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A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is asked to assess and adapt the unit to better meet the unique needs of the older adult patient. Using complexity principles, what would be the best approach to take for implementation of this change?
- A. Involve affected staff in the decision-making process.
- B. Focus the assessment on the unit and do not consider the hospital as a whole.
- C. Create a mandatory policy to force workers to participate in problem-solving solutions.
- D. Select a management approach that does not change.
Correct Answer: A
Rationale: Correct Answer: A
Rationale: In complex systems like a medical unit, involving affected staff in decision-making is crucial as they have valuable insights and frontline experience. This participatory approach fosters ownership, engagement, and innovation. It allows for diverse perspectives to be considered, leading to more effective and sustainable solutions tailored to the specific needs of older adult patients. By involving staff, the nurse manager can leverage collective intelligence and build a culture of collaboration and continuous improvement.
Incorrect Choices Summary:
B: Focusing only on the unit overlooks the interconnectedness of systems within the hospital, potentially missing out on valuable resources and expertise.
C: Implementing a mandatory policy can create resistance, decrease morale, and inhibit creativity, leading to suboptimal outcomes.
D: Maintaining the status quo in a dynamic environment like healthcare is not conducive to adaptation and improvement, hindering the ability to meet the evolving needs of older adult patients.
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To help nurse managers better manage their time, the chief nursing officer suggests that they:
- A. Progress through the workday without a plan.
- B. Put off important tasks until they feel motivated to start them.
- C. Only accept projects that exactly fit their specifications.
- D. Decline requests that are not in alignment with their priorities.
Correct Answer: D
Rationale: The correct answer is D: Decline requests that are not in alignment with their priorities. This is the best option for nurse managers to manage their time effectively. By focusing on tasks that align with their priorities, they can ensure they are using their time efficiently and effectively. Progressing without a plan (choice A) is not recommended as it can lead to disorganization and inefficiency. Putting off important tasks (choice B) is counterproductive and can lead to increased stress and missed deadlines. Only accepting projects that fit exact specifications (choice C) may limit opportunities for growth and development. In summary, by declining requests that do not align with priorities, nurse managers can optimize their time management and focus on what truly matters.
A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?
- A. I need to speak with you about unit expectations regarding delegating and completing tasks.
- B. You have been very inconsiderate of others by not completing your share of the work.
- C. If you don't do your share of the work, I will have to inform the nurse manager.
- D. Several staff members have commented that you don't do your fair share of the work.
Correct Answer: A
Rationale: The correct answer is A: "I need to speak with you about unit expectations regarding delegating and completing tasks." This statement addresses the issue directly and professionally, focusing on establishing clear communication and setting expectations. By having a conversation about unit expectations, it allows for clarification on roles and responsibilities, promoting accountability and teamwork.
Incorrect Choices:
B: This statement uses accusatory language and does not address the issue constructively.
C: Threatening to inform the nurse manager may escalate the conflict instead of resolving it through open communication.
D: This choice involves hearsay and gossip, which is not an effective way to address the issue professionally.
A family is keeping vigil at a critically ill patient's bedside. The nurse speaks with the family members and asks if they would benefit from a chaplain visit or resources to aid with grief and coping. What role is the nurse assuming through this action?
- A. Follower
- B. Manager
- C. Laissez-faire
- D. Leader
Correct Answer: D
Rationale: The correct answer is D: Leader. By offering resources and support to the family during a difficult time, the nurse is taking on a leadership role. The nurse is demonstrating initiative, empathy, and guidance in providing options for additional assistance. This action shows the nurse's ability to take charge, make decisions, and support the family in coping with the situation.
A: Follower - Incorrect. The nurse is not following anyone's lead but rather taking charge and offering support.
B: Manager - Incorrect. While the nurse is managing care, the specific action of offering resources and support goes beyond typical managerial duties.
C: Laissez-faire - Incorrect. Laissez-faire implies a hands-off approach, which is not the case here as the nurse is actively engaging with the family.
E, F, G: No options provided.
With regard to nursing practice, nurse managers are held responsible for:
- A. Referring all errors in nursing judgment to state disciplinary boards.
- B. Verifying that attending physicians are properly licensed to provide care on patient care units.
- C. Practicing within legal guidelines established under state law and nurse practice acts.
- D. Creating an environment of severe consequences for nursing errors to ensure quality practice.
- E. Ensuring that nursing staff under their supervision are currently licensed to practice.
Correct Answer: C,E
Rationale: The correct answers are C and E. Nurse managers are responsible for ensuring that nursing practice is within legal guidelines and that all nursing staff under their supervision are currently licensed. This is crucial for maintaining patient safety, quality care, and regulatory compliance. Referring errors to disciplinary boards (A) is not solely the role of nurse managers. Verifying physician licenses (B) is outside the scope of nursing practice. Creating an environment of severe consequences (D) may not promote a culture of learning and improvement. Choice F and G are not provided.
When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation. Which of the following does NOT correspond with the five rights of delegation?
- A. The task being delegated matches the AP's skill level.
- B. The task being delegated to the AP is relatively non-invasive.
- C. The task being delegated to the AP is within their scope of practice.
- D. The task being delegated requires close supervision.
Correct Answer: D
Rationale: Rationale: Choice D is incorrect because a task requiring close supervision does not align with the five rights of delegation, which include right task, right circumstances, right person, right direction/communication, and right supervision/evaluation. Delegated tasks should match the AP's skill level, be within their scope of practice, and not necessarily require constant supervision. Tasks that need close supervision should typically be handled by a licensed healthcare professional. The other choices (A, B, C) correspond with the principles of delegation by ensuring tasks are appropriate for the AP's skill level, non-invasive, and within their scope of practice.