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. The staff nurse is experiencing what type of conflict when the babysitter calls to cancel on the day of an important committee meeting?

• A. Intergroup conflict
• B. Perceived conflict
• C. Role conflict
• D. Structural conflict

Correct answer: C

Rationale: The correct answer is C: Role conflict. Role conflict arises when one has conflicting responsibilities or obligations, such as being scheduled to work while also needing to care for children. In this scenario, the staff nurse faces a conflict between their role as a parent needing childcare and their role as a professional scheduled to present at a committee meeting. Intergroup conflict (A) involves disputes between different groups, not conflicting roles within an individual. Structural conflict (D) stems from issues within the organizational structure, not conflicting responsibilities. Perceived conflict (B) refers to misunderstandings or misinterpretations between parties, not conflicting roles.

3. A nurse is talking with the partner of a client who has dementia. The client's partner expresses frustration about finding time to manage household responsibilities while caring for their partner. The nurse should identify that the partner is experiencing which of the following types of role-performance stress?

• A. Role ambiguity
• B. Role overload
• C. Role conflict
• D. Sick role

Correct answer: C

Rationale: In this scenario, the partner is struggling to balance caring for their loved one with dementia and managing household responsibilities. This situation represents role conflict, where conflicting demands from different roles (caregiver and homemaker) create stress. Role ambiguity (choice A) refers to uncertainty about what is expected in a role, not conflicting demands. Role overload (choice B) occurs when there are too many responsibilities within a single role, not conflicting roles. The sick role (choice D) is a sociological concept related to the rights and responsibilities of individuals who are ill.

4. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: Clients may request a DNR order, but they need to be fully informed of all the ramifications of the decision. Therefore, the health-care provider will consult with the client and family before the order is written.

5. An RN�s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN�s teaching to the client?

• A. When a heart ceases to beat, the client is pronounced clinically dead.
• B. Physicians must write do not resuscitate (DNR) orders.
• C. A DNR order can be written after the health-care provider has discussed it with the client and family.
• D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

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