Nursing Elites

1. There are many ways to ensure that your appraisal system is nondiscriminatory. Which of the following is one way to ensure this?

• A. Giving the appraisal once per year
• B. Having no appeal process
• C. Withholding information from the employee
• D. Not allowing any input from the employee

Correct answer: A

Rationale: To ensure that an appraisal system is nondiscriminatory, one important step is to provide the appraisal once per year. This allows for ongoing evaluation and helps prevent bias. Choice B is incorrect because having no appeal process can lead to unfair treatment without a chance for review. Choice C is incorrect as withholding information from the employee can hinder transparency and objectivity. Choice D is incorrect as not allowing any input from the employee can overlook valuable insights and perspectives that could contribute to a fair evaluation process.

2. A client with frequent tonic-clonic seizures is being admitted. What action should the nurse add to the client's plan of care?

• A. Ensure blankets are placed on all four sides of the bed.
• B. Refrain from using restraints during seizure activity.
• C. Position the client laterally during seizure activity.
• D. Have a tongue depressor available at the client's bedside.

Correct answer: D

Rationale: The correct action the nurse should add to the client's plan of care is to have a tongue depressor available at the client's bedside. This is important during a seizure to prevent the client from biting their tongue. Placing the client laterally helps maintain a clear airway and prevents aspiration, making choice C a good practice during seizure activity. Using restraints during a seizure can cause injuries and should be avoided, making choice B incorrect. Wrapping blankets around all four sides of the bed is unnecessary for seizure management and does not contribute to the client's safety during a seizure, making choice A incorrect.

3. The changes brought forth by the state boards of nursing are an example of which type of change agent?

• A. Resistance
• B. Empirical–rational
• C. Normative–reeducative
• D. Power–coercive

Correct answer: D

Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.

4. Which of the following is a challenge the profession of nursing faced?

• A. Nursing contributing to the stigma of AIDS in the 1980s out of fear.
• B. Nursing practice flourishing in field hospitals during the Korean War with abundant supplies and equipment.
• C. Many nurses feeling frustrated with the lack of independent functioning after the Vietnam War.
• D. A decline in the number of hospice nurses due to ethical dilemmas.

Correct answer: C

Rationale: The correct answer is C. After the Vietnam War, many nurses felt frustrated with the lack of independent functioning when they returned home. This challenge was faced by the profession of nursing as nurses who functioned independently in mobile hospital units during the war found themselves restricted in their practice upon returning. Choices A, B, and D are incorrect because they do not address the specific challenge of lack of independent functioning faced by nurses after the Vietnam War.

5. In determining a way to make shift change more effective for the nurse and the client, a hospital implemented a course of action. After a week of implementation, the decision was deemed inappropriate. What step of Roger's diffusion of innovations is this?

• A. Confirmation
• B. Implementation
• C. Knowledge
• D. Persuasion

Correct answer: A

Rationale: The correct answer is A: Confirmation. In the diffusion of innovations theory by Rogers, the confirmation stage seeks reinforcement of the action taken. In this scenario, after implementing the course of action regarding shift changes, the decision was reviewed and found inappropriate, aligning with the confirmation phase. Choice B, 'Implementation,' refers to putting the plan into action, which had already been done. Choice C, 'Knowledge,' pertains to becoming aware of the innovation, not evaluating its effectiveness. Choice D, 'Persuasion,' involves efforts to influence individuals to adopt the innovation, not verifying its appropriateness.

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