Nursing Elites

1. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.

• A. Parallel
• B. Functional
• C. Service-integrated
• D. Matrix

Correct answer: B

Rationale: The correct answer is B: Functional. In functional structures, employees are grouped into departments based on specialty, allowing individuals with similar skills and tasks to work together efficiently. In this scenario, organizing the hospital into departments such as nursing, dietary, and pharmacy based on their specialties exemplifies a functional organizational structure. Choice A, Parallel structure, involves independent units working on similar tasks, which is not the case here. Choice C, Service-integrated structure, emphasizes cross-functional teamwork across various departments, which is not the main focus in the scenario. Choice D, Matrix structure, involves employees reporting to multiple managers for different projects or tasks, which is not described in the scenario.

2. Which of the following is a common characteristic of a high-performing healthcare team?

• A. Effective communication
• B. Shared leadership
• C. Collaborative decision making
• D. Hierarchical structure

Correct answer: C

Rationale: Collaborative decision making is a key characteristic of a high-performing healthcare team because it involves team members working together to make decisions that lead to the best outcomes for patients. Effective communication is important in any team, but collaborative decision making goes beyond communication by involving team members in the decision-making process. Shared leadership is also crucial for a high-performing team, as it promotes equality and empowerment among team members. On the other hand, a hierarchical structure can hinder effective communication and teamwork by creating barriers between team members and limiting input from all team members, which is counterproductive to achieving optimal healthcare outcomes.

3. Two RNs are discussing the benefits of professional liability insurance. Which of the following is a reason for an RN to have a professional liability insurance policy?

• A. No expenses are involved in frivolous lawsuits.
• B. If a nurse is found guilty of malpractice, the institution can sue the nurse.
• C. Liability policies may also cover charges of libel, slander, assault, and HIPAA violations.
• D. Only doctors are sued for malpractice.

Correct answer: C

Rationale: Professional liability insurance is essential for nurses to have as it may cover charges of libel, slander, assault, and HIPAA violations. Option A is incorrect as there are expenses involved in frivolous lawsuits. Option B is incorrect because if a nurse is found guilty of malpractice, the institution can sue the nurse. Option D is incorrect as nurses can also be sued for malpractice, not just doctors.

4. After discussing alternatives to dressing change procedures to minimize discomfort, the nursing staff accepted a new procedure. This is an example of which stage of Havelock's model of change?

• A. Moving
• B. Self-renewal
• C. Refreezing
• D. Unfreezing

Correct answer: A

Rationale: The correct answer is A: Moving. In the moving stage of Havelock's model of change, the focus is on selecting a solution or alternative. In this scenario, the nursing staff accepting a new procedure after discussing alternatives aligns with the moving stage, where the decision to adopt a change is made. Choices B, C, and D are incorrect. Self-renewal refers to personal growth, refreezing involves stabilizing the change, and unfreezing is related to preparing for change, none of which directly correspond to the situation described in the question.

5. A nurse is discussing the responsibility of caring for clients with clostridium difficile infection. Which of the following information should the nurse include in the teaching?

• A. Have family members wear a gown and gloves when visiting.
• B. Clean contaminated surfaces in the client's room with a bleach solution.
• C. Use alcohol-based hand sanitizer when leaving the client's room.
• D. Assign the client to a room with a private bathroom.

Correct answer: A

Rationale: When caring for clients with clostridium difficile infection, it is important to prevent the spread of the bacteria. Having family members wear a gown and gloves when visiting helps reduce the risk of transmission. Cleaning contaminated surfaces with a bleach solution, not phenol, is recommended to effectively kill the C. difficile spores. Using alcohol-based hand sanitizer is not sufficient, as it may not be effective against C. difficile spores. Assigning the client to a room with a private bathroom is more beneficial than a negative airflow system, as it helps prevent the spread of bacteria to other clients.

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