Nursing Elites

1. A new manager is implementing an initiative with the desired outcome of having the unit run more smoothly. What quality is the manager demonstrating?

• A. Being unrealistic
• B. Being a change agent
• C. Being democratic
• D. Being authoritarian

Correct answer: B

Rationale: The correct answer is B: Being a change agent. The manager is demonstrating the quality of being a change agent by implementing an initiative aimed at improving the unit's operations. A change agent initiates and drives changes to enhance effectiveness and efficiency within the unit. Choice A is incorrect because the manager's actions are not described as unrealistic but rather proactive. Choice C, being democratic, is incorrect as it does not relate to the manager's initiative to improve unit operations. Choice D, being authoritarian, is also incorrect as the manager is not described as enforcing changes through strict control and power.

2. According to Maslow's theory, which level of needs must be met first?

• A. Self-actualization needs
• B. Esteem needs
• C. Safety needs
• D. Physiological needs

Correct answer: D

Rationale: According to Maslow's hierarchy of needs, physiological needs are at the lowest level and must be satisfied first before an individual can progress to fulfilling higher-level needs. Physiological needs include basic requirements for survival such as food, water, shelter, and sleep. Esteem needs, safety needs, and self-actualization needs are higher-level needs that can only be addressed once physiological needs are adequately met. Therefore, the correct answer is D, physiological needs.

3. A nurse is caring for a client who reports difficulty falling asleep. Which of the following recommendations should the nurse make?

• A. Watch a television program in bed before going to sleep.
• B. Drink a cup of hot cocoa before bedtime.
• C. Maintain a consistent time to wake up each day.
• D. Exercise 1 hour before going to bed.

Correct answer: C

Rationale: The correct answer is C: "Maintain a consistent time to wake up each day." Establishing a regular wake-up time helps regulate the body's internal clock and promotes better sleep patterns. Watching television in bed (Choice A) can actually hinder sleep due to the light emitted by screens affecting melatonin production. Drinking beverages with caffeine like hot cocoa (Choice B) close to bedtime can interfere with falling asleep. Exercising vigorously right before bed (Choice D) can increase alertness and make it harder to fall asleep.

4. A registered nurse (RN) is caring for a patient who is one of Jehovah’s Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle?

• A. Autonomy
• B. Nonmaleficence
• C. Beneficence
• D. Distributive justice

Correct answer: A

Rationale: This is an example of the ethical principle of autonomy.

5. 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.

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