Nursing Elites

1. Your values do not coincide with your colleagues. When you report for your shift on nights and staff are not responding to patient requests for pain medication, you, as the nurse responsible for collecting data about patient quality of care, should:

• A. Explain to the nurse manager that quality problems are because of staff apathy.
• B. Issue a memo to staff to assess patients and document their response to the pain medication.
• C. Explain to staff that improving quality is one of your annual goals and you expect them to follow through.
• D. Schedule meetings to engage with staff to monitor pain management.

Correct answer: D

Rationale: As the nurse responsible for collecting data about patient quality of care, it is important to address the issue of staff not responding to patient requests for pain medication. Scheduling meetings to engage with staff to monitor pain management is the most appropriate course of action in this scenario. By enlisting support from staff, reviewing patient satisfaction data, and quality reports about pain management, you can effectively address the issue and improve patient care. Choices A, B, and C are not as effective as they do not involve actively engaging with staff, reviewing data, and working collaboratively to address the problem.

2. A client discharges AMA (against medical advice). This is an example of the _________ type of risk category?

• A. nurse-focused
• B. physician-focused
• C. medical-legal incident
• D. Patient-focused

Correct answer: C

Rationale: When a client discharges AMA, it falls under the medical-legal incident risk category. This choice focuses on the legal aspect of the situation, as it involves the patient's right to make decisions about their care, informed consent, and the associated legal implications. Choices A and B are incorrect as they unnecessarily specify individual healthcare roles and do not encompass the broader legal implications of discharging against medical advice. Choice D, patient-focused, is also incorrect as it doesn't capture the legal and risk-related aspects of the scenario.

3. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?

• A. Moral suffering
• B. Moral distress
• C. Ethical dilemma
• D. Veracity

Correct answer: B

Rationale: The correct answer is B, moral distress. Moral distress occurs when one knows the ethically correct action to take but feels constrained in their ability to take that action due to institutional, hierarchical, or other constraints. In this scenario, the nurses are experiencing uneasiness and discomfort due to an ethical issue, which aligns with the definition of moral distress. Choice A, moral suffering, is not the most appropriate term in this context as moral distress better describes the situation. Choice C, ethical dilemma, refers to a situation where a person is faced with two equally undesirable alternatives, which does not fully capture the nurses' current experience. Choice D, veracity, is unrelated to the nurses' situation and does not fit the context of the scenario.

4. A nurse needs to know how to increase her power base. Which of the following are ways nurses can generate power as described by Umiker?

• A. Using body language, standing when talking
• B. Listening for feelings
• C. Using words, avoiding clichés
• D. All of the above

Correct answer: D

Rationale: The correct answer is D: 'All of the above.' Umiker describes four ways to generate power: using words, through delivery, by listening, and through body language. Choice A is correct as it mentions using body language. Choice B is correct as it mentions listening. Choice C is correct as it pertains to using words effectively and avoiding clichés. Therefore, all the choices are ways nurses can generate power as described by Umiker.

5. A client is having difficulty breathing while receiving supplemental oxygen via a nasal cannula in a supine position. Which of the following interventions should the nurse take first?

• A. Suction the client's airway.
• B. Instruct the client to perform incentive spirometry every hour.
• C. Assist the client to an upright position.
• D. Humidify the client's supplemental oxygen.

Correct answer: C

Rationale: When a client is experiencing difficulty breathing, the priority intervention is to assist the client to an upright position. This position helps improve ventilation by maximizing lung expansion and promoting better oxygenation. Suctioning the airway may be necessary if there is an obstruction, but repositioning the client is the initial step. Instructing the client to perform incentive spirometry and humidifying oxygen are important interventions but not the first priority in this scenario.

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