Nursing Elites

1. You believe that you are working harder than other nurses and that you take care of patients that are more complex. You are angry that other staff nurses have less complex and lower acuity patients, but you __________ .

• A. Avoid discussing the situation because you do not want to be perceived as a complainer.
• B. Know that you need to discuss the inequity with the nurse manager because you are resenting the work and becoming more dissatisfied in your job
• C. A & B
• D. None of the above

Correct answer: C

Rationale: Professionals communicate their views in a respectful and direct manner. In discussing the situation with the manager, professionals may gain insights about their reactions to stress and how they can cope with the intense demands of the healthcare environment. Choice A is incorrect because avoiding discussing the situation does not address the underlying issue and may lead to increased frustration. Choice B is correct as it emphasizes the importance of addressing the inequity with the nurse manager to find a constructive solution. Choice D is incorrect as it does not provide any guidance on how to handle the situation effectively.

2. When a client with a terminal diagnosis asks about advance directives, what should the nurse do?

• A. Engage the client and ask why they want to discuss this without their partner present.
• B. Provide information on advance directives and offer brochures.
• C. Advise the client to schedule a discussion with their provider.
• D. Focus on the client's current feelings and postpone planning for a later time.

Correct answer: A

Rationale: Choice A is the correct response as it demonstrates active listening and empathy by engaging the client in a discussion about their concerns regarding advance directives. It also recognizes the importance of involving the client's partner in such discussions, promoting shared decision-making and support. Choices B and C lack the personalized approach needed in this situation and do not address the client's immediate request for information. Choice D is incorrect as it disregards the client's expressed need to discuss advance directives and focuses solely on their current feelings, delaying a crucial conversation.

3. Change is a mandatory skill for managers. Successful change agents display certain characteristics. Some of these characteristics are: (Select all that apply.)

• A. Energy
• B. Confidence
• C. Ambiguity
• D. Trustworthiness

Correct answer: C

Rationale: The correct answer is 'C: Ambiguity.' The rationale behind this is that the provided list of characteristics that successful change agents demonstrate includes 'realistic thinking' as one of the traits, not 'ambiguity.' Therefore, 'A: Energy,' 'B: Confidence,' and 'D: Trustworthiness' are not among the characteristics mentioned in the extract.

4. Which of the following is considered voluntary turnover?

• A. Desire to leave
• B. Termination
• C. Forced resignation
• D. Floating

Correct answer: A

Rationale: The correct answer is A, 'Desire to leave.' Voluntary turnover occurs when an employee chooses to leave the organization. In this case, it is a direct function of the nurse's desire to leave. Termination and forced resignation are involuntary processes where the decision is made by the employer, not the employee. 'Floating' refers to the reassignment of a nurse to a unit different from their usual work unit and is not directly related to turnover.

5. Which of the following is an essential element of a quality improvement (QI) program?

• A. Blame and punishment
• B. Employee satisfaction
• C. Continual monitoring
• D. Strict adherence to policies

Correct answer: C

Rationale: The essential element of a quality improvement (QI) program is continual monitoring. Continual monitoring allows for the ongoing assessment of processes, identification of areas for improvement, and tracking of progress. Option A, 'Blame and punishment,' is incorrect as QI programs focus on systemic issues rather than individual blame. Option B, 'Employee satisfaction,' while important for organizational culture, is not an essential element of QI programs. Option D, 'Strict adherence to policies,' is valuable but not the core essential element, which is continual monitoring to drive improvement.

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