Leadership Nursing Practice Questions

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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 individuals know the ethically correct action to take but are constrained from doing so due to various reasons, such as organizational constraints or lack of support. In this scenario, the nurses feel unease and discomfort due to an ethical issue, indicating a conflict between their moral values and actions. The unit manager addressing the issue at the team meeting suggests that the nurses are experiencing moral distress.

A: Moral suffering is a broader term encompassing various negative emotions related to moral issues, not specifically the conflict between knowing the right action and being unable to act on it like in moral distress.
C: Ethical dilemma refers to a situation where individuals must choose between conflicting moral principles, which is not explicitly described in the scenario.
D: Veracity refers to truthfulness or honesty and is not directly related to the nurses' uneasiness and discomfort in dealing with the ethical issue.

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Which of the following should be included in a discussion of advance directives with new nurse graduates?

  • A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
  • B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
  • C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
  • D. The advance directive designates a health-care surrogate who will make known the client’s wishes regarding medical treatment if the client is unable to do so.
Correct Answer: A

Rationale: Step 1: The Patient Self-Determination Act requires healthcare providers, including nurses, to inform clients of their right to create an advance directive.
Step 2: New nurse graduates need to understand this legal requirement to comply with ethical and legal standards.
Step 3: By discussing this requirement with new nurse graduates, they will be better equipped to provide information and support to clients regarding advance directives.
Step 4: This step is crucial in ensuring that clients' autonomy and right to self-determination are respected.
Step 5: Option A is the correct answer as it directly relates to the legal obligation of nurses in discussing advance directives with clients.
Summary: Options B, C, and D are incorrect as they do not address the specific legal requirement outlined in the Patient Self-Determination Act for informing clients about their right to create an advance directive.

Which of the following is a common characteristic of a high reliability organization (HRO)?

  • A. Flexibility
  • B. Reluctance to simplify
  • C. Preoccupation with failure
  • D. Deference to expertise
Correct Answer: C

Rationale: The correct answer is C: Preoccupation with failure. High reliability organizations (HROs) prioritize identifying and addressing potential failures to prevent catastrophic events. This focus on failure helps them anticipate, detect, and respond to risks effectively. A: Flexibility may be important but not a defining characteristic of HROs. B: Reluctance to simplify is not a common characteristic as HROs value simplicity and clarity in communication. D: Deference to expertise is beneficial but not exclusive to HROs as many organizations value expertise. Therefore, the preoccupation with failure is the key characteristic of a high reliability organization.

After change-of-shift report, which patient should the nurse assess first?

  • A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
  • B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
  • C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
  • D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain
Correct Answer: C

Rationale: The correct answer is C because the patient with hyperosmolar hyperglycemic syndrome showing signs of poor skin turgor and dry oral mucosa is at risk for severe dehydration and potential complications. Assessing this patient first is crucial to address their immediate needs.

Choice A is incorrect as the 19-year-old with possible dawn phenomenon can be assessed after the patient with hyperosmolar hyperglycemic syndrome who is at higher risk.

Choice B is incorrect as a blood glucose reading of 230 mg/dL in a 35-year-old with type 1 diabetes is high but not indicative of an immediate life-threatening situation compared to severe dehydration.

Choice D is incorrect as the 68-year-old with peripheral neuropathy and foot pain, while in discomfort, does not present an immediate threat to their life like severe dehydration does in a patient with hyperosmolar hyperglycemic syndrome.

The staff of a medical-surgical unit is in disagreement about holiday scheduling. The nurse manager knows that this is what type of conflict?

  • A. Intragroup conflict
  • B. Intergroup conflict
  • C. Interpersonal conflict
  • D. Intrapersonal conflict
Correct Answer: A

Rationale: The correct answer is A: Intragroup conflict. In this scenario, the conflict is happening within the staff of the medical-surgical unit, making it an intragroup conflict. The staff members belong to the same group or team, and the conflict arises within this specific group. This type of conflict typically involves disagreements, tension, or differences of opinion among members of the same group.

Summary:
B: Intergroup conflict involves conflicts between different groups or teams, not within the same group.
C: Interpersonal conflict refers to conflicts between individuals, not within a group.
D: Intrapersonal conflict involves internal conflicts within an individual, not within a group.

One reason for conducting a comprehensive medical exam on an applicant is:

  • A. It is needed to protect the organization from legal actions.
  • B. It is required after a strenuous interview.
  • C. It is mandated by law.
  • D. It is necessary to screen for disabilities that may impact employment.
Correct Answer: A

Rationale: The correct answer is A because conducting a comprehensive medical exam helps protect the organization from potential legal actions related to discriminatory hiring practices. It ensures that the applicant meets the job's physical requirements and doesn't pose a health risk to themselves or others in the workplace. Choice B is incorrect as medical exams are not typically required after interviews. Choice C is incorrect as not all jurisdictions mandate comprehensive medical exams. Choice D is incorrect as screening for disabilities should be done through non-discriminatory means, not solely through medical exams.

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