Nursing Elites

1. Which of the following is the preferable alternative to firing an employee?

• A. Voluntary resignation
• B. Training
• C. Confrontation
• D. Coaching

Correct answer: A

Rationale: The preferable alternative to firing an employee is voluntary resignation. When an employee voluntarily resigns, it allows them to leave on their terms, maintaining their dignity and possibly avoiding negative consequences associated with being fired. Training, confrontation, and coaching are not alternatives to firing but rather methods that can be used to address performance or behavior issues before resorting to termination.

2. 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.

3. How has advanced technology in health care, such as integrated health records, benefited nurses?

• A. Skip the assessment step of the nursing process
• B. Order medications
• C. Take blood samples
• D. Track patients' vital signs

Correct answer: D

Rationale: Advanced technology in health care, like integrated health records, has enabled nurses to efficiently track patients' vital signs. This capability helps nurses monitor patients' health status closely and make informed decisions regarding their care. Choices A, B, and C are incorrect because technology does not replace the vital role of nurses in conducting assessments, ordering medications (typically done by prescribers), or collecting blood samples.

4. 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.

5. Which of the following should be included in a discussion of advance directives with new nurse graduates?

• A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
• B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
• C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
• D. The advance directive designates a health-care surrogate who will make known the client�s wishes regarding medical treatment if the client is unable to do so.

Correct answer: D

Rationale: One function of the advance directive is to appoint a health-care surrogate who will make known the client�s wishes for medical treatment to the medical and nursing team if the client is unable to do so.

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