Nursing Elites

1. Which of the following strategies is most effective for improving staff morale?

• A. Increasing workload
• B. Increasing salaries
• C. Providing feedback
• D. Offering incentives

Correct answer: C

Rationale: Providing feedback is the most effective strategy for improving staff morale. Feedback helps employees understand their performance, areas of improvement, and areas of strength, fostering a sense of recognition and growth. Increasing workload (choice A) can lead to burnout and decreased morale. While increasing salaries (choice B) and offering incentives (choice D) can be motivating, they may not address underlying issues or provide the same level of personal development and recognition that feedback offers.

2. During a physical assessment of adult clients, which of the following techniques should the nurse use?

• A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
• B. Palpate the client's abdomen before auscultating bowel sounds.
• C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
• D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.

Correct answer: B

Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.

3. A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to 'get back' at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict?

• A. Perceived conflict
• B. Disruptive conflict
• C. Competitive conflict
• D. Felt conflict

Correct answer: B

Rationale: The behavior displayed by the resident and the nurse is an example of disruptive conflict. In disruptive conflict, the parties involved engage in activities to reduce, defeat, or eliminate the opponent. The resident refusing to answer calls and the nurse retaliating with frequent calls to 'get back' at him exemplify behaviors aimed at causing disruption and conflict between them. Perceived conflict refers to each party's perception of the other's position, competitive conflict involves one side winning at the expense of the other, and felt conflict is about the feelings of opposition within the relationship, none of which fully capture the nature of the conflict displayed in this scenario.

4. According to Maslow's theory, which level of needs must be met first?

• A. Self-actualization needs
• B. Esteem needs
• C. Safety needs
• D. Physiological needs

Correct answer: D

Rationale: According to Maslow's hierarchy of needs, physiological needs are at the lowest level and must be satisfied first before an individual can progress to fulfilling higher-level needs. Physiological needs include basic requirements for survival such as food, water, shelter, and sleep. Esteem needs, safety needs, and self-actualization needs are higher-level needs that can only be addressed once physiological needs are adequately met. Therefore, the correct answer is D, physiological needs.

5. A Nurse Manager completes an interruption log and identifies two staff members who take an inordinate amount of time with drop-in issues that are not urgent. What are some methods to address this behavior in an attempt to better manage time? (Select all that apply.)

• A. Designate specific time slots for drop-in visits.
• B. Position the desk chair so it is not facing the hallway.
• C. Communicate with staff about using e-mail for non-urgent matters to improve time management.
• D. When staff members drop in, the manager should stand and remain standing during the conversation.

Correct answer: A

Rationale: Designating specific time slots for drop-in visits helps in managing interruptions effectively by consolidating them into designated periods. This approach allows the Nurse Manager to allocate focused time for addressing these issues without disrupting workflow. Option B, repositioning the desk chair, is not a standard strategy for managing time or interruptions. Option C, promoting the use of e-mail for non-urgent matters, may help in some cases but may not entirely address the behavior of extended drop-in visits. Option D, standing during conversations, may not be practical for longer discussions and does not provide a structured approach to address time management issues.

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