Nursing Elites

1. A staff nurse is working with a patient who is on a critical pathway for education in preparation for home care. Which one of the following responsibilities would the nurse address first?

• A. Taking vital signs
• B. Answering the client's questions
• C. Evaluating client teaching
• D. Reviewing the information with the client and family

Correct answer: D

Rationale: The correct answer is D. Reviewing the information with the client and family should be addressed first. This step involves ensuring that the client and family fully understand the information provided, which is crucial before proceeding with any other responsibilities. Taking vital signs (choice A) is important but not the priority in this scenario. Answering the client's questions (choice B) and evaluating client teaching (choice C) can come after reviewing the information to ensure effective communication and understanding.

2. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?

• A. Ask the client to consider a direct donation
• B. Withhold the blood transfusion
• C. Ask the client to consider a direct donation
• D. Request a consultation with the ethics committee

Correct answer: A

Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.

3. In dealing with a conflict on a unit, the nurse manager decides to ask one of the staff nurses, who is not moving towards resolution, to transfer to another unit. What tactic has the manager implemented?

• A. Avoidance
• B. Withdrawal
• C. Suppression
• D. Competition

Correct answer: C

Rationale: The correct answer is C: Suppression. In this scenario, the nurse manager has implemented a suppression tactic by asking the staff nurse to transfer to another unit, which eliminates one of the conflicting parties from the current unit. This technique aims to resolve the conflict by physically separating the individuals involved. Choices A, B, and D are incorrect: Avoidance involves ignoring the conflict, withdrawal is the act of pulling out or retreating, and competition refers to a situation where one party's gain is at the expense of the other.

4. A new nurse is thinking about the ways she can demonstrate leadership in her position. Which of the following is true about leadership?

• A. Leadership is a component of nursing practice.
• B. Leadership requires a position of oversight.
• C. Leadership depends on the actions of others.
• D. Only experienced nurses can demonstrate leadership.

Correct answer: A

Rationale: The correct answer is A: 'Leadership is a component of nursing practice.' Leadership is an essential aspect of nursing practice that involves inspiring, guiding, and influencing others to achieve common goals. Choice B is incorrect because leadership can be demonstrated at various levels within an organization, not just positions of oversight. Choice C is incorrect as leadership involves taking initiative and guiding others, rather than depending solely on the actions of others. Choice D is incorrect as leadership qualities can be demonstrated by individuals at all levels of experience, not exclusively by experienced nurses.

5. A client complains every morning that the night shift nursing staff does not answer his call light promptly to assist his elimination needs. His concerns are not shared with the Nurse Manager, and he falls while trying to walk to the bathroom. This fall could be attributed to which of the following?

• A. Breakdown in communication
• B. Lack of staff
• C. Lack of concern
• D. Breakdown in management

Correct answer: A

Rationale: The correct answer is A: Breakdown in communication. In this scenario, the client's complaints about the night shift nursing staff not responding promptly to his call light indicate a lack of effective communication. If the client's concerns were properly communicated to the Nurse Manager, steps could have been taken to address the issue and prevent the fall. Choice B, Lack of staff, is incorrect as the issue here is not related to staffing levels but rather to communication breakdown. Choice C, Lack of concern, is not the primary cause of the fall; the root cause lies in communication failure. Choice D, Breakdown in management, while related, is not as direct a cause as the breakdown in communication which led to the fall.

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