Nursing Elites

1. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

• A. Assertive management
• B. A shifting paradigm
• C. Critical thinking
• D. Smarter LPN graduates

Correct answer: B

Rationale: The correct answer is B: A shifting paradigm. The increasing use of LPNs in management positions, particularly in long-term care facilities, represents a changing paradigm in healthcare management. This shift indicates a move towards assigning leadership responsibilities to LPNs, signaling a departure from traditional industry roles. Choices A, C, and D are incorrect because the situation described does not primarily demonstrate assertive management, critical thinking, or the intelligence of LPN graduates. The focus is on the evolving role of LPNs in management, suggesting a broader change in healthcare practices.

2. A group of workers wish to seek union representation that would protect all workers in the agency, including unlicensed assistive personnel and non-nursing employees such as a nutritionist and dietary workers. The type of union being sought is the strongest collective group and is known by what term?

• A. A right-to-work bargaining organization
• B. An occupational union
• C. Industrial unionism
• D. Union shop

Correct answer: C

Rationale: Industrial unionism refers to a union that represents all workers in a particular industry, regardless of their specific job roles. In this scenario, the workers are looking for a union that covers a wide range of employees in the agency, making industrial unionism the most suitable option. Choice A, 'A right-to-work bargaining organization,' is incorrect as right-to-work laws pertain to union security agreements and do not define the type of union being sought. Choice B, 'An occupational union,' is incorrect as it typically represents workers within a specific occupation, not across various roles as described in the scenario. Choice D, 'Union shop,' is incorrect as it refers to a workplace where employees are required to join or pay union dues as a condition of employment, which is different from the scenario described.

3. Nurses on a unit provide personal hygiene, administer medications, educate patients, and provide emotional support. The nurses are providing patient care based on which nursing delivery system?

• A. total patient care
• B. team nursing
• C. functional nursing
• D. partnership nursing

Correct answer: A

Rationale: The correct answer is A, total patient care. Total patient care refers to a nursing delivery system where one nurse is responsible for providing all aspects of care to the patient. In this system, the nurse assumes full responsibility for the patient's care, including personal hygiene, medication administration, patient education, and emotional support, ensuring comprehensive and individualized care. Choice B, team nursing, involves a team of healthcare providers working together to provide care to a group of patients. Choice C, functional nursing, divides tasks among different team members based on their skills and expertise. Choice D, partnership nursing, does not represent a recognized nursing delivery system, making it an incorrect option.

4. According to Watson's theory, how should the nurse manager deal with a staff member who has a substance addiction and is arriving at work under the influence of the substance?

• A. Send the nurse home with instructions not to return until clear of the substance.
• B. Call the police and have the nurse arrested for working while impaired.
• C. Confront the nurse privately, order drug testing, and suggest a substance abuse program.
• D. Notify the board of nursing and fire the nurse immediately.

Correct answer: C

Rationale: According to Watson's theory, a caring approach is essential. Confronting the nurse privately, ordering drug testing, and suggesting a substance abuse program demonstrates empathy and supports the staff member in seeking help for their addiction. This approach aligns with the principles of human caring and compassion, focusing on the well-being and recovery of the individual rather than punitive measures. Choices A and D are too harsh and lack empathy, not considering the individual's well-being or offering support for rehabilitation. Choice B is inappropriate and punitive, not aligned with a caring and compassionate approach as advocated by Watson's theory.

5. What motivates a nurse to perform tasks, whether at work or off duty?

• A. Personal motivation
• B. Facility policies
• C. Fear of reprisals
• D. Parental expectations

Correct answer: A

Rationale: Personal motivation is the driving force behind a nurse's actions, influencing their decisions and behaviors both during work hours and while off duty. It is an internal drive that compels them to act in a certain way, regardless of external factors such as facility policies, fear of reprisals, or parental expectations. While facility policies may guide their actions within the workplace, they do not address motivation. Fear of reprisals and parental expectations are external factors and are less likely to be the primary motivators for a nurse's actions.

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