Nursing Elites

1. A manager identifies that he is spending more time than desired on completing repetitive paperwork. Which of the following would be appropriate ways to address this issue? (EXCEPT)

• A. Combining data reports to reduce duplication
• B. Delegating staff evaluations to the staff nurse on the unit with the most experience
• C. Assigning the preliminary draft of the schedule to a subcommittee of staff nurses
• D. Saying no to inappropriate paperwork assignments

Correct answer: B

Rationale: Delegating staff evaluations to a staff nurse, even if experienced, is not appropriate as it falls outside their scope and responsibility. Choices A, C, and D are suitable ways to address the issue of spending excessive time on repetitive paperwork. Combining data reports, assigning the preliminary draft of the schedule to a subcommittee of staff nurses, and saying no to inappropriate paperwork assignments are all effective strategies to streamline processes and reduce managerial workload.

2. Which of the following types of leadership behaviors would be most useful when managing a staff of newly trained CNAs (Certified Nursing Assistants)?

• A. Achievement-oriented
• B. Supportive
• C. Participative
• D. Directive

Correct answer: D

Rationale: The most useful type of leadership behavior when managing a staff of newly trained CNAs (Certified Nursing Assistants) would be directive. Directive leadership involves giving specific guidance, ensuring adherence to rules and procedures, scheduling work efforts, and clearly telling employees what is expected. This approach is particularly beneficial for newly trained staff who may require clear instructions and guidance. - Achievement-oriented leadership focuses on setting challenging goals and encouraging employees to reach their highest potential. While this can be beneficial in some situations, it may not be the most suitable for managing newly trained CNAs who require more guidance and direction. - Supportive leadership involves providing emotional support, encouragement, and assistance to employees. While emotional support is essential in any work environment, newly trained CNAs may benefit more from clear direction and guidance. - Participative leadership involves involving employees in decision-making processes. While this can promote employee engagement and empowerment, newly trained CNAs may require more structured guidance and direction to ensure they understand their roles and responsibilities.

3. When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?

• A. Position the client in a side-lying position.
• B. Perform the irrigation using a 20-mL syringe.
• C. Instill 15 mL of irrigation fluid into the catheter with each flush.
• D. Measure and record the amount of irrigant used.

Correct answer: B

Rationale: When irrigating an indwelling urinary catheter, the nurse should use a 20-mL syringe for the procedure. This syringe size helps to provide adequate pressure for effective irrigation. Placing the client in a side-lying position is not necessary for this procedure. Instilling a specific amount of irrigation fluid into the catheter is not mentioned in the scenario. Subtracting the amount of irrigant used from the client's urine output is not a standard practice in catheter irrigation.

4. 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.

5. A nurse manager asks the staff to submit written suggestions for a change in policy. The group would then vote on the different suggestions. What type of decision-making technique did the nurse manager use?

• A. Statistical aggregation
• B. Nominal group technique
• C. Brainstorming
• D. Delphi

Correct answer: B

Rationale: The nurse manager used the nominal group technique. This technique involves group members submitting written suggestions, followed by a voting process. Statistical aggregation involves analyzing numerical data, not suggestions. Brainstorming focuses on generating creative ideas collectively, without a structured voting process. Delphi technique involves reaching a consensus through a series of questionnaires or surveys, without a direct voting process.

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