Nursing Elites

1. 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.

2. The nurse listens as the physician asks the patient to participate in a research study and realizes the physician is not adequately explaining the risks of the study. As they leave the patient's room, the nurse encourages the physician to go back and explain the risks more thoroughly. What role is this nurse playing in patient care?

• A. Teacher
• B. Caregiver
• C. Advocate
• D. Communicator

Correct answer: C

Rationale: The nurse is acting as an advocate by ensuring the patient is fully informed before consenting to participate in the study. Advocacy in healthcare involves supporting and promoting the patient's rights, including the right to be fully informed about their care and treatment options. By advocating for the patient in this scenario, the nurse is prioritizing the patient's well-being and autonomy. Choices A, B, and D are incorrect. The nurse is not acting as a teacher, caregiver, or communicator specifically in this scenario, but rather advocating for the patient's right to informed consent.

3. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

4. 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.

5. The nurse is caring for a patient who has just received a cancer diagnosis. The patient is crying. The nurse recognizes this patient is operating on what level of Maslow's hierarchy of needs?

• A. Self-esteem
• B. Love and belonging
• C. Safety
• D. Self-actualization

Correct answer: C

Rationale: In Maslow's hierarchy of needs, safety needs come after physiological needs. When a patient is crying after receiving a cancer diagnosis, they may be feeling a lack of security and safety. This indicates that the patient is operating on the level of safety needs in Maslow's hierarchy. Choice A, self-esteem, focuses on confidence and respect, which is not the immediate concern when receiving a cancer diagnosis. Choice B, love and belonging, pertains to relationships and social connections, which are important but not the primary focus in this situation. Choice D, self-actualization, involves personal growth and fulfilling one's potential, which is a higher-level need compared to safety needs, making it less likely for a patient to be operating at this level when distressed by a cancer diagnosis.

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