Nursing Elites

1. How will working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims affect staff?

• A. Feelings of extreme overload.
• B. Fear of failure.
• C. A pessimistic sense about the world.
• D. Inability to separate intense work situations from personal situations.

Correct answer: B

Rationale: Working in a high-volume, noisy emergency room in an urban area with a high incidence of assault victims can lead to feelings of extreme overload, a pessimistic sense about the world, and an inability to separate intense work situations from personal situations. Fear of failure is not specifically mentioned in the context of the question, so it is the correct answer. The constant noises and intense emotional situations can create tension, stress, and negative reactions among staff. Managers can help by assessing the environment, labeling situations, and debriefing with staff to make them more aware of how stressors impact their behaviors.

2. A nurse is focusing on improving the ability to multitask without losing focus and to turn problems into opportunities. Which of the following leadership theories describes the nurse’s focus?

• A. Emotional intelligence
• B. Motivation theory
• C. Situational leadership theory
• D. Transformational leadership theory

Correct answer: D

Rationale: Transformational leadership theory describes the nurse’s focus.

3. Penalties should be __________ .

• A. Determining the employee's awareness of the policy
• B. Describing the staff nurse's behavior that violated the policy
• C. Progressive
• D. Confrontation

Correct answer: C

Rationale: Penalties for policy violations should be progressive. This means that the disciplinary actions should escalate based on the severity or frequency of the violation. For minor infractions, like smoking in an unauthorized area, a progressive approach may include oral warnings, written warnings, suspension, and termination if the behavior persists. In contrast, major violations, such as theft, may warrant immediate and severe consequences like suspension or termination. Choices A, B, and D are incorrect as they do not address the concept of progressively escalating penalties based on the violation's severity or recurrence.

4. A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?

• A. Amitriptyline decreases the depression caused by your foot pain.
• B. Amitriptyline helps prevent transmission of pain impulses to the brain.
• C. Amitriptyline corrects some of the blood vessel changes that cause pain.
• D. Amitriptyline improves sleep and reduces awareness of nighttime pain.

Correct answer: B

Rationale: The correct answer is B. Amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, which helps in reducing the transmission of pain impulses to the brain. Choice A is incorrect because amitriptyline primarily works on pain transmission rather than directly on depression. Choice C is inaccurate as amitriptyline's mechanism of action is not related to correcting blood vessel changes. Choice D is partially true as amitriptyline can improve sleep, but the primary mechanism related to pain relief is by preventing pain impulses from reaching the brain.

5. Which of the following would be considered an urgent and important issue?

• A. Replacing two staff who were injured while caring for a violent patient
• B. Updating the employee break room with new furniture
• C. Preparing educational packets on self-administration of insulin for patients
• D. Arranging a team-building event for staff members

Correct answer: A

Rationale: The correct answer is A because replacing staff injured while caring for a violent patient is both urgent and important. This issue directly relates to staff safety and patient care, requiring immediate attention. Choice B is not urgent or crucial to patient care. Choice C is important but may not be as urgent as the situation in choice A. Choice D is not as critical as replacing injured staff, making it a less urgent and important issue.

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