Nursing Elites

1. A nurse needs to know how to increase her power base. Which of the following are ways nurses can generate power as described by Umiker?

• A. Using body language, standing when talking
• B. Listening for feelings
• C. Using words, avoiding clichés
• D. All of the above

Correct answer: D

Rationale: The correct answer is D: 'All of the above.' Umiker describes four ways to generate power: using words, through delivery, by listening, and through body language. Choice A is correct as it mentions using body language. Choice B is correct as it mentions listening. Choice C is correct as it pertains to using words effectively and avoiding clichés. Therefore, all the choices are ways nurses can generate power as described by Umiker.

2. What is the main concern with collective bargaining?

• A. Create tension among nurses.
• B. Reform health care.
• C. Secure economic security.
• D. Unite the nurses.

Correct answer: A

Rationale: The main concern with collective bargaining is that it can create tension among nurses. The bargaining process may lead to divisions between staff nurses and management, rather than uniting them. This tension can arise from differing priorities, goals, or interests between the two groups, potentially impacting the effectiveness of the bargaining process. Choices B, C, and D are incorrect because the primary focus of the concern is on the potential negative impact on nurse relationships, not on reforming healthcare, ensuring economic security, or uniting nurses.

3. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

4. What is the primary purpose of clinical pathways in healthcare?

• A. Reduce hospital readmissions
• B. Standardize care
• C. Provide individualized care
• D. Streamline care processes

Correct answer: C

Rationale: The primary purpose of clinical pathways in healthcare is to provide individualized care. While clinical pathways do involve standardizing treatment plans, their main goal is to tailor these plans to the individual needs of patients. This customization ensures that patients receive care that is specific to their condition and requirements, rather than a one-size-fits-all approach. Choices A, B, and D are incorrect because although reducing hospital readmissions, standardizing care, and streamlining care processes can be benefits of clinical pathways, they are not the primary purpose. The main focus is on delivering personalized treatment paths to enhance patient outcomes.

5. A client complains every morning that the night shift nursing staff does not answer his call light promptly to assist his elimination needs. His concerns are not shared with the Nurse Manager, and he falls while trying to walk to the bathroom. This fall could be attributed to which of the following?

• A. Breakdown in communication
• B. Lack of staff
• C. Lack of concern
• D. Breakdown in management

Correct answer: A

Rationale: The correct answer is A: Breakdown in communication. In this scenario, the client's complaints about the night shift nursing staff not responding promptly to his call light indicate a lack of effective communication. If the client's concerns were properly communicated to the Nurse Manager, steps could have been taken to address the issue and prevent the fall. Choice B, Lack of staff, is incorrect as the issue here is not related to staffing levels but rather to communication breakdown. Choice C, Lack of concern, is not the primary cause of the fall; the root cause lies in communication failure. Choice D, Breakdown in management, while related, is not as direct a cause as the breakdown in communication which led to the fall.

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