Nursing Elites

1. Which of the following is an example of an effective conflict resolution strategy?

• A. Ignoring the conflict
• B. Assigning blame to one party
• C. Encouraging open communication
• D. Enforcing strict rules

Correct answer: C

Rationale: Encouraging open communication is an effective conflict resolution strategy because it promotes transparency, understanding, and collaboration among individuals involved in the conflict. By encouraging open communication, parties can express their perspectives, concerns, and needs, leading to the identification of common ground and potential solutions. This approach fosters a positive and constructive environment for resolving conflicts and can help prevent misunderstandings and escalation of issues. Choices A, B, and D are not effective conflict resolution strategies. Ignoring the conflict can lead to unresolved issues, assigning blame can escalate tensions and hinder problem-solving, and enforcing strict rules may not address the underlying causes of the conflict or promote mutual understanding.

2. An expensive variable in salary budgets is overtime pay. Which of the following is a viable option to reduce overtime?

• A. Limiting overtime for highly paid workers
• B. Reducing the number of beds
• C. Using per diem workers
• D. Refusing to pay overtime

Correct answer: C

Rationale: The correct answer is C: Using per diem workers. By utilizing per diem workers, organizations can flexibly adjust staffing levels based on demand without incurring overtime costs. This approach helps in managing overtime budgets effectively. Choice A is incorrect because limiting overtime for highly paid workers may not address the root cause of overtime expenses. Choice B is incorrect as reducing the number of beds does not directly impact overtime costs. Choice D is not a practical solution as refusing to pay overtime can lead to legal issues and employee dissatisfaction.

3. A registered nurse (RN) is caring for a patient who is one of Jehovah�s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?

• A. Autonomy
• B. Nonmaleficence
• C. Beneficence
• D. Distributive justice

Correct answer: A

Rationale: This is an example of the ethical principle of autonomy.

4. Your values do not coincide with your colleagues. When you report for your shift on nights and staff are not responding to patient requests for pain medication, you, as the nurse responsible for collecting data about patient quality of care, should:

• A. Explain to the nurse manager that quality problems are because of staff apathy.
• B. Issue a memo to staff to assess patients and document their response to the pain medication.
• C. Explain to staff that improving quality is one of your annual goals and you expect them to follow through.
• D. Schedule meetings to engage with staff to monitor pain management.

Correct answer: D

Rationale: As the nurse responsible for collecting data about patient quality of care, it is important to address the issue of staff not responding to patient requests for pain medication. Scheduling meetings to engage with staff to monitor pain management is the most appropriate course of action in this scenario. By enlisting support from staff, reviewing patient satisfaction data, and quality reports about pain management, you can effectively address the issue and improve patient care. Choices A, B, and C are not as effective as they do not involve actively engaging with staff, reviewing data, and working collaboratively to address the problem.

5. A 54-year-old patient is admitted with diabetic ketoacidosis. Which admission order should the nurse implement first?

• A. Infuse 1 liter of normal saline per hour.
• B. Give sodium bicarbonate 50 mEq IV push.
• C. Administer regular insulin 10 U by IV push.
• D. Start a regular insulin infusion at 0.1 units/kg/hr.

Correct answer: A

Rationale: In a patient admitted with diabetic ketoacidosis, the initial priority is to address dehydration and electrolyte imbalances. Infusing 1 liter of normal saline per hour helps correct hypovolemia and restore electrolyte balance, making it the first essential step in managing diabetic ketoacidosis. Sodium bicarbonate is not routinely recommended in treating diabetic ketoacidosis and should not be given routinely as it may worsen the acidosis. Administering regular insulin and starting an insulin infusion are important but should come after fluid resuscitation to stabilize the patient's condition.

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