Nursing Elites

1. In dealing with a conflict on a unit, the nurse manager decides to ask one of the staff nurses, who is not moving towards resolution, to transfer to another unit. What tactic has the manager implemented?

• A. Avoidance
• B. Withdrawal
• C. Suppression
• D. Competition

Correct answer: C

Rationale: The correct answer is C: Suppression. In this scenario, the nurse manager has implemented a suppression tactic by asking the staff nurse to transfer to another unit, which eliminates one of the conflicting parties from the current unit. This technique aims to resolve the conflict by physically separating the individuals involved. Choices A, B, and D are incorrect: Avoidance involves ignoring the conflict, withdrawal is the act of pulling out or retreating, and competition refers to a situation where one party's gain is at the expense of the other.

2. Which of the following best describes the concept of total quality management (TQM)?

• A. Top-down management
• B. Employee-centered approach
• C. Continuous improvement
• D. Quality control

Correct answer: C

Rationale: The correct answer is C: Continuous improvement. Total quality management (TQM) focuses on continuously improving all aspects of healthcare delivery to enhance patient care, safety, and overall quality. Choice A, 'Top-down management,' does not capture the essence of TQM, which involves involvement at all levels of an organization. Choice B, 'Employee-centered approach,' while important, is not the defining characteristic of TQM. Choice D, 'Quality control,' is a component of TQM but does not fully encompass its comprehensive approach to quality improvement.

3. A nurse is discussing the responsibility of caring for clients with clostridium difficile infection. Which of the following information should the nurse include in the teaching?

• A. Have family members wear a gown and gloves when visiting.
• B. Clean contaminated surfaces in the client's room with a bleach solution.
• C. Use alcohol-based hand sanitizer when leaving the client's room.
• D. Assign the client to a room with a private bathroom.

Correct answer: A

Rationale: When caring for clients with clostridium difficile infection, it is important to prevent the spread of the bacteria. Having family members wear a gown and gloves when visiting helps reduce the risk of transmission. Cleaning contaminated surfaces with a bleach solution, not phenol, is recommended to effectively kill the C. difficile spores. Using alcohol-based hand sanitizer is not sufficient, as it may not be effective against C. difficile spores. Assigning the client to a room with a private bathroom is more beneficial than a negative airflow system, as it helps prevent the spread of bacteria to other clients.

4. A client is admitted to a medical-surgical unit after six hours in the emergency room. He requests that his AM care be delayed to allow him to rest. The nurse complies with his request. This is an example of which type of management philosophy?

• A. Continuous quality improvement
• B. Total quality management
• C. Six Sigma
• D. Quality management

Correct answer: B

Rationale: Total Quality Management (TQM) emphasizes meeting customer needs and satisfaction. In this scenario, by honoring the client's request to delay care to allow for rest, the nurse is aligning with the customer-focused approach of TQM. TQM seeks to continuously improve processes and services to enhance customer experiences and outcomes. Continuous Quality Improvement focuses on incremental improvements in processes and outcomes over time. Six Sigma is a data-driven approach to process improvement that aims to reduce defects and errors. Quality Management is a broader concept that encompasses various strategies to ensure quality standards are met.

5. What behaviors can be observed before a person becomes violent? (EXCEPT)

• A. Wandering
• B. Tense shoulders and clenched fists
• C. Blank stare
• D. Positioned with one foot in back and an arm pulled back

Correct answer: A

Rationale: Before a person becomes violent, observable behaviors may include tense shoulders, clenched fists, a blank stare, and being positioned with one foot in back and an arm pulled back. Wandering is not typically associated with threatening behaviors signaling imminent violence. DelBel (2003) suggests that strategies such as relaxed body language, maintaining physical distance, and silence can help de-escalate an agitated individual's response.

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