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 nurse manager needs to resolve a conflict between the staff nurses and the physical therapy department. What type of power might the manager utilize? (EXCEPT)

• A. Connection and referent power
• B. Reward and punishment power
• C. Legitimate power
• D. Information power

Correct answer: C

Rationale: In this scenario, the nurse manager may utilize various types of power to resolve the conflict between the staff nurses and the physical therapy department. Referent power and connection power are based on respect/admiration and influential links, respectively. Information power is about access to valuable data. Reward power involves offering inducements for cooperation, while punishment power is about imposing penalties for non-compliance. Legitimate power, however, is derived from the manager's authority associated with their job and rank. Since the question asks for the type of power the manager might utilize 'EXCEPT,' legitimate power, being a key type of power often used in managerial roles, is the correct answer. It's important for the nurse manager to understand the dynamics of power and utilize the appropriate types to effectively address interdepartmental conflicts.

3. Which of the following scenarios would be an example of shared governance on a nursing unit?

• A. Staff nurses delegate activities to CNAs.
• B. Procedure manuals are written by a committee of nurse managers.
• C. Staff nurses and CNAs make their own schedules.
• D. A unit manager seeks advice from her supervisor.

Correct answer: C

Rationale: The correct answer is C. Shared governance in a nursing unit involves staff nurses and CNAs having autonomy and decision-making power in aspects like scheduling, which is reflected in them making their own schedules. This scenario aligns with the philosophy of shared governance where nursing practice is best determined by nurses. Choices A, B, and D do not exemplify shared governance as they involve hierarchical delegation, managerial decision-making, and seeking advice from superiors rather than autonomous decision-making by frontline staff.

4. To best reduce the potential for risk, what type of atmosphere is needed to be developed?

• A. Nurse-focused
• B. Physician-focused
• C. Family-focused
• D. Patient-focused

Correct answer: D

Rationale: The correct answer is 'Patient-focused.' When aiming to reduce the potential for risk, it is essential to prioritize the needs and well-being of the patients. Creating a patient-focused atmosphere helps ensure that decisions and actions are made with the patients' best interests in mind. Choices A, B, and C are incorrect because while nurses, physicians, and families play essential roles in healthcare, when it comes to reducing risks, the primary focus should be on the patients themselves.

5. 12. A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time will it be most important for the nurse to monitor for symptoms of hypoglycemia?

• A. 10:00 AM
• B. 12:00 PM
• C. 2:00 PM
• D. 4:00 PM

Correct answer: A

Rationale: After receiving aspart (NovoLog) insulin, which has a rapid onset, it is crucial to monitor the patient for symptoms of hypoglycemia during the peak action time. Typically, the peak action of aspart insulin occurs around 2 hours after administration. Therefore, the nurse should be most vigilant for hypoglycemia symptoms at 10:00 AM. Choice B (12:00 PM) is incorrect as it falls after the expected peak action time. Choices C (2:00 PM) and D (4:00 PM) are also incorrect because the peak action time of aspart insulin typically occurs earlier, around 2 hours post-administration.

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