Nursing Elites

1. After examining her client's abdomen and noting assessment of significant findings, even though the client says it doesn't hurt, the nurse says to a colleague, 'I think something is going on here; I am going to investigate further.' This nurse is using:

• A. Deductive reasoning.
• B. Intuition.
• C. Trial and error.
• D. Modified scientific method.

Correct answer: B

Rationale: The correct answer is B: Intuition. In this scenario, the nurse is relying on intuition, which refers to a 'gut feeling' or instinctive understanding without the conscious use of reasoning. Deductive reasoning (choice A) involves drawing specific conclusions from general principles. Trial and error (choice C) is a problem-solving method that involves trying various methods until the correct one is found. The modified scientific method (choice D) refers to a structured approach to conducting experiments in a scientific setting, which is not applicable in this situation where the nurse is relying on a hunch or intuition.

2. The nurse manager has two employees with a longstanding conflict that is affecting the group's productivity and cohesiveness. She decides to meet with the employees in private, bring the conflict out into the open, and attempt to resolve it through knowledge and reason. Which conflict management strategy did she employ?

• A. Confrontation
• B. Suppression
• C. Collaboration
• D. Intervention

Correct answer: A

Rationale: The nurse manager employed the conflict management strategy of 'Confrontation.' Confrontation involves bringing the conflict out into the open and attempting to resolve it through knowledge and reason, making it the most effective means of resolving conflict in this scenario. Choice B, 'Suppression,' involves ignoring or avoiding the conflict, which is not what the nurse manager did. Choice C, 'Collaboration,' refers to working together to find a mutually acceptable solution and was not explicitly mentioned in the scenario. Choice D, 'Intervention,' typically involves a third party stepping in to help resolve the conflict, which was not the case here.

3. A Nurse Manager completes an interruption log and identifies two staff members who take an inordinate amount of time with drop-in issues that are not urgent. What are some methods to address this behavior in an attempt to better manage time? (Select all that apply.)

• A. Designate specific time slots for drop-in visits.
• B. Position the desk chair so it is not facing the hallway.
• C. Communicate with staff about using e-mail for non-urgent matters to improve time management.
• D. When staff members drop in, the manager should stand and remain standing during the conversation.

Correct answer: A

Rationale: Designating specific time slots for drop-in visits helps in managing interruptions effectively by consolidating them into designated periods. This approach allows the Nurse Manager to allocate focused time for addressing these issues without disrupting workflow. Option B, repositioning the desk chair, is not a standard strategy for managing time or interruptions. Option C, promoting the use of e-mail for non-urgent matters, may help in some cases but may not entirely address the behavior of extended drop-in visits. Option D, standing during conversations, may not be practical for longer discussions and does not provide a structured approach to address time management issues.

4. As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?

• A. Evidence-based practice guides risk management principles.
• B. Client teaching is the responsibility of the team leader.
• C. The initial level of practice responsibility will be limited.
• D. Seniority is the main determinant of client assignments.

Correct answer: C

Rationale: In a differentiated practice model, the scope of nursing practice and responsibility are tailored to different levels of experience. As a new graduate with limited experience, the nurse can expect that the initial level of practice responsibility will be limited to match their skill level and knowledge. This allows for a gradual increase in responsibilities as the nurse gains more experience and expertise. Choice A is incorrect because evidence-based practice is related to clinical decision-making, not the staffing model. Choice B is incorrect as client teaching is typically a shared responsibility among the healthcare team, not solely the team leader's. Choice D is incorrect as differentiated practice models focus on skill level and competence rather than seniority when determining client assignments.

5. A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent?

• A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse.
• B. Incompetence only impacts the individual nurse.
• C. The director should follow her institution�s formal process for reporting and handling practices that jeopardize patient safety.
• D. Most nurse practice acts direct how to handle incompetent nurses.

Correct answer: C

Rationale: Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed.

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