Nursing Elites

1. The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse's best caring response?

• A. Yell at the physician for yelling at a new graduate and report the incident to the supervisor.
• B. Wait until the situation ends and comfort the graduate privately.
• C. Suggest that the physician take a quieter and more private approach to the problem.
• D. Ignore the situation to avoid embarrassing the graduate further.

Correct answer: C

Rationale: Suggesting a quieter and more private approach to the problem is the best caring response as it addresses the issue respectfully. This response shows empathy towards the graduate nurse and also aims to improve the situation without escalating it further. Choice A is not ideal as responding to yelling with yelling can exacerbate the situation and create more tension. Choice B, while offering comfort, does not directly address the inappropriate behavior of the physician. Choice D is not recommended as ignoring the situation may not help the graduate nurse and can lead to the continuation of inappropriate behavior without intervention.

2. If a nurse accepts the role of charge nurse on the evening shift, what effect will unionization have on the nurse's new position?

• A. The nurse can file a grievance that will be arbitrated automatically by the Union
• B. Charge nurse is part of the management team, so Union participation would be a conflict of interest
• C. The nurse is not eligible for collective bargaining activities dealing with unfair labor practices
• D. The nurse can be represented by the union because charge nurses are not considered part of the management team

Correct answer: B

Rationale: Choosing answer B is correct because charge nurses are typically considered part of the management team. As part of the management team, the charge nurse has decision-making responsibilities that align with the interests of the organization. Therefore, participating in a union would create a conflict of interest. Options A, C, and D are incorrect. Option A is incorrect because union arbitration is not typically applicable to management positions. Option C is incorrect because charge nurses, as part of the management team, would not be eligible for collective bargaining activities like frontline staff. Option D is incorrect because charge nurses, due to their managerial responsibilities, are generally not represented by unions for collective bargaining purposes.

3. How does the nurse apply Maslow's hierarchy of needs in care?

• A. Judging the patient's behavior
• B. Improving the skillfulness of care
• C. Understanding the patient's behavior
• D. Improving communication skills

Correct answer: C

Rationale: Maslow's hierarchy of needs is a framework that helps nurses understand the different levels of human needs and prioritize care accordingly. By applying this framework, nurses can better understand the patient's behavior in the context of their unmet needs. This understanding allows nurses to provide holistic and patient-centered care that addresses not just the physical but also the emotional, social, and psychological needs of the patient. Choice A is incorrect because applying Maslow's hierarchy is about understanding, not judging, the patient's behavior. Choice B is incorrect as it does not directly relate to the application of Maslow's hierarchy. Choice D is also incorrect as improving communication skills, although important, is not the primary focus when applying Maslow's hierarchy of needs in care.

4. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

5. When considering factors like high risk for falls, infection protocols, and special communication needs to determine the mix and number of staff needed on a telemetry unit, what is being utilized?

• A. diagnostic related groups
• B. clinical pathways
• C. case management
• D. Patient classification system

Correct answer: D

Rationale: In this scenario, the nurse is using a Patient Classification System, which helps in determining the appropriate staffing levels based on the acuity and care requirements of the patients in the telemetry unit. By considering factors like high risk for falls, infection protocols, and special communication needs, the nurse can allocate the right mix and number of staff to provide safe and effective care. The other choices are incorrect because diagnostic related groups are used for billing purposes, clinical pathways are standard care plans for specific diagnoses, and case management involves coordinating care and services for patients.

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