

Correct answer: B

Rationale: The correct answer is 'Unfreezing the system.' In Lewin's Force-Field Model, unfreezing is the stage where the existing equilibrium is disrupted to motivate participants and prepare them for change. Building trust and recognizing the need for change are essential components of this stage. Choice A, 'Moving the system to a new level,' does not specifically address the initial stage of disruption. Choice C, 'Refreezing the system,' comes after change has been implemented, not before. Choice D, 'Institutionalization,' refers to the stage where the change becomes the new norm, which is different from unfreezing.

4. A Manager decides that setting goals will assist her in better utilizing her time. Which of the following are true regarding goal setting in the Manager role?

• A. Goals need to be measurable, realistic, and achievable to be effective.
• B. Writing goals will increase the stress level of the Manager.
• C. Goals should be vague, so they are more likely to be met.
• D. Setting goals is a time waster in the Manager role.

Correct answer: A

Rationale: Setting goals is beneficial for a Manager as they provide direction and save time. Therefore, goals need to be measurable, realistic, and achievable to be effective. Choice B is incorrect as writing goals does not increase stress but rather helps in time management. Choice C is incorrect because vague goals can lead to confusion and lack of clarity. Choice D is also incorrect as setting goals is a productive activity that aids in time management and achievement.

5. A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

• A. Perceived conflict
• B. Disruptive conflict
• C. Competitive conflict
• D. Felt conflict

Correct answer: B

Rationale: The behavior displayed by the resident and the nurse is an example of disruptive conflict. In disruptive conflict, the parties involved engage in activities to reduce, defeat, or eliminate the opponent. The resident refusing to answer calls and the nurse retaliating with frequent calls to 'get back' at him exemplify behaviors aimed at causing disruption and conflict between them. Perceived conflict refers to each party's perception of the other's position, competitive conflict involves one side winning at the expense of the other, and felt conflict is about the feelings of opposition within the relationship, none of which fully capture the nature of the conflict displayed in this scenario.

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