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 nurse is planning care of an adolescent who is postoperative following a lumbar laminectomy. Which of the following interventions should the nurse include in the plan of care?

• A. Limit the adolescent's visitors.
• B. Select the adolescent's food choices.
• C. Encourage the adolescent's guardian to assist with personal hygiene.
• D. Allow the adolescent to make decisions regarding their daily routine.

Correct answer: C

Rationale: The correct answer is C because after a lumbar laminectomy, the adolescent may need assistance with personal hygiene due to limited mobility and pain. Encouraging the guardian to assist with personal hygiene ensures proper care and prevents complications. Choice A is incorrect as limiting visitors may affect the adolescent's emotional well-being and support system. Choice B is incorrect as the adolescent should have autonomy in selecting their food choices as long as they align with their dietary restrictions post-surgery. Choice D is incorrect as the adolescent may need guidance and support in decision-making during the postoperative period.

3. By using ___________ in the workplace, nurses increase their professional influence.

• A. political skills
• B. reward power
• C. expert power
• D. power and politics

Correct answer: C

Rationale: By using expert power in the workplace, nurses increase their professional influence. Expert power is derived from an individual's knowledge, skills, or expertise in a particular area. This allows nurses to influence others based on their competence and credibility, rather than through political skills (choice A), reward power (choice B), or the combination of power and politics (choice D). While political skills and understanding power dynamics can be beneficial, expert power is particularly effective in enhancing a nurse's professional influence.

4. A technique used to eliminate negative behavior by ignoring the behavior is known as __________.

• A. Punishment
• B. Extinction
• C. Shaping
• D. Equity

Correct answer: B

Rationale: The correct answer is B, 'Extinction.' Extinction is a behavioral psychology technique where undesirable behavior is ignored, leading to its eventual decrease or elimination. This process involves withholding reinforcement that was previously maintaining the behavior. Choice A, 'Punishment,' involves applying negative consequences to reduce unwanted behavior, which is different from extinction. Choice C, 'Shaping,' is a method of gradually molding or reinforcing behaviors to reach a desired behavior, not ignoring negative behavior. Choice D, 'Equity,' refers to fairness and equal treatment, which is unrelated to eliminating negative behavior through ignoring it.

5. An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision makers involved. Which step best describes the current stage the RN is working through?

• A. Assessment
• B. Diagnosis
• C. Planning
• D. Implementation

Correct answer: C

Rationale: The correct answer is C: Planning. In the planning phase of addressing an ethical dilemma, the goals of treatment are established, decision makers are identified, and all available options are reviewed. The assessment phase involves collecting data and information, the diagnosis phase involves analyzing the information to identify the problem, and the implementation phase involves carrying out the chosen plan of action. Therefore, in this scenario, where decision makers are being identified, the RN is in the planning stage.

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