Nursing Elites

1. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

2. Penalties should be __________ .

• A. Determining the employee's awareness of the policy
• B. Describing the staff nurse's behavior that violated the policy
• C. Progressive
• D. Confrontation

Correct answer: C

Rationale: Penalties for policy violations should be progressive. This means that the disciplinary actions should escalate based on the severity or frequency of the violation. For minor infractions, like smoking in an unauthorized area, a progressive approach may include oral warnings, written warnings, suspension, and termination if the behavior persists. In contrast, major violations, such as theft, may warrant immediate and severe consequences like suspension or termination. Choices A, B, and D are incorrect as they do not address the concept of progressively escalating penalties based on the violation's severity or recurrence.

3. Which of the following is a trait that was found to be common among leaders in trait theory?

• A. Communication of duties assigned
• B. Adaptability and changing priorities
• C. Order giving and decision making for a group
• D. Communication of goal direction

Correct answer: D

Rationale: The correct answer is D, 'Communication of goal direction.' Trait theory suggests that effective leaders possess certain traits, one of which is the ability to clearly communicate the direction and goals of the group. This trait helps in aligning the efforts of the team towards a common objective. Choices A, B, and C are incorrect because while communication, adaptability, decision-making, and order giving are important skills for leaders, the specific trait commonly associated with leaders in trait theory is the ability to communicate the direction and goals.

4. 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 correct answer is 'Disruptive conflict.' In disruptive conflict, the parties involved are engaged in activities to reduce, defeat, or eliminate the opponent. In this scenario, the resident and the nurse are engaging in behaviors that disrupt their professional relationship by intentionally ignoring pages and making excessive retaliatory calls. Perceived conflict refers to a situation where one or more parties believe that a conflict exists, competitive conflict involves striving to achieve personal goals at the expense of others, and felt conflict refers to the emotional involvement in a conflict situation.

5. A nurse is caring for a client who is scheduled to be transferred to a long-term care facility. The client's family questions the nurse about the reasons for the transfer. Which of the following responses made by the nurse is appropriate?

• A. The transfer of your family member is being done because the provider knows what's best.
• B. Would you like us to discuss the transfer with your family member?
• C. Why are you so concerned about this transfer?
• D. I know how you feel. My parent had to be transferred to a long-term care facility.

Correct answer: A

Rationale: The correct response is A because it provides a professional and reassuring explanation for the transfer, focusing on the expertise of the healthcare provider. Choice B offers to include the family member in the discussion, which may not address their concerns directly. Choice C appears defensive and does not address the family's inquiry. Choice D shifts the focus to the nurse's personal experience, which may not be relevant or helpful to the family seeking information about their own situation.

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