Nursing Elites

1. Which of the following best describes the concept of shared governance?

• A. Top-down management
• B. Nurse-led committees
• C. Shared decision making
• D. Hierarchical structure

Correct answer: C

Rationale: The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.

2. During a performance appraisal, how should the manager best provide constructive feedback to an employee?

• A. Focus only on the negative aspects of performance
• B. Provide general comments without specifics
• C. Discuss specific examples of strengths and areas for improvement
• D. Delay feedback until the next appraisal period

Correct answer: C

Rationale: During a performance appraisal, the best approach to provide constructive feedback is by discussing specific examples of strengths and areas for improvement. This method allows the employee to understand what they are excelling at and where they need to focus on development. By highlighting both aspects, the employee can work on enhancing their performance effectively. Option A is incorrect because solely focusing on the negative aspects can demotivate the employee and hinder their growth. Option B is incorrect as providing general comments without specifics does not offer clear guidance for improvement. Option D is also incorrect as delaying feedback can prevent timely corrective actions and hinder performance progress.

3. How will working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims affect staff?

• A. Feelings of extreme overload.
• B. Fear of failure.
• C. A pessimistic sense about the world.
• D. Inability to separate intense work situations from personal situations.

Correct answer: B

Rationale: Working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims can lead to feelings of extreme overload, a pessimistic sense about the world, and an inability to separate intense work situations from personal situations. Fear of failure is not specifically mentioned in the context of the question, so it is the correct answer. The constant noises and intense emotional situations can create tension, stress, and negative reactions among staff. Managers can help by assessing the environment, labeling situations, and debriefing with staff to make them more aware of how stressors impact their behaviors.

4. Which of the following are effective ways to apply power and politics in nursing? (EXCEPT)

• A. Picketing the employer
• B. Networking with other professionals
• C. Writing letters to legislators
• D. Joining professional organizations

Correct answer: A

Rationale: The correct answer is A - 'Picketing the employer.' Networking with other professionals, writing letters to legislators, and joining professional organizations are effective ways to apply power and politics in nursing. Picketing the employer is not an appropriate approach in a healthcare setting as it may lead to disruptions in patient care and conflict within the workplace.

5. A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the past 3 days. Which of the following findings should the nurse expect?

• A. Blood pressure 144/82 mm Hg
• B. Urine specific gravity 1.03
• C. Neck vein distention
• D. Urine specific gravity 1.01

Correct answer: A

Rationale: In a client experiencing vomiting and diarrhea, the nurse should expect findings such as dehydration, which can lead to hypovolemia and subsequent increased heart rate and decreased blood pressure. A blood pressure of 144/82 mm Hg is indicative of possible dehydration in this client. Urine specific gravity is typically increased in dehydrated individuals, so choices B and D are incorrect. Neck vein distention is not a typical finding associated with vomiting and diarrhea; therefore, choice C is also incorrect.

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