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. A 34-year-old has a new diagnosis of type 2 diabetes. The nurse will discuss the need to schedule a dilated eye exam

• A. every 2 years
• B. as soon as possible
• C. when the patient is 39 years old
• D. within the first year after diagnosis

Correct answer: B

Rationale: The correct answer is 'B' - as soon as possible. Patients with type 2 diabetes should have a dilated eye exam shortly after diagnosis to check for any signs of diabetic retinopathy, a common complication of diabetes. Waiting for 2 years (choice A) may lead to missing early signs of eye damage. Choice C is incorrect as there is no specific age requirement mentioned for the eye exam. Choice D is also incorrect because early detection and intervention are crucial in diabetic eye disease.

3. An RN comes upon a serious motor vehicle accident that has just occurred and no first responders are on the scene. One car has been flipped upside down, and she can see the driver still in the car. The RN decides to stop and help. She knows she is protected from civil liability as long as she does which of the following?

• A. Acts in an ordinary, reasonable, and prudent professional manner
• B. Assures that information obtained is not communicated to anyone else
• C. Does not make any verbal comments that could lead to economic harm
• D. Fails to meet the established standards of practice

Correct answer: A

Rationale: The correct answer is A: 'Acts in an ordinary, reasonable, and prudent professional manner.' In emergency situations, healthcare professionals are protected from civil liability as long as they act in a manner that any other reasonable and prudent professional would under similar circumstances. Choice B is incorrect because communication of relevant information is essential for patient care and handover to other healthcare providers. Choice C is incorrect as it pertains to a different issue of preventing economic harm rather than addressing the immediate medical needs of the injured driver. Choice D is incorrect because failing to meet established standards of practice can lead to liability, especially in emergencies where immediate action is required to save lives.

4. Which of the following is an example of a conflict of interest in nursing?

• A. A nurse accepting gifts from a patient
• B. A nurse working for two competing healthcare organizations
• C. A nurse disclosing patient information without consent
• D. A nurse delegating tasks improperly

Correct answer: B

Rationale: The correct answer is B. A nurse working for two competing healthcare organizations represents a conflict of interest as it may affect impartiality. Choice A is incorrect as accepting gifts from a patient may be a violation of ethical standards, but it is not a conflict of interest. Choice C is incorrect as disclosing patient information without consent is a breach of confidentiality, not a conflict of interest. Choice D is incorrect as delegating tasks improperly relates to professional competence, not a conflict of interest.

5. 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.

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