Nursing Elites

1. Which of the following is likely to facilitate union activity?

• A. Managers communicating effectively with employees
• B. Managers listening to concerns of employees
• C. Belief that low wages cause job dissatisfaction
• D. Belief that supervisors are not understanding of unionizing

Correct answer: C

Rationale: The correct answer is C because according to a study by Bilchik (2000), organizations are more likely to unionize if there is a belief that low wages cause job dissatisfaction. Choices A and B focus on effective communication and listening, which may actually prevent union activity by addressing employee concerns directly. Choice D, the belief that supervisors are not understanding of unionizing, may lead to dissatisfaction but doesn't directly facilitate union activity as the belief that low wages cause job dissatisfaction does.

2. How can a staff nurse recognize they are experiencing burnout? (EXCEPT)

• A. They are spending more time talking to staff on other units.
• B. Staff is questioning their clinical judgment.
• C. They sleep longer hours, sometimes coming in late to work.
• D. They are drinking alcohol more frequently to relax.

Correct answer: A

Rationale: Recognizing burnout is essential to maintaining quality patient care. Spending more time talking to staff on other units is a common practice and does not necessarily indicate burnout. On the other hand, staff questioning their clinical judgment, sleeping longer hours or coming in late to work, and resorting to alcohol to relax are signs of burnout. These behaviors can impact patient care and indicate the professional is struggling to cope with stressors.

3. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?

• A. Moral suffering
• B. Moral distress
• C. Ethical dilemma
• D. Veracity

Correct answer: B

Rationale: The correct answer is B, moral distress. Moral distress occurs when one knows the ethically correct action to take but feels constrained in their ability to take that action due to institutional, hierarchical, or other constraints. In this scenario, the nurses are experiencing uneasiness and discomfort due to an ethical issue, which aligns with the definition of moral distress. Choice A, moral suffering, is not the most appropriate term in this context as moral distress better describes the situation. Choice C, ethical dilemma, refers to a situation where a person is faced with two equally undesirable alternatives, which does not fully capture the nurses' current experience. Choice D, veracity, is unrelated to the nurses' situation and does not fit the context of the scenario.

4. What is the primary focus of a performance appraisal for nursing staff?

• A. To identify areas for salary increases
• B. To evaluate overall job performance
• C. To provide feedback on clinical skills
• D. To determine eligibility for promotions

Correct answer: C

Rationale: The primary focus of a performance appraisal for nursing staff is to provide feedback on clinical skills, identify areas for improvement, and support professional development. While salary increases, overall job performance evaluation, and promotions may be factors considered during a performance appraisal, the primary goal is to assess and enhance clinical skills to ensure high-quality patient care.

5. When communicating with a client who has a complaint, what principle is important to keep in mind?

• A. Supervisors should always be involved.
• B. The client's physician is often the cause of the problem.
• C. Avoid discussion of complaints.
• D. Clients and families should be treated with respect; communication should be open and honest.

Correct answer: D

Rationale: When addressing complaints from clients, it is crucial to prioritize treating clients and families with respect. Open and honest communication fosters trust and transparency in resolving issues effectively. This client-centered approach emphasizes the importance of maintaining positive relationships within the healthcare setting. Choices A, B, and C are incorrect. Involving supervisors in every communication with a client who has a complaint may not always be necessary or practical. Blaming the client's physician for the issue is unprofessional and does not address the client's concerns. Avoiding discussion of complaints can lead to unresolved issues and dissatisfaction among clients.

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