Nursing Elites

1. Which of the following is an essential element of a quality improvement (QI) program?

• A. Blame and punishment
• B. Employee satisfaction
• C. Continual monitoring
• D. Strict adherence to policies

Correct answer: C

Rationale: The essential element of a quality improvement (QI) program is continual monitoring. Continual monitoring allows for the ongoing assessment of processes, identification of areas for improvement, and tracking of progress. Option A, 'Blame and punishment,' is incorrect as QI programs focus on systemic issues rather than individual blame. Option B, 'Employee satisfaction,' while important for organizational culture, is not an essential element of QI programs. Option D, 'Strict adherence to policies,' is valuable but not the core essential element, which is continual monitoring to drive improvement.

2. A staff nurse describes the unit manager as 'a born leader.' The nurse ascribes to which theory of leadership?

• A. Trait theories
• B. Behavioral theories
• C. Formal leadership theories
• D. Democratic leadership theories

Correct answer: A

Rationale: The correct answer is A: Trait theories. The nurse describing the unit manager as 'a born leader' aligns with trait theories of leadership, which suggest that certain inborn characteristics or traits contribute to effective leadership. This theory emphasizes that leaders possess natural qualities that make them suitable for leadership roles. Choices B, C, and D are incorrect. Behavioral theories focus on the actions and behaviors of leaders, formal leadership theories emphasize organizational structure and roles, and democratic leadership theories pertain to a style of leadership that involves participative decision-making.

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 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. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision-makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the ethical decision-making process, after identifying the decision-makers involved, the next step is typically planning. During the planning stage, the RN will consider the available options, weigh the ethical principles involved, and develop a course of action to address the ethical dilemma. Choice A, Assessment, involves gathering information and data about the situation. Choice B, Diagnosis, involves analyzing the gathered information to identify the ethical issue. Choice D, Implementation, comes after planning and involves putting the chosen course of action into practice.

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