Nursing Elites

1. Staff refuse to report unsafe conditions, with unattended entrances throughout the health care facility noted. Unidentified individuals are wandering the unit at night, and you:

• A. Establish expectations.
• B. Demand that they leave immediately.
• C. Ask them to leave.
• D. Observe their behaviors.

Correct answer: A

Rationale: In this scenario, the correct course of action is to establish expectations. By setting clear guidelines and expectations, you can address the issue of unidentified individuals wandering the unit at night in a proactive manner. This approach helps communicate what behaviors are acceptable, ensuring the safety of both staff and patients. Demanding that they leave immediately may not address the root cause of the problem and could escalate the situation. Simply observing their behaviors may not effectively resolve the issue or prevent future incidents. Asking them to leave without first establishing expectations may not prevent similar occurrences in the future.

2. Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following?

• A. Quality management is not useful in the outpatient setting
• B. Benchmarking compares outcomes in a variety of settings and disciplines
• C. Quality management is used only in the primary care setting
• D. Benchmarking looks only at outcomes specific to nursing

Correct answer: B

Rationale: The major difference between quality management and benchmarking is that benchmarking compares outcomes in a variety of settings and disciplines. Choice A is incorrect because quality management can be applied in both inpatient and outpatient settings. Choice C is incorrect as quality management is not limited to primary care and can be implemented across various healthcare settings. Choice D is incorrect as benchmarking does not solely focus on nursing outcomes but rather compares outcomes across different disciplines and settings.

3. A new nurse manager is attempting to solve a management issue by using one solution after another until she solves the problem. This would be known as what type of method?

• A. Decision making
• B. Trial and error
• C. Experimentation
• D. Analysis

Correct answer: B

Rationale: The correct answer is B. Trial and error is a method used by new managers to solve problems by trying different solutions until one is successful. In this scenario, the nurse manager is using a trial and error approach by attempting various solutions until the issue is resolved. Choices A, C, and D are incorrect because decision making involves making choices based on available information, experimentation involves testing hypotheses in a controlled setting, and analysis entails examining data and information to gain insights or draw conclusions, none of which directly reflect the iterative process of trial and error.

4. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?

• A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
• B. Encourage the client to explore the reasons behind feeling useless.
• C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
• D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'

Correct answer: A

Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.

5. When looking at the issue surrounding absenteeism, an innovative approach would be:

• A. Rewarding those who do not use days.
• B. Substituting personal days.
• C. Termination.
• D. Disciplinary actions.

Correct answer: B

Rationale: The correct answer is B. Substituting personal days for sick days can be considered an innovative approach to addressing absenteeism as it allows for proper planning by the nurse manager. This approach promotes a proactive and flexible solution that encourages employees to manage their time off more effectively. Choice A, rewarding those who do not use days, may not address the root causes of absenteeism and could create a culture of presenteeism. Choices C and D, termination and disciplinary actions, are punitive measures that do not focus on preventive strategies or address the underlying reasons for absenteeism.

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