Nursing Elites

1. Which of the following best describes the concept of shared governance?

• A. Top-down management
• B. Nurse-led committees
• C. Shared decision making
• D. Hierarchical structure

Correct answer: C

Rationale: The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.

2. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?

• A. Moral suffering
• B. Moral distress
• C. Ethical dilemma
• D. Veracity

Correct answer: B

Rationale: The correct answer is B, moral distress. Moral distress occurs when one knows the ethically correct action to take but feels constrained in their ability to take that action due to institutional, hierarchical, or other constraints. In this scenario, the nurses are experiencing uneasiness and discomfort due to an ethical issue, which aligns with the definition of moral distress. Choice A, moral suffering, is not the most appropriate term in this context as moral distress better describes the situation. Choice C, ethical dilemma, refers to a situation where a person is faced with two equally undesirable alternatives, which does not fully capture the nurses' current experience. Choice D, veracity, is unrelated to the nurses' situation and does not fit the context of the scenario.

3. What is the main purpose of the NCLEX examination?

• A. Ensure that individuals have passed nursing classes.
• B. Provide assurance that nursing schools are part of the service agency.
• C. Enable potential students to determine the best nursing schools.
• D. Ensure the safety of the public.

Correct answer: D

Rationale: The main purpose of the NCLEX examination is to ensure the safety of the public by determining if candidates have the knowledge and skills necessary to provide safe and effective nursing care. Choice A is incorrect as the exam evaluates if individuals are ready to begin nursing practice, not just passed classes. Choice B is incorrect as the exam is not related to the affiliation of nursing schools with service agencies. Choice C is incorrect as the exam is not designed to help potential students choose the best nursing schools, but rather to assess individual readiness for nursing practice to protect public safety.

4. Which of the following best describes the concept of evidence-based management?

• A. Using personal experience to make managerial decisions
• B. Combining managerial expertise with the latest research evidence
• C. Using intuition and experience to guide management decisions
• D. Relying on peer-reviewed literature to inform management practices

Correct answer: B

Rationale: The concept of evidence-based management involves combining managerial expertise with the latest research evidence to make informed decisions. Choice A is incorrect because relying solely on personal experience may not align with the best available evidence. Choice C is incorrect as it emphasizes intuition over research evidence. Choice D is incorrect because evidence-based management involves not only peer-reviewed literature but also incorporating managerial expertise.

5. The unit manager of a 32-bed medical-surgical unit allows the staff nurses to do self-governance for scheduling, client care assignments, and committee work. The manager would be considered which type of leader?

• A. Autocratic
• B. Democratic
• C. Bureaucratic
• D. Laissez-faire

Correct answer: D

Rationale: The correct answer is D, Laissez-faire. In a laissez-faire leadership style, the manager exerts very little control and allows the staff to have a high degree of autonomy in decision-making and problem-solving. This type of leader provides guidance when needed but largely leaves the decision-making process to the staff. Autocratic leadership (choice A) is characterized by centralizing decision-making authority, democratic leadership (choice B) involves shared decision-making, and bureaucratic leadership (choice C) relies on adherence to rules and procedures.

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