Nursing Elites

1. Which of the following can cause negative effects on decision making among groups?

• A. Rationalization
• B. Groupthink
• C. Risky shift
• D. Dialectical inquiry

Correct answer: B

Rationale: The correct answer is B: Groupthink. Groupthink is a negative phenomenon occurring in highly cohesive, isolated groups where members tend to think alike, which hinders critical thinking and can lead to poor decision-making. Rationalization refers to justifying or explaining behaviors or decisions in a logical manner. Risky shift is a phenomenon in groups where decisions become riskier or more extreme than individual members would make on their own. Dialectical inquiry is a technique used to counteract groupthink by encouraging debate and presenting opposing viewpoints to arrive at more thoughtful decisions.

2. A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?

• A. Suction the client's airway.
• B. Instruct the client to perform incentive spirometry every hour.
• C. Assist the client to an upright position.
• D. Humidify the client's supplemental oxygen.

Correct answer: C

Rationale: When a client is experiencing difficulty breathing, the priority intervention is to assist the client to an upright position. This position helps improve ventilation by maximizing lung expansion and promoting better oxygenation. Suctioning the airway may be necessary if there is an obstruction, but repositioning the client is the initial step. Instructing the client to perform incentive spirometry and humidifying oxygen are important interventions but not the first priority in this scenario.

3. Healthcare systems primarily have functional structures. Which of the following would be an example of this?

• A. Open communication exists between Physical Therapy and Nursing.
• B. Medicine has authority over nursing.
• C. Laboratory services have little authority.
• D. All nursing tasks fall under nursing service.

Correct answer: D

Rationale: The correct answer is D. In functional structures, employees are grouped in departments by specialty, with similar tasks being performed by the same group. This means that in a healthcare system with a functional structure, all nursing tasks would fall under the nursing service. Choices A, B, and C are incorrect because open communication between departments, one department having authority over another, or the level of authority of a particular department do not necessarily represent a functional structure.

4. Although technology has seen many advances, which two ethical principles may be in conflict because of technology?

• A. Beneficence and justice
• B. Beneficence and nonmaleficence
• C. Beneficence and veracity
• D. Beneficence and confidentiality

Correct answer: B

Rationale: The correct answer is B: Beneficence and nonmaleficence. Beneficence refers to the obligation to do good and act in the best interest of the patient, while nonmaleficence means to 'do no harm.' With advances in technology, there can be situations where the pursuit of benefit (beneficence) may inadvertently cause harm (nonmaleficence), leading to a conflict between these two ethical principles. Choice A, beneficence and justice, is incorrect because justice pertains to fairness and equality in the distribution of resources and treatments, not conflicting directly with beneficence. Choice C, beneficence and veracity, involves the obligation to tell the truth and is not in direct conflict with beneficence. Choice D, beneficence and confidentiality, relate to maintaining privacy and trust, which can complement rather than conflict with beneficence in most cases.

5. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?

• A. The RN tells the client he is not allowed to leave until the physician has released him.
• B. The RN asks the client why he wishes to leave.
• C. The RN asks the client to explain what he understands about his medical diagnosis.
• D. The RN asks the client to sign an against medical advice discharge form.

Correct answer: A

Rationale: The RN tells the client he is not allowed to leave until the physician has released him would be considered false imprisonment.

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