Nursing Elites

1. The staff nurse delegates AM care for two patients to the UAP (Unlicensed Assistive Person). What principle of delegation is the nurse following?

• A. Delegation requires a situation with clearly defined superiors.
• B. Delegation can only exist with a subordinate.
• C. Delegation is a tool used by various healthcare professionals.
• D. You can delegate only those tasks.

Correct answer: D

Rationale: The correct answer is D: 'You can delegate only those tasks.' Delegation in nursing involves transferring responsibility for the performance of a task while retaining accountability for the outcome. The principle of delegation does not require a situation with clearly defined superiors (choice A). Delegation can exist not only with a subordinate but also with colleagues or other healthcare team members (choice B). Delegation is not exclusive to nurses and is a tool used by various healthcare professionals (choice C). Therefore, the best choice is D as it accurately reflects the principle of delegation in nursing.

2. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?

• A. Measure the ankle-brachial index.
• B. Check for changes in skin pigmentation.
• C. Assess for unilateral or bilateral foot drop.
• D. Ask the patient about symptoms of depression.

Correct answer: A

Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.

3. The belief that effort will lead to a specific performance level in an individual is known as:

• A. Rewards.
• B. Expectancy.
• C. Valence.
• D. Instrumentality.

Correct answer: B

Rationale: The correct answer is B: Expectancy. Expectancy refers to the perceived probability that effort will lead to a specific performance level. This aligns with the concept of expectancy theory in psychology, which emphasizes the importance of individuals' beliefs regarding the link between effort and outcomes. Choices A, C, and D are incorrect. Rewards (choice A) typically refer to incentives given after achieving a goal, valence (choice C) is the value a person places on a particular outcome, and instrumentality (choice D) is the belief that a particular outcome is contingent on achieving a specific level of performance.

4. Which of the following is an example of a secondary prevention activity?

• A. Blood pressure screening
• B. Administering medications
• C. Developing a care plan
• D. Providing rehabilitation

Correct answer: A

Rationale: The correct answer is A, blood pressure screening. Secondary prevention aims to identify and treat conditions early to prevent their progression. Blood pressure screening helps in early detection of hypertension, allowing for timely intervention. Choices B, C, and D are not examples of secondary prevention activities. Administering medications (B) can be part of treatment after a condition is diagnosed, developing a care plan (C) is more related to organizing and coordinating care rather than prevention, and providing rehabilitation (D) focuses on recovery and improvement post-diagnosis rather than early detection and prevention.

5. A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

• A. Perceived conflict
• B. Disruptive conflict
• C. Competitive conflict
• D. Felt conflict

Correct answer: B

Rationale: The behavior displayed by the resident and the nurse is an example of disruptive conflict. In disruptive conflict, the parties involved engage in activities to reduce, defeat, or eliminate the opponent. The resident refusing to answer calls and the nurse retaliating with frequent calls to 'get back' at him exemplify behaviors aimed at causing disruption and conflict between them. Perceived conflict refers to each party's perception of the other's position, competitive conflict involves one side winning at the expense of the other, and felt conflict is about the feelings of opposition within the relationship, none of which fully capture the nature of the conflict displayed in this scenario.

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