Nursing Elites

1. Which of the following is the correct definition of 'chain of command'?

• A. The hierarchy of authority and responsibility
• B. Relationship without authority
• C. Activity directed through linear authority
• D. The tendency for people to perform as expected

Correct answer: A

Rationale: The correct definition of 'chain of command' is the hierarchy of authority and responsibility. This term refers to the order in which authority and power in an organization are wielded and delegated from top management to every employee at every level. Choice B, 'Relationship without authority,' is incorrect because the chain of command specifically involves authority and responsibility. Choice C, 'Activity directed through linear authority,' is not a precise definition of the chain of command, as it does not encompass the full scope of authority and hierarchy. Choice D, 'The tendency for people to perform as expected,' is unrelated to the concept of the chain of command.

2. When communicating with a client who has a complaint, what principle is important to keep in mind?

• A. Supervisors should always be involved.
• B. The client's physician is often the cause of the problem.
• C. Avoid discussion of complaints.
• D. Clients and families should be treated with respect; communication should be open and honest.

Correct answer: D

Rationale: When addressing complaints from clients, it is crucial to prioritize treating clients and families with respect. Open and honest communication fosters trust and transparency in resolving issues effectively. This client-centered approach emphasizes the importance of maintaining positive relationships within the healthcare setting. Choices A, B, and C are incorrect. Involving supervisors in every communication with a client who has a complaint may not always be necessary or practical. Blaming the client's physician for the issue is unprofessional and does not address the client's concerns. Avoiding discussion of complaints can lead to unresolved issues and dissatisfaction among clients.

3. Staff are sometimes injured when a patient or visitor becomes agitated. If a staff member reports an injury, the following actions should take place: (EXCEPT)

• A. Notify security.
• B. Complete an incident report.
• C. Notify the nursing supervisor.
• D. Ensure that staff has been examined.

Correct answer: B

Rationale: When a staff member reports an injury resulting from an agitated patient or visitor, several actions should be taken. These actions include notifying security to ensure safety, notifying the nursing supervisor for appropriate follow-up, and ensuring that the injured staff member has been examined to assess the extent of the injury. Completing an incident report is not the correct action to exclude because documenting the incident is crucial for legal and healthcare purposes. Incident reports provide a detailed account of what occurred, which is essential for investigations, insurance claims, and improving safety protocols. Therefore, all other options are necessary steps to take when a staff member reports an injury, making completing an incident report the correct answer for exclusion.

4. A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards. What type of decision-making strategy would this be?

• A. Satisficing
• B. Routine
• C. Adaptive
• D. Rationalizing

Correct answer: A

Rationale: The correct answer is A: Satisficing. Satisficing is a decision-making strategy where the person chooses an alternative that is good enough given the circumstances. In this scenario, the nurse manager is making a satisfactory decision by managing the unit with the three remaining nurses to meet minimal staffing standards despite the reduced availability of staff. Choice B, Routine, does not apply as the decision made in the scenario is not part of a regular or standard procedure. Choice C, Adaptive, is not the best fit as the decision is more about making do with the available resources rather than adapting to a new situation. Choice D, Rationalizing, does not align with the scenario as it refers to justifying decisions rather than making a practical choice under constraints.

5. What innate tendency influences staff to act in a certain way?

• A. Instinct
• B. Appreciation
• C. Control
• D. Esteem

Correct answer: A

Rationale: The correct answer is A: Instinct. Instinct theory suggests that behaviors are influenced by inherited or innate tendencies, guiding individuals to act in specific ways without conscious reasoning. In the context of staff behavior, instinct can play a significant role in shaping their actions and responses. Choices B, C, and D are incorrect. Appreciation, control, and esteem are external factors that may influence staff behavior, but in this context, the question specifically asks for an innate tendency that influences staff to act in a certain way, which aligns more closely with instinctive tendencies rather than external factors like appreciation, control, or esteem.

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