Nursing Elites

1. Which of the following scenarios would be an example of shared governance on a nursing unit?

• A. Staff nurses delegate activities to CNAs.
• B. Procedure manuals are written by a committee of nurse managers.
• C. Staff nurses and CNAs make their own schedules.
• D. A unit manager seeks advice from her supervisor.

Correct answer: C

Rationale: The correct answer is C. Shared governance in a nursing unit involves staff nurses and CNAs having autonomy and decision-making power in aspects like scheduling, which is reflected in them making their own schedules. This scenario aligns with the philosophy of shared governance where nursing practice is best determined by nurses. Choices A, B, and D do not exemplify shared governance as they involve hierarchical delegation, managerial decision-making, and seeking advice from superiors rather than autonomous decision-making by frontline staff.

2. The charge nurse role has negatively affected your relationship with your friends and made you feel tense and isolated. You decide that you will delegate more time-consuming tasks to staff who are not your friends, who then complain to your nurse manager about your perceived unfairness. You decide to:

• A. Talk with your friends individually to let them know that you will be assigning patients to all staff in an equitable manner.
• B. Not express your angry feelings.
• C. Talk about staff who are annoying you with staff on other units.
• D. Ignore your feelings of uncertainty, hoping they will diminish.

Correct answer: A

Rationale: In this scenario, it is essential to address the perceived unfairness in task delegation. Talking with your friends individually to explain that patients will be assigned equitably is the most appropriate course of action. This approach promotes transparency and fairness in task allocation, helping to maintain professional relationships. Choices B, C, and D are not suitable responses. Choice B ignores the issue, choice C involves unprofessional behavior by gossiping about colleagues, and choice D neglects addressing the root cause of the problem.

3. A client requires a 24-hr urine collection. Which of the following statements by the client indicates an understanding of the teaching?

• A. ''I had a bowel movement, but I was able to save the urine.''
• B. ''I have a specimen in the bathroom from about 30 minutes ago.''
• C. ''I drink a lot, so I will fill up the bottle and complete the test quickly.''
• D. ''I flushed what I urinated at 7:00 a.m. and have saved all urine since.''

Correct answer: C

Rationale: Option C demonstrates an understanding of the need to collect urine over 24 hours. The client's statement shows awareness that increased fluid intake will help in filling up the collection bottle quickly, which is essential for an accurate test result. This choice reflects the correct understanding of the teaching. Options A, B, and D do not reflect the necessary comprehension for a 24-hr urine collection process. Option A involves a bowel movement, which is not relevant to a urine collection. Option B only mentions a specimen from 30 minutes ago, not over a 24-hour period. Option D indicates flushing urine, which contradicts the idea of saving all urine for the test.

4. As the definition of nursing evolved, which of the following nurse theorists focused on the uniqueness of nursing?

• A. Florence Nightingale
• B. Virginia Henderson
• C. Martha Rogers
• D. Abraham Maslow

Correct answer: B

Rationale:

5. When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model?

• A. Moving the system to a new level
• B. Unfreezing the system
• C. Refreezing the system
• D. Institutionalization

Correct answer: B

Rationale: The correct answer is 'Unfreezing the system.' In Lewin's Force-Field Model, unfreezing is the stage where the existing equilibrium is disrupted to motivate participants and prepare them for change. Building trust and recognizing the need for change are essential components of this stage. Choice A, 'Moving the system to a new level,' does not specifically address the initial stage of disruption. Choice C, 'Refreezing the system,' comes after change has been implemented, not before. Choice D, 'Institutionalization,' refers to the stage where the change becomes the new norm, which is different from unfreezing.

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