Nursing Elites

1. Which of the following is a common characteristic of a high reliability organization (HRO)?

• A. Flexibility
• B. Reluctance to simplify
• C. Preoccupation with failure
• D. Deference to expertise

Correct answer: C

Rationale: A common characteristic of a high reliability organization (HRO) is a preoccupation with failure. HROs focus on identifying and addressing potential failure points to prevent errors and maintain high levels of safety and reliability. This mindset helps them anticipate and mitigate risks proactively, leading to better outcomes and performance. Choices A, B, and D are incorrect. While flexibility, reluctance to simplify, and deference to expertise may be important in various contexts, they are not the primary defining characteristics of a high reliability organization. The core focus of HROs is on continuously monitoring for potential failures and working to prevent them.

2. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?

• A. Recency error
• B. Leniency error
• C. Halo error
• D. Absolute judgment

Correct answer: A

Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.

3. What is the primary goal of patient advocacy in nursing?

• A. To ensure patient safety
• B. To provide emotional support
• C. To advocate for patient rights
• D. To provide financial assistance

Correct answer: C

Rationale: The primary goal of patient advocacy in nursing is to advocate for patient rights. While ensuring patient safety and providing emotional support are important aspects of nursing care, the core focus of patient advocacy is to uphold and protect the rights of patients. Providing financial assistance is not typically a primary goal of patient advocacy in nursing.

4. The belief that effort will lead to a specific performance level in an individual is known as:

• A. Rewards.
• B. Expectancy.
• C. Valence.
• D. Instrumentality.

Correct answer: B

Rationale: The correct answer is B: Expectancy. Expectancy refers to the perceived probability that effort will lead to a specific performance level. This aligns with the concept of expectancy theory in psychology, which emphasizes the importance of individuals' beliefs regarding the link between effort and outcomes. Choices A, C, and D are incorrect. Rewards (choice A) typically refer to incentives given after achieving a goal, valence (choice C) is the value a person places on a particular outcome, and instrumentality (choice D) is the belief that a particular outcome is contingent on achieving a specific level of performance.

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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