Nursing Elites

1. Which of the following is an example of a macro-level health policy?

• A. Local health ordinances
• B. State licensing regulations
• C. National healthcare legislation
• D. Institutional policies

Correct answer: C

Rationale: The correct answer is national healthcare legislation. This type of policy operates at a broad level, influencing healthcare delivery and financing across an entire nation. It sets overarching frameworks and regulations that impact various aspects of the healthcare system on a large scale, affecting a wide population rather than specific localities or institutions. Choices A, B, and D are not examples of macro-level health policy. Local health ordinances pertain to specific areas or communities, state licensing regulations focus on a state level, and institutional policies are internal regulations of a particular healthcare facility.

2. After working at your job for 10 months and feeling unable to tolerate the tension and stress between staff nurses and the laissez-faire nurse manager who is not a leader, what is the best course of action?

• A. Submit a resignation and leave within 30 days.
• B. Complain to staff about the nurse manager.
• C. Seek another position within the healthcare organization and apply for a transfer.
• D. Inform the chief nursing officer that you are leaving and explain your dissatisfaction with the lack of leadership.

Correct answer: C

Rationale: In this situation, it is best to seek another position within the healthcare organization and apply for a transfer. Making professional decisions should involve careful evaluation and consideration. It is important to align personal values with the organizational culture. By seeking advice from a mentor or counselor, you can gain valuable insights and consider different perspectives. Resigning abruptly, complaining to staff, or informing the chief nursing officer without exploring other options may not be the most effective or professional approach in this scenario.

3. Which of the following are effective ways to apply power and politics in nursing? (EXCEPT)

• A. Picketing the employer
• B. Networking with other professionals
• C. Writing letters to legislators
• D. Joining professional organizations

Correct answer: A

Rationale: The correct answer is A - 'Picketing the employer.' Networking with other professionals, writing letters to legislators, and joining professional organizations are effective ways to apply power and politics in nursing. Picketing the employer is not an appropriate approach in a healthcare setting as it may lead to disruptions in patient care and conflict within the workplace.

4. 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.

5. Staff refuse to report unsafe conditions, with unattended entrances throughout the health care facility noted. Unidentified individuals are wandering the unit at night, and you:

• A. Establish expectations.
• B. Demand that they leave immediately.
• C. Ask them to leave.
• D. Observe their behaviors.

Correct answer: A

Rationale: In this scenario, the correct course of action is to establish expectations. By setting clear guidelines and expectations, you can address the issue of unidentified individuals wandering the unit at night in a proactive manner. This approach helps communicate what behaviors are acceptable, ensuring the safety of both staff and patients. Demanding that they leave immediately may not address the root cause of the problem and could escalate the situation. Simply observing their behaviors may not effectively resolve the issue or prevent future incidents. Asking them to leave without first establishing expectations may not prevent similar occurrences in the future.

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