Nursing Elites

1. The nurse manager is talking with the CNA about her time management. Which of the following is an example of a nurse manager as a coach?

• A. Your timely response to patients' call lights is exemplary.
• B. Your appearance is seldom professional.
• C. You must get the vital signs taken on time or you will be disciplined.
• D. You never report AM blood sugar levels on time.

Correct answer: A

Rationale: The correct answer is A: 'Your timely response to patients' call lights is exemplary.' This choice reflects a positive reinforcement approach, providing feedback that praises and encourages good behavior. A coach in a professional setting aims to motivate, guide, and support staff rather than focusing on negative aspects or threats of discipline. Effective coaching involves recognizing and acknowledging employees' strengths and achievements to inspire continuous improvement and development. Choices B, C, and D are not examples of coaching as they either focus on criticism regarding appearance, use threatening language, or highlight a negative behavior without offering guidance or support.

2. A client experiences difficulty breathing after the change of shift. The nurse on duty discovers that the IVFs were infusing at a rate 10 times the calculated normal. After notifying the physician and correcting the rate, what should be the next step in the client's care?

• A. Notify family
• B. Discipline the previous nurse
• C. Complete an incident report
• D. Obtain legal consultation

Correct answer: C

Rationale: The correct next step in the client's care after notifying the physician and correcting the rate of IVFs is to complete an incident report. This report is essential for documenting the adverse event, analyzing the cause, and implementing preventive measures to avoid similar incidents in the future. Notifying the family, disciplining the previous nurse, and obtaining legal consultation are not immediate priorities in this situation. Family notification may follow the incident report, disciplining the previous nurse is a separate administrative process, and legal consultation is usually not required for a medical error corrected promptly.

3. Which of the following is an example of an environmental factor that could influence decision-making in nursing?

• A. Personal preferences
• B. Ethical considerations
• C. Availability of resources
• D. All of the above

Correct answer: D

Rationale: The correct answer is D, 'All of the above.' Environmental factors encompass a wide range of influences on decision-making in nursing. Personal preferences can impact how a nurse chooses a course of action, ethical considerations guide decision-making based on moral principles, and the availability of resources determines the options that are feasible. Therefore, all of these factors play a significant role in influencing decision-making in nursing. Choices A, B, and C are incorrect because each of them individually represents a specific environmental factor, whereas the correct answer D acknowledges that all of these factors collectively contribute to influencing decision-making.

4. Which of the following is an example of an ethical dilemma in nursing?

• A. Choosing between two equally undesirable alternatives
• B. Reporting a colleague's unethical behavior
• C. Balancing patient confidentiality with the need to disclose information
• D. Deciding whether to comply with a patient's request that conflicts with professional ethics

Correct answer: D

Rationale: The correct answer is D. An ethical dilemma in nursing involves deciding whether to comply with a patient's request that conflicts with professional ethics, balancing competing values and principles. Choices A, B, and C do not directly represent ethical dilemmas in nursing. Choice A describes a general ethical dilemma, choice B involves professional conduct rather than a dilemma, and choice C refers to a confidentiality issue rather than conflicting ethical principles.

5. Lippitt's phases of change are important factors in the change process. The phase that involves key people in data collection is known as:

• A. Assess the motivation.
• B. Choose a change agent.
• C. Diagnose the problem.
• D. Maintain the change.

Correct answer: C

Rationale: The correct answer is C: 'Diagnose the problem.' In Lippitt's phases of change, the first step is to diagnose the problem, which involves key people in data collection and problem-solving. This step is crucial as it helps identify the root causes of the issues that need to be addressed. Assessing the motivation (A) comes later in the change process once the problem has been diagnosed. Choosing a change agent (B) and maintaining the change (D) are also important steps in the change process but do not specifically involve key people in data collection as in the diagnosis phase.

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