Nursing Elites

1. Staff refuse to report unsafe conditions, with unattended entrances throughout the health care facility noted. Unidentified individuals are wandering the unit at night, and you:

• A. Establish expectations.
• B. Demand that they leave immediately.
• C. Ask them to leave.
• D. Observe their behaviors.

Correct answer: A

Rationale: In this scenario, the correct course of action is to establish expectations. By setting clear guidelines and expectations, you can address the issue of unidentified individuals wandering the unit at night in a proactive manner. This approach helps communicate what behaviors are acceptable, ensuring the safety of both staff and patients. Demanding that they leave immediately may not address the root cause of the problem and could escalate the situation. Simply observing their behaviors may not effectively resolve the issue or prevent future incidents. Asking them to leave without first establishing expectations may not prevent similar occurrences in the future.

2. What type of staffing involves scheduling a certain number of people per day consistently?

• A. Flexible
• B. Mixed
• C. Block
• D. Creative

Correct answer: C

Rationale: The correct answer is C, Block staffing. Block staffing involves scheduling a consistent number of staff per day. This method ensures a predictable workforce on each shift, allowing for better planning and allocation of resources. Choices A, B, and D are incorrect because they do not specifically refer to the consistent scheduling of a certain number of staff per day as seen in block staffing.

3. Which theory views motivation as learning?

• A. Reinforcement
• B. Process
• C. Operant
• D. Conditioning

Correct answer: A

Rationale: The correct answer is A, Reinforcement. Reinforcement theory views motivation as learning through the association of behaviors with consequences. Choice B, Process, is too vague and does not specifically relate motivation to learning. Choice C, Operant, is a type of conditioning that focuses on voluntary behavior and its consequences, not motivation as learning. Choice D, Conditioning, is a general term that does not directly connect motivation with learning.

4. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP) working in the diabetic clinic?

• A. Measure the ankle-brachial index.
• B. Check for changes in skin pigmentation.
• C. Assess for unilateral or bilateral foot drop.
• D. Ask the patient about symptoms of depression.

Correct answer: A

Rationale: The correct answer is A: Measure the ankle-brachial index. This task involves using a Doppler ultrasound device to assess blood flow, which can be safely delegated to UAP. Choices B, C, and D require a higher level of assessment and interpretation that should be performed by licensed nursing staff. Checking for changes in skin pigmentation (B) and assessing for foot drop (C) involve more complex assessments that require nursing judgment. Asking about symptoms of depression (D) involves a psychosocial assessment, which should be performed by licensed personnel qualified to address mental health concerns.

5. 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.

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