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. 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 'Functional.' In a functional structure, organizations group employees into departments based on specialty, where similar tasks are performed by the same group. In this scenario, the hospital organizing its departments by specialty such as nursing, dietary, and pharmacy aligns with the characteristics of a functional structure. Choice A, 'Parallel,' does not fit the scenario described; parallel structures involve separate, independent units operating in parallel with little interaction. Choice C, 'Service-integrated,' does not align with the scenario either as it involves integrating services across departments. Choice D, 'Matrix,' is not the correct answer as it involves a complex organizational structure where employees report to multiple managers simultaneously, which is not the case in the scenario provided.

3. Which of the following is a common characteristic of a high-performing healthcare team?

• A. Effective communication
• B. Shared leadership
• C. Collaborative decision making
• D. Hierarchical structure

Correct answer: C

Rationale: Collaborative decision making is a key characteristic of a high-performing healthcare team because it involves team members working together to make decisions that lead to the best outcomes for patients. Effective communication is important in any team, but collaborative decision making goes beyond communication by involving team members in the decision-making process. Shared leadership is also crucial for a high-performing team, as it promotes equality and empowerment among team members. On the other hand, a hierarchical structure can hinder effective communication and teamwork by creating barriers between team members and limiting input from all team members, which is counterproductive to achieving optimal healthcare outcomes.

4. Cultural diversity presents an important challenge to nurse managers due to which of the following?

• A. A nursing shortage exists
• B. Staff nurses are not trained to be culturally sensitive
• C. 80% of nursing staff comes from one or more minority groups
• D. The increase in cultural diversity is seen both in the patient population and the nursing staff

Correct answer: D

Rationale: Cultural diversity presents an important challenge to nurse managers due to the increase in cultural diversity seen both in the patient population and the nursing staff. This challenge requires nurse managers to ensure that their nursing staff can effectively communicate and provide culturally competent care to patients from diverse backgrounds. Choice A is incorrect because it does not directly relate to the impact of cultural diversity. Choice B is incorrect as it focuses on the training of staff nurses rather than the overall challenge of managing cultural diversity. Choice C is incorrect as the percentage of nursing staff from minority groups, while important, is not the primary reason cultural diversity poses a challenge to nurse managers.

5. What term refers to the situation where the pay of newer employees is similar to or higher than that of more experienced employees?

• A. Salary compression
• B. Salary expectations
• C. Salary range
• D. Salary inflation

Correct answer: A

Rationale: Salary compression is the term used to describe the situation where the pay of newer employees is similar to or higher than that of more experienced employees. This can happen when newer employees are paid higher salaries to attract them, leading to a compressed salary structure in the organization. Choice B, 'Salary expectations,' does not specifically refer to the scenario described in the question. Choice C, 'Salary range,' is a broader term referring to the range of salaries offered for a particular job or position, not specifically related to the disparity between new and experienced employees. Choice D, 'Salary inflation,' does not accurately describe the situation of newer employees earning higher salaries than more experienced ones; instead, it refers to a general increase in wages across the board.

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