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. One of the perceptions of turnover is:

• A. Poor management
• B. Rejection of the job
• C. Loss of poor performers
• D. Poor job atmosphere

Correct answer: B

Rationale: The correct answer is B: 'Rejection of the job.' According to Steers and Stone, turnover can be perceived by coworkers as a rejection of the job. Choice A, 'Poor management,' is incorrect because turnover perception is more related to individual feelings about the job rather than management. Choice C, 'Loss of poor performers,' is incorrect as it focuses on the outcome of turnover rather than the perception. Choice D, 'Poor job atmosphere,' is incorrect as it describes a cause of turnover rather than a perception.

3. In preparation for a client's procedure with a latex allergy, which of the following precautions should the nurse take?

• A. Ensure sterilization of nondisposable items with ethylene oxide.
• B. Wear hypoallergenic latex gloves that do not contain powder.
• C. Cleanse latex ports on IV tubing with chlorhexidine before injecting medication.
• D. Wrap monitoring cords with stockinette and tape them in place.

Correct answer: B

Rationale: The correct answer is B: Wear hypoallergenic latex gloves that do not contain powder. When a client has a latex allergy, it is crucial to avoid direct contact with latex-containing products to prevent an allergic reaction. Choosing hypoallergenic latex gloves that are powder-free reduces the risk of the client being exposed to latex allergens. Option A is incorrect because using ethylene oxide for sterilization does not directly address the client's latex allergy. Option C is incorrect because cleansing latex ports with chlorhexidine does not eliminate the risk of latex exposure. Option D is incorrect as it does not specifically address the issue of latex allergy during the procedure.

4. Your values do not coincide with your colleagues. When you report for your shift on nights and staff are not responding to patient requests for pain medication, you, as the nurse responsible for collecting data about patient quality of care, should:

• A. Explain to the nurse manager that quality problems are because of staff apathy.
• B. Issue a memo to staff to assess patients and document their response to the pain medication.
• C. Explain to staff that improving quality is one of your annual goals and you expect them to follow through.
• D. Schedule meetings to engage with staff to monitor pain management.

Correct answer: D

Rationale: As the nurse responsible for collecting data about patient quality of care, it is important to address the issue of staff not responding to patient requests for pain medication. Scheduling meetings to engage with staff to monitor pain management is the most appropriate course of action in this scenario. By enlisting support from staff, reviewing patient satisfaction data, and quality reports about pain management, you can effectively address the issue and improve patient care. Choices A, B, and C are not as effective as they do not involve actively engaging with staff, reviewing data, and working collaboratively to address the problem.

5. The length of a coaching session should be no longer than:

• A. 15 minutes.
• B. 60 minutes.
• C. 10 minutes.
• D. 30 minutes.

Correct answer: C

Rationale: The correct answer is C: '10 minutes.' Coaching sessions are recommended to last between 5-10 minutes to ensure they are concise and impactful. Choice A ('15 minutes') is incorrect because it exceeds the recommended duration. Choice B ('60 minutes') is incorrect as it is too long for an effective coaching session, leading to decreased engagement. Choice D ('30 minutes') is also incorrect as it surpasses the optimal time frame for a coaching session.

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