Nursing Elites

1. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?

• A. First
• B. Second
• C. Third
• D. Fourth

Correct answer: A

Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.

2. What is the primary function of discipline?

• A. To punish
• B. To evaluate
• C. To teach
• D. To ridicule

Correct answer: C

Rationale: The primary function of discipline is to teach individuals appropriate behavior and help them learn from their mistakes. Discipline is meant to guide individuals towards self-improvement and understanding of rules and expectations. Choices A, B, and D are incorrect because discipline is not primarily about punishment, evaluation, or ridicule. While consequences may be a part of discipline, the main goal is to educate and promote positive behavior.

3. Which question during the assessment of a diabetic patient will help the nurse identify autonomic neuropathy?

• A. �Do you feel bloated after eating?�
• B. �Have you seen any skin changes?�
• C. �Do you need to increase your insulin dosage when you are stressed?�
• D. �Have you noticed any painful new ulcerations or sores on your feet?�

Correct answer: A

Rationale:

4. Which of the following scenarios would be an example of shared governance on a nursing unit?

• A. Staff nurses delegate activities to CNAs.
• B. Procedure manuals are written by a committee of nurse managers.
• C. Staff nurses and CNAs make their own schedules.
• D. A unit manager seeks advice from her supervisor.

Correct answer: C

Rationale: The correct answer is C. Shared governance in a nursing unit involves staff nurses and CNAs having autonomy and decision-making power in aspects like scheduling, which is reflected in them making their own schedules. This scenario aligns with the philosophy of shared governance where nursing practice is best determined by nurses. Choices A, B, and D do not exemplify shared governance as they involve hierarchical delegation, managerial decision-making, and seeking advice from superiors rather than autonomous decision-making by frontline staff.

5. One reason for conducting a comprehensive medical exam on an applicant is:

• A. It is needed to protect the organization from legal actions.
• B. It is required after a strenuous interview.
• C. It is mandated by law.
• D. It is necessary to screen for disabilities that may impact employment.

Correct answer: A

Rationale: Conducting a comprehensive medical exam on an applicant is crucial to protect the organization from legal actions. This examination helps ensure that the applicant meets the health standards required for the job, reducing the risk of potential liabilities for the organization related to health issues that may arise during employment. Choice B is incorrect because the exam is not a follow-up to a strenuous interview. Choice C is incorrect as not all comprehensive medical exams are mandated by law; they are often part of an organization's policy. Choice D is incorrect as the primary goal of the exam is to assess the applicant's health status in relation to the job requirements, not to screen for disabilities.

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