Nursing Elites

1. Which of the following theories best describes current health care delivery systems?

• A. Open system theory
• B. Closed system theory
• C. Chaos theory
• D. Contingency theory

Correct answer: D

Rationale: The contingency theory best describes the current health care delivery systems. Contingency theory emphasizes that there is no one best way to organize or manage, and the effectiveness of an organization is contingent upon internal and external factors. In healthcare, the delivery systems must often adapt and be flexible in response to various factors like patient needs, technological advancements, and regulatory changes. Open system theory focuses on the interaction between a system and its environment, but it does not capture the dynamic and adaptive nature of current healthcare systems. Closed system theory suggests systems are self-contained and do not interact with the environment, which is not accurate for healthcare systems that constantly interact with patients, providers, and external factors. Chaos theory deals with complex systems and unpredictability, which while relevant to some aspects of healthcare, does not provide a comprehensive framework for understanding healthcare delivery systems.

2. A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that:

• A. Each RN would coordinate care for a group of clients.
• B. One RN would pass meds for all clients on a unit.
• C. Each RN would deliver total care to an assigned group of clients.
• D. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients.

Correct answer: B

Rationale: In a functional nursing delivery system, tasks are divided among the staff based on their roles. One of these roles is medication administration, where one RN may pass medications for all clients on a unit. Option A is incorrect because coordinating care for a group of clients is more aligned with team nursing. Option C is incorrect as it describes total care nursing, not functional nursing. Option D is incorrect as it reflects team nursing with a mix of different roles sharing responsibility.

3. Which of the following is likely to facilitate union activity?

• A. Managers communicating effectively with employees
• B. Managers listening to concerns of employees
• C. Belief that low wages cause job dissatisfaction
• D. Belief that supervisors are not understanding of unionizing

Correct answer: C

Rationale: The correct answer is C because according to a study by Bilchik (2000), organizations are more likely to unionize if there is a belief that low wages cause job dissatisfaction. Choices A and B focus on effective communication and listening, which may actually prevent union activity by addressing employee concerns directly. Choice D, the belief that supervisors are not understanding of unionizing, may lead to dissatisfaction but doesn't directly facilitate union activity as the belief that low wages cause job dissatisfaction does.

4. During a performance appraisal, how should the manager best provide constructive feedback to an employee?

• A. Focus only on the negative aspects of performance
• B. Provide general comments without specifics
• C. Discuss specific examples of strengths and areas for improvement
• D. Delay feedback until the next appraisal period

Correct answer: C

Rationale: During a performance appraisal, the best approach to provide constructive feedback is by discussing specific examples of strengths and areas for improvement. This method allows the employee to understand what they are excelling at and where they need to focus on development. By highlighting both aspects, the employee can work on enhancing their performance effectively. Option A is incorrect because solely focusing on the negative aspects can demotivate the employee and hinder their growth. Option B is incorrect as providing general comments without specifics does not offer clear guidance for improvement. Option D is also incorrect as delaying feedback can prevent timely corrective actions and hinder performance progress.

5. In dealing with conflict, the manager knows that feelings or perceptions about the situation will have an effect. According to Filey, what is this effect known as?

• A. Conflict suppression
• B. Resolution aftermath
• C. Antecedent conditions
• D. Manifest behavior

Correct answer: D

Rationale: Feelings or perceptions about the situation initiate behavior, known as manifest behavior. Antecedent conditions refer to preexisting conditions that may have led to the conflict but are not the immediate effect of feelings or perceptions. Resolution aftermath pertains to the consequences or outcomes following conflict resolution. Conflict suppression refers to the action of suppressing conflict without addressing its root causes, which is a subsequent step after the manifestation of behavior.

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