Nursing Elites

1. A nurse manager who tells the staff to 'come to me with any problem' but then keeps the office door closed is using what type of communication?

• A. Intrasender conflict
• B. Diagonal communication
• C. Metacommunication
• D. Upward communication

Correct answer: A

Rationale: The correct answer is A: Intrasender conflict. Intrasender conflict happens when there is a discrepancy between verbal and nonverbal communication. In this scenario, the nurse manager's verbal message encourages staff to communicate openly, but the closed office door sends a conflicting nonverbal message, creating intrasender conflict. Metacommunication involves nonverbal behaviors like gestures or facial expressions that support or contradict verbal communication. Upward communication refers to the flow of information from staff to management or lower to upper management. Diagonal communication involves communication between individuals or departments at different hierarchical levels.

2. The problem of overrating staff performance is called ___________ .

• A. Recency error
• B. Absolute judgment
• C. Halo error
• D. Leniency error

Correct answer: D

Rationale: The correct answer is D, 'Leniency error.' Leniency error occurs when a manager tends to overrate staff performance, giving higher ratings than deserved. Choice A, 'Recency error,' refers to the tendency to focus only on recent behaviors or events when evaluating performance. Choice B, 'Absolute judgment,' is not directly related to overrating staff performance; it refers to making evaluations without considering the context or comparison points. Choice C, 'Halo error,' involves allowing one positive aspect of an individual to overshadow other factors in performance evaluation, which is different from overrating overall staff performance.

3. Which of the following best describes the purpose of benchmarking in healthcare?

• A. To compare performance metrics across organizations
• B. To identify best practices and implement them
• C. To ensure compliance with standards
• D. To develop new clinical guidelines

Correct answer: B

Rationale: The correct answer is B: 'To identify best practices and implement them.' Benchmarking in healthcare aims to compare performance metrics across organizations to identify the most effective practices and implement them. This helps healthcare providers improve their performance and outcomes by adopting proven successful strategies. Choices A, C, and D are incorrect because while benchmarking may involve comparing performance metrics and ensuring standards compliance, its primary purpose is to identify and implement best practices.

4. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

5. The nurse is assessing a 22-year-old patient experiencing the onset of symptoms of type 1 diabetes. Which question is most appropriate for the nurse to ask?

• A. "Are you anorexic?"
• B. "Is your urine dark colored?"
• C. "Have you lost weight lately?"
• D. "Do you crave sugary drinks?"

Correct answer: C

Rationale: Weight loss is a common symptom in the onset of type 1 diabetes due to the body's inability to use glucose for energy. The lack of insulin leads the body to break down fat and muscle for fuel, causing unintentional weight loss. This is a more relevant question compared to the others, as it directly relates to the metabolic changes associated with type 1 diabetes.

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