Nursing Elites

1. When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model?

• A. Moving the system to a new level
• B. Unfreezing the system
• C. Refreezing the system
• D. Institutionalization

Correct answer: B

Rationale: The correct answer is 'Unfreezing the system.' In Lewin's Force-Field Model, unfreezing is the stage where the existing equilibrium is disrupted to motivate participants and prepare them for change. Building trust and recognizing the need for change are essential components of this stage. Choice A, 'Moving the system to a new level,' does not specifically address the initial stage of disruption. Choice C, 'Refreezing the system,' comes after change has been implemented, not before. Choice D, 'Institutionalization,' refers to the stage where the change becomes the new norm, which is different from unfreezing.

2. As an RN stands in line for the cafeteria cashier, he overhears the staff in front of him talking about a client the RN took care of earlier in the week. The client’s room number is mentioned along with the diagnosis and prognosis. Which of the following actions should the RN take?

• A. Join in the conversation in case the RN is assigned to care for the client in the future.
• B. Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA).
• C. Correct a statement made by one of the staff members.
• D. Ignore the conversation.

Correct answer: B

Rationale: Remind the staff members that they are in a public location and sharing this information is a breach of the Health Insurance Portability and Accountability Act (HIPAA).

3. 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.

4. Politics is defined as the art of influencing the allocation of scarce resources. An example of a scarce resource allocated by the manager of a patient care unit is:

• A. Raises for the staff.
• B. Patient supplies in the utility room.
• C. Staffing that minimizes overtime.
• D. Paper for the printer.

Correct answer: C

Rationale: In a healthcare setting, scarce resources can include money, time, personnel, and materials. Staffing decisions directly impact the allocation of personnel resources and can affect overtime costs, making it a critical resource managed by the unit manager. Patient supplies in the utility room and paper for the printer are important, but staffing decisions have a more direct impact on resource allocation within the unit. Raises for staff are typically granted by the institution and are not directly controlled by the unit manager.

5. A manager identifies that he is spending more time than desired on completing repetitive paperwork. Which of the following would be appropriate ways to address this issue? (EXCEPT)

• A. Combining data reports to reduce duplication
• B. Delegating staff evaluations to the staff nurse on the unit with the most experience
• C. Assigning the preliminary draft of the schedule to a subcommittee of staff nurses
• D. Saying no to inappropriate paperwork assignments

Correct answer: B

Rationale: Delegating staff evaluations to a staff nurse, even if experienced, is not appropriate as it falls outside their scope and responsibility. Choices A, C, and D are suitable ways to address the issue of spending excessive time on repetitive paperwork. Combining data reports, assigning the preliminary draft of the schedule to a subcommittee of staff nurses, and saying no to inappropriate paperwork assignments are all effective strategies to streamline processes and reduce managerial workload.

Similar Questions