Nursing Elites

1. A nurse manager wants to implement a new policy on the unit. What is the first step in the change process according to Lewin's Change Theory?

• A. Unfreeze the system
• B. Move the system to a new level
• C. Refreeze the system
• D. Evaluate the system

Correct answer: A

Rationale: The correct answer is A: 'Unfreeze the system.' According to Lewin's Change Theory, unfreezing the system is the initial step in the change process. This step involves preparing the organization for change by creating awareness of the need for change, addressing any resistance, and establishing a sense of urgency. Choice B, 'Move the system to a new level,' is incorrect as it does not align with the first step of unfreezing. Choice C, 'Refreeze the system,' is incorrect as it pertains to the final stage of solidifying the change, not the first step. Choice D, 'Evaluate the system,' is incorrect as evaluation typically occurs after the change has been implemented, not at the beginning of the change process.

2. The process by which registered nurses assess and judge the performance of peers against some predetermined standard is called:

• A. Group evaluation.
• B. Peer review.
• C. Forced distribution evaluation.
• D. Essay evaluation.

Correct answer: B

Rationale: The correct answer is B: Peer review. Peer review is a process in which professional peers assess and judge the performance of their colleagues against predetermined standards. Essay evaluations involve describing an employee's performance through a detailed written narrative. Forced distribution evaluation is a method where employees are rated based on a fixed distribution, similar to grading on a curve. Group evaluation, on the other hand, involves managers comparing individual and group performance against organizational standards.

3. Which of the following best describes the concept of shared decision-making in healthcare?

• A. The process by which patients make healthcare decisions on their own
• B. A collaborative process that allows patients and providers to make healthcare decisions together
• C. A method for providers to dictate treatment plans to patients
• D. The use of evidence-based guidelines to make healthcare decisions

Correct answer: B

Rationale: The correct answer is B. Shared decision-making in healthcare involves a collaborative process between patients and providers to make healthcare decisions together. This approach considers the patient's preferences, values, and the best available evidence to reach a decision that aligns with the patient's goals. Choice A is incorrect because shared decision-making does not involve patients making decisions on their own. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients without involving them in the decision-making process. Choice D is incorrect as it refers to the use of evidence-based guidelines, which is important but not the sole focus of shared decision-making.

4. Which of the following can cause negative effects on decision making among groups?

• A. Rationalization
• B. Groupthink
• C. Risky shift
• D. Dialectical inquiry

Correct answer: B

Rationale: The correct answer is B: Groupthink. Groupthink is a negative phenomenon occurring in highly cohesive, isolated groups where members tend to think alike, which hinders critical thinking and can lead to poor decision-making. Rationalization refers to justifying or explaining behaviors or decisions in a logical manner. Risky shift is a phenomenon in groups where decisions become riskier or more extreme than individual members would make on their own. Dialectical inquiry is a technique used to counteract groupthink by encouraging debate and presenting opposing viewpoints to arrive at more thoughtful decisions.

5. One of the perceptions of turnover is:

• A. Poor management
• B. Rejection of the job
• C. Loss of poor performers
• D. Poor job atmosphere

Correct answer: B

Rationale: The correct answer is B: 'Rejection of the job.' According to Steers and Stone, turnover can be perceived by coworkers as a rejection of the job. Choice A, 'Poor management,' is incorrect because turnover perception is more related to individual feelings about the job rather than management. Choice C, 'Loss of poor performers,' is incorrect as it focuses on the outcome of turnover rather than the perception. Choice D, 'Poor job atmosphere,' is incorrect as it describes a cause of turnover rather than a perception.

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