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. After discussing alternatives to dressing change procedures to minimize discomfort, the nursing staff accepted a new procedure. This is an example of which stage of Havelock's model of change?

• A. Moving
• B. Self-renewal
• C. Refreezing
• D. Unfreezing

Correct answer: A

Rationale: The correct answer is A: Moving. In the moving stage of Havelock's model of change, the focus is on selecting a solution or alternative. In this scenario, the nursing staff accepting a new procedure after discussing alternatives aligns with the moving stage, where the decision to adopt a change is made. Choices B, C, and D are incorrect. Self-renewal refers to personal growth, refreezing involves stabilizing the change, and unfreezing is related to preparing for change, none of which directly correspond to the situation described in the question.

3. A Nurse Manager completes an interruption log and identifies two staff members who take an inordinate amount of time with drop-in issues that are not urgent. What are some methods to address this behavior in an attempt to better manage time? (Select all that apply.)

• A. Designate specific time slots for drop-in visits.
• B. Position the desk chair so it is not facing the hallway.
• C. Communicate with staff about using e-mail for non-urgent matters to improve time management.
• D. When staff members drop in, the manager should stand and remain standing during the conversation.

Correct answer: A

Rationale: Designating specific time slots for drop-in visits helps in managing interruptions effectively by consolidating them into designated periods. This approach allows the Nurse Manager to allocate focused time for addressing these issues without disrupting workflow. Option B, repositioning the desk chair, is not a standard strategy for managing time or interruptions. Option C, promoting the use of e-mail for non-urgent matters, may help in some cases but may not entirely address the behavior of extended drop-in visits. Option D, standing during conversations, may not be practical for longer discussions and does not provide a structured approach to address time management issues.

4. Which of the following best describes the role of a nurse advocate?

• A. Direct patient care provider
• B. Advocate for patient needs
• C. Manage nursing staff
• D. Ensure policy adherence

Correct answer: B

Rationale: The correct answer is B: 'Advocate for patient needs.' A nurse advocate's primary role is to stand up for the patient's rights and ensure their needs are met. Choice A, 'Direct patient care provider,' is incorrect as while nurses do provide direct patient care, the specific role of a nurse advocate goes beyond that. Choice C, 'Manage nursing staff,' is incorrect as this pertains to a nurse manager's role, not a nurse advocate. Choice D, 'Ensure policy adherence,' is also incorrect as this reflects more of a quality assurance or compliance role, rather than the advocacy role of a nurse advocate.

5. A client discharges AMA (against medical advice). This is an example of the _________ type of risk category?

• A. nurse-focused
• B. physician-focused
• C. medical-legal incident
• D. Patient-focused

Correct answer: C

Rationale: When a client discharges AMA, it falls under the medical-legal incident risk category. This choice focuses on the legal aspect of the situation, as it involves the patient's right to make decisions about their care, informed consent, and the associated legal implications. Choices A and B are incorrect as they unnecessarily specify individual healthcare roles and do not encompass the broader legal implications of discharging against medical advice. Choice D, patient-focused, is also incorrect as it doesn't capture the legal and risk-related aspects of the scenario.

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