Nursing Elites

1. The manager of a medical-surgical unit is very task-motivated. Using Fiedler's Contingency Theory, under what circumstances would the manager be most effective?

• A. Only during highly stressful situations.
• B. When there is little to no stress.
• C. Under highly structured situations.
• D. When the situation is loosely structured.

Correct answer: C

Rationale: According to Fiedler's Contingency Theory, task-motivated managers are most effective under highly structured situations. This is because in such environments, where priorities are clear and tasks are well-defined, task-oriented managers can excel in organizing and accomplishing objectives efficiently. Choices A and B are incorrect because the effectiveness of a task-motivated manager is not solely linked to stress levels but rather to the structure of the situation. Choice D is also incorrect as a loosely structured situation would not provide the clarity and direction that a task-motivated manager thrives in.

2. As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?

• A. Evidence-based practice guides risk management principles.
• B. Client teaching is the responsibility of the team leader.
• C. The initial level of practice responsibility will be limited.
• D. Seniority is the main determinant of client assignments.

Correct answer: C

Rationale: In a differentiated practice model, the scope of nursing practice and responsibility are tailored to different levels of experience. As a new graduate with limited experience, the nurse can expect that the initial level of practice responsibility will be limited to match their skill level and knowledge. This allows for a gradual increase in responsibilities as the nurse gains more experience and expertise. Choice A is incorrect because evidence-based practice is related to clinical decision-making, not the staffing model. Choice B is incorrect as client teaching is typically a shared responsibility among the healthcare team, not solely the team leader's. Choice D is incorrect as differentiated practice models focus on skill level and competence rather than seniority when determining client assignments.

3. Which of the following is an example of an ethical dilemma in nursing?

• A. Choosing between two equally undesirable alternatives
• B. Reporting a colleague's unethical behavior
• C. Balancing patient confidentiality with the need to disclose information
• D. Deciding whether to comply with a patient's request that conflicts with professional ethics

Correct answer: D

Rationale: The correct answer is D. An ethical dilemma in nursing involves deciding whether to comply with a patient's request that conflicts with professional ethics, balancing competing values and principles. Choices A, B, and C do not directly represent ethical dilemmas in nursing. Choice A describes a general ethical dilemma, choice B involves professional conduct rather than a dilemma, and choice C refers to a confidentiality issue rather than conflicting ethical principles.

4. Lippitt's phases of change are important factors in the change process. The phase that involves key people in data collection is known as:

• A. Assess the motivation.
• B. Choose a change agent.
• C. Diagnose the problem.
• D. Maintain the change.

Correct answer: C

Rationale: The correct answer is C: 'Diagnose the problem.' In Lippitt's phases of change, the first step is to diagnose the problem, which involves key people in data collection and problem-solving. This step is crucial as it helps identify the root causes of the issues that need to be addressed. Assessing the motivation (A) comes later in the change process once the problem has been diagnosed. Choosing a change agent (B) and maintaining the change (D) are also important steps in the change process but do not specifically involve key people in data collection as in the diagnosis phase.

5. Although technology has seen many advances, which two ethical principles may be in conflict because of technology?

• A. Beneficence and justice
• B. Beneficence and nonmaleficence
• C. Beneficence and veracity
• D. Beneficence and confidentiality

Correct answer: B

Rationale: The correct answer is B: Beneficence and nonmaleficence. Beneficence is the ethical principle of doing good to benefit others, while nonmaleficence is the principle of doing no harm to others. With technological advances, there can be a conflict between these two principles, as the benefits of technology may inadvertently cause harm, leading to an ethical dilemma. Choices A, C, and D are incorrect because while beneficence is involved in all options, the conflicting principle of nonmaleficence specifically addresses the avoidance of harm, making it the most relevant in the context of technology's impact on ethical principles.

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