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. What is the primary role of a nurse in palliative care?

• A. To provide emotional support to patients and families
• B. To coordinate patient care and provide pain management
• C. To administer medications and treatments
• D. To conduct research on end-of-life care

Correct answer: B

Rationale: The correct answer is B. In palliative care, a nurse's primary role is to coordinate patient care and provide pain management. While emotional support (Choice A) is a crucial aspect of palliative care, it is not the primary role of a nurse in this setting. Administering medications and treatments (Choice C) is part of the nurse's responsibilities but not the primary role. Conducting research (Choice D) is important for advancing palliative care but is not the primary role of a nurse providing direct patient care in this context.

3. Change is a mandatory skill for managers. Successful change agents display certain characteristics. Some of these characteristics are: (Select all that apply.)

• A. Energy
• B. Confidence
• C. Ambiguity
• D. Trustworthiness

Correct answer: C

Rationale: The correct answer is 'C: Ambiguity.' The rationale behind this is that the provided list of characteristics that successful change agents demonstrate includes 'realistic thinking' as one of the traits, not 'ambiguity.' Therefore, 'A: Energy,' 'B: Confidence,' and 'D: Trustworthiness' are not among the characteristics mentioned in the extract.

4. The charge nurse role has negatively affected your relationship with your friends and made you feel tense and isolated. You decide that you will delegate more time-consuming tasks to staff who are not your friends, who then complain to your nurse manager about your perceived unfairness. You decide to:

• A. Talk with your friends individually to let them know that you will be assigning patients to all staff in an equitable manner.
• B. Not express your angry feelings.
• C. Talk about staff who are annoying you with staff on other units.
• D. Ignore your feelings of uncertainty, hoping they will diminish.

Correct answer: A

Rationale: In this scenario, it is essential to address the perceived unfairness in task delegation. Talking with your friends individually to explain that patients will be assigned equitably is the most appropriate course of action. This approach promotes transparency and fairness in task allocation, helping to maintain professional relationships. Choices B, C, and D are not suitable responses. Choice B ignores the issue, choice C involves unprofessional behavior by gossiping about colleagues, and choice D neglects addressing the root cause of the problem.

5. Which of the following theories best describes current health care delivery systems?

• A. Open system theory
• B. Closed system theory
• C. Chaos theory
• D. Contingency theory

Correct answer: D

Rationale: The contingency theory best describes the current health care delivery systems. Contingency theory emphasizes that there is no one best way to organize or manage, and the effectiveness of an organization is contingent upon internal and external factors. In healthcare, the delivery systems must often adapt and be flexible in response to various factors like patient needs, technological advancements, and regulatory changes. Open system theory focuses on the interaction between a system and its environment, but it does not capture the dynamic and adaptive nature of current healthcare systems. Closed system theory suggests systems are self-contained and do not interact with the environment, which is not accurate for healthcare systems that constantly interact with patients, providers, and external factors. Chaos theory deals with complex systems and unpredictability, which while relevant to some aspects of healthcare, does not provide a comprehensive framework for understanding healthcare delivery systems.

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