Nursing Elites

1. A nurse manager is interested in solving a serious conflict that exists among the nursing staff. He uses a strategy that involves allowing the group to explore a number of solutions and come to a consensus on a solution. What strategy for conflict resolution has the manager used?

• A. Integrative decision-making
• B. Win-win
• C. Competing
• D. Confrontation

Correct answer: A

Rationale: The correct answer is A: Integrative decision-making. Integrative decision-making involves allowing a group to explore various solutions and work together to reach a consensus. This strategy focuses on collaboration and finding a solution that meets the needs of all parties involved. Choices B, C, and D are incorrect. 'Win-win' is another term for integrative decision-making, 'Competing' involves pursuing one's own interests at the expense of others, and 'Confrontation' implies a direct conflict rather than a collaborative approach to resolution.

2. In determining a way to make shift change more effective for the nurse and the client, a hospital implemented a course of action. After a week of implementation, the decision was deemed inappropriate. What step of Roger's diffusion of innovations is this?

• A. Confirmation
• B. Implementation
• C. Knowledge
• D. Persuasion

Correct answer: A

Rationale: The correct answer is A: Confirmation. In the diffusion of innovations theory by Rogers, the confirmation stage seeks reinforcement of the action taken. In this scenario, after implementing the course of action regarding shift changes, the decision was reviewed and found inappropriate, aligning with the confirmation phase. Choice B, 'Implementation,' refers to putting the plan into action, which had already been done. Choice C, 'Knowledge,' pertains to becoming aware of the innovation, not evaluating its effectiveness. Choice D, 'Persuasion,' involves efforts to influence individuals to adopt the innovation, not verifying its appropriateness.

3. Which statement by the patient indicates a need for additional instruction in administering insulin?

• A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
• B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
• C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
• D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

4. In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?

• A. Determine what type of activities the patient enjoys.
• B. Remind the patient that exercise will improve self-esteem.
• C. Teach the patient about the effects of exercise on glucose levels.
• D. Give the patient a list of activities that are moderate in intensity.

Correct answer: A

Rationale: The correct answer is to determine what type of activities the patient enjoys. This approach is crucial as it helps in personalizing the exercise plan to the patient's preferences, making it more likely for them to adhere to it. Choice B is incorrect because focusing on self-esteem may not directly motivate the patient to engage in exercise. Choice C, although important, may not be the initial step as understanding the patient's preferences comes first. Choice D limits the patient's autonomy by not involving them in the decision-making process.

5. How are values learned?

• A. Reading books
• B. Formal degrees
• C. Continuous reinforcement
• D. Meeting diverse individuals

Correct answer: C

Rationale: Values are learned through continuous reinforcement, where behaviors or beliefs are strengthened by consequences or rewards. Reading books (choice A) may expose individuals to different perspectives and values, but the active learning and internalization of values typically occur through reinforcement. Formal degrees (choice B) may provide education and knowledge, but values are more likely to be ingrained through continuous reinforcement. Meeting diverse individuals (choice D) can also influence values, but the consistent reinforcement of desired behaviors is a more direct method for learning values.

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