Nursing Elites

1. A ___________ manager supervises a number of first-level managers, usually within related specialties.

• A. self-directed
• B. first-level
• C. middle-level
• D. self-motivated

Correct answer: C

Rationale: A middle-level manager is responsible for overseeing a group of first-level managers who handle day-to-day operations within their respective specialties. Middle-level managers play a crucial role in coordinating and aligning the efforts of multiple first-level managers to achieve organizational goals. They act as a bridge between top management and frontline employees, ensuring that strategies are effectively implemented at the operational level. Choice A, 'self-directed,' refers to an individual's ability to manage their own work without direct supervision and does not specifically relate to supervising other managers. Choice B, 'first-level,' describes the managers being supervised, not the position responsible for overseeing them. Choice D, 'self-motivated,' pertains to an individual's drive and determination, which is not directly related to the hierarchical level of management being discussed.

2. During a performance appraisal, how should the manager best provide constructive feedback to an employee?

• A. Focus only on the negative aspects of performance
• B. Provide general comments without specifics
• C. Discuss specific examples of strengths and areas for improvement
• D. Delay feedback until the next appraisal period

Correct answer: C

Rationale: During a performance appraisal, the best approach to provide constructive feedback is by discussing specific examples of strengths and areas for improvement. This method allows the employee to understand what they are excelling at and where they need to focus on development. By highlighting both aspects, the employee can work on enhancing their performance effectively. Option A is incorrect because solely focusing on the negative aspects can demotivate the employee and hinder their growth. Option B is incorrect as providing general comments without specifics does not offer clear guidance for improvement. Option D is also incorrect as delaying feedback can prevent timely corrective actions and hinder performance progress.

3. Which of the following is an essential element of a quality improvement (QI) program?

• A. Blame and punishment
• B. Employee satisfaction
• C. Continual monitoring
• D. Strict adherence to policies

Correct answer: C

Rationale: The essential element of a quality improvement (QI) program is continual monitoring. Continual monitoring allows for the ongoing assessment of processes, identification of areas for improvement, and tracking of progress. Option A, 'Blame and punishment,' is incorrect as QI programs focus on systemic issues rather than individual blame. Option B, 'Employee satisfaction,' while important for organizational culture, is not an essential element of QI programs. Option D, 'Strict adherence to policies,' is valuable but not the core essential element, which is continual monitoring to drive improvement.

4. A nurse is caring for a client who has diarrhea due to shigella. Which of the following precautions should the nurse implement for this client?

• A. Have the client wear a mask when receiving visitors.
• B. Limit the client's time with visitors to no more than 30 minutes per day.
• C. Assign the client to a room with negative-pressure airflow exchange.
• D. Wear a gown when caring for the client.

Correct answer: B

Rationale: The correct answer is B because limiting the client's time with visitors helps prevent the spread of shigella infection to others. Shigella is transmitted through the fecal-oral route, so minimizing contact time reduces the risk of transmission. Choice A is incorrect as there is no need for the client to wear a mask in this situation. Choice C is also incorrect as negative-pressure airflow exchange rooms are typically used for clients with airborne infections. Choice D is incorrect as wearing a gown is not the primary precaution needed for shigella infection.

5. Healthcare systems primarily have functional structures. Which of the following would be an example of this?

• A. Open communication exists between Physical Therapy and Nursing.
• B. Medicine has authority over nursing.
• C. Laboratory services have little authority.
• D. All nursing tasks fall under nursing service.

Correct answer: D

Rationale: The correct answer is D. In functional structures, employees are grouped in departments by specialty, with similar tasks being performed by the same group. This means that in a healthcare system with a functional structure, all nursing tasks would fall under the nursing service. Choices A, B, and C are incorrect because open communication between departments, one department having authority over another, or the level of authority of a particular department do not necessarily represent a functional structure.

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