Nursing Elites

1. A nurse manager is interested in solving a serious conflict that exists among the nursing staff. He uses a strategy that involves allowing the group to explore a number of solutions and come to a consensus on a solution. What strategy for conflict resolution has the manager used?

• A. Integrative decision-making
• B. Win-win
• C. Competing
• D. Confrontation

Correct answer: A

Rationale: The correct answer is A: Integrative decision-making. Integrative decision-making involves allowing a group to explore various solutions and work together to reach a consensus. This strategy focuses on collaboration and finding a solution that meets the needs of all parties involved. Choices B, C, and D are incorrect. 'Win-win' is another term for integrative decision-making, 'Competing' involves pursuing one's own interests at the expense of others, and 'Confrontation' implies a direct conflict rather than a collaborative approach to resolution.

2. Verbal interventions with an agitated patient may be calming. These interventions include:

• A. Holding and reassuring the patient
• B. Encouraging other staff to distract the patient
• C. Remaining calm and keeping an arm's distance
• D. Standing close to the patient while talking

Correct answer: C

Rationale: The correct answer is C: Remaining calm and keeping an arm's distance. Agitated individuals benefit from minimal verbal and physical stimulation. They respond to their environment based on how nurses interact with them. If an individual feels threatened or cornered, the response will generally be self-protective and reactive. Standing close to the patient (choice D) can be perceived as invasive and may escalate the situation. Holding and reassuring the patient (choice A) may not be effective if the patient perceives it as intrusive. Encouraging other staff to distract the patient (choice B) may introduce unnecessary stimulation. Therefore, the recommended approach is to remain calm and keep a safe distance to provide a non-threatening environment for the agitated patient.

3. An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached?

• A. One or more of the parties may be able to reconcile their values.
• B. The patient�s point of view is recognized as valuable.
• C. The dilemma involves two or more equally unpleasant choices.
• D. The institution is unable to honor the patient�s request.

Correct answer: D

Rationale: A patient may make a request that is not possible within the institution. When this occurs, a solution may not be possible within the institution and the patient may need to be transferred to a different institution that may be able to honor the request.

4. The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problems?

• A. Downward communication
• B. Lateral communication
• C. Distorted communication
• D. Upward communication

Correct answer: B

Rationale: The correct answer is B: Lateral communication. Lateral communication occurs between individuals or departments of the same hierarchical level, making it suitable for addressing conflicts between the staff on a medical-surgical unit and the occupational therapy department. Upward communication involves communication from staff to management or from lower management to middle or upper management. Downward communication is typically directive communication from an authority figure or manager to staff. Distorted communication is not a recognized type of communication and does not apply to this scenario.

5. What is the primary focus of a performance appraisal for nursing staff?

• A. To identify areas for salary increases
• B. To evaluate overall job performance
• C. To provide feedback on clinical skills
• D. To determine eligibility for promotions

Correct answer: C

Rationale: The primary focus of a performance appraisal for nursing staff is to provide feedback on clinical skills, identify areas for improvement, and support professional development. While salary increases, overall job performance evaluation, and promotions may be factors considered during a performance appraisal, the primary goal is to assess and enhance clinical skills to ensure high-quality patient care.

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